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HomeMy WebLinkAbout2727 ROOSEVELT ST; #A; CBR2022-3718; PermitBuilding Permit Finaled Residential Permit Print Date: 08/03/2023 Job Address: 2727 ROOSEVELT ST, # A, CARLSBAD, CA 92008-1776 Permit Type: Parcel#: Valuation: Occupancy Group: #of Dwelling Units: Bedrooms: BLDG-Residential 2031013400 $11,528.00 Work Class: Track#: Lot#: Project#: Plan#: Construction Type: Alteration Bathrooms: Occupant Load: Orig. Plan Check#: CBR2022-3718 Plan Check#: Code Edition: Sprinkled: Project Title: Description: ADD (8) NEW WINDOWS 2ND FLR RESIDENTIAL UNITS Applicant: Property Owner: CURTIS CLAVE 2727 ROOSEVELT ST, # B CARLSBAD, CA 92008-1695 FABRIC 2727 ROOSEVELT LLC 2659 STATE ST, # 100 CARLSBAD, CA 92008-1627 (619) 840-7721 FEE BUILDING PLAN CHECK BUILDING PLAN REVIEW-MINOR PROJECTS (PLN) SB1473-GREEN BUILDING STATE STANDARDS FEE STRONG MOTION -RESIDENTIAL (SMIP) WINDOWS/DOOR -RESIDENTIAL Total Fees: $649.95 Total Payments To Date: $649.95 Permit No: Status: (city of Carlsbad CBR2022-3718 Closed -Finaled Applied: 10/06/2022 Issued: 02/14/2023 Fina led Close Out: 08/03/2023 Final Inspection: 06/28/2023 INSPECTOR: de Roggenbuke, Dirk Balance Due: AMOUNT $216.45 $98.00 $LOO $1.50 $333.00 $0.00 Please take NOTICE that approval of your project includes the "Imposition" 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 442-339-2719 I 760-602-8560 f I www.carlsbadca.gov { Cicyof Carlsbad RESIDENTIAL BUILDING PERMIT APPLICATION 8-1 Plan Check ________ _ Est. Value PC Deposit Date Job Address i' '7 z '7 Ro osev:•t st Unit:. _____ .APN: zo 5 -lo 1 -1'f-0C, CT/Project #: __________________ Lot #: ____ Year Built: __ I _1_?-'-t _____ _ BRIEF DESCRIPTION OF WORK: □ New SF: Living SF,, ____ Deck SF,, ___ Patio SF,. ____ .Garage SF __ _ Is this to create an Accessory Dwelling Unit? OY ON New Fireplace? OYON,ifyeshowmany? ___ _ D Remodel: SF of affected area Is the area a conversion or change of use? O YO N □ Pool/Spa: ____ SF Additional Gas or Electrical Features? ____________ _ □ Solar:. ___ KW, ___ ,Modules, Mounted:ORoof O Ground, TIit: 0 YON, RMA: 0 YO N, Battery:OYO N, Panel Upgrade: OY ON Electric Meter number: ___________ _ Other: ,4JJif1.i, ,f o•"-" wi~,~ov "/H"•~5r APPLICANT (PRIMARY CONTACT) Name: C vr-\i Cl~v, Roqret elf f'+ Address: 7727 City: c,_riJ i. ,1 Phone: 7bo 0 [3 Email: ?ur+,1 q} State: c,4 '1fo >\ DESIGN PROFESSIONAL Name: {:"U:j ( I ir,.,,!l;Y" Address: ~o,;-hlt~"l:!:1' ~ V :P'!c:£. City: fl ; State: Cl\ Phone: ~Qt; 7~1. b'S'"IJ. Zip: '12,Jo'K Ave- Zip: ~'3QZ.3 PROPERTY OWNER Name: Cv., C/~vf Address: 7-72-7 ,~oLJPc,l-t s+ City: c~r1d,4J state: c,t Zip: ?zocf: Phone: 7b1 h[3 '1bs'\ Email: C(,1,+, f e f~hc-, ( n°vrJ:h:i:,e,,f;r. (Hn CONTRACTOR OF RECORD /cvvn,r b ,u\J,r Business Name: e,; "'<'.Tl J Cfa,u: Address: 27l7 l;',w:,v,/f J-+- City: Ciodih, !:. State: cir Zip: 'lZDOY' Phone: 16 l&'i 40) Email: c,v-\'11 € -t',~bt,l ·•½v:'l:!:O::t~{-,, i'"l Email: '¥'9 6) 19col ,,.,., .,,,-.. "'f, h, cu,,,._ Architect State License: _.,(.....,;3;;.L;;..> ...;'..::b:...{c,_ _____ _ CSLB License #:, ______ Class:. ______ _ Carlsbad Business License# (Required):. _______ _ APPLICANT CERTIFICATION: I certify that I have read the application and state that the above information is correct and that the information of the plans is accurate. J agree to comply with all City ordinances and State laws relating ta building construction. SIGN:~A NAME (PRINT}: _.;:c;..;"''-"r_'h:.;.0,..__.....,._C""'I m ... v;..;<:.,._ __ DATE: 'l../ t'j /'Z J 1635 Faraday Ave Carlsbad, CA 92008 Ph: 442-339-2719 Email: Building@carlsbadca.gov REV 04122 THIS PAGE REQUIRED AT PERMIT ISSUANCE PLAN CHECK NUMBER: ______ _ A BUILDING PERMIT CAN BE ISSUED TO EITHER A STATE LICENSED CONTRACTOR OR A PROPERTY OWNER. IF THE PERSON SIGNING THIS FORM IS AN AGENT FOR EITHER ENTITY AN AUTHORIZATION FORM OR LETTER IS REQUIRED PRIOR TO PERMIT ISSUANCE. (OPTION A): LICENSED CONTRACTOR DECLARATION: I hereby affirm under penalty of per jury that I am I icensed 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 penal tyof perjury one of the following declarations (CHOOSE ONE): 