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Home My WebLink About1383 SAPPHIRE DR; ; CB110270; Permit,' ' City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 02-11-2011 Pool Permit Permit No: CB110270 Job Address: Permit Type: Parcel No: Valuation: Reference #: PC#: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 1383 SAPPHIRE DR CBAD POOL Lot#: 0 2122500400 $18,324.00 Construction Type: NEW SCHEILER: 450 SF POOL/SPN/GAS TO BBQ/ ELE TO BBQ Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 02/07/2011 JMA 02/11/2011 02/11/2011 SO-CAL CUSTOM POOLS & SPAS LAND ACQUISITION MANAGEMENT L L C MALLORY&NATSIS LLP 3730 HIBISCUS CR 92008 760 477-7378 Building Permit Add'I Building Permit Fee Plan Check Add'I Plan Check Fee Electrical Fee Plumbing Fee Strong Motion Fee Green Bldg Standards (SB1473) Fee Renewal Fee Add'I Renewal Fee Other Building Fee Additional Fees TOTAL PERMIT FEES 1900 MAIN ST IRVINE CA 92614 $199.71 $0.00 $129.81 $0.00 $20.00 $27.00 $1.83 $1.00 $0.00 $0.00 $0.00 $0.00 $379.35 Total Fees: $379.35 Total Payments To Date: $379.35 Balance Due: Inspector: FINAL APPROVAL Date: ,(·JI · I I Clearance: $0.00 NOTICE: Please take NOTICE that approval of your project includes the "lmposit1on· of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these tees/exactions. If you protest them, you must follow the protest procedures set !orth in Government Code Section 66020{a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Mun1c1pal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul the!r imposition, You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacily changes, nor planning, zoning, grading or other similar application processing or service iees in connection with this project. NOA DOES IT APPLY lo any t i h , r i h City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 02-11-2011 Storm Water Pollution Prevention Plan (SWPPP) Permit Permit No:SW110036 Job Address: Permit Type: Parcel No: Reference #: CB#: Project Title: 1383 SAPPHIRE DR CBAD SWPPP 2122500400 CB110270 SCHEILER: Lot#: 0 Status: Applied: Entered By: Issued: Inspect Area: Tier: ISSUED 02/07/2011 JMA 02/11/2011 450 SF POOL/SPA//GAS TO BBQ & FIREPIT/ ELE TO BBQ Priority: M Applicant: SO-CAL CUSTOM POOLS & SPAS 3730 HIBISCUS CR 92008 760 477-7378 Emergency Contact: JIMI JACKSON 760-547-4523 SWPPP Plan Check SWPPP Inspections Additional Fees TOTAL PERMIT FEES Total Fees: $257.00 Owner: LAND ACQUISITION MANAGEMENT L L C MALLORY&NATSIS LLP 1900 MAIN ST IRVINE CA 92614 $49.00 $208.00 $0.00 $257.00 Total Payments To Date: $257.00 Balance Due: $0.00 FINAL. APPROVAL OATF._):Jl-'L;fa~NCE_ SIGNATURE_ fl /l: ________ _ • «~~ Building Permit Application 1635 Faraday Ave., carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Plan Check No. C I \ C 2-7 0 ¥ CITY OF Est. Value CARLSBAD Plan Ck. Deposit Fax: 760-602-8558 www.carlsbadca.gov Date z., 7 I I SWPP I \ 0 0 3b JOB ADDRESS ' r. SUITE#/SPACE#/UNIT# APN CT/PROJECT# LOT# #BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Atea(s) EXlSTING USE GARAGE (SF) CONTACTNAME (IIDI ADDRESS CITY STATE ZIP PHONE FAX PROPERTY OWNER N ADDRESS CITY ·~ PHONE FAX EMAIL ARCH/D STATE UC.# STATE (Sec. 70 1.5 Business and Professions Code: Any City or County which requires a permit to constroct, alter, improve, demolish or repair any structure, prior Its issuance, also r~uires 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 {hat he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section ?031.5 by any applicant for a permit subjects the applicant to a cMI penalty of not more than five hundred dollars {$500}). WORKERS' COMPENSATION Workers' Compensation DeclaraUon: f hereby affirm under penalty of perjury ooe of the following decfarstions: 0 I have and wll maintain a certificate of conHnt to self-Insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit ·s issued. "--fll I have and wiH maintain workers' ~~n· ft!.n1red by !:ion 37~r Code, for the performi gJJhe work !!:!permit 1s issued My workers' compe numberare lnsuranceCo ----.:1¥ ~ cQA~ PohcyNo _ '-:101~,9 ExpirationDate~)..\c.i-\-..1.-.\....