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Home My WebLink About2910 CAPAZO CT; ; CB012766; Permit09-18-2001' City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Pool Permit Permit No:CB012766 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 2910CAPAZOCTCBAD POOL 2153902000 Lot#: 0 $13,591.00 Construction Type: NEW CHANCY RES-415 SF POOL/SPA Applicant: CALIFORNIA POOLS 1611 S RANCHO SANTA FE ROAD SAN MARCOS, CA 92069 619-292-7212 Status: ISSUED Applied: 08/22/2001 Entered By: RMA Plan Approved: 09/18/2001 Issued: 09/18/2001 Inspect Area: 0176 09/18/01 0002 01 Owner: CGP CARLIN REVOCABLE TRUST 03-22-00 1905 REDWING ST SAN MARCOS CA 92069 02 178-85 Total Fees: $263.67 Total Payments To Date: $84.82 Balance Due: $178.85 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Electrical Fee Plumbing Fee Strong Motion Fee Renewal Fee Add'l Renewal Fee Other Building Fee Additional Fees TOTAL PERMIT FEES $130.49 $0.00 $84.82 $0.00 $20.00 $27.00 $1.36 $0.00 $0.00 $0.00 $0.00 $263.67 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1;TION FOR OFFICE USE PLAN CHECK EST. VAL. Plan Ck. Depo Validate Date Address (include Bldg/Suite Business Name (at this address) Legal De Lot No.Total # of units Assessor's Parcel Existing Use Description of Work 2. SQ. FT.#of Stories ff of Bedrooms # of Bathrooms Name Address OCity ractor Q Agent fof Contractor Q Owner Q Agent for Owner lo "P.. f-"i > x-,*" I \J~i S)ate/fcp~~ Telephone tt State/Zip Telephone tt Address City CW)fl-za GM * CityName 5. CONTRACTOR - COMPANY NAME (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code] or that he is exempt therefrom, and the basis for the alleged r violajjifj of faction 7031.5 by any appjicant MfTaypermit subjects the applicant to a civil penalty oj^npt^more (han five hundred dollars [$500])., Name State License # Address License Class City State/Zii City Business License # •Telephone tt Designer Name Address City State/Zip Telephone State License tt 6. WORKERS-COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: f~l I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of thework for which this permit is issued. O^'l have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: . Insurance Company fY {LlTVVTsJtv-JU/CfS Policy NoUJMOQ-IS^fU ~^ Expiration Date \ ~2r-*>( ~O \ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) l~l CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage^ unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to/fha cost-»f compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE 7, OWNER I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). [~l I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). O I am exempt under Section Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. O YES C]NO 2. I (have / have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone number / contractors license number): 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work): PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOM NON-RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Q YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES Q NO IF ANY OF THE ANSWERS ARE YES. A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 8, CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S ADDRESSLENDER'S NAME _ _ 9. APPLICANT CERTIFICATION