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Home My WebLink About2390 OUTLOOK CT; ; CBR2020-2443; PermitBuilding Permit Finaled Residential Permit Print Date: 09/17/2021 Job Address: 2390 OUTLOOK CT, CARLSBAD, CA 92010-2193 Permit Type: Parcel#: Valuation: Occupancy Group: #of Dwelling Units: Bedrooms: Bathrooms: Occupant Load: Code Edition: Sprinkled: Project Title: BLDG-Residential 1675900900 $40,811.81 Work Class: Track#: Lot#: Project#: Plan#: Construction Type: Orig. Plan Check#: Plan Check#: Description: PACKARD: 779 SF POOL AND SPA FEE BUILDING PERMIT FEE ($2000+) BUILDING PLAN CHECK FEE (BLDG) Property Owner: PACKARD JARED AND ERIN 2390 OUTLOOK CT CARLSBAD, CA 92010 ELECTRICAL BLDG RESIDENTIAL NEW/ADDITION/REMODEL PLUMBING BLDG RESIDENTIAL NEW/ADDITION/REMODEL SB1473 GREEN BUILDING STATE STANDARDS FEE STRONG MOTION-RESIDENTIAL SWPPP INSPECTION FEE TIER 1-Medium BLDG SWPPP PLAN REVIEW FEE TIER 1-MEDIUM Pool Total Fees: $1,003.59 Total Payments To Date: $1,003.S9 (city of Carlsbad Permit No: CBR2020-2443 Status: Applied: Issued: Finaled Close Out: Inspector: Final Inspection: CoApplicant: Closed -Finaled 09/30/2020 10/26/2020 PDrei 09/17/2021 BOYER POOLS AND SPAS INC 1309 HILLSIDE DR FALLBROOK, CA 92028-9568 (858) 762-2242 Balance Due: AMOUNT $348.40 $243.88 $41.00 $62.00 $2.00 $5.31 $246.00 $55.00 $0.00 Please take NOTICE that approval of your project includes the "lmposition11 of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth 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 Municipal 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 their 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 capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitation has previously otherwise expired. Building Division Page 1 of 1 1635 Faraday Avenue, Carlsbad CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov d/ ~ City of Carlsbad RESIDENTIAL BUILDING PERMIT APPLICATION B-1 Plan Check ~~20-:41/3 Est. ValueO ff/. f- PC Deposit Date <\ • 3 0 · '202,o JobAddress .2311> owY/vc,k (1;,w.\--Suite: APN: fl 7 ~C/ Ot) 'J ()D ----· CT/Project #: ________________ Lot #: ____ Year Built: ________ _ Fire Sprinklers: ()vE~ NO Air Conditioning:Q YES~ NO Electrical Panel Upgrade: QYES~ NO BRIEF DESCRIPTION OF WORK: , . / l,,t1/cl Z'fi> SQ n pcil) Y0' by u,) 'l fr ckRp fN/ 0 Addition/New: _____ Living SF, ___ Deck SF, ___ ,Patio SF, ____ Garage SF __ Is this to create an Accessory Dwelling Unit? Ov ON New Fireplace? Ov ON, if yes how many? __ D Remodel: _____ .SF of affected area Is the area a conversion or change of use ? Ov ON W Pool/Spa: ":f ?Li SF Additional Gas or Electrical Features? _,._(l/'--0 ________ _ osolar: ___ KW, ___ .Modules, Mounted:0Roof 0Ground, Tilt: 0 vO N, RMA: Ov ON, Batterv:Ov ON, Panel Upgrade: Ov ON D Reroof: __________ .....,.,...... ____________________ _ 'tt Plumbing/Mechanical/Electrical p\14 L -+ J f.Pr v e:J L 1 0 Only: Other: This permit Is to be Issued In the name of the Property Owner as Owner-Builder, licensed contractor or Authorized Agent of the owner or contractor. The person listed as the Applicant below will be the main point of contact throughout the permit process. PROPERTY OWNER APPLICANT 0 PROPERTY OWNERS AUTHORIZED AGENT APPLICANT D Name: , Ja,red ffl.