--- This section need not be completed if the penrnt Is for one hundred dollars ($100) or less □ Certificate of Exemption: I cenily that in the perfonna of the work for which th rmI! Is issued, I shall not employ any pe,son In any manner so as to become subject to the Workers' Compensation laws of California. WARNING: Failure to secure worktfl' n11fon age is awfu, ·eet an employer to criminal penalties and cMI Ants up to one hundred thousand doUart (&100,000), In addHlon to the cost of compensation, damagu asp I~ In Ion 37 of the La code, Inter t and attorney's fees. .6$ CONTRACTOR SIGNATURE I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: □ I, as owner of the property or my employees d 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 lo mi owner of property 'Mio builds or Improves thereon, and who does such wcrt 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). □ 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 Conlractor's License Law). □ I am exempt under Section, ----~usiness and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for conslructioo of the proposed property improvement. O Yes □ No 2. I (have I have not) signed an application for a building permit for lhe proposed work. 3.1 have contracted with the following person (finn) to provide the proposed conslruclion (include name address I phone I contractors' license number): 4. I plan to provide portions of the work, but J have hired the following person to coordinate, supervise and provide the major work (include name I address/ phone/ 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 f address/ phone/ type of WOik): ,1/S PROPERTY OWNER SIGNATURE CJAGENT DATE COMPLETE THIS SECTION FOR NON·RESJDENTIAL BUILDING PERMITS ONLY Is lhe applicant or future building occupant required to submit a business plan, acutely hazardous materials registration loon or risk management end prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 Yes □ No Is the applicant or future buHding occupant required to obtain e pem,it from the air pollution conlrol district or air quality management district? 0 Yes □ No Is the facility to be constructed within 1,000 feet of the outer boundary of e school site? □ Yes □ No F ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPllCANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTRot. DISTRICT. CONSTRUCTION LENDING AGENCY I hereby affirm that there 1s a coostruction lending agency for the performance of the work this permit is issued (Sec 3097 (1) Civil Code) Lender's Name Lender's Address APPLICANT CERTIFICATION I certll'y1hat I have 188d the appllcatlon and state that the aboYe lnlonnation Is conect and that the Information on the plans Is acwrate. I agree to comptywllh all Qty ordinances and State laws relating to building construction. I h8l8lly aul-orize rep,esen-olltle aty olCarlsbad i>enler upon Ille above menlbled property for i1spediJn pt.lfl058S. I ALSO AGREE TO SAVE, l~EMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LL'\BIUTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: Al'I OSHA. pennit is requi'ed U excavations CMr 5'0' deep and demolioon or oonstructi)n of structures CMr 3 stires fl heght. EXPIRATION: Every pennit issued by lhe Blilding Offbal under lhe provisioos f this Code shall expie by liTiilaoon and become nuN and \()jd W lhe buildilg a-\Wik auhorized by sud, pemit is not <XllTITl8rlald 'Mhi 180 days from Ile dale of such perrrilo-•Ille buidilg .-fii'\~~I • suspeooed .-abarooned at anyli!To aflerlle ""'1< ocommencod ilr a peood ol 180 days(Secoon 106.4.4 lklibm &idilg Code). AS APPLICANT'S SIGNATURE G~ K DATE / ./' '-l City of Carlsbad Bldg Inspection Request Permit# CB110270 Title: SCHEILER: For: 05/27/2011 Inspector Assignment: MC --- Description: 450 SF POOUSPA//GAS TO BBQ & FIRE PIT/ ELECT TO BBQ Type:POOL Sub Type: Job Address: Suite: Location: OWNER 1383 SAPPHIRE DR Lot: 0 LAND ACQUISITION MANAGEMENT L LC Owner: LAND ACQUISITION MANAGEMENT L L C Remarks: Total Time: CD Description Act Comments Phone: 7605474573 lnspector-d.L Requested By: JIMMY JACKSON Entered By: CHRISTINE 59 Final Pool ~---- ---------- Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# lns12ection Histort Date Description Act lnsp Comments 04/29/2011 55 Fence/Pre-Plaster AP PD GATES, ALARMS OK 03/18/2011 11 Ftg/Foundation/Piers AP PD 03/18/2011 23 Gas/Test/Repairs AP PD EQUIP, FIREPIT, BBQ 03/18/2011 51 Excav/Steel/Bonding/Fence AP PD 03/18/2011 52 Underground Plumbing AP PD 03/18/2011 53 Electric/Conduit/Wiring AP PD BBQ, POOL 03/15/2011 11 Ftg/Foundation/Piers co MC NOTICE ATTACHED 03/15/2011 23 Gas/Test/Repairs co MC 03/15/2011 31 Underground/Conduit-Wiring co MC 03/15/2011 51 Excav/Steel/Bonding/Fence co MC 03/14/2011 31 Underground/Conduit-Wiring co PD 03/14/2011 52 Underground Plumbing co PD 03/14/2011 53 Electric/Conduit/Wiring co PD 04/29/2011 10:23 FAX APR-~·eta11 ~:12A FRCl'l:LUIZ INSPECTio-45 71.:t·9013El30 .. ~~Oll~T: '* itomttt 01'«-lllll'IIOTOl\'INAMI: r..