I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE. INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over 5'0* deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 1 80 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced far a period of 1 80 dae (Secton 1 0S/t^m/iform Building Code). APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance Inspection List Permit*: CB012766 Type: POOL CHANCY RES-415 SF POOL/SPA Date Inspection Item Inspector Act Comments 01/10/2002 59 01/10/2002 59 Final Pool Final Pool 12/19/2001 55 Fence/Pre-Plaster 12/17/2001 55 10/10/2001 51 10/10/2001 52 10/10/2001 53 10/09/2001 51 10/09/2001 52 10/09/2001 53 10/05/2001 51 10/05/2001 52 10/05/2001 53 10/03/2001 51 Fence/Pre-Plaster Excav/Steel/Bonding/Fence Underground Plumbing Electric/Conduit/Wiring Excav/Steel/Bonding/Fence Underground Plumbing Electric/Conduit/Wiring Excav/Steel/Bonding/Fence Underground Plumbing Electric/Conduit/Wiring Excav/Steel/Bonding/Fence JC RCB JC JC JC JC JC JC JC JC JC JC JC Rl AP AP CO AP AP AP NR NR NR CO AP AP CO NOTE POOL FENCING MAY NOT BE WITHIN REQUIREMENTS AFTER FINAL INSP CORRECTIONS MADE, ALARMS O.K. - OK TO PLASTER DOOR ALARMS TEMP FENCE POOL FENCING FENCING NOTE : GAS TO BBQ P.V.C. TO LIGHTS POOL FENCING Friday, January 11, 2002 Page 1 of 1 City of Carlsbad Bldg Inspection Request For: 01/10/2002 Permit^ CB012766 Title: CHANCY RES-415 SF POOL/SPA Description: Inspector Assignment: JC Type: POOL Sub Type: Job Address: 2910 CAPAZO CT Suite: Lot Location: APPLICANT CALIFORNIA POOLS Owner: Remarks: Total Time: Phone: 7607448868 Inspector: \J « C/_.._ Requested By: KATHY Entered By: CHRISTINE CD Description 59 Final Pool Act Comments Associated PCRs Inspection Histo Date Description 12/19/2001 55 Fence/Pre-Plaster 12/17/2001 55 Fence/Pre-Plaster CO JC 10/10/2001 51 Excav/Steel/Bonding/Fence AP JC 10/10/2001 52 Underground Plumbing AP JC 10/10/2001 53 Electric/Conduit/Wiring AP JC 10/09/2001 51 Excav/Steel/Bonding/Fence NR JC 10/09/2001 52 Underground Plumbing NR JC 10/09/2001 53 Electric/Conduit/Wiring NR JC 10/05/2001 51 Excav/Steel/Bonding/Fence CO JC 10/05/2001 52 Underground Plumbing AP JC 10/05/2001 53 Electric/Conduit/Wiring AP JC 10/03/2001 51 Excav/Steel/Bonding/Fence CO JC CORRECTIONS MADE. ALARMS O.K. - OK TO PLASTER DOOR ALARMS TEMP FENCE POOL FENCING FENCING NOTE : GAS TO BBQ P.V.C. TO LIGHTS POOL FENCING City of Carlsbad Bldg Inspection Request For: 12/19/2001 PermiW CB012766 Title: CHANCY RES-415 SF POOL/SPA Description: Type: POOL Sub Type: Job Address: 2910 CAPAZO CT Suite: Lot 0 Location: APPLICANT CALIFORNIA POOLS Owner: /2_*.OO -I 2- • ^>° Remarks: Total Time: Inspector Assignment: JC Phone: 7607448868 Inspector: Requested By: KATHY Entered By: ROBIN CD Description 55 Fence/Pre-Plaster Act Comments O.K. Associated PCRs Date 12/17/2001 10/10/2001 10/10/2001 10/10/2001 10/09/2001 10/09/2001 10/09/2001 10/05/2001 10/05/2001 10/05/2001 10/03/2001 Inspection Historv Description 55 Fence/Pre-Plaster 51 Excav/Steel/Bonding/Fence 52 Underground Plumbing 53 Electric/Conduit/Wiring 51 Excav/Steel/Bonding/Fence 52 Underground Plumbing 53 Electric/Conduit/Wiring 51 Excav/Steel/Bonding/Fence 52 Underground Plumbing 53 Electric/Conduit/Wiring 51 Excav/Steel/Bonding/Fence Act CO AP AP AP NR NR NR CO AP AP CO lns[ JC JC JC JC JC JC JC JC JC JC JC Insp JC JC JC JC JC JC JC JC JC JC JC Comments DOOR ALARMS TEMP FENCE POOL FENCING FENCING NOTE : GAS TO BBQ P.V.C. TO LIGHTS POOL FENCING SAN WEOO (COUNTY) AREACIRCUIT CARD AND LOAD SUMMARY 19M NCC)DePART*IENT OF PLANNING AND LAND USE - BUILDING DIVISIONCAW »W8T BC nuxo OUT AND AVAILABLE AT THE SERVICE eowweiTfwtHEnouoHiMlrscTONTIM "*•" Wld C-^Paxo tT Owmr ( /Vr Contactor PANEL '•v Tc^/ r r//»yc.»