<Wcl Name: _________________ _ Address: 2-3 'lil OitH.,,,k l\- Clty: (Mlsb",) State: G-'\-Zip: 'J Z.lliD Address: _________________ _ City: ________ -'State: __ .Zip: ____ _ Phone: _________________ _ Phone: 1i.C>-8Z8-~.rs- Emall: 1u11) £~ (iJ=uJ.,.,,,'11) 0 f Email: _________________ _ DESIGN PROFESSIONAL APPLICANT O CONTRACTOR APPLICANT~ Name: _______________ _ Address: ______________ _ City: _______ .State: ___ ,Zlp: ___ _ Phone: _______________ _ Email: _______________ _ Architect State License: _________ _ Name:_--r'~~-:-r-L..:::~~~~-------- Address:~...w..:~...:...::.Ll.!JJc::1...._[;..L..,-:------,.--- City: f-4 ___ .___.Zip:_l'.i ... -1_u_· -t..,-=----- Phone:_,.........;....!!,--r''-'---'c-----;=-------- Email:_~!!i!li:.~~:..L.,:_;:.:i!!:!.;::C.:..:..:....l.:::.!!.J...,,-,---- State License/class: 1'/6:; Bus. License: &L•s 00(, '13'2.. (-:>] 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca:.&QY REV. 08120 IDENTIFY WHO Will PERFORM THE WORK BY COMPLETING (OPTION A) OR (OPTION B) BELOW: (OPTION A): LICENSED CONTRACTOR DECLARATION: I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. I also affirm under penalty of perjury one of the following declarations: 01 have and will maintain a certificate of consent to self-Insure for workers' compensation provided by Section 3700 of the labor Code, for the performance of the work which this permit is issued. Policy No. ________________________________________ _ 01 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 workers' compensation insurance carrier and policy number are: Insurance Company Name: _____________________ _ Polley No, ___________________________ Explratlon Date: ______________ _ ~rtificate of EKemption: 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 ~J;ct to the workers' compensation laws of California. WARNING: Failure to secure workers compensation coverage is unlawful and shall subject an employer to criminal penattles and civil fines up to $100,000.00, in addition the to the cost of compensation, damages as provided for In Section 3706 of the Labor Code, Interest and attorney's fees. CONSTRUCTION LENDING AGENCY. IF ANY: I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code}. Lender's Name: ______________________ ,Lender's Address.:-------------------;--- J /zg J ·1,-1> CONTRACTOR PRINT: 'J5(it,n L,:~"'«"y SIG~~ DATE: (OPTION B): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt from Contractor's License Law for the following reason: 01, 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 sate. If, however, the building or improvement is sold within one year of completion, the owner-bullder will have the burden of proving that he did not build or Improve for the purpose of sale). Q1, 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). 01 am exempt under Business and Professions Code Division 3, Chapter 9, Article 3 for this reason: D•owner Builder acknowledgement and verification form" has been filled out, signed and attached to this application. 0 Owners "Authorized Agent Form" has been filled out, signed and attached to this application giving the agent authority to obtain the permit on the owner's behalf. By my signature below! acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered oy this permit, l cannot legally sell a structure that I have buiit as an owner-builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site: http://www.leginfo.ca.gov/co/aw,html. OWNER PRINT: SIGN: __________ DATE: ______ _ APPLICANT CERTIFICATION: SIGNATURE REQUIRED AT THE TIME OF SUBMITTAL By my