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. _________________________________________ _ -OR- DI have and will maintain worker's 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: ------------------------I Policy No. ___________________________ Expiration Date: ________________ , -OR- D 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 is unlawful and shall subject an employer to criminal penalties 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: ______________________ _ CONTRACTOR CERTIFICATION: The applicant certifies that all documents and plans clearly and accurately show all exlsting and proposed buildings, structures, access roads, and utilities/utility easements. All proposed modifications and/or additions are clearly labeled on the site plan. Any potentially existing detail within these plans inconsistent with the site plan are not approved for construction and may be required to be altered or removed. The city's approval of the application is based on the premise that the submitted documents and plans show the correct dimensions of; the property, buildings, structures and their setbacks from property lines and from one another; access roads/easements, and utilities. The existing and proposed use of each building as stated is true and correct; all easements and other encumbrances to development have been accurately shown and labeled as well as all on-site grading,/site preparation. All improvements existing on the property were completed in accordance with all regulations in existence at the time of their construction, unless otherwise noted. NAME (PRINT): _________ SIGNATURE: _________ DATE: _____ _ Note: If the person signing above is an authorized agent for the contra Id er of authorization on contractor letterhead. -OR- (OPTION B): OWNER-BUILDER DECLARATION: .!)ereby affirm that I am exempt from Contractor's License Law for the following reason: ~ _1, 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). -OR- □1, 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). -OR- DI am exempt under Business and Professions Code Division 3, Chapter 9, Article 3 for this reason: AND, D FORM B-61 "Owner Builder Acknowledgement and Verification Form" is required for any permit issued to a property owner. By my signature below I acknowledge that, except for my persona! residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot lega!ly sell a structure that I have built as an owner-builder if it has not been constructed in its entirety by licensed contractors./ understand that a copy of the app/icabl e law, Section 7044 of the Business and Professions Code, is available upon request when this appl /cation is submitted or at the following Website: http://www.leginfo.ca.govlcalaw.html. OWNER CERTIFICATION: The applicant certifies that all documents and plans clearly and accurately show all existing and proposed buildings, structures, access roads, and utilities/utility easements. All proposed modifications and/or additions are clearly labeled on the site plan. Any potentially existing detail within these plans inconsistent with the site plan are not approved for construction and may be required to be altered or removed. The city's approval of the application is based on the premise that the submitted documents and plans show the correct dimensions of; the property, buildings, structures and their setbacks from property lines and from one another; access roads/easements, and utilities. The existing and proposed use of each building as stated is true and correct; all easements and other encumbrances to development have been accurately shown and labeled as well as all on-site grading/site preparation. All improvements existing on the property were completed in accordance with all regulations in existence at the time of their construction, unless otherwise noted. NAME(PRINT): CV1r+i1 Cl~.r( SIGN: s,f;/)/1/J, DATE: 2-/t~ ('2-':> Note: If the erson si nin above is an authorized a ent for the ro ert owner include form B-62 si ned b owner. 