The URL can be used to link to this page

Home My WebLink About2417 MICA RD; ; CBR2023-0296; PermitBuilding Permit Finaled Residential Permit Print Date: 10/17/2023 Job Address: Permit Type: Parcel#: Valuation: Occupancy Group: #of Dwelling Units: Bedrooms: Bathrooms: Occupant Load: Code Edition: Sprinkled: Project Title: 2417 MICA RD, CARLSBAD, CA 92009-1733 BLDG-Residential Work Class: 2132701400 Track#: $18,502.20 Lot#: Project#: Plan#: Construction Type: Orig. Plan Check#: Plan Check#: Description: JONES: NEW POOL/SPA (285 SF) Pool Permit No: Status; Ccityof Carlsbad CBR2023-0296 Closed -Finaled Applied: 01/23/2023 Issued: 04/17/2023 Finaled Close Out: 10/17/2023 Final Inspection: 09/19/2023 INSPECTOR: Alvarado, Tony Applicant: Property Owner: Contractor: BARBIE CROWDER 1137 OAK DR JONES GREGORY SAND KATIE L FAMILY TRUSl SAN DIEGUITO POOL AND SPA CONSTRUCTIOI 11-14-15 LLC VISTA, CA 92084-4660 2417 MICA RD 1106 2ND ST, # STE 364 CARLSBAD, CA 92009-1733 ENCINITAS, CA 92024-5096 (760) 801-0055 FEE BUILDING PLAN CHECK BUILDING PLAN REVIEW -MINOR PROJECTS (LDE) BUILDING PLAN REVIEW -MINOR PROJECTS (PLN) SB1473 -GREEN BUILDING STATE STANDARDS FEE STRONG MOTION -RESIDENTIAL (SMIP) SWIMMING POOL-RESIDENTIAL SWPPP INSPECTION TIER 1-Medium BLDG SWPPP PLAN REVIEW TIER 1-Medium Total Fees: $1,062.31 Total Payments To Date: $1,062.31 Balance Due: AMOUNT $159.90 $194.00 $98.00 $1.00 $2.41 $246.00 $292.00 $69.00 $0.00 Please take NOTICE that approval of your project includes the 11 lmposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction. 11 You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. lf yot,J 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 ( City of Carlsbad RESIDENTIAL BUILDING PERMIT APPLICATION B-1 Plan Check Est. Value PC Deposit Date Job Address 2417 Mica Road Carlsbad CA 92009 Unit: _____ APN: 2132701400 CT /Project #: ___________________ Lot#: 67 Year Built: _2_01_0 ________ _ BRIEF DESCRIPTION OF WORK: New Pool and Spa 0 New SF: Living SF, ____ Deck SF, ___ Patio SF, ____ Garage SF __ _ Is this to create an Accessory Dwelling Unit? O Y O N New Fireplace? O YON, if yes how many? ___ _ D Remodel: _____ .SF of affected area Is the area a conversion or change of use? 0 YO N l;::::J Pool/Spa:._2_85 ____ .SF Additional Gas or Electrical Features? _____________ _ 0Solar:. ___ KW, ___ Modules, Mounted:QRoof QGround, Tilt:() Y() N, RMA: 0 YO N, Battery:OYO N, Panel Upgrade: OYON Electric Meter number: ------------- 0th er: APPLICANT (PRIMARY CONTACT) Name: Barbie Crowder PROPERTY OWNER Name:Jones ---------------------Address: 1137 Oak Dr City: Vista State:_c_A __ Zip: 92084 Phone: 7605215360 Email: barbie.crowder@gmail.com Address: 24 t 7 Mica Rd City: Carlsbad Phone: 9152202175 Email: aleriche30@gmail.com DESIGN PROFESSIONAL CONTRACTOR OF RECORD State:_c_A __ .Zip: 92009 Name: Business Name: San Dieguito Pool Construction ·-------------------Address: Address: 748 s Vinewood st #A City: State: Zip: City: Escondido State: CA Zip:_9_20_2_9 ____ _ ----------------Phone: Phone: 9162202175 Email: Email: a1eriche30@gmaH.com Architect State License: CSLB License#: 578033 Class:._c_-5_3 _____ _ Carlsbad Business License# (Required): BL010935-t2-2021 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. I agree to comply with all City ordinances and State lows relating to building construction. NAME (PRINT): _M_ik_e_M_ed_u_ll_a ____ _ SIGN: /vi ike, /vi ed«llcv DATE: 01/23/2023 1635 Faraday Ave Carlsbad, CA 92008 Ph: 442-339-2719 Email: Building@rnrLsbadca.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 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 (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- (!I I 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;n_•'-"-'-"'-"'-"-'"-'-'-------------------·• Policy No. 9458002661 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 CERT/FICA T/ON: 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 e)(istence at the time of their construction, unless otherwise noted. NAME (PRINT): Mike Medulla SIGNATURE: 1',fike, 1',fedull.,a, DATE: 1/23/2023 ------------Note: If the person signing above is an authorized agent for the contra t id I tt r of authorization on contractor letterhead. -OR- (OPTION B): OWNER-BUILDER DECLARATION: I hereby affirm thot I am exempt from Contractor's License Law for the following reason: D I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale {Sec. 7044, Business and Professions Code: The Contractor's license Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). -OR- D 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-O I 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 personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally sell a structure that I have built 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 7044of the Business and Prof essians Code, is available upon request when this application is submitted orat the following Web site: http://www.leginfo.ca.govlcalaw.html. OWNER CERTIFICATION: The applicant certifies that all documents and plans clearly and accurately show all e)(iSting 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 e)(istlng detail w1thln 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 e)(iSting 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 e)(isting on the property were completed in accordance with all regulations in e)(istence at the time of their construction, unless otherwise noted NAME (PRINT): SIGN: owner. 