signature below, I certify that: I am the property owner or State of California licensed Contractor or authorized to act on the property owner or contractor's behalf. I certify that f have read the application and stat@ 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 representative 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 SAIO CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT, OSHA: An OSHA permit is required for excavations over 5'0' deep and demollt,on or construction of structures over 3 stones m height q::;;~-,,,,~,,, ...-1 APPLICANT PRINT: Jj/Z /A ,J j-/1(tvif(-( 'fl SIGN: __::::.:_ '__:___I DATE: 7 )GJ )z, "Ll ; , ~ 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760~602-2719 Fax: 760*602-8558 Email: Building@carlsbadca.KQ."!:' 2 REV. 08/20 Building Permit Inspection History Finaled (city of Carlsbad Permit Type: BLDG-Residential Application Date: 09/30/2020 Owner: COOWNER PACKARD JARED AND ERIN Work Glass: Pool lssuu Date: 10/26/2020 Subdivision: CARLSBAD TCT#99-08 Status: Closed -Finaled Expiration Date: 09/14/2021 Address· 2390 OUTLOOK CT IVR Number: 29042 CARLSBAD, CA 92010-2193 -~·-.. ··--····~-.. _. -~=··· "" --~---·-·-· ••"••••~u ___ ~··-·"····-- Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection Date Start Date Status -··-~·••~···•·~"••----·-·-·-~-·•g--------··---~-------·· -·-·--··-·-·- 12104/2020 12104/2020 BLDG-23 145501-2020 Passed Peter Dreibelbis Complete Gas/TesURepalrs Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes BLDG-51 145402-2020 Passed Peter Dreibelbis Complete Excav/Steel(Pools) Checklist !tern COMMENTS Passed BLDG-Building Deficiency Gas and electric ug ok Yes 02126/2021 02126/2021 BLDG-54 Equipotential 151491-2021 Passed Pau I Burnette Complete Bond(Pools) 03/16/2021 03/16/2021 BLDG-55 1527 43-2021 Failed Paul Burnette Reinspection Incomplete Fence/Prep laster Checklist Item COMMENTS Passed BLDG-Building Deficiency No 03/18/2021 03/18/2021 BLDG-55 152942-2021 Passed Paul Burnette Complete Fence/Preplaster Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes 09/17/2021 09/17/2021 BLOG-Final Inspection 166664-2021 Passed Peter Dreibelbis Complete Checklist Item COMMENTS Passed BLDG-Building Deficiency No BLDG-Plumbing Final No BLDG-Mechanical Final No BLDG-Structural Final No BLDG-Electrical Final No Friday, September 17, 2021 Page 1 of 1 STORM WATER POLLUTION PREVENTION NOTES 1. ALL NECESSARY EOU!PMENT AND MATERIALS 9-IALL B£ AVAILABLE ON SITE TO FACILITATE RAPID !NSTAL.LA110N OF EROSION ANO SEDII.IENT CONTROL BMPs WHEN RAIN 1S EMINENT. 2. lHE 0"M-IER/COflRACTOR SHALL RESTORE ALL EROSION CONTROL DEVICES TO WORKING ORDER TO THE SATISFACTION OF THE QTY INSPECTOR AFTER EACH RUN-OFf PRODUCING RAINFALL 3. lHE OYINER/CONTRACTOR SHALL INSTALL ADDITIONAL EROSION CONTROL MEASURES AS MAY BE R£QUIRED BY THE OTY INSPECTOR DUE TO INCOMPLETE GRADING OPERATIONS OR UNFORESEEN CIRCUMSTANCES WHICH MAY ARISE. 4. All REMOVABlf PROTECTIVE DEvlCES SHALL BE IN PLACE AT THE END OF EAQ-1 WORKING DAY ~EN THE FIi/£ (5) DAY RAIN PROBABILITY FORECAST EXCEEDS FORTY PECENT ( 40,:}. Sil T AND OTHER DEBRIS SHALL BE REMOVED AFlER EACH RAINFALL. 5. ALL GRAv£1.. BAGS SHALL CONTAIN 3/4 INCH MINIMUM AGGREGATE. 6. AD£QUATE EROSION AND SEDIMENT CONTROL AND PERIMETER PROTECTION BEST MANAGEMENT PRACTICE MEASURES MUST BE INST All£0 AND MAINTAINED. 