1635 Faraday Ave Carlsbad, CA 92008 Ph: 442-339-2719 Email: Building@carfsbadca.gov 2 REV. 04/22 I. {city of Carlsbad OWNER-BUILDER ACKNOWLEDGEMENT FORM B-61 Development Services Building Division 1635 Faraday Avenue 442-339-2719 www.carlsbadca.gov OWNER-BUILDER ACKNOWLEDGMENT FORM Pursuant to State of California Health and Safety Code Section 19825-19829 To: Property Owner An application for construction permit(s) has been submitted in your name listing you as the owner-builder of the property located at: Site Address _ _.Z:.a.,_7-"2"-'7'-------'--'R"'-o"'r.r'-"e-"-v-"--'--'-(-'-f----'St-:'....'... __ :::_C-"-~'---' l"'-J2.l_,:_•.::.J_---".C1..:Ac__'lce2i!=J_,,_.f _____ _ The City of Carlsbad ("City") is providing you with this Owner-Builder Acknowledgment and Verification form to inform you of the responsibilities and the possible risks associated with typical construction activities issued in your name as the Owner-Builder. The City will not issue a construction permit until you have read and initialed your understanding of each provision in the Property Owner Acknowledgment section below and sign the form. An agent of the owner cannot execute this notice unless you, the property owner, complete the Owner's Authorized Agent form and it is accepted by the City of Carlsbad. INSTRUCTIONS: Please read and initial each statement below to acknowledge your understanding and verification of this information by signature at the bottom of the form. These are very important construction related acknowledgments designed to inform the property owner of his/her obligations related to the requested permit activities. k I understand a frequent practice of unlicensed contractors is to have the property owner obtain an "Owner Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed contractor and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner--Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 11. &, I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed contractor to assume this responsibility. 111. ~I understand as an "Owner·Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own. IV. .,e,t_. I understand contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. V. --t/? I understand if l employ or otherwise engage any persons, other than California licensed contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. 1 REV. 08/20 Owner-Builder Acknowledgement Continued VI. ..t!:!:::.._1 understand if I am considered an "employer" under state and federal law1 I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. VII. & I understand under California Contractors' State License Law, an Owner--Builder who builds single··· family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building contractor. VIII. /4. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) which result from any latent construction defects in the workmanship or materials. IX. ~ I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. X. ~I am aware of and consent to an Owner".Suilder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address: Z..72-7 Ro.reVe/f ,+-c~,/J I,,,( C,tl-q;;,~of" XI. _k1 agree that, as the party legally and financially responsible forth is proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. XII. _A_1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractor's State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner- Builder and wish to hire contractors, you will be responsible for verifying whether or not those contractors are properly licensed and the status of their workers' compensation coverage. Before a building permit can be issued, this form must be completed, signed by the property owner and returned to the City of Carlsbad Building Division. I declare under penalty of perjury that I have read and understand alf of the information provided on this form and that my responses, including my authority to sign this form, is true and correct. I am aware that I have the option to consult with legal counsel prior to signing this form, and I have either (1) consulted with legal counsel prior to signing this form or (2) hove waived this right in signing this form without the advice of legal counsel. Cf r,-rc Property Owner Name (PRINT) U-v;)____u_. "---"------.,1.