* mow ' Phon» PMirit Number 1 COTM» Tract Nurrtwr ATM in 84. tt. AJ.C. 1 VOLTS • W«E LOCATION PeW^ 5'fj9 Pfr /id t Fi I te r PjrvF W.F- Pum^ ^^ JS _^ fC^t^t— *" • -^ I |"t ^ • • MAttd CKT 3 8 7 8 11 13 15 17 » 21 23 28 27 29 31 33 38 37 39 41 MO) SIZE 6 1 P1 V1 IS WIRE «r/s 0 I lY I HI \i f if TYPE £^ / r - | Cu I {~^ I <iv IMSC I 1 ( j | 1 ( \ LTO 5 REC 1 REC LTO MSC AMPBKWFU8E D MLO CflrnpuMLMd WIRE SIZE TYPE SIZE CKT 2 4 6 a 10 12 14 16 18 20 22 24 26 26 30 32 34 36 38 40 42 LOCATION .„. ,,. ..,..„ AMPS At A) C)aaaa OFCI SteNo. f-f ^f • • • ii. n^a ^ iQi U6Miy CWKiUCBCT. Ma. « TypurDCUDAL V D) CondutSter.. Q cu DAL A) B) C) LwndrydRMft 0) E) SMCitouMtan 220 I 220 220 422-7 210.S2(tf) nd 280-81(0 2SO-80(«).81(«) 250-83(C} 2104.680-70: O Boftroom(«) D KRerwn a Oonoo(») Q HyrtroirmooQi tub J~ O OuUoom Q CfJ^if^tti^-// \ City of Carlsbad Bldg Inspection Request For: 12/17/2001 Permit* CB012766 Title: CHANCY RES-415 SF POOL/SPA Description: Type: POOL Sub Type: Job Address: 2910CAPAZOCT Suite: Lot 0 Location: APPLICANT CALIFORNIA POOLS Owner: Remarks: Inspector Assignment: JC Phone: 7607448868 Inspector: J , Total Time: CD Description 55 Fence/Pre-Plaster Requested By: MIKE Entered By: KAREN Act Comments Associated PCRs Inspection History Date 10/10/2001 10/10/2001 10/10/2001 10/09/2001 10/09/2001 10/09/2001 10/05/2001 10/05/2001 10/05/2001 10/03/2001 Description 51 Excav/Steel/Bonding/Fence 52 Underground Plumbing 53 Electric/Conduit/Wiring 51 Excav/Steel/Bonding/Fence 52 Underground Plumbing 53 Electric/Conduit/Wiring 51 Excav/Steel/Bonding/Fence 52 Underground Plumbing 53 Electric/Conduit/Wiring 51 Excav/Steel/Bonding/Fence Act AP AP AP NR NR NR CO AP AP CO Insp JC JC JC JC JC JC JC JC JC JC Comments TEMP FENCE POOL FENCING FENCING NOTE : GAS TO BBQ P.V.C. TO LIGHTS POOL FENCING NOTICE (760) 602-2700 1635 FARM>AY AVENUE DATE LOCATION PERMIT NO YES FOR INSPECTION CALL (760) 602-2725. FOR INFORMATION, CONTACT RE-INSPECTION City of Carlsbad Bldg Inspection Request For: 10/10/2001 Permit# CB012766 Title: CHANCY RES-415 SF POOL/SPA Description: Inspector Assignment: JC Type: POOL Sub Type: Job Address: 2910 CAPAZO CT Suite: Lot 0 Location: APPLICANT CALIFORNIA POOLS Owner: Remarks: Phone: 7607448868 Inspector: ^ j, Total Time: CD Description 51 Excav/Steel/Bonding/Fence 52 Underground Plumbing 53 Electric/Conduit/Wiring Requested By: KATHY Entered By: CHRISTINE Act ^Comments M Associated PCRs Inspection History Date Description Act Insp Comments 10/05/2001 51 Excav/Steel/Bonding/Fence CO JC FENCING 10/05/2001 52 Underground Plumbing AP JC 10/05/2001 53 Electric/Conduit/Wiring AP JC 10/03/2001 51 Excav/Steel/Bonding/Fence CO JC NOTE : GAS TO BBQ P.V.C. TO LIGHTS POOL FENCING Oct ID 01 10:18a PflTRELL ENGINEERING GROUP 626 963 4812 BATREIX E7VGI7VEERI7VG GROUP, ITVC. 651 E. -JMorthridge Ave. Pit: (010) 305-4062 Glencioro, CA 91741 PAX: (818) 963-4812 Project: 1<\\O Client: Engineer: 2 Date:. Sheet of INI AND NOT PMCT Of STRUCTURE •vcpot.U PLANNING/ENGINEERING APPROVALS PERMIT NUMBER CB ADDRESS DATE RESIDENTIAL ADDITION MINOR «$10,000.00) TENANT IMPROVEMENT PLAZA CAMINO REAL CARLSBAD COMPANY STORES VILLAGE FAIRE COMPLETE OFFICE BUILDING OTHER PLANNER DATE ENGINEER DATE Docs/MBf onus/Planning Engineering Approval! City of Carlsbad Public Works — Engineering BUILDING PLANCHECK CHECKLIST POOLS BUILDING PLANCHECK NUMBER: CB BUILDING ADDRESS:G PROJECT DESCRIPTION: Pool ASSESSOR'S PARCEL NUMBER : 3 & - 1><?