7. lHE QTY INSPECTOR SHALL HAVE THE AUTHORITY TO ALTER THJS PLAN DURING OR BEFORE CONSlRUCTION AS NEEDED TO ENSURE COMPLIANCE 'NITH CITY STORM WATER QUALITY REGULATIONS. OWNER'S CERTIFICATE: I UNDERSTAND AND ACKN01M...fDCl: 1HAT I MUST: (1) l~LEMENT BEST MANAGEMENT PRACTICES (BMPS) DURING CONS"IRUCTION ACTIVITIES TO TH[ MAXIMUM EXTENT PRACTICABLE TO AVOID TI-I[ MOBILIZATION ~ POLLUTANTS SUQ-1 AS SEDIMENT AND TO AVOID lHE EXPOSURE Of STOOM WATER TO CONS"IRUCTION RELATED POLLUTANTS; ANO (2) ADHERE TO, ANO AT -'LI. TIMES, COMPLY WITH ll·HS an APPROVED TIER 1 CONSTRUCTION S"IA'P THROUGHOUT THE OURATIOO OF THE CONSTRUCTION ACTMTIES UNTIL rnE CONSTRUCTION WORK IS COMPLETE ANO APPROVED 1 BY TH.L-QTY OF CARLSBAf} ( I CA.V'-L#.tAf((J ...,_ STORM WATER COMPLIANCE FORM TIER 1 CONSTRUCTION SWPPP E-29 CB R1o2o-2.4lf3 SW BEST MANAGEMENT PRACTICES (BMP) SELECTION TABLE E'OSio~ Conlrd Sedill'en! Como! BMPs Tr,tcldng No'l-5:orm Watc1 Waste Managerle!ll aid Materials '"" Cor:trol BMPs Mamge!renl BV:,s Pok.1ion Conlrcl BMPs u .Q ~ 2 1; u • . • 1i ~ ~ l g_ • u 0 j ~ 0 2 U• j ~ -~ ;; " ;s s I ~ 6 B g. .5 " .. • J; ~ .§ Best Management Practice" .. t fil~ . ~~ ~ .i.: •• l: • 0 ,= ~.§' u 10 ~5 (BMP) Description -') • ·5 j ~ ~ g' ID ~ s •• Uo /; ·~ ~ =: 1 ~ ~8 i5 .f I, m ~-i g' O:;:; ., ~-08 !g . ]f ~ l ~E ~il ~~ ~-~ ;o 8, -g :ei . ~ • • ! a 4J g~ :,;,:, ~g ·~i i ~-:g g l, ~ Ji ~ ~ i g' 2 g i~ '6.1 ~ ~,5 '" ti VJ~ ~ ind: id: ~&i ~~ ~ ~~ ~o ~ s ~ ~u CASQA Desigllaoofl ➔ ~ ro ~ ' ~ v ~ ~ ~ ro 0 N ' ~ ~ ro ' N ~ v ~ ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' tl 0 u u m m ~ ~ ~ m m m I" ~ ~ ~ ~ ~ l! l! l! 'i' a! Conslructior AciMcy w w w ~ z z z z Grodn<1/Soil Oisturb<Ylce Trenchrl xcovotion St illnn Orilran "" Concrete/Aspholt Sawcuttinn Concrete Flot'#Ofk Po'oino Cooduil/Pioe Installation Stuccoruortor Work Woste Di,....osol Stooi'l av Down Area Eo.Ji I Maintenance O"ld Fuelinn Hazcrdous Subs\Of"I~ Use/Slorooe Dewoterino Slle Access Across Dirt Other flistl: lnstroctions: I. Check the box to the left of oll opplicoble construction oclivity (first column) e~pected to occur during construction. 2. Localed along the top of the BMP Tcble is o list of BMP's with it's corresponding Colifomio Stormwoter-Quality Association (O.SQA) designation number. Choose Ofle or mere St.f's you intend to use during construdiOl'l from the list. Check the box 11here the chosen octivily row intersects with the BMP coh;mn. 3 Refer to the CASOA constructioo hmdbool-: for Hlformatioo and details of the chosen BMPs md how to apply them to the project. i ;o' ~E u• 2[ oo z~ ~ ' i SHOW THELOCAT/ONS OF ALL CHOSEN BMPs ABOVE ON THE PROJECTS SITE PLAN/EROSION CONTROL PLAN. SEE THE REVERSE SIDE OF THIS SHEET FOR A SAMPLE EROSION CONTROL PLAN. PROJECT "FORMATIO, , . '/" j( (-\-2.. 3 "/C ,,....,, v~ s;1, "''= I , Z 5-"/ /) o q Ct Assessor's Pcrcel Number: -BMP's are subject to field inspection- Emergeocy Contact: '3(,v,,.. LtiW"iP""'.e'"'[ N~, .j)••1-16t.•<.1.']4. 24 Hour Ph011e:_,a~,).....,._~~--- ~ ii ~, oO §§ oS ~ ' l! r; /7 o lz,.o ~ Construction Threat to Storm Water-Quolity (Checi< Box) ~ MEDIUM O LOW Page 1 of 1 REV 02/16 (.