1635 Faraday Ave Carlsbad, CA 92008 Ph: 442-339-2719 Email: Building@carlsbadca.gov 2 REV. 04/22 Building Permit Inspection History Finaled ' Gityof Carlsbad PERMIT INSPECTION HISTORY for (CBR2023-0296) Permit Type: BLDG-Residential Application Date: 01/23/2023 Owner: TRUST JONES GREGORY SAND KATIE L FAMILY TRUST 11-14-15 Work Class: Pool Issue Date: 04/17/2023 Subdivision: Status: Closed -Finaled Expiration Date: 02/27/2024 Address: 2417 MICA RD IVR Number: 46076 CARLSBAD, CA 92009-1733 Scheduled Actual Inspection Type Inspection No, Inspection Primary Inspector Reinspection Inspection Date Start Date Status 06/06/2023 06/06/2023 BLDG-51 213240-2023 Passed Tony Alvarado Tuesday, October 17, 2023 Excav/Steel(Pools) Checklist Item BLDG-Building Deficiency NOTES Created By Angie Teanio COMMENTS 1. Swimming pool and spa steel reinforcement for engineer plants, electrical conduit, gas plumbing line under test, pool plumbing lines under test, preconstruction meeting requirements, SWPPPS -approved. TEXT 916-220-2175 Alex BLDG-52 Pool Plumbing 213242-2023 Passed Tony Alvarado Checklist Item BLOG-Building Deficiency NOTES Created By Angie Teanio COMMENTS 1. Swimming pool and spa steel reinforcement for engineer plants, electrical conduit, gas plumbing line under test, pool plumbing lines under test, preconstruction meeting requirements, SWPPPS -approved. TEXT 916-220-2175 Alex BLDG-53 Elec/Condull/Wirlng(Po ols) 213241-2023 Passed Tony Alvarado Checklist Item BLOG-Building Deficiency NOTES Created By Angie Teanio COMMENTS 1. Swimming pool and spa steel reinforcement for engineer plants, electrical conduit. gas plumbing line under test, pool plumbing lines under test, preconstruction meeting requirements, SWPPPS -approved. TEXT 916-220-2175 Alex BLDG-54 Equipotential 213511-2023 Partial Pass Tony Alvarado Bond(Pools} Passed Yes Created Date 06105/2023 Passed Yes Created Date 06105/2023 Passed Yes Created Date 06105/2023 Complete Complete Complete Relnspection Incomplete Page 1 of4 PERMIT INSPECTION HISTORY for (CBR2023-0296) Permit Type: BLDG-Residential Application Date: 01/23/2023 Owner: TRUST JONES GREGORY SAND KATIE L FAMILY TRUST 11-14-15 Work Class: Pool Issue Date: 04/17/2023 Subdivision: Status: Closed -Fina led Expiration Date: 02/27/2024 Address: 2417 MICA RD IVR Number: 46076 CARLSBAD, CA 92009-1733 Scheduled Date Actual Inspection Type Start Date Inspection No. Inspection Status Primary Inspector Reinspection Inspection Tuesday, October 17, 2023 Checklist Item BLDG-Building Deficiency COMMENTS 1. Partial pass -echo potential swimming pool and spa ground bond wire, located at four points at perimeter of pool/spa, Bond-ground wire tails verified -partial pass. Swimming pool and spa steel reinforcement for engineer plants, electrical conduit, gas plumbing line under test, pool plumbing lines under test, preconstruction meeting requirements, SWPPPS -approved. BLDG-SW-Inspection Checklist Item 213510-2023 COMMENTS Partial Pass Tony Alvarado Ive inactives slopes properly stabilized? Are areas flatter than 3:1 covered or protected? Are sediment controls properly maintained? Are erosion control BMPs functioning properly? Are natural areas protected from erosion? Is the entrance stabilized to prevent tracking? Have sediments been tracked on to the street? Have materials collected around the storm drains? Has sediment accumulated on impervious surfaces? Are dumpsters and trash receptacles covered? Has trash/debris accumulated throughout the site? Are stockpiles and spoils protected from runoff? Are all storage areas clean and maintained? Were spills/leaks observed during the inspection? Were there any discharges during the inspection? Are BMPs stockpiled for emergency deployment? BLDG-SW-Pre-Con 213243-2023 Passed Tony Alvarado Passed Yes Relnspection Incomplete Passed Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Complete Page 2 of4 I PERMIT INSPECTION HISTORY for (CBR2023-0296) Permit Type: BLDG-Residential Application Date: 01/23/2023 Owner: TRUST JONES GREGORY SAND KATIE L FAMILY TRUST 11-14-15 Work Class: Pool Issue Date: 04/17/2023 Subdivision: Status: Closed -Finaled Expiration Date: 02/27/2024 Address: 2417 MICA RD IVR Number: 46076 CARLSBAD, CA 92009-1733 Scheduled Date Actual Inspection Type Start Date Inspection No. Inspection Primary Inspector Reinspection Inspection Checklist Item BLDG-Building Deficiency NOTES Created By Angie Teanio Status COMMENTS TEXT 916-220-2175 Alex 08/3112023 08/31/2023 BLDG-54 Equipotential 222568-2023 Partial Pass Tony Alvarado Bond(Pools) Checklist Item BLDG-Building Deficiency COMMENTS August 31, 2023: 1. Fence (perimeter, safety, barrier), gates, and gate latches, and all door alarms leading up to swimming pool and spa locations-approved. Pending 2. Equipotential bond wire, required at rear metal glass wall less than 5' feet distance to swimming pool waters edge, needs to be bonded with equipotential ground bond wire. Informed Contractor representative and will verify echo potential, swimming, pool, and spa bond wire, completed at final swimming pool and spa inspection. BLDG-55 Fence/Preplaster 222569-2023 Passed Tony Alvarado Checklist Item COMMENTS BLDG-Building Deficiency 09/1912023 09/1912023 BLDG-Final Inspection 224367-2023 Passed Tony Alvarado Tuesday, October 17, 2023 Checklist Item BLDG-Plumbing Final BLDG-Mechanical Final BLDG-Structural Final BLDG-Electrical Final BLDG-SW-Inspection COMMENTS 224569-2023 Passed Tony Alvarado Passed Yes Created Date 06/05/2023 Reinspection Incomplete Passed Yes Complete Passed Yes Complete Passed Yes Yes Yes Yes Complete Page 3 of 4 PERMIT INSPECTION HISTORY for (CBR2023-0296) Permit Type: BLDG-Residential Application Date: 01/23/2023 Owner: TRUST JONES GREGORY SAND KATIE Work Class: Pool Issue Date: 04/17/2023 Status: Closed -Finaled Expiration Date: 02/27/2024 Scheduled Date IVR Number: Actual Inspection Type Start Date Inspection No. Checklist Item Are inactives slopes properly stabilized? Are areas flatter than 3:1 covered or protected? Are sediment controls properly maintained? Are erosion control BMPs functioning properly? Are natural areas protected from erosion? Is the entrance stabilized to prevent tracking? Have sediments been tracked on to the street? Have materials collected around the storm drains? Has sediment accumulated on impervious surfaces? Are dumpsters and trash receptacles covered? Has trash/debris accumulated throughout the site? Are all storage areas clean and maintained? Were spills/leaks observed during the inspection? Were there any discharges during the inspection? COMMENTS Tuesday, October 17, 2023 46076 Inspection Status L FAMILY TRUST 11-14-15 Subdivision: Address: 2417 MICA RD CARLSBAD, CA 92009-1733 Primary Inspector Reinspection Inspection Passed Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Page 4 of 4 STORM WATER POLLUTION PREVENTION NOTES 1. ALL NECESSARY EQUIPMENT AND MATERIALS 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 INSPECTOR AFTER EACH RUN-OFF PRODUCING RAINFALL. 3. THE OWNER/CONTRACTOR SHALL INSTALL ADDITIONAL EROSION CONTROL MEASURES AS MAY BE REQUIRED BY THE CITY INSPECTOR DUE TO INCOMPLETE 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 PECENT ( 40%). SILT AND OTHER DEBRIS SHALL BE REMOVED AFTER EACH RAINFALL. 