~. ca, 111~~_, , .. .,.,., .... 111 C.110170 MTINMftlleA,_..ll#MIIAI CIASl'W.TI ~1 ...... ~, .. I COlffMCtoll &,,Ca!PM .......... ,. 2,fOO IUIOtlNT'IIMl'TN t,jpOun119 caa,n Jou --"'" NG.OIMIIIUI 1 00.0.""""'8 HPGunh nm&.-.~ 10 /IV,MT NIA 'fletlllT ...... NIA llfllt~IID, 1,12. 1 CM'f,... NIA ~TIDIIIIIUI&: To, _, !he atlde IIOTD: NA•Not~ TMI 1119almenl _,. .. , 1111"8 4" x I" fflOIO, RMulla,_.onlylOthe ....,.,... .... , DA.11 ........ MOW. Sl5'11 ~utlD IU~TDAff .,,w11 3N o, l!QUHM TSOHIIICWI icnn. CAU&IRICA&.M,. .. MIAT QAft ,.. a,tCIIIIN IOIUfflPIOA'nOtll 11ST 01' °" 1 I ' Nvalll 11'1.1.ffl' TUT TSIT .... ... ... noaa.11., a ~.,,, 12:10PM 4.oGe 4.011 HA . '1'11t......,..,.,..,... 'r ... CIHI 10IINnlillll 1 W! • ~ DMlelollt I W4 • ~ ICAWC)Ulder U•IIII• 1,9 T□r17604537944 ~lr.!ll fflCh!rf Lug NI~ r:f!A ~ 001 P.1 _,_ 1 ....... ...,,,.__ 0-... --°'"'" V ~ NIA ..,.MIi. NIA eu,.,. NIA MtCIMfllT NIA AIIUCQIIC:. 1/IIIP, NIA - ------041..a -~11 -...... l"'D lllaiAI • IQ.IN, 1,M, 191M me• IN • NA ,2.a 37,1111 2,lff 3 'IMlkTWPt~l'lltAITMCUllillftJI 1•Cellt, 31f0ofttflll!Cflek. l•tanMr. 4•~ Slfllff,,,_..., f•._I",._,■~ 04/29/2011 10:23 FAX Ff'R-29-2011 "9:1~ FR01iWIZ INSPECTIOS 714-9013080 lr11pec1ion Typc(s) Jnspeciicn Datc(s) Dcsc: ib I List Tts:s Made: RICHARD LUIZ 5071 LOYOLA AVENUE WESTMINSiER, CA 92683 Report of Special Inspection J Periodic To·.al lnspec1 lon ·rime Each Day: • Dato j ~2,"l.j I _Hours =2 T0117604537944 "1]002 P,2 Lis! !!ems Requiring Corrcc1ion, include 1.1ncorrcc1ed hems previously listed To 1he best or my knowlcd&c, the work Inspected was In accordance with the Building Dcpartinent 3('1pro,·ed design in specl(ic tions and applicable workmanship provl~lon, or the U.B.C ,i.i.cept as n01td o Signed;-=,-.~--=~====:.-!==----- ?rint Full Name; ~cA,A&t;> IJ H Z -· --·-·-----•·-·--· ----- t'ORM Sl•Ol,'lt «''» ~ CITY OF CARLSBAD BUILDING PLANCHECK - POOLS/RETAINING WALLS CHECKLIST Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov E-37 DATE: =-+-'--'-I-_,_._~= PLANCH~{ NO.: CB 11 ¼r r. 0 DR S: [3K~ <:;;Af'P-\i(YL:E: ~ PROJECTDESC IPTION: \~U.. Sr1/G>06?,._ ~ plle.Sf(\ PROJECT DESCRIPTION: U Pool / 0 Retainin~all ASSESSOR'S PARCEL NUMBER: 21r l5cJ ..--0 ~ 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 ensure continued conformance with applicable codes. Please review carefully all comments attached, as failure to comply with instructions in this report can result m~n of permi'. to build. A I. . ( By:~k/~te: ~ ATTACHMENTS D Final Map D Grading Permit Application □ Grading Plan D Right-of-Way Permit Application D Storm Water Compliance Form(s) D Other E-37 DENIAL Please see the attached report of deficiencies marked with □. 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: ________ Date: By: Date: -------- By: Date: -------- ENGINEERING DEPT. CONTACT PERSON Name: Linda Ontiveros City of Carlsbad Email: linda.ontiveros@carlsbadca.gov Phone: 760-602-2773 Fax: 760-602-1052 NOTE: If there are retaining walls associated with your project, please check with the building department if these walls need to be pulled by separate RETAINING WALL PERMIT. Page 1 of 3 REV 6/30/10 ~□ □ □ □ E-37 □ □ □ □ □ □ □ i,..or tf{cr 02--0 7 __D),\)b Lf3D-5 b SITE PLAN 1. Provide a fully dimensioned site plan drawn to scale. Show: A North arrow C. Property lines B. Existing & proposed structures D. Easements 2. Show on site plan: A Drainage patterns B. Existing & proposed slopes D. Indicate what will happen with soil excavated from pool area C. Existing topography E. Retaining 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 is over 4' in height, a separate permit is required. Retaining Wall Permit CB ______ Applied for ____ Approved 3. Include on title sheet: A Site address B. Assessor's parcel number C. Legal description D. Grading quantities Cut __ Fill __ Import ___ Export 4. Project does not comply with the following engineering conditions of approval for project no. Conditions were complied with by: Date: ---------- GRADING PERMIT REQUIREMENTS 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 5c. A grading permit has been applied for: DWG _______ _ 5d. No grading permit required. Page 2 of 3 REV 6/30/10 ✓□ g_ □ a-□ g....