__ City of Carlsbad DETERMINATION OF PROJECT'S SWPPP TIER LEVEL AND CONSTRUCTION THREAT LEVEL E-32 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov I'm applying for: □ Grading Permit Project Name: ~-.:kf\'(l D Address:2310 ll~•t-k c,r: Building Permit Right-of-way permit □ Other Project ID: ~-~~-DWG #/CB# _____ _ APN /(, 7£ 1foo 10<) Disturbed Area: -----'Ac Section 1: Determination of Project's SWPPP Tier Level SWPPP (Check annlicable criteria and circle the corresoondina SWPPP Tier Level, then ao to section 21 Tier Level Exemgt -No Threat Project Assessment Criteria My project is in a category of permit types exempt from City Construction SW PPP requirements. Provided no significant grading proposed, pursuant to Table1, section 3.2.2 of Storm Water Standards, the followino .. permits are exemnt from SW PPP renuirement.~.: Exempt ► Electrical ► Patio ► Mobile Home ► Plumbing ,. Spa (Factory-Made) ,, Fire Sprinkler ► Mechanical .,.. Re-Roofing ,. Sign ), Roof-Mounted Solar Array .... Tier 3-Significant Threat Assessment Criteria (See Construction General Permit (CGP) Section I.B)* 0 My project includes construction or demolition activity that results in a land disturbance of equal to or greater than one acre including but not limited to clearing, grading, grubbing or excavation; or, 0 My project includes construction activity that results in land disturbance of less than one acre but the construction activity is part of a larger common plan of development or the sale of one or more acres of disturbed land surface or, 0 My Project is associated with construction activity related to residential, commercial, or industrial Tier 3 development on lands currently used for agriculture; or 0 My project is associated with construction activity associated with Linear Underground/overhead Projects (LUP) including but not limited to those activities necessary for installation of underground and overhead linear facilities (e.g. conduits, substructures, pipelines, towers, poles, cables, wire, towers, poles, cables, wires, connectors, switching, regulating and transforming equipment and associated ancillary facilities) and include but not limited to underground utility mark out, potholing, concrete and asphalt cutting and removal, trenching. excavation, boring and drilling, access road. tower footings/foundation, pavement repair or replacement, stockpile/borrow locations. 0 Other per CGP Tier 2-Moderate Threat Assessment Criteria: My project does not meet any of the Significant Threat Assessment Criteria described above and meets one or more of the following criteria: 0 Project requires a grading plan pursuant to the Carlsbad Grading Ordinance (Chapter 15.16 of the Carlsbad Municipal Code); or, 0 Project will 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 and project meets one or more of the additional following criteria: Tier 2 • 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 storm 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 throuah Aor. 30). Tier 1-Low Threat Assessment Criteria J\. My project does not meet any of the Significant or Moderate Threat criteria above, is not an exempt permit type per above and the project meets one or more of the following criteria: Tier 1 • results in some soil disturbance; and/or • includes outdoor construction activities (such as roof framing, saw cutting, equipment washing, material stockoilina, vehicle fuelina, waste stockoilinn\ • Items listed are excerpt from CGP. CGP governs cntena for tnggers for Tier 3 SW PPP. Developer/owner shall confirm coverage under the current CGP and any amendments, revisions and reissuance thereof. E-32 Page 1 of 2 Rev. 2116116 SWPPP Section 2: Determination of Project's Construction Threat Level Tier (Check applicable criteria under the Tier Level as determined in section 1, circle Construction Level the corresponding Construction Threat Level, then complete the Threat Level signature block below) Exempt -Not Applicable -Exempt Tier 3 -High Construction Threat Assessment Criteria: M~ Project meets one or more of lhe following: □ Project site is 50 acres or more and grading will occur during the rainy season □ Project site is located within the Buena Vista or Agua Hedionda Lagoon watershed, inside or within 200 feet of an environmentally sensitive area (ESA) or discharges directly to an ESA High □ Soil at site is moderately to highly erosive (defined as having a predominance of soils Tier3 with USDA-NRCS Erosion factors kf greater than or equal to 0.4) □ Site slope is 5 to 1 or steeper □ Construction is initiated during the rainy season or will extend into the rainy season (Oct. 1 -April 30). □ Owner/contractor received a Storm Water Notice of Violation within past two years Tier 3 -Medium Construction Threat Assessment Criteria Medium □ All projects not meeting Tier 3 High Construction Threat Assessment Criteria Tier 2 -High Con§truction Threat A§sessm!;!nt Criteri~: M~ Proj!;!gt me!;!ts on!! or more of the following: □ Project is located within the Buena Vista or Agua Hedionda Lagoon watershed, inside or within 200 feet of an environmentally sensitive area (ESA) or discharges directly to an ESA □ Soil at site is moderately to highly erosive (defined as having a predominance of soils High with USDA-NRCS Erosion factors k1 greater than or equal to 0.4) Tier2 □ Site slope is 5 to 1 or steeper □ Construction is initiated during the rainy season or will extend into the rainy season (Oct. 1-Apr. 30). □ Owner/contractor received a Storm Water Notice of Violation within past two years □ Site results in 10,000 sq. ft. or more of soil disturbance Tier 2 -Medium Construction Threat Assessment Criteria Medium □ My project does not meet Tier 2 High Threat Assessment Criteria listed above Tier 1 -Medium Construction Threat Assessment Criteria: M~ Project meets one or more of the following: □ Owner/contractor received a Storm Water Notice of Violation within past two years Medium □ Site results in 500 sq. ft. or more of soil disturbance Tier 1 □ Construction will be initiated during the rainy season or will extend into the rainy season (Oct.1-April 30) Tier 1 -Low Construction Threat Assessment Criteria Low □ My project does not meet Tier 1 Medium Threat Assessment Criteria listed above I certify to the best of my knowledge that the above statements are true and correct. I will prepare and submit an appropriate tier level SWPPP as determined above prepared in accordance with the City SWPPP Manual. I understand and acknowledge that I must adhere to and comply with the storm water best management ptaclices pursuant to Title 15 of the Carlsbad Municipal Code and to City Standatds at all times during construction activities for the permit type(s) checked above. The City Engineer/Building Official may authorize minor variances from the Construction Threat Assessment Criteria in special circumstances where it can be shown that a lesser or higher SWPPP Tier Level is warranted. Owner/Owner's Authorized Agent Name: Title: f5/<·J AN f-ts-MPa (Dr,fr uvrh>v-- City Concurrence: Yes No (For City Use Only) Date: 1/tJ/ 2,i>lD By: Dale: Project 10: Page 2 of 2 Rev. 2/16/16