5. ALL GRAVEL BAGS SHALL CONTAIN 3/4 INCH MINIMUM AGGREGATE. 6. ADE QUA TE EROSION AND SEDIMENT CONTROL AND PERIMETER PROTECTION BEST MANAGEMENT PRACTICE MEASURES MUST BE INSTALLED AND MAINTAINED. 7. THE CITY INSPECTOR SHALL HAVE THE AUTHORITY TO ALTER THIS PLAN DURING OR BEFORE CONSTRUCTION AS NEEDED TO ENSURE COMPLIANCE WITH CITY STORM WATER QUALITY REGULATIONS. OWNER'S CERTIFICATE: I UNDERSTAND AND ACKNOWLEDGE THAT I MUST: (1) IMPLEMENT BEST MANAGEMENT PRACTICES (BMPS) DURING CONSTRUCTION ACTIVITIES TO THE MAXIMUM EXTENT PRACTICABLE TO AVOID THE MOBILIZATION OF POLLUTANTS SUCH AS SEDIMENT AND TO AVOID 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 CARLSBAD. 13Aur6 ~02-a,,.,Qt:,. °/2- OWNER~~GENT ~~-~?T) OWNER(S)/OWNER'S AGENT NAME (SIGNATURE) 1 r~ 1 /-i--s DATE E-29 STORM WATER COMPLIANCE FORM TIER 1 CONSTRUCTION SWPPP E-29 CB 202-":>-oz._'11,:;> SW -- BEST MANAGEMENT PRACTICES (BMP) SELECTION TABLE Erosion Control Sediment Control BMPs Tracking Non-Storm Water Waste Management and Materials BMPs Control BMPs Management BMPs Pollution Control BMPs C C C -0 -0 0 :;; C C -0 :;; :;; c,, 0 "' -0 "' -0 "' C " " C E C -0 :, :, 0 .5 c,, 0 E C 0 E -~ ~ :;; -0 ·c .9-"' 0 :::;; -0 "' c,, ~ "' --.5. ~ :, '"' c,, c,, Ca, :;; C "' C: "'"' "' 0 <:::._ er ~ 0 C <'<l Oc, a. ·c:. ·c -Cu, C > ~ ~ w "' C 0 Best Management Practice* .5 0 ro ~ 0"' 0 ~ 0 "' > "' ,. "' ,= "' 0 C u "' -i} "' 0 --.c C E u~ "' -0 "' :::;; C a, C (BMP) Description ➔ "' " "'(/) ·a "' c,, "' c,, ro ·5 C c,, C -0 "' D C ~ -"' "' "' ;;:: Cl ::::, "3 ~ Q.) -D 0 ;< C ~ 0 -0 w -0 '"' 0"' CC 0 ~ E :;; c:i " C Cl 0 ro (/) ·-c,, Cl--"''--u"' 0 0 c,, "' "' :::;; Cl c,, C "' Ile E D -NU, ~ D "' o"' 0 ~-;;:: "' X ~ E ~ " Q'l:;::; a, C a. c.. _g "' D E -"' '" -:, .c = Cl) = 3: a; :.,i:J :0 u ·c: ·-"" ·c "" --0 .C C "' " ~ "' :, -0 :0 (1) ·--0 CD ~ D "' -"' -0 D 0 -·-a. 'c "' > ~-.C D -" ·-~ D ·-D "'~ " 0 ~ D -"' 0 ~ " C 0 0 D ~ ~t -.c "' -o -0 2c ·-C "' 0 0 ~ 0 "' .c .c ~ -D D -~ -"" .8 0 DO 0 "' -□-D -Q_ 0 o □ 0 ;;:: WO vi V) (/) u t.: 0 (/) > (/) (/) (L C/l C (/) Ile ;;:: ct (L 0 (L >u :::;; (/) ::,a (/) (/) u (/) ::,a CASQA Designation ➔ r--CX) "' .,., ... "' 0 N "' r--CX) -N .,., ... "' <D r--CX) I I I I I I I I I I I I I I I I I I I I I I I u u u u w w w w w w w w Ile fl= (/) (/) (/) (/) i ::,a ::,a ::,a :::;; Construction Activity w w w w (/) (/) (/) lf) lf) lf) lf) lf) f-z z z z ;;:: ;;:: ;;:: ;;:: X Grading/Soil Disturbance -,,,c..._ >< --::::::a-< ,,.., <rr•nchin""• xcavation) -;,< .'><' rs;;..:, ·~ I~ Stocknilinn Drillinn !Barino Concrete I Asohalt Sawcuttina Concrete Flatwork Pavina Conduit/Pioe Installation Stucco/Mortar Work Waste Disnosal Staainn /Lav Down Area Enuinment Maintenance and Fuelinn Hazardous Substance Use /Storaae Dewaterina Site Access Across Dirt Other !list): Instructions: 1. Check the box to the left of all applicable construction activity (first column) expected to occur during construction. 2. Located along the top of the BMP Table is a list of BMP's with it's corresponding California Stormwater Quality Association (CASQA) designation number. Choose one or more BMPs you intend to use during construction from the list. Check the box where the chosen activity row intersects with the BMP column. 3. Refer to the CASQA construction handbook for information and details of the chosen BMPs and how to apply them to the project. SHOW THE LOCA T/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 INFORMATION Site Address: 24\1 M \Gf\ RoAQ Assessor's Parcel Number: 2 i ~-?.. 71) •-\ 4~0D Emergency Contact: Name: fft;_q Ui€:,\c..t-t:z;: 24 Hour Phone: a.1\p • Z,!,O l175 Construction Threat to Storm Water Quality (Check Box) 0 MEDIUM J2sLOW "' -"' 0 ;;:: -C "'"' " E 0"' ~ c,, OD NC DD :,: ::,a <D I ::,a ;;:: "' -"' o-,<: C "' "'E -"' ~"" U D CC DD u ::,a CX) I ::,a ;;:: ·=------ -~ Page 1 of 1 REV 02/16 Building Permit Finaled Residential Permit Print Date: 10/03/2023 Job Address: 4805 NEBLINA DR, # #2, CARLSBAD, CA 92008-3725 Permit Type: BLDG-Residential Work Class: Second Dwelling Unit Parcel#: 2073502600 Track#: Valuation: $109,215.60 Lot#: Occupancy Group: R-3 Project#: #of Dwelling Units: 1 Plan#: Bedrooms: Bathrooms: Construction Type:V-B Orig. Plan Check #: Occupant Load: Plan Check#: Code Edition: Sprinkled: No Project Title: Description: NUNAN: ATTACHED ADU (560 SF) Applicant: PICASSO ON THE GO RON NUNAN 4805 NEBLINA DR CARLSBAD, CA 92008-3725 (949) 394-7215 FEE BUILDING PLAN CHECK CERTIFICATE OF OCCUPANCY Property Owner: NU NAN FAMILY TRUST 4805 NEBLINA DR CARLSBAD, CA 92008-3725 SB1473 -GREEN BUILDING STATE STANDARDS FEE SFD & DUPLEXES STRONG MOTION -RESIDENTIAL (SMIP) SWPPP INSPECTION TIER 1 -Medium BLDG SWPPP PLAN REVIEW TIER 1-Medium Total Fees: $2,460.35 Total Payments To Date: $2,460.35 Permit No: Status: {'city of Carlsbad CBR2023-1219 Closed -Finaled Applied: 03/13/2023 Issued: 05/16/2023 Finaled Close Out: 10/03/2023 Final Inspection: 09/07/2023 INSPECTOR: Alvarado, Tony Balance Due: AMOUNT $813.15 $16.00 $5.00 $1,251.00 $14.20 $292.00 $69.00 $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 {_ City of Carlsbad RESIDENTIAL BUILDING PERMIT APPLICATION B-1 Plan Check Est. Value PC Deposit Date Job Address __ '.j._i"'-o-'5'--_,J_e..,;;;.:'b_l_, .... ·l'\..,='---0 ...... c ___ unit: ____ ,APN: _________ _ CT/Project #: __________________ ,Lot #: ____ Year Built: _________ _ BRIEF DESCRIPTION oF WORK: fl +-to.. c..-1\ e. 2 ADV o+ 0\-(?P ,o 1-s l,.o s..;;i F-:t- ew SF: Living SF, 5JaO Deck SF, ___ Patio SF, ____ Garage SF __ _ Is this to create an Accessory Dwelling Unit? O Y O N New Fireplace? O YON, if yes how many? ___ _ 0 Remodel: _____ .SF of affected area Is the area a conversion or change of use? O YO N 0 Pool/Spa: _____ .SF Additional Gas or Electrical Features? ____________ _ 0 Solar: ___ KW, ___ Modules, Mounted:QRoof QGround, Tilt: 0 YON, RMA: 0 YO N, Battery:OYO N, Panel Upgrade: CY ON Electric Meter number: ___________ _ Other: APPLICANTjfRIMARY CONTACT) PROPERTY OWNER ~~ Name: ~n /VvAc:...A. Name: __ ..,!•~<~:::::_ _____________ _ Address: ''·U/'0 '5' N~bb ""'-Or Address:. ________________ _ City: ~S~ State: ~ Zip: .