-□ E3-□ -er-□ E-37 □ □ □ □ □ □ □ □ □ 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: 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. STORM WATER REQUIREMENTS Construction Compliance 7a. Project Threat Assessment Form complete. 7b. Enclosed Project Threat Assessment Form incorrectly completed. Please make the corrections, re-sign a new form and resubmit with next submittal. 7c. Requires Tier 1 Storm Water Pollution Prevention Plan. Please complete attached form and return (SW fl ~ 5b ) Post-Development (SUSMPI Compliance 7d. 7e. 7f. 7g. 7h. Storm Water Standards Questionnaire complete. Storm Water Standards Questionnaire incorrectly completed. Please make the corrections, re-sign the questionnaire and resubmit with next submittal. Project is subject to Standard Storm Water Requirements. See city Standard Urban Storm Water Management Plan (SUSMP) for reference. Disconnect discharges per SUSMP. Do not connect runoff from impervious surfaces to storm drains without first discharging water over landscape areas. See SUSMP. Minimize use of impervious surfaces per SUSMP. Redesign to reduce the excessive use of impervious area (pavement) on project. Use a balanced design of pervious surfaces (landscape area, planters, etc.) and impervious surfaces. See SUSMP 8. Remarks Page 3 of 3 REV 6130110 «~~ ~ CITY OF STORM WATER COMPLIANCE FORM TIER 1 CONSTRUCTION SWPPP E-29 Development Services land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov CARLSBAD This form is required for all pools, retaining walls or whenever a building footprint is enlarged. STORM WATER COMPLIANCE CERTIFICATE ✓ My project is not in a category of permit types exempt from the Construction SWPPP requirements ✓ My project is not located inside or within 200 feet of an environmentally sensitive area with a significant potential for contributing pollutants to nearby receiving waters by way of stem, water runoff or non-storm water discharge(s). ✓ My project does not require a grading plan pursuant to the Carlsbad Grading Ordinance (Chapter 15.16 of the Carlsbad Municipal Code) ✓ My project will not result in 2,500 square feet or more of soils disturbance including any associated construction staging, stockpiling, pavement removal, equipment storage, refueling and maintenance areas that meets one or more of the additional following criteria: • located within 200 feet of an environmentally sensitive area or the Pacific Ocean; and/or, • disturbed area is located on a slope with a grade at or exceeding 5 horizontal to 1 vertical; and/or • disturbed area is located along or within 30 feet of a stom, drain inlet, an open drainage channel or watercourse; and/or • construction will be initiated during the rainy season or will extend into the rainy season (Oct. 1 through April 30). I CERTIFY TO THE BEST OF MY KNOWLEDGE THAT ALL OF THE ABOVE CHECKED STATEMENTS ARE TRUE AND CORRECT. I AM SUBMITTING FOR CITY APPROVAL A TIER 1 CONSTRUCTION SWPPP PREPARED IN ACCORDANCE WITH THE REQUIREMENTS OF CITY STANDARDS. I UNDERSTAND AND ACKNOWLEDGE THAT I MUST: (1) IMPLEMENT BEST MANAGEMENT PRACTICES (BMPS) DURING CONSTRUCTION ACTIVITIES TO THE MAXIMUM EXTENT PRACTICABLE TO MINIMIZE THE MOBILIZATION OF POLLUTANTS SUCH AS SEDIMENT AND TO MINIMIZE THE EXPOSURE OF STORM WATER TO CONSTRUCTION RELATED POLLUTANTS; AND, (2) ADHERE TO, AND AT ALL TIMES, COMPLY WITH THIS CITY APPROVED TIER 1 CONSTRUCTION SWPPP THROUGHOUT THE DURATION OF THE CONSTRUCTION ACTIVITIES UNTIL THE CONSTRUCTION WORK IS COMPLETE AND APPROVED BY THE CITY OF Cl\lll.SBAD. &~J,,{l DATE E-29 STORM WATER POLLUTION PREVENTION NOTES 1. ALL NECESSARY EQUIPMENT AND MA TE RIALS SHALL BE AVAILABLE ON SITE TO FACILITATE RAPID INSTALLATION OF EROSION AND SEDIMENT CONTROL BMPS WHEN RAIN IS EMINENT. 