<9 - ENGINEERING DEPARTMENT APPROVAL The item you have submitted for review has been approved. The approval is based on plans, information and/or specifications provided in your submittal; therefore, any changes to these items after this date, including field modifications, must be reviewed by this office to insure continued conformance with applicable codes. Please review carefully all comments attached, as failureJo-comply with instructions in this report can result irysusDensioffoTbermit to build. DENIAL Please see the attached report of deficiencies marked with D. Make necessary corrections to plans or specifications for compliance with applicable codes and standards. Submit corrected plans and/or specifications to this office for review. By: By: By: Date: Date: Date: ATTACHMENTS Grading Permit Application Grading Permit Checklist Right-of-Way Permit Application Right-of-Way Permit Submittal Checklist and Information Sheet ENGINEERING DEPT. CONTACT PERSON NAME: Casey R. Arndt City of Carlsbad ADDRESS: 1635 Faraday Avenue Carlsbad, CA 92008 PHONE:(760) 602-2775 H:\Dovntopment Seivic<»\MASTERS«;HECKUSTS\Building Plancheck Cklisl Form- POOLS doc Rev. 8122/96 1635 Faraday Avenue • Carlsbad, CA 92OO8-7314 - (760) 6O2-272O • FAX (760) 6O2-8562 Q Q Q BUILDING PLANCHECK CHECKLIST - POOLS SITE PLAN 1. Provide a fully dimensioned site plan drawn to scale. Show: LinesArrow B^Existing & Proposed Structures 2. Show on site plan: . inage Patterns /xBTExisting & Proposed Slopes ^"Existing Topography Indicate what will happen with * spjl excavated from pool area EK-"T^etaining Walls (location and height) Note: If excavated soil is not to be removed from property but regraded on site, show proposed elevations and slopes. If any portion of retaining walls are over 4' in height, a separate permit is required. Retaining Wall Permit CB Applied for Approved 3. Include on title sheet: Site Address Ssessor's Parcel Number Z Legal Description D. Grading Quantities Cut Fill Import/Export a) If grading is not required, write "No Grading" on plot plan. 4. Project does not comply with the following Engineering Conditions of approval for Project No. Conditions were complied with by: GRADING PERMIT REQUIREMENTS Date: The conditions that invoke the need for grading permit are found in Section 11.06.030 of the Municipal code. 5a. Inadequate information available on Site Plan to make a determination on grading requirements. Include accurate grading quantities (cut, fill, import, export). 