-, zPOd"' City:. _________ State:. ___ Zip:. ____ _ Phone: q ':I q -3,i 'f -7 2-1 ':J' Phone: _________________ _ Email: Cao QvQBO ~ 'ije k:JA;iJ,Q?tY)Email: ___________________ _ DESIGN PROFESSIONAL CONTRACTOR OF RECORD Name: Business Name: Address: Address: City: State: Zip: City: State: ___ .Zip: ______ _ Phone: Phone: Email: Email: Architect State License: 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. I agree to comply with all City ordinances and State Jaws relating to building construction. \ /lNAME(PRINT): f2ou f../uow1 'fi1GN: ~~ 1 -----DATE: ,5;-IC,-"2.-•"l-j "'1-'i635 Faraday Ave Carlsbad,CA 92008 Ph: 442-339-2719 Email: Building@carlsbadca.gov REV. 04122 THIS PAGE REQUIRED AT PERMIT ISSUANCE PLAN CHECK NUMBER: C,o '2 Z,:,1.J1:,-1 2. I °I 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 off irm under penal tyof per jury that I am I icensed underprovis ions 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 alsoaffinn under penalty of 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. PoficyNo. -OH.- 01 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 fs issued. My workers' compensation insurance carrier and policy number are: lnsuranceCompany Name: Policy No. Expiration Date: -OR- D Certificate of Exemption: l 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: Fallure 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) Civl! Code). Lender's Name: Lender's Address: CONTRACTOR CERT/FICA TION: The applicant certifies that all documents and plans clearly and accurately show all ellisting and proposed buildings, structures, access roads, and utilities/utility easements. Afl proposed modifications and/or additions are clearly labeled on !he site plan. Any potentially exiSling detail within these plans inconsistent with the site plan are not approved ro, 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/easemellts, and utilities. The existing and proposed use of each buUdlng as stated is true and correct; all easements and other encumbrances to development have been accurdtely shown and labeled as well as all on-site grading/site preparation. All improvements exkting 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 contractor , rovlde a letter of authorization on contractor letterhead. -OR- (OPTION B): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt from Contractor's License Law for the fallowing reason: D I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure Is not intended or offered for sale {Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completlon, the owner-bu!lder will have the burden of proving that he did not build or improve for the purpose of sale). -OR- □ 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) llcensed pursuant to the Contractor's license Law). -Oft-□ I am exempt under Business and Professions Code Division 3, Chapter 9, Article 3 for this reason: AND, ~ORM 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 personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally 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 applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted orat the following Web site: http:/lwww.leginfo.ca.gov/cofaw.html. OWNER CERT/FICA TION: The applicant certifies that all documents and plans clearly and accurately show all eKistlng and proposed buildings, structures, access roads, and utilitles/utl/lty easements. All proposed modifications and/or additions are clearly labeled on the site plan. Any potentially existing detaU wllhln these plans Inconsistent with the slte 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 lhe 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 ;,::~:;•p:::~;:the p,oprr:::•mpl~" :c:•~h all ,eg,latloos ;" e,i,tee:;m, :•I• C•y=::;:•te~ ( ~ -~l, 3 Note: If the erson sl nln above Is an authorized a ent for the ert owner Include form B-62 si ned b ro ert owner. 1635 Faraday Ave Carlsbad, CA 92008 Ph: 442~339-2719 Email: Building@carlsbadca.gov 2 REV. 04/22 {cicyof 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 ta State a/ 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 __ LJ ............ °K~0-.5_._N,,..,eJ,--=c__c__l L..>l 00~___.,D,,__,r--'''-----'&...,·=1_~\J"'-W."""'--'=---=-----''f-'l."-v-'---"---O-'~'------- 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. I. ~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. ~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. II. Ill. IV. V. ~ 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. ~ understand contractors are required by law to be licensed and bonded in California and to list their license n'~mb~rs on permits and contracts. .JJJ:!_1 understand if I 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. 05/22 Owner-Builder Acknowledgement Continued VI. ~I understand if I am considered an "employer" under state and federal law, 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 la%5 _m5v 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 sale1 unless all work is performed • by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of th~o7" is performed under contract with a licensed general building contractor. VIII. ~ 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 c,951!tr1ction 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 l-800-321-CSLB (2752) or www.cslb.ca.gov for more information a9,out ~censed contractors. X. -~--1• am aware of and consent to an Owner-Builder 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: XI. XII. __ agree that, as the party legally and financially responsible for this proposed construction activity, I will abide b~all 8fplicable laws and requirements that govern Owner-Builders as well as employers. ~ 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. Lfcensed 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 all of the information provided on this form and that my responses, including my authority to sign this farm, 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) have waived this right in signing this form without the advice of legal counsel. Property Owner Name (PRINT) Property Owner Signature Date 3 REV.05/22 Building Permit Inspection History Finaled ~ityof Carlsbad PERMIT INSPECTION HISTORY for (CBR2023-1219) Permit Type: BLDG-Residential Work Class: Second Dwelling Unit Application Date: 0311312023 Dwner: TRUST NU NAN FAMILY TRUST Issue Date: 05/16/2023 Subdivision: CARLSBAD TCT#74-19 Status: Closed -Finaled Expiration Date: 01/29/2024 IVR Number: 47378 Scheduled Actual Inspection Type Inspection No. Inspection Date Start Date Status 0611312023 06/13/2023 BLDG-21 214025-2023 Passed Underground/Underflo or Plumbing Checklist Item COMMENTS BLDG-Building Deficiency NOTES Created By TEXT Angie Teanio 949-394-7215 Ron BLDG-SW-Inspection 214202-2023 Partial Pass Tuesday, October 3, 2023 Address: 4805 NEBLINA DR, # #2 CARLSBAD, CA 92008-3725 Primary Inspector Reinspection Tony Alvarado Passed Yes Created Date 06/12/2023 Tony Alvarado Reinspectlon Inspection Complete Incomplete Page 1 of 12 PERMIT INSPECTION HISTORY for (CBR2023-1219) Permit Type: BLDG-Residential Application Date: 03/13/2023 Owner: TRUST NUNAN FAMILY TRUST Work Class: Second Dwelling Unit Issue Date: 05/16/2023 Subdivision: CARLSBAD TCT#74-19 Status: Closed -Finaled Expiration Date: 01/29/2024 Address: 4805 NEBLJNA DR, # #2 IVR Number: 47378 CARLSBAD, CA 92008-3725 Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection Date Start Date Status Checklist Item COMMENTS Passed Are inactives slopes properly Yes stabilized? Are areas flatter than 3:1 Yes covered or protected? Are sediment controls properly Yes maintained? Are erosion control BMPs Yes functioning properly? Are natural areas protected Yes from erosion? Are perimeter control BMPs Yes maintained? Is the entrance stabilized to Yes prevent tracking? Have sediments been tracked Yes on to the street? Have materials collected Yes around the storm drains? Has sediment accumulated on Yes impervious surfaces? Are dumpsters and trash Yes receptacles covered? Has trash/debris accumulated Yes throughout the site? Are stockpiles and spoils Yes protected from runoff? Are all storage areas clean Yes and maintained? Were spills/leaks observed Yes during the inspection? Were there any discharges Yes during the inspection? Are portable restrooms Yes properly positioned? Do portable restrooms have Yes secondary containment? Are BMPs stockpiled for Yes emergency deployment? 06/16/2023 06/16/2023 BLOG-11 214470-2023 Passed Tony Alvarado Complete Foundation/Ftg/Plers (Rebar) Tuesday, October 3, 2023 Page 2 of 12 PERMIT INSPECTION HISTORY for (CBR2023-1219) Permit Type: BLDG-Residential Work Class: Second Dwelling Unit Status: Closed -Finaled Application Date: 03/13/2023 Issue Date: 05/16/2023 Expiration Date: 01/29/2024 IVR Number: 47378 Owner: TRUST NUNAN FAMILY TRUST Subdivision: CARLSBAD TCT#74-19 Address: 4805 NEBLINA DR, # #2 CARLSBAD, CA 92008-3725 Scheduled Date Actual Inspection Type Start Date Inspection No. Inspection Status Primary Inspector Reinspection Inspection Tuesday, October 3, 2023 Checklist Item BLDG-Building Deficiency NOTES Created By Angie T eanio COMMENTS June 16, 2023: 1. Footing foundation steel reinforcement work, per structural plans and detail specifications -approved. 2. Geotechnical/soils engineer-foundation/footing bottoms and concrete slab pad bottoms, probe and tested for soils compaction certification report-verified and approved. 3. Footing foundation; type, size, steel placement for footing foundations and slab reinforcement-verified and approved. 4. Property line and building structure setback surveyor certification letter-prior to pouring footing foundation and pad system-verified and approved. 5. The rest of slab footing foundation steel reinforcement structural system -OK per plan. 6. SWPPPS/BMPS-all soil and erosion control devices and measures, intact/in-place during entire construction process -verified and OK. TEXT 949-394-7215 Ron BLDG-12 Steel/Bond Beam 214469-2023 Passed Tony Alvarado Checklist Item BLDG-Building Deficiency COMMENTS June 16, 2023: 1. Footing foundation steel reinforcement work, per structural plans and detail specifications -approved. 2. Geotechnical/soils engineer-foundation/footing bottoms and concrete slab pad bottoms, probe and tested for soils compaction certification report-verified and approved. 3. Footing foundation; type, size, steel placement for footing foundations and slab reinforcement-verified and approved. 4. Property line and building structure setback surveyor certification letter-prior to pouring footing foundation and pad system-verified and approved. 5. The rest of slab footing foundation steel reinforcement structural system -OK per plan. 6. SWPPPS/BMPS-a\l soil and erosion control devices and measures, intacUin-place during entire construction process -verified and OK. Passed Yes Created Date 06/15/2023 Passed Yes Complete Page 3 of 12 PERMIT INSPECTION HISTORY for (CBR2023-1219) Permit Type: BLDG-Residential Work Class: Second Dwelling Unit Application Date: 03/13/2023 Issue Date: 05/16/2023 Status: Closed -Finaled Expiration Date: 01/29/2024 IVR Number: 47378 Scheduled Actual Inspection Type Inspection No. Inspection Date Start Date Status NOTES Created By TEXT Angie Teanio 949-394-7215 Ron BLDG-SW-Inspection 214551-2023 Partial Pass Checklist Item COMMENTS Are inactives slopes properly stabilized? Are areas flatter than 3:1 covered or protected? Are sediment controls property maintained? Are erosion control BMPs functioning properly? Are natural areas protected from erosion? Are perimeter control BMPs maintained? Is the entrance stabilized to prevent tracking? Have sediments been tracked on to the street? Have materials collected around the storm drains? Has sediment accumulated on impervious surfaces? Are dumpsters and trash receptacles covered? Has trash/debris accumulated throughout the site? Are stockpiles and spoils protected from runoff? Are all storage areas clean and maintained? Were spills/leaks observed during the inspection? Were there any discharges during the inspection? Are portable restrooms properly positioned? Do portable restrooms have secondary containment? Are BMPs stockpiled for emergency deployment? 