2. THE OWNER/CONTRACTOR SHALL RESTORE ALL EROSION CONTROL DEVICES TO WORKING ORDER TO THE SATISFACTION OF THE CITY ENGINEER AFTER EACH RUN-OFF PRODUCING RAINFALL. 3. THE OWNER/CONTRACTOR SHALL INSTALL ADDITIONAL EROSION CONTROL MEASURES AS MAY BE REQUIRED BY THE CITY ENGINEERING OR BUILDING INSPECTOR DUE TO UNCOMPLETED GRADING OPERATIONS OR UNFORESEEN CIRCUMSTANCES WHICH MAY ARISE. 4. ALL REMOVABLE PROTECTIVE DEVICES SHALL BE IN PLACE AT THE END OF EACH WORKING DAY WHEN THE FIVE (5) DAY RAIN PROBABILITY FORECAST EXCEEDS FORTY PERCENT (40%). SILT AND OTHER DEBRIS SHALL BE REMOVED AFTER EACH RAINFALL. 5. ALL GRAVEL BAGS SHALL BE BURLAP TYPE WITH 3/4 INCH MINIMUM AGGREGATE. 6. ADEQUATE EROSION AND SEDIMENT CONTROL AND PERIMETER PROTECTION BEST MANAGEMENT PRACTICE MEASURES MUST BE INSTALLED AND MAINTAINED. SPECIAL NOTES Page 1 of 3 Estimated Construction Start Date ----~' Project Duration 3 Months 24 hour Phone:-. L,p ~'--( \ -1-\\&.p Perceived Threat to Stom, Water Quality ~Mediu£0cr f -Arr !fl~ If medium box is checked, must attach a site plan sheet showing proposed work area and location of proposed structural BMPs For City Use Only \ REV 4/30/10 Erosion Control Tracking Non-Storm Water Waste Management and Materials Sediment Control BMPs Control BMPs BMPs Management BMPs Pollution Control BMPs C C C c c 0 ~ 0 -0 ~ Q) -0 Q) C ti C O> m E C E "O "' 0 C O> m C m s I '5 _g. Q) .gi ;; -g _; E ;; ii ·e m O> I;; C ::, 2-O> ::; O> C. Q) C c g.m ~ ·c " .,. Q) m C ~ s Best Management Practice "" .& m; e a, ·a ·e -Q) (!) s UJ -~ C ~ 1,! :!i "' ~ O> m u e Q) m (BMP) Description -+ "' *"' -~ >-E O> a, C "' "O m "O -;; "' ::; s ;;: s 1l m Jg m ~-~ ~-~ -gill' C C ;;: C D :::, ~ "' "' ::, is§, c O> "O "' 0 m s ::, Q) 1 ::; D ~ a, a, m () m il ~ 0 D C Q) Jll EM ~i ~~ O> ~ s. ~j "ii ·a "E ~ "8 ~ Q) -~ -" -;; -::, :· C .2 ·c -" g €·= "-" z > Q) il "O :c e --"O .. -ffl s " :!2 .. " -g Q) C .c .. ·;; -" ~ C ~ "'e .2 "' -" e i .. .. .2 e l3 ~ 91& .. & ~ .. .9 0 0 (!) UJ D "' in "' () ii: (!) "'> "' "'a. ;;: a. ::; ::; "' "' :,: (), CASQA Designation ➔ 0 0 0 ~ :;:; '1 "t "1 'I' ,._ :l: 0 ~ N ;,;; "' ,._ "' ~ N ~ "t "' ; ; 0 LU ~ ci: d, d, d, ::; ::; ::; UJ UJ UJ UJ LU ::; ..;Construction Activity UJ UJ UJ "' "' "' "' "' "' "' >->-z z z z ;;: ;;: ;;: ;;: ;;: ;;: ;;: UJ "' . 1 .r.:;radina/Soil Disturbance w T""'nchina/Excavation ~ , · ;:;tockcilina -"" Drillinn1Morino . 1~ .L,,Eoncrete/Asphalt Saw , I~ cuttina ,. Concrete flatwork Pavino I. ..-r ... nduiVPioe Installation , ·~-Stucco/Mortar Work I -.. \a.-aste Disnnc,al --taaino/lav Down Area ,,_ " ' Equipment Maintenance . •· and Fuelin!J .-~- Hazardous Substance Use/Stor~e Dewaterina ,_ · site Access Across Dirt Other (list): Instructions: Begin by reviewing the list of construction activities and checking the box to the left of any activity that will occur during the proposed construction. Add any other activity descriptions in the blank activity description boxes provided for that purpose and place a check in the box immediately to the left of the added activity description. For each activity descrribed, pick one or more best management practices (BMPs) from the list located along the top of the form. Then place an X in the box at the place where the activity rr.m intersects with the BMP column. Do this for each activity that was checked off and for each of the selected BMPs selected from the list. For Example -If the project includes site access across dirt, then check the box to the left of a Site Access Across Dirt". Then review the list for something that appties such as •stabilized Construction Ingress/Egress" under Tracking Control. Follow along the ~Site Access Across Dirt" row until you get to the ·stabilized Construction Ingress/Egress" column and place an X in the box where the two meet. As another example say the project included a stockpile that you intend to cover with a plastic sheet. Since plastic sheeting is not on the list of BMPs, then write in MCover with Plastic" in the blank column under the heading Erosion Control BMPs. Then place an X in the box where the astockpiling" row intersects the new gCover