5b. Grading Permit required. A separate grading plan prepared by a registered Civil Engineer must be submitted together with the completed application form attached. Note: The Grading Permit must be issued and rough grading approval obtained prior to issuance of a Building Permit Page 2 of 3 H:\Oevetepnnnl S«vice»\MASTERS\CHECKUSTS\Building Planchsok CKBsl Fwm- POOLS.doc -iSTV •>ND/3' Q RD/ 5c. A Grading Permit has been applied for: PE2 DWG Grading Inspector sign off by: Date: 5d. No Grading Permit required. MISCELLANEOUS PERMITS 6. A RIGHT-OF-WAY PERMIT is required to do work in City Right-of-Way and/or private work adjacent to the public Right-of-Way. A separate Right-of-Way issued by the Engineering Department is required for the following: Q Please complete attached Right-of-Way application form and return to the Engineering Department together with the requirements on the attached Right- of-Way checklist, at the time of resubmittal. Right-of-Way Permit and Pool Building Permit will be issued simultaneously. 7. Remarks. Page 3 of 3 H:\Dmelopmenl S«cvices\MASTEHS\CHECKLISTS\Building Pl«ncheck CWwl Form- POOLS.doc RIS-lM-01 12:27 PM CAUIFORNIftx'POOL.S 619 T44 8084 P. 01 CORD CERTIFICATE OF LIABILITY INSURANCb (909)941-1500 Kessler"Alair Ins. Service*, License t OA 91387 2335 W Foothill «tvd., Ste. 1 Upland, CA 917«« (909)932-2133 Inc. INSURED Cai ifornU Pools, Inc M106 East C*rvey Ave. West Covin», CA 91791 South COVE-RAGE'S OATEIMM/ODrtY) 01/02/2001^ THIS CERTIFICATb IS ISbCJbU Ab A MATTtK Or NFORMAllON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE Fremont Compensation THE POLICIES OF INSURANCE LISTEb'HFLOW HAVE BU-.N ISSUED TO THC INSURED NAMFO ABOVC fOU THE POLICY PfcRIOD INDICATED. NOTWITHSTANDING ANY REOUIRfcMONT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CER I ICICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDS QY THE POLICIES DESCRIBED HI:REIN IS SUOJf-CT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS Of7 SUCH POLICIES. AGGRCGATE LIMITS SHOWN MAY HAVE DCEN HF.OUCED OY PAID CLAIMS. 'SS i A TYPE OF INSURANCE GENERAL LIABILITY ^•W COMMCACIAI frf-NhHAL LIABILITY ~~) CLAIMS MAOE [ | OCCUH CBNl AOSRCCATB LIMIT APPLIES PCR. AW OMOBILE IIABILITY ANYAU10 AULQWNCD AUTOS HIRCDAUIOS NON-OWNED AUt 05 OARAGE LIABILITY ""] ANY AUTO EXCESS LIABILITY """] OCCUR t 1 J CLAIMS MADE =1 06DUCTIDLC RCTCNTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY <btn'i:R POLICY NUMDER NOO-712121-0.1 'DATE'lMM/OCf/Yvr 12/31/2000 rDAT6(MM/OWYYJ" 12/31/2001 LIMITS tACH ACCURRLNCE KIKI- IMMAGC (Ally 4n« Hie) Mf n rxr (Any on* fvnn) 11-NSONAL 1 ADV INJUKY- ONl-KAi. AGGncGATE HKOOUCTS - COMP/OP ACC COMBINED SINGLPI IMIT DOOH.Y INJURY(Hc> pnrMVt) BODILY 1N.I1IRY (Pei acwa«nu Al ITO ONLY • LA ACUUENT OTIIPRTIIAN tAACCAUIOONI.Y: A00 FACHOCCURRENCb AOC^tCATF „ 1 Wl!. MA 11.11 1 IO1II-X [TORYIIMirsI [ IX C.L. EACHAtxiOfeNI b 1 . 1 "SMASH . CA EMPLOYEE t.l.. OISFASP . POLICY LIMIT I *» S *J t I t 1 S J * ' . 1 J t S t * 1,000,000 1 1,000,000 1 1,000,000 DESCRIPTION OF OPERATlONS/LOCATlONSA'EHICLES'EXCLUSlONS ADDED 8Y F.NDOASFMC T/SPECIAL PROVISIONS lofltractnrf License Number: CUI102 .CERTIFICATE HOLDER ADDITIONAL INSURED: INSURER LETTER CANCELLATION Contractors St*t« License Board r. 0. Box 26000 Sicramento , CA 95826 SHOULD ANY OF THL AUOVE OCSCKIOEO POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THtHtOF, THf ISSUING COMPANY WILL ENDEAVOR TO MAJL 10 DAYS WRITTEN NOTICE TO TIC CCRTICICATE HOLDER NAMED TO THE LEFT. OUf TA1LURE TO MAII. SUCH NOTICE SHALL IMPOSE NO OuLIGATiow OR LIABII rrr OF ANY KINO UPON THE COMPANY. ijJS AOEN~i S OR REPRESENTATIVES. "A'UTHOMULU REPRCSENTATIVE B 25-5 (7/87)T988 en