07/12/2023 07/12/2023 BLDG-15 Roof/ReRoof 217310-2023 Passed (Patio) Checklist Item COMMENTS BLDG-Building Deficiency Tuesday, October 3, 2023 Owner: TRUST NUNAN FAMILY TRUST Subdivision: CARLSBAD TCT#74-19 Address: 4805 NEBLINA DR, # #2 CARLSBAD, CA 92008-3725 Primary Inspector Reinspection Inspection Created Date 06/15/2023 Tony Alvarado Reinspection Incomplete Passed Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Tony Alvarado Complete Passed Yes Page 4 of 12 PERMIT INSPECTION HISTORY for (CBR2023-1219) Permit Type: BLDG-Residential Application Date: 03/13/2023 Owner: TRUST NU NAN FAMILY TRUST Work Class: Second Dwelling Unit Issue Date: 05/16/2023 Subdivision: CARLSBAD TCT#74-19 Status: Closed -Finaled Expiration Date: 01/29/2024 Address: 4805 NEBLINA DR, # #2 IVR Number: 47378 CARLSBAD, CA 92008-3725 Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection Date Start Date Status BLDG-84 Rough 217049-2023 Partial Pass Tony Alvarado Reinspection Incomplete Combo(14,24,34,44) Checklist Item COMMENTS Passed BLDG-14 Yes Frame-Steel-Bolting-Welding (Decks) BLDG-24 Rough-Topout Yes BLDG-34 Rough Electrical Yes BLDG-44 Yes Rough-Ducts-Dampers BLDG-SW-Inspection 217308-2023 Partial Pass Tony Alvarado Reinspectlon Incomplete Tuesday, October 3, 2023 Page 5 of 12 PERMIT INSPECTION HISTORY for (CBR2023-1219) Permit Type: BLDG-Residential Work Class: Second Dwelling Unit Application Date: 03/13/2023 Owner: TRUST NUNAN FAMILY TRUST Issue Date: 05/16/2023 Status: Closed -Finaled Expiration Date: 01/29/2024 Scheduled Date 07/13/2023 IVR Number: Actual Inspection Type Start Date Inspection No. Checklist Item Are inactives slopes properly stabilized? Are areas flatter than 3:1 covered or protected? Are sediment controls properly maintained? Are erosion control BMPs functioning properly? Are natural areas protected from erosion? Are perimeter control BMPs maintained? Is the entrance stabilized to prevent tracking? Have sediments been tracked on to the street? Have materials collected around the storm drains? Has sediment accumulated on impervious surfaces? Are dumpsters and trash receptacles covered? Has trash/debris accumulated throughout the site? Are stockpiles and spoils protected from runoff? Are all storage areas clean and maintained? Were spills/leaks observed during the inspection? Were there any discharges during the inspection? Are portable restrooms properly positioned? Do portable restrooms have secondary containment? Are BMPs stockpiled tor emergency deployment? COMMENTS 07/13/2023 BLDG-84 Rough Combo(14,24,34,44) 217303-2023 Checklist Item BLDG-14 Frame-Steel-Bolting-Welding (Decks) BLDG-24 Rough-Topout BLDG-34 Rough Electrical BLDG-44 Rough-Ducts-Dampers COMMENTS Tuesday, October 3, 2023 47378 Inspection Status Passed Subdivision: CARLSBAD TCT#74-19 Address: 4805 NEBLINA DR, # #2 CARLSBAD, CA 92008-3725 Primary Inspector Reinspection Inspection Tony Alvarado Passed Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Passed Yes Yes Yes Yes Complete Page 6 of 12 PERMIT INSPECTION HISTORY for (CBR2023-1219) Permit Type: BLDG-Residential Work Class: Second Dwelling Unit Status: Scheduled Date Closed -Finaled Actual Inspection Type Start Date Application Date: 03/13/2023 Issue Date: 05/16/2023 Expiration Date: 01/29/2024 IVR Number: Inspection No. 47378 Inspection Status Owner: TRUST NU NAN FAMlL Y TRUST Subdivision: CARLSBAD TCT#74-19 Address: 4805 NEBLINA DR, # #2 CARLSBAD, CA 92008-3725 Primary Inspector Reinspection Inspection BLDG-SW-Inspection Checklist Item 217 480-2023 COMMENTS Partial Pass Tony Alvarado Reinspection Incomplete Passed Tuesday, October 3, 2023 Are inactives slopes properly stabilized? Are areas flatter than 3:1 covered or protected? Are sediment controls properly maintained? Are erosion control BMPs functioning properly? Are natural areas protected from erosion? Ive perimeter control BMPs maintained? Is the entrance stabilized to prevent tracking? Have sediments been tracked on to the street? Have materials collected around the storm drains? Has sediment accumulated on impervious surfaces? Are dumpsters and trash receptacles covered? Has trash/debris accumulated throughout the site? Are stockpiles and spoils protected from runoff? Are all storage areas clean and maintained? Were spills/leaks observed during the inspection? Were there any discharges during the inspection? Are portable restrooms properly positioned? Do portable restrooms have secondary containment? Are BMPs stockpiled for emergency deployment? Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Page 7 of 12 PERMIT INSPECTION HISTORY for (CBR2023-1219) Permit Type: Work Class: Status: Scheduled Date BLDG-Residential Application Date: Second Dwelling Unit Issue Date: Closed -Finaled Expiration Date: IVR Number: Actual Inspection Type Start Date Inspection No. Checklist Item Are inactives slopes properly stabilized? Are areas flatter than 3: 1 covered or protected? Are sediment controls properly maintained? Are erosion control BMPs functioning properly? Are natural areas protected from erosion? Do basins appear to be maintained as required? Are perimeter control BMPs maintained? Is the entrance stabilized to prevent tracking? Have sediments been tracked on to the street? Are storm drain inlets protected and maintained? Have materials collected around the storm drains? Has sediment accumulated on impervious surfaces? Are dumpsters and trash receptacles covered? Has trash/debris accumulated throughout the site? Are stockpiles and spoils protected from runoff? Are all storage areas clean and maintained? Are spill kits provided onsite? Are washout areas maintained and protected? Were spills/leaks observed during the inspection? Were there any discharges during the inspection? Is the SWPPP wall map up to date and accurate? Was the SWPPP or Erosion Control Plan reviewed? Are portable restrooms properly positioned? Do portable restrooms have secondary containment? Are BMPs stockpiled for emergency deployment? COMMENTS Tuesday, October 3, 2023 03/13/2023 05/16/2023 01/29/2024 47378 Inspection Status Owner: TRUST NUNAN FAMILY TRUST Subdivision: CARLSBAD TCT#74-19 Address: 4805 NEBLINA DR, # #2 CARLSBAD, CA 92008-3725 Primary Inspector Reinspection Inspection Passed No No No No No No No No No No No No No No No No No No No No No No No No No Page 8 of 12 PERMIT INSPECTION HISTORY for (CBR2023-1219) Permit Type: BLDG-Residential Work Class: Second Dwelling Unit Application Date: 03/13/2023 Owner: TRUST NUNAN FAMILY TRUST Status: Closed -Finaled Issue Date: 05/16/2023 Subdivision: CARLSBAD TCT#74-19 Expiration Date: 01/29/2024 IVR Number: 47378 Address: 4805 NEBLINA DR, # #2 CARLSBAD, CA 92008-3725 Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection Date Start Date Status 07/25/2023 07/25/2023 BLDG-16 Insulation 218567-2023 COMMENTS Passed Tony Alvarado Tuesday, October 3, 2023 Checklist Item BLDG-Building Deficiency NOTES Created By Angie Teanio July 25, 2023: 1. SWPPPS, & BMPS, and all erosion control measures and devices installed - approved. 