with Plastic" column. To learn more about what each BMP description means, you may wish to review the BMP Reference Handout prepared to assist applicants in the selection of appropriate Best Management Practice measures. The reference also explains the California Stonnwater Quality Association (CASQA) designation and how to apply the various selected BMPs to a project. E-29 Page 2 of 3 REV 4/30/10 ..... ~ - Entries for ltem:3 -Fire-OK to Issue 08:24 02/23/2011 Action Comments By Date AP NIA APPLICANT DELETED THE FIRE PIT KG 0211112011 AP Approved installation of fire pit if no less than GR 0212312011 30 lineal feet from habitat hardline and no less than 10 feet from any combustible structure. Total Rows: 2 Page 1 «~ ¥ CITY OF CARLSBAD INSTRUCTIONS: STORM WATER STANDARDS QUESTIONNAIRE E-34 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov To address post-development pollutants that may be generated from development projects, the City requires that new development and significant redevelopment priority projects incorporate Permanent Storm Water Best Management Practices (BMP's) into the project design per the City's Standard Urban Stormwater Management Plan (SUSMP). Initially this questionnaire must be completed by the applicant in advance of submitting for a development application (subdivision, discretionary permits and/or construction permits). The results of the questionnaire determine the level of storm water standards that must be applied to a proposed development or redevelopment project. Depending on the outcome, your project will either be subject to 'Standard Stormwater Requirements' or be subject additional criteria called 'Priority Development Project Requirements'. Many aspects of project site design are dependent upon the storm water standards applied to a project. Applicant responses to the questionnaire represent an initial assessment of the proposed project conditions and impacts. City staff has responsibility for making the final assessment after submission of the development application. If staff determines that the questionnaire was incorrectly filled out and is subject to more stringent storm water standards than initially assessed by the applicant, this will result in the return of the development application as incomplete. In this case, please make the changes to the questionnaire and resubmit to the City. If applicants are unsure about the meaning of a question or need help in determining how to respond to one or more of the questions, they are advised to seek assistance from Land Development Engineering staff. A separate completed and signed questionnaire must be submitted for each new development application submission. Only one completed and signed questionnaire is required when multiple development applications for the same project are submitted concurrently. In addition to this questionnaire, applicants for construction permits must also complete, sign and submit a Project Threat Assessment Form to address construction aspects of the project. Please answer the questions below, follow the instructions and sign the form at the end. I 1. Is your project a significant redevelopment? DEFINITION: Significant redevelopment is defined as the creation, addition or replacement of at least 5,000 square feet of impervious surface on an already existing developed site. Significant redevelopment includes, but is not limited to: the expansion of a building footprint; addition to or replacement of a structure; structural development including an increase in gross floor area and/or exterior construction remodeling; replacement of an impervious surface that is not part of a routine maintenance activity; and land disturbing activities related with structural or impervious surfaces. Replacement of impervious surfaces includes any activity that is not part of a routine maintenance activity where impervious material(s) are removed, exposing underlying soil during construction. If your project IS considered significant redevelopment, then please skip Section 1 and proceed with Section 2. If your project IS NOT considered significant redevelopment, then please proceed to Section 1. E-34 Page 1 of 3 REV 4130/10 «~ ~ CITY OF CARLSBAD iSECTION 1 PRIORITY