-, __ ~ty Owner Signature 2 ~1,y23 Date REV.08/20 Building Permit Inspection History Finaled (City of Carlsbad - PERMIT INSPECTION HISTORY for.(CBR.2022-3718) Permit Type: BLDG-Residential Work Class: Alteration Application Date: 10/06/2022 Owner: FABRIC 2727 ROOSEVELT LLC Status: Closed -Finaled Issue Date: 02/14/2023 Subdivision: SEASIDE LANDS Expiration Date: 11/22/2023 IVR Number: 43827 Address: 2727 ROOSEVELT ST, # A CARLSBAD, CA 92008-1776 Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection Date Start Date Status 05/22/2023 05/22/2023 BLDG-14 211682-2023 Passed Dirk de Roggenbuke Frame/Steel/Bolting/We lding (Decks) Checklist Item BLDG-Building Deficiency NOTES Created By Angie Teanio COMMENTS 5/22/23 framing for new windows ok to shear TEXT 760-683-4631 Curtis 05/26/2023 05/26/2023 BLDG-18 Exterior 212296-2023 Passed Dirk de Roggenbuke Lath/Drywall Checklist Item BLDG-Building Deficiency NOTES Created By Angie Teanio COMMENTS TEXT 760-683-4631 Curtis 06/28/2023 06/28/2023 BLDG-Final Inspection 215697-2023 Passed Thursday, August 3, 2023 Checklist Item BLDG-Building Deficiency BLDG-Plumbing Final BLDG-Mechanical Final BLDG-Structural Final BLDG-Electrical Final NOTES Created By Angie Teanio COMMENTS TEXT 760-683-4631 Curtis Dirk de Roggenbuke Passed Yes Created Date 05/19/2023 Passed Yes Created Date 05/25/2023 Passed Yes Yes Yes Yes Yes Created Date 06/27/2023 Complete Complete Complete Page 1 of 1 OFFICE USE ONLY SAN DIEGO REGIONAL HAZARDOUS MATERIALS QUESTIONNAIRE RECORO ID # __________________ I PLAN CHECK # __________________ I Business Name FABRIC 2727 Roosevelt LLC Project Address (include suite) 2727 Roosevelt Mailing Address (include suite) 2659 State Street Project Contact Curtis Clave Business Contact Curtis Clave City Carlsbad State CA Telephone# 7606834631 Zip Code 92008 City Carlsbad State Zip Code CA 92008 Applicant E-mail curtis@fabricinvestments.com Telephone# 7606834631 BP DATE APN# 203-1 01 -34-00 Plan File# The following questions represent the facility's activities, NOT the specific project description. PART I: FIRE DEPARTMENT -HAZARDOUS MATERIALS DIVISION: OCCUPANCY CLASSIFICATION: (not required for projects within the City of San Diego): Indicate by circling the item, whether your business will use, process, or store any of the following hazardous materials. If any of the items are circled, applicant must contact the Fire Protection Agency with jurisdiction prior to plan submittal. Occupancy Rating: Facility's Square Footage (including proposed project): 1. Explosive or Blasting Agents 5. Organic Peroxides 9. Water Reactives 13. Corrosives 2. Compressed Gases 6. Oxidizers 10. Cryogenics 14. Other Health Hazards 3. Flammable/Combustible Liquids 7. Pyrophorics 11. Highly Toxic or Toxic Materials 15. None of These. 4. Flammable Solids 8. Unstable Reactives 12. Radioactives PART II: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH -HAZARDOUS MATERIALS DIVISION (HMO): If the answer to any of the questions is yes, applicant must contact the County of San Diego Hazardous Materials Division, 5500 Overland Avenue, Suite 170, San Diego, CA 92123. Call (858) 505-6700 prior to the issuance of a building permit. FEES ARE REQUIRED Project Completion Date: Expected Date of Occupancy: YES NO □ lli:I (for new construction or remodeling projects) Is your business listed on the reverse side of this form? (check all that apply). Will your business dispose of Hazardous Substances or Medical Waste in any amount? 0 CalARP Exempt I Date Initials 1. 2 3. □ l!SI D IS Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500 pounds and/or 200 cubic feet? 0 CalARP Required I ~ Will your business store or handle carcinogens/reproductive toxins in any quantity? !El" Will your business use an existing or install an underground storage tank? Date Initials 4. 5. 6. 7. 8. □ □ □ □ □ 6g Will your business store or handle Regulated Substances (CalARP)? ~ Will your business use or install a Hazardous Waste Tank System (Title 22, Article 1 0)? 