2. Two layers of thermal insulation per architectural plans and detail specifications, for closed, roof rafter bays at au. Vaulted ceiling locations 1. One single layer of rigid insulation. 2. Second layer of energy, efficient (typical) fiberglass insulation -approved two layer, thermal energy, efficient, insulation. TEXT 760-580-6656 Carlos BLDG-SW-Inspection 218653-2023 Partial Pass Tony Alvarado Passed Yes Created Dale 07/24/2023 Complete Reinspection Incomplete Page 9 of 12 PERMIT INSPECTION HISTORY for (CBR2023-1219) Permit Type: BLDG-Residential Application Date: 03/13/2023 Owner: TRUST NUNAN FAMILY TRUST Work Class: Second Dwelling Unit Issue Date: 05/16/2023 Subdivision: CARLSBAD TCT#7 4-19 Status: Closed -Frnaled Expiration Date: 01/29/2024 Address: 4805 NEBLINA DR, # #2 IVR Number: 47378 CARLSBAD, CA 92008-3725 Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection Date Start Date Status Checklist Item COMMENTS Passed Are inactives slopes properly Yes stabilized? Are areas flatter than 3: 1 Yes covered or protected? Are sediment controls properly Yes maintained? Are erosion control BMPs Yes functioning properly? Are natural areas protected Yes from erosion? Are perimeter control BMPs Yes maintained? Is the entrance stabilized to Yes prevent tracking? Have sediments been tracked Yes on to the street? Have materials collected Yes around the storm drains? Has sediment accumulated on Yes impervious surfaces? Are dumpsters and trash Yes receptacles covered? Has trash/debris accumulated Yes throughout the site? Are an storage areas clean Yes and maintained? Are spill kits provided onsite? Yes Were there any discharges Yes during the inspection? Are portable restrooms Yes properly positioned? Do portable restrooms have Yes secondary containment? 07/31/2023 07/31/2023 BLDG-17 Interior 219192-2023 Passed Tony Alvarado Complete Lath/Drywall Checklist Item COMMENTS Passed BLDG-Building Deficiency Drywall/gypsum board and hardy backer at Yes wet locations, scope of work -approved. BLDG-SW-Inspection 219194-2023 Partial Pass Tony Alvarado Reinspection Incomplete Tuesday, October 3, 2023 Page 10 of 12 PERMIT INSPECTION HISTORY for (CBR2023-1219) Permit Type: BLDG-Residential Application Date: 03/13/2023 Owner: TRUST NU NAN FAMILY TRUST Work Class: Second Dwelling Unit Issue Date: 05/16/2023 Subdivision: CARLSBAD TCT#74-19 Status: Closed -Finaled Expiration Date: 01/29/2024 Address: 4805 NEBLINA DR, # #2 IVR Number: 47378 CARLSBAD, CA 92008-3725 Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection Date Start Date Status Checklist Item COMMENTS Passed Are inactives slopes properly Yes stabilized? Are areas flatter than 3:1 Yes covered or protected? Are sediment controls properly Yes maintained? Are erosion control BMPs Yes functioning properly? Are natural areas protected Yes from erosion? Are perimeter control BMPs Yes maintained? Is the entrance stabilized to Yes prevent tracking? Have sediments been tracked Yes on to the street? Have materials collected Yes around the storm drains? Has sediment accumulated on Yes impervious surfaces? Are dumpsters and trash Yes receptacles covered? Has trash/debris accumulated Yes throughout the site? Are all storage areas clean Yes and maintained? Are spill kits provided onsite? Yes Were there any discharges Yes during the inspection? Are portable restrooms Yes properly positioned? Do portable restrooms have Yes secondary containment? 08/01/2023 07/31/2023 BLDG-18 Exterior 219096-2023 Passed Tony Alvarado Complete Lath/Drywall Checklist Item COMMENTS Passed BLDG-Building Deficiency Exterior metal, stucco, wire, lathing Yes material, installed and approved. 09/07/2023 09/07/2023 BLDG-Final Inspection 223090-2023 Passed Tony Alvarado Complete Checklist Item COMMENTS Passed BLDG-Plumbing Final Yes BLDG-Mechanical Final Yes BLDG-Structural Final Yes BLDG-Electrical Final Yes Tuesday, October 3, 2023 Page 11 of12 PERMIT INSPECTION HISTORY for (CBR2023-1219) Permit Type: BLDG-Residential Work Class: Second Dwelling Unit Application Date: 03/13/2023 Issue Date: 05/16/2023 Status: Closed -Finaled Expiration Date: 01/29/2024 Scheduled Date IVR Number: Actual Inspection Type Start Date Inspection No. BLDG~SW~lnspection Checklist Item 223310-2023 COMMENTS Are inactives slopes properly stabilized? Are areas flatter than 3:1 covered or protected? Are sediment controls properly maintained? Are erosion control BMPs functioning properly? Are natural areas protected from erosion? Are perimeter control BMPs maintained? Is the entrance stabilized to prevent tracking? Have sediments been tracked on to the street? Have materials collected around the storm drains? Has sediment accumulated on impervious surtaces? Are dumpsters and trash receptacles covered? Has trash/debris accumulated throughout the site? Are stockpiles and spoils protected from runoff? Are all storage areas clean and maintained? Were spills/leaks observed during the inspection? Were there any discharges during the inspection? Are portable restrooms properly positioned? Do portable restrooms have secondary containment? Are BMPs stockpiled for emergency deployment? Tuesday, October 3, 2023 47378 Inspection Status Passed Owner: TRUST NU NAN FAMILY TRUST Subdivision: CARLSBAD TCT#74-19 Address: 4805 NEB LINA DR, # #2 CARLSBAD, CA 92008-3725 Primary Inspector Reinspection Inspection Tony Alvarado Complete Passed Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Page 12 of 12 ( City of Carlsbad CERTIFICATION OF SCHOOL FEES PAID This form must be completed by the City, the applicant, and the appropriate school districts and returned to the City prior to issuing a building permit. The City will not issue any building permit without a completed school fee form. Project# & Name: /0eJ? \, ,-__ A O V Permit #: CBR2023-1219 ------------------ Project Address: 4805 NEBLINA DR #2 Assessor's Parcel #: 2073502600 ------------------ Project Applicant: TRUST NU NAN FAMILY TRUST (Owner Name) Residential Square Feet: New/Additions: .)