PROJECT TYPE STORM WATER STANDARDS QUESTIONNAIRE E-34 NEW DEVELOPMENT Does you project meet one or more of the following criteria: Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov YES NO 1. Housing subdivisions of 10 or more dwelllng units. Examples: single family homes, multi-family homes, ~ condominium and aoartments 2. Commercial -greater than 1-acre. Any development other than heavy industry or residential. Examples: hospitals; ~ laboratories and other medical facilities; educational institutions; recreational facilities; municipal facilities; commercial nurseries; multi-apartment buildings; car wash facilities; mini-malls and other business complexes; shopping malls; hotels; office buildinas; oublic warehouses: automotive dealershios; airfields; and other lioht industrial facilities. 3. Heavy Industrial I Industry-greater than 1 acre. Examples: manufacturing plants, food processing plants, metal \..{:_) working facilities, printing plants, and fleet storage areas (bus, truck, etc.). 4. Automotive repair shop. A facility categorized in any one of Standard Industrial Classification (SIC) codes 5013, l<-?i 5014, 5541, 7532-7534, and 7536-7539 5. Restaurants. Any facility that sells prepared foods and drinks for consumption, including stationary lunch counters '\ and refreshment stands selling prepared foods and drinks for immediate consumption (SIC code 5812), where the i-land area for development is greater than 5,000 square feet. Restaurants where land development is less than 5,000 square feet shall meet all SUSMP requirements except for structural treatment BMP and numeric sizing criteria reauirements and hvdromodification rAl'luirements. 6. Hillside development. Any development that creates 5,000 square feet of impervious surface and is located in an area with known erosive soil conditions, where the development will grade on any natural slope that is twenty-five ,,.( ' aercent (25%) or greater. 7. Environmentally Sensitive Area (ESAJ 1• All development located within or directly adjacent2 to or discharging \ directly3 to an ESA (where discharges from the development or redevelopment will enter receiving waters within the f ESA), which either creates 2,500 square feet of impervious surface on a proposed project site or increases the area of imnArviousness of a oronnsed oroiect site to 10% or more of its naturallv occurrina condition. 8. Parking lot. Area of 5,000 square feet or more, or with 15 or more parking spaces, and potentially exposed to urban ~· runoff '-LJ 9. Streets, roads, highways, and freeways. Any paved surface that is 5,000 square feet or greater used for the ~) transportation of automobiles, trucks, motorcycles, and other vehicles C 10. Retail Gasoline Outlets. Serving more than 100 vehicles per day and greater than 5,000 square feet " < ' 11. Coastal Development Zone. Any project located within 200 feet of the Pacific Ocean and ( 1) creates more than '-2i 2500 square feet of impermeable surface or (2) increases impermeable surface on property by more than 10%. 12. More than 1-acre of disturbance. Project results in the disturbance of more than 1-acre or more of land and is considered a Pollutant-generating Development Project4• \ ,, 1 Environmentally Sensitive Areas include but are not limited to all Clean Water Act Section 303(d) impaired water bodies; areas designated as Areas of Special Biological Significance by the State Water Resources Control Board (Water Quality Control Plan for the San Diego Basin (1994) and amendments); water bodies designated with the RARE beneficial use by the State Water Resources Control Board (Water Quality Control Plan for the San Diego Basin (1994) and amendments); areas designated as preserves or their equivalent under the Multi Species Conservation Program within the Cities and County of San Diego; and any other equivalent environmentally sensitive areas which have been Identified by the Copennittees. 2 "Directly adjacent" means situated within 200 feet of the Environmentally Sensitive Area. 3 "Discharging directly to" means outflow from a drainage conveyance system that is composed entirely of flows from the subject development or redevelopment site, and not commingled with flow from adjacent lands. 4 Pollutant-generating Development Projects are those projects that generate pollutants at levels greater than background levels. In general, these include all projects that contribute to an exceedance to an impaired water body or which create new impervious sulfaces greater than 5000 square feet and/or introduce new landscaping areas that require routine use of fertilizers and pesticides. In most cases linear pathway projects that are for infrequent vehicle use, such as emergency or maintenance access, or for pedestrian or bicycle use, are not considered Pollutant-generating Development Projects If they are bullt with pervious surfaces or If they sheet flow to surroundin rvious surfaces. Section 1 Results: .If you answered YES to ANY of the questions above your project is subject to Priority Development Project requirements. Please check the "meets PRIORITY DEVELOPMENT PROJECT requirements" box in Section 3. A Stonn Water Management Plan, prepared in accordance with City Stenn Water Standards, must be submitted at time of application. If you answered NO to ALL of the questions above, then your project is subject to Standard Stormwater Requirements. Please check the "does not meet PDP requirements" box in Section 3. E-34 Page 2 of 3 REV 4130/10 ' «1'» ~ CITY OF CARLSBAD STORM WATER STANDARDS QUESTIONNAIRE E-34 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov SECTION 2 SIGNIFICANT REDEVELOPMENT Complete the Questions below reaardina vour redevelopment prolect: YES NO 1. Project results in the disturbance of more than 1-acre or more of land and is considered a Pollutant-generating IV, Develocment Proiect (see definition in Section 1 ). If you answered NO, please proceed to question 2. I If you answered YES, then you ARE a significant redevelopment and you ARE subject to PRIORITY DEVELOPMENT PROJECT reauirements. Please check the "meets PRIORITY DEVELOPMENT PROJECT reauirements" box in Section 3 below. 2. Is the project redeveloping an existing priority project type? (Priority projects are defined in Section 1) \/J If you answered YES, please proceed to question 3. I If you answered NO, then you ARE NOT a significant redevelopment and your project is subject to STANDARD STORMWATER REQUIREMENTS. Please check the ~does not meet PDP reauirements" box in Section 3 below. 3. Is the project solely limited to just one of the following: -...,G a. Trenching and resurfacing associated with utility work? f,,,._ /\ b. Resurfacing-and reconfiguring existing surface parking lots? '-f-J c. New sidewalk construction, pedestrian ramps, or bike lane on public and/or private existing roads? { t) d. Replacement of existing damaged pavement? ''-,L- If you answered NO to ALL of the questions, then proceed to question 4. If you answered YES to ANY of the questions then you ARE NOT a significant redevelopment and your project is subject to Standard Stormwater Reauirements. Please check the "does not meet PDP reauirements" box in Section 3 below. 4. Will your redevelopment project create, replace, or add at least 5,000 square feet of impervious surfaces on an existing X development or, be located within 200 feet of the Pacific Ocean and (1 )create more than 2500 square feet of impermeable surface or (2) increases impermeable surface on the orooertv bv more than 10%? If you answered YES, you ARE a significant redevelopment, and you ARE subject to PRIORITY DEVELOPMENT PROJECT requirements! Please check the "meets PRIORITY DEVELOPMENT PROJECT requirements" box in Section 3 below. If you answered NO, then you ARE NOT a significant redevelopment and your project is subject to STANDARD STORMWATER REQUIREMENTS. Please check the "does not meet PDP requirements" box in Section 3 below. SECTION3 Questionnaire Results: □ p My project meets PRIORITY DEVELOPMENT PROJECT (PDP) requirements and must comply with additional stormwater criteria per the SUSMP and must prepare a Storm Water Management Plan for submittal at time of application. My project does not meet PDP requirements and must only comply with STANDARD STORMWATER REQUIREMENTS per the SUSMP. Applicant lnfom,ation and Signature Box This Box for City Use Only y s NO Applica By: Dale: Date: u E-34 Page 3of3 REV 4130/10 ,.., j