0 CalARP Complete I [gJ Will your business store petroleum in tanks or containers at your facility with a total facility storage capacity equal to or greater than 1,320 gallons? (California's Aboveground Petroleum Storage Act). Date Initials PART Ill: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT (APCD): The following questions are intended to identify the majority of air pollution issues at the planning stage. Your project may require additional measures not identified by these questions. Some residential projects may be exempt from APCD requirements. If yes is answered for either questions 1, 2 or 5 or for more comprehensive requirements, please contact APCD at apcdcomp@sdcounty.ca.qov; (858) 586-2650; or 10124 Old Grove Road. San Diego, CA 92131. YES NO 1. D ~ Will the project disturb 100 square feet or more of existing building materials? 2. D ~ Will any load supporting structural members be removed? 3. D ~ (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been performed by an individual that has passed an EPA-approved building inspector course? 4. D !Kl (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Based on the survey results, will the project disturb any asbestos containing material? If yes, a notification may be required at least 10 working days prior to commencing asbestos removal. Additionally, a notification may be required prior to the removal of a load supporting structural member(s) regardless of the presence of asbestos. 5. D f!{] Will the project or associated construction equipment emit air contaminants? See the reverse side of this form for typical equipment requiring an APCD permit. If yes, contact APCD prior to the issuance of a building permit. 6. D !Kl (ANSWER ONLY IF QUESTION 5 IS YES) Will the project or associated construction equipment be located within 1.000 feet of a school bounda ? Briefly describe business activities: Briefly describe proposed project: ;\J,,,. v r Je r f~-lv"< hn 1~, 1 declare under penalty of pe~ury that to the best of my knowledge and belief ~ade herein are true and correct. Cw-:h> clove ~ Name of Owner or Authorized Agent Signature of Owner or Authorized Agent 'I I l7 I 2l Date FOR OFFICAL USE ONLY: FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: ________________________________ _ I I , EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY COUNTY-HMO~ APCD COUNTY-HMO APCD COUNTY-HMO APCO . A stamp In this box only exempts businesses from completing or updating a Hazardous Materials Business Plan. Other permitting requirements may still apply HM-9171 (9118) County of San Diego -□EH -Hazardous Materials Division { City of Carlsbad STORM WATER STANDARDS QUESTIONNAIRE E-34 Development Services Land Development Engineering 1635 Faraday Avenue 442-339-2750 www.carlsbadca.gov IN m· o , -·i:t-. ~ ? • "_ :v~.\~4· ..:.,· ?P;i~· :/t;1ftLi~1¾;tifJffJlJ. i:·::;_;;:~:·/(f?r 1 , •""'', "l::ifr v-~!'!: , .,:.' 1r1 • __ , -~·-"\ £.&t •;ffe•,k'},h,fy;,,,I•· Y _.t'.c,#r d, ., .• .,. "' 41 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 (BMPs) into the project design per Carlsbad BMP Design Manual (BMP Manual). To view the BMP Manual, refer to the Engineering Standards (Volume 5). 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 PROJECT' requirements, "PRIORITY DEVELOPMENT PROJECT (PDP) requirements or not considered a development project. This questionnaire will also determine if the project is subject to TRASH CAPTURE REQUIREMENTS Your 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 you, 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 you are unsure about the meaning of a question or need help in determining how to respond to one or more of the questions, please seek assistance from Land Development Engineering staff. A completed and signed questionnaire must be submitted with each development project application. Only one completed and signed questionnaire is required when multiple development applications for the same project are submitted concurrent! . • • PROJECT NAME: Beech House APN: 203-101-34-00 ADDRESS: 2727 Roosevelt Street, Carlsbad, Ca 92008 The project is (check one): D New Development IX] Redevelopment The total proposed disturbed area is:~0 ___ ft2 ( 0 ) acres The total proposed newly created and/or replaced impervious area is:~0 ___ ft2 ( 0 ) acres If your project is covered by an approved SWQMP as part of a larger development project, provide the project ID and the SWQMP # of the larger development project: ProjectlD _________________ SWQMP #: __________________ , Then, go to Step 1 and follow the instructions. When completed, sign the form at the end and submit this with your application to the city. This Box for City Use Only YES NO Date: Project ID: City Concurrence: □ □ By: E-34 Page 1 of 4 REV 08122 YES NO Is your project LIMITED TO routine maintenance activity and/or repair/improvements to an existing building or structure that do not alter the size (See Section 1.3 of the BMP Design Manual for guidance)? IXI D If you answered "yes" to the above question, provide justification below then go to Step 6, mark the box stating "my project is not a 'development project' and not subject to the requirements of the BMP manual" and complete applicant information. Justification/discussion: (e.g. the project includes only interior remodels within an existing building): The building improvements only include the addition of new windows. There is no disturbance to the site and there is no additional square footage of building to be added If you answered "no" to the above question, the project is a 'development project', go to Step 2. To determine if your project is exempt from PDP requirements pursuant to MS4 Permit Provision E.3.b.(3), please answer the following questions: Is your project LIMITED to one or more of the following: YES NO 1. Constructing new or retrofitting paved sidewalks, bicycle lanes or trails that meet the following criteria: a) Designed and constructed to direct storm water runoff to adjacent vegetated areas, or other non- erodible permeable areas; OR b) Designed and constructed to be hydraulically disconnected from paved streets or roads; OR c) Designed and constructed with permeable pavements or surfaces in accordance with USEPA Green Streets uidance? 2. Retrofitting or redeveloping existing paved alleys, streets, or roads that are designed and constructed in accordance with the US EPA Green Streets guidance? 3. Ground Mounted Solar Array that meets the criteria provided in section 1.4.2 of the BMP manual? D D D D D D If you answered "yes" to one or more of the above questions, provide discussion/justification below, then go to Step 6, mark the second box stating "my project is EXEMPT from PDP ... " and complete applicant information. Discussion to justify exemption (e.g. the project redeveloping existing road designed and constructed in accordance with the USEPA Green Street guidance): If you answered "no" to the above questions, your project is not exempt from PDP, go to Step 3. E-34 Page 2 of 4 REV 08/22 To determine if your project is a PDP, please answer the following questions (MS4 Permit Provision E.3.b.(1 )): YES NO 1. Is your project a new development that creates 10,000 square feet or more of impervious surfaces collectively over the entire project site? This includes commercial, industrial, residential, mixed-use, and public development projects on public or private land. 2. Is your project a redevelopment project creating and/or replacing 5,000 square feet or more of impervious surface collectively over the entire project site on an existing site of 10,000 square feet or more of impervious surface? This includes commercial, industrial, residential, mixed-use, and public development projects on public or private land. 3. Is your project a new or redevelopment project that creates and/or replaces 5,000 square feet or more of impervious surface collectively over the entire project site and supports a restaurant? A restaurant is a facility that sells prepared foods and drinks for consumption, including stationary lunch counters and refreshment stands selling prepared foods and drinks for immediate consumption (Standard Industrial Classification (SIC) code 5812). 4. Is your project a new or redevelopment project that creates 5,000 square feet or more of impervious surface collectively over the entire project site and supports a hillside development project? A hillside development ro·ect includes develo men! on an natural sic e that is twen -five percent or realer. 5. Is your project a new or redevelopment project that creates and/or replaces 5,000 square feet or more of impervious surface collectively over the entire project site and supports a parking lot? A parking lot is a land area or facility for the temporary parking or storage of motor vehicles used personally for business or for commerce. 6. Is your project a new or redevelopment project that creates and/or replaces 5,000 square feet or more of impervious street, road, highway, freeway or driveway surface collectively over the entire project site? A street, road, highway, freeway or driveway is any paved impervious surface used for the transportation of automobiles, trucks, motorcycles, and other vehicles. 7. Is your project a new or redevelopment project that creates and/or replaces 2,500 square feet or more of impervious surface collectively over the entire site, and discharges directly to an Environmentally Sensitive Area (ESA)? "Discharging Directly to" includes flow that is conveyed overland a distance of 200 feet or less from the project to the ESA, or conveyed in a pipe or open channel any distance as an isolated flow from the project to the ESA (i.e. not commingled with flows from adjacent lands).* 8. Is your project a new development or redevelopment project that creates and/or replaces 5,000 square feet or more of impervious surface that supports an automotive repair shop? An automotive repair shop is a facility that is categorized in any one of the following Standard Industrial Classification (SIC) codes: 5013, 5014, 5541, 7532-7534, or 7536-7539. 9. Is your project a new development or redevelopment project that creates and/or replaces 5,000 square □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ feet or more of impervious area that supports a retail gasoline outlet (RGO)? This category includes □ □ RGO's that meet the following criteria: (a) 5,000 square feet or more or (b) a project Average Daily Traffic (ADT) of 100 or more vehicles per day. 10. Is your project a new or redevelopment project that results in the disturbance of one or more acres of land D D and are expected to generate pollutants post construction? 11. Is your project located within 200 feet of the Pacific Ocean and (1) creates 2,500 square feet or more of impervious surface or (2) increases impervious surface on the property by more than 10%? (CMC D D 21.203.040) If you answered "yes" to one or more of the above questions, your project is a PDP. If your project is a redevelopment project, go to step 4. If your project is a new project, go to step 5, complete the trash capture question. If you answered "no" to all of the above questions, your project is a 'STANDARD PROJECT'. Go to step 5, complete the trash capture question. * 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; Habitat Management Plan; and any other equivalent environmentally sensitive areas which have been identified by the City. E-34 Page 3 of 4 REV 08/22 Does the redevelopment project result in the creation or replacement of impervious surface in an amount of less than 50% of the surface area of the previously existing development? Complete the percent impervious calculation below: Existing impervious area (A) = ____________ sq. ft. Total proposed newly created or replaced impervious area (B) = ___________ sq. ft. Percent impervious area created or replaced (B/A)*100 = _____ % YES NO □ □ If you answered "yes", the structural BMPs required for PDP apply only to the creation or replacement of impervious surface and not the entire development. Go to step 5, complete the trash capture question. If you answered "no," the structural BM P's required for PDP apply to the entire development. Go to step 5, complete the trash capture question. YES NO Is the Project within any of the following Priority Land Use (PLU) categories and not exempt from trash capture requirements per section 4.4.2.2 of the BMP Manual? R-23 (15-23 du/ac), R-30 (23-30 du/ac), Pl (Planned Industrial), CF (Community Facilities), GC (General D D Commercial), L (Local Shopping Center), R (Regional Commercial), V-B (Village-Barrio), VC (Visitor Commercial), 0 (Office), VC/OS (Visitor Commercial/Open Space), Pl/O (Planned Industrial/Office), or Public Transportation Station If you answered "yes", the 'PROJECT' is subject to TRASH CAPTURE REQUIREMENTS. Go to step 6, check the first box stating, "My project is subject to TRASH CAPTURE REQUIREMENTS ... " and the second or third box as determined in step 3. If you answered "no", Go to step 6, check the second or third box as determined in step 3. List exemption if applicable for 'no' answer here: □ My project is subject to TRASH CAPTURE REQUIREMENTS and must comply with TRASH CAPTURE REQUIREMENTS of the BMP Manual. I understand I must prepare a Storm Water Quality Management Plan (SWQMP). □ My project is a 'STANDARD PROJECT' OR EXEMPT from PDP and must only comply with 'STANDARD PROJECT' stormwater requirements of the BMP Manual. I will submit a "Standard Project Requirement Checklist Form E-36''. If my project is subject to TRASH CAPTURE REQUIREMENTS, I will submit a TRASH CAPTURE Storm Water Quality Management Plan (TCSWQMP) per E-35A. □ My project is a PDP and must comply with PDP stormwater requirements of the BMP Manual. I understand I must prepare a Storm Water Quality Management Plan (SWQMP) per E-35 template for submittal at time of application. Note: For projects that are close to meeting the PDP threshold, staff may require detailed impervious area calculations and exhibits to verify if 'STANDARD PROJECT' stormwater requirements apply. 1XJ My project is NOT a 'development project' and is not subject to the requirements of the BMP Manual. Applicant Information and Signature Box Applicant Name: Greg Coleman Applicant Signature: ~ /}.(!_ E-34 Applicant Title: _A_r_c_h_it_e_ct ___________ _ Date: 08/29/22 Page 4 of 4 REV 08/22 Building Permit Finaled (_ City of Carlsbad Revision Permit Print Date: 08/03/2023 Job Address: Permit Type: Parcel#: Valuation: Occupancy Group: #of Dwelling Units: Bedrooms: Bathrooms: Occupant Load: Code Edition: Sprinkled: Project Title: 2727 ROOSEVELT ST, # A, CARLSBAD, CA 92008-1776 BLDG-Permit Revision Work Class: 2031013400 Track#: $11,528.00 Lot#: Project#: Plan#: Construction Type: Orig. Plan Check#: Plan Check#: Permit No: Status: Residential Permit Revision PREV2023-0017 Closed -Finaled Applied: 02/21/2023 Issued: 03/09/2023 Fina led Close Out: 08/03/2023 Final Inspection: INSPECTOR: Description: REVISION TO ADD SIDING OVER STUCCO: //ADD (8) NEW WINDOWS 2ND FLR RESIDENTIAL UNITS Applicant: Property Owner: CURTIS CLAVE FABRIC 2727 ROOSEVELT LLC 2727 ROOSEVELT ST, # B CARLSBAD, CA 92008-1695 FEE BUILDING PLAN CHECK FEE (manual) BUILDING PLAN CHECK REVISION ADMIN FEE 2659 STATE ST, # 100 CARLSBAD, CA 92008-1627 (619) 840-7721 Total Fees: $155.00 Total Payments To Date: Building Division $155.00 Balance Due: 1635 Faraday Avenue, Carlsbad CA 92008-7314 I 442-339-2719 I 760-602-8560 f I www.carlsbadca.gov AMOUNT $120.00 $35.00 $0.00 Page 1 of 1 (city of Carlsbad PLAN CHECK REVISION OR DEFERRED SUBMITTAL APPLICATION Development Services Building Division 1635 Faraday Avenue 442-339-2719 www.carlsbadca.gov B-15 Original Plan Check Number C 13R 2°-z. -z. -371 IS Plan Revision Number PM-Y"Z.0-z._.3 -o o ,, cA 'lieu'!\ CONTACT INFORMATION: Phone 160 6%'3 ~631 City C,,..-1,J.. /\ Zip q 2oo'l Original plans prepared by an architect or engineer, revisions must be signed & stamped by that person. 1. Elements revised: [11 Plans D Calculations D Soils D Energy D Other 2. Describe revisions in detail PREV2023-0017 #A 2727 ROOS0EsYo~~ ~!J sTucco I/ADD (8) NEW REVISION TO AD WINDOWS 2ND FLR RESIDENTIAL UNITS 2031013400 2/21/2023 PREV2023-0017 4. Does this revision, in any way, alter the exterior of the project? 5. Does this revision add ANY new floor area(s)? 6. Does this revision affect any fire re~es? 7. Is this a complete set? D Yes~ ,§'.$'Signature _Jho /h D Yes D Yes IZJ Yes 1K] No gj No Date 3. List page(s) where each revision is shown 0 No 1635 Faraday Avenue, Carlsbad, CA 92008 Ph: 442-339-2719 Fax: 760-602-8558 Email: building@carlsbadca.gov www.carlsbadca.gov