\o'O 5tf+ Second Dwelling Unit: ------------------ Commercial Square Feet: New/Additions: ------------------- City Certification:City of Carlsbad Building Division Date: 05/16/2023 Certification of ApplicanUOwners. The person executing this declaration ("Owner'') certifies under penalty of perjury that ( 1) the information provided above is correct and true to the best of the Owner's knowledge, and that the Owner will file an amended certification of payment and pay the additional fee if Owner requests an increase in the number of dwelling units or square footage after the building permit is issued or if the initial determination of units or square footage is found to be incorrect, and that (2) the Owner is the owner/developer of the above described project(s), or that the person ~ Carlsbad Unified School District 6225 El Camino Real Carlsbad CA 92009 Phone: (760) 331-5000 D Encinitas Union School District 101 South Rancho Santa Fe Rd Encinitas, CA 92024 Phone: (760) 944-4300 x1166 D San Dieguito Union H.S. District 684 Requeza Dr. Encinitas, CA 92024 Phone: (760) 753-6491 Ext 5514 (By Appt. Only) D San Marcos Unified Sch. District 255 Pico Ave Ste. 100 San Marcos, CA 92069 Phone: (760) 290-2649 Contact: Katherine Marcelja (By Appt.only) D Vista Unified School District 1234 Arcadia Drive Vista CA 92083 Phone: (760) 726-2170 x2222 SCHOOL DISTRICT SCHOOL FEE CERTIFICATION (To be completed by the school district(s)) THIS FORM INDICATES THAT THE SCHOOL DISTRICT REQUIREMENTS FOR THE PROJECT HAVE BEEN OR WILL BE SATISFIED. The undersigned, being duly authorized by the applicable School District, certifies that the developer, builder, or owner has satisfied the obligation for school facilities. This is to certify that the applicant listed on page 1 has paid all amounts or completed other applicable school mitigation determined by the School District. The City may issue building permits for this project. Signature of Authorized School District Officia~'---' ~tJ.tujj ~YYlf.11£2) Title: 0.Jfenh--f?rnM/-CARLSBAD UNIFIED SCHOOL DISTRICT Date: S (/tpj~~ Name of School District: 6225 EL CAMINO REAL Phone(1 bD) 3.3)-5l5D0~ CARLSBAD, CA 92009 COMMUNITY DEVELOPMENT -Building Division 1635 Faraday Ave I Carlsbad, CA 92008-7314 I 442-339-2719 I 760-602-8560 f I building@carlsbadca.gov I www.carlsbadca.gov SAN DIEGO REG I ONAL OFFICE USE ONLY HAZARDOUS MATERIALS Project Address (include suite) '-f Pos e,j:, k Mailing Address (include suite) Project Contact QUESTIONNAIRE r . Business Contact City 6'.r \, ') 'oc..J\. City Applicant E-mail r applicant must contact the Fire Protection Agency with jurisdiction prior to plan submittal. RECORD ID# PLAN CHECK# Telephone# State LA. State Telephone# .:,, t~ Occupancy Rating: Facility's Square Footage (including proposed project): 1. Explosive or Blasting Agents 5. Organic Peroxides 9. Water Reactives BP DATE 14'1-3 APN# Plan File# tena s. 13. Corrosives 2.Jj- -72 . ...IS 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 :::PA"::R:-=Tir=II ·::-· S'f::A'":'N:='Dl"::E'::':G=i'OF::::':C-:f-O-=:U:':-:NTY~:::D:'l'E=:P:tARTfT:::'M7E<::N~T:r:':"O::iFr'2E<::NV'='i<IRt:O:'::N::"Mi:iEEN::::T':::A:EL':-:H::-'E'nAt'lLt'-T:f.H:;:-:-iHio;iAZ~A:::R::-'DOfflU~S;;MeAT:r.E:':::R::il,A::':LS':-:::"Dl:':'Vl:..:;S;.<=I'5:0'::'N~~~: If the answer to any of the questions 1s yes, app ,cant must contact t aunty o an 1ego zar ous atenals iv1s1on, venue, u1te n 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: 1. D Is your business listed on the reverse side of this form? (check all that apply). YES ~NO (for new construction or remodeling projects) 2. D Will your business dispose of Hazardous Substances or Medical Waste in any amount? 3. D ~ Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500 4. 5. 6. 7. 8. D D D D D pounds and/or 200 cubic feet? 2 Will your business store or handle carcinogens/reproductive toxins in any quantity? ;,e-will your business use an existing or install an underground storage tank? ,0-Will your business store or handle Regulated Substances (CalARP)? ,.a-Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)? ...{:t 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). 0 CalARP Exempt I Date lnltials 0 CalARP Required Date lnltials 0 CalARP Complete I Date lnltials PART Ill: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT (APCDl: 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.gov; (858) 586-2650; or 10124 Old Grove Road, San Diego, CA 92131 . YES NO 1. D d Will the project disturb 100 square feet or more of existing building materials? 2. D :,er-Will any load supporting structural members be removed? 3. 0 0 (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 D (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 ,0"' 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 O (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: I dec~n~f p~hat to the best of my knowledge and _be_l_ie_f_t _r_e_sp_o_n_s_e_s_m_a_d_e_he_re_in_a_re_t_rue_a_nd_c_o_r_re_ct. Name of Owner or Authorized Agent Signature of Owner or Authorized Agent Date FOR OFFICAL USE ONLY: FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: _____________________________ _ BY· DATE· I I EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY COUNTY-HMO* APCO COUNTY-HMO APCO COUNTY-HMO APCO .. *A stamp 1n this box ~exempts businesses from completing or updating a Hazardous Materials Business Plan. Other perm1tt1ng requirements may still apply HM-9171 (9/18) County of San Diego -DEH -Hazardous Materials Division C cityof Carlsbad PURPOSE CLIMATE ACTION PLAN CONSISTENCY CHECKLIST 8-50 Development Services Building Division 1635 Faraday Avenue 442-339-2719 www.carlsbadca.gov This checklist is intended to help building permit applicants identify which Climate Action Plan (CAP) ordinance requirements apply to their project. This completed checklist (B-50) must be included with the building permit application. The Carlsbad Municipal Code (CMC) can be referenced during completion of this document by clicking on the provided links to each municipal code section. NOTE: The following type of permits are not required to fill out this form ❖ Patio I ❖ Decks I ❖ PME (w/o panel upgrade) I ❖ Pool Consultation with a certified Energy Consultant is encouraged to assist in filling out this document. Appropriate certification includes, but is not limited to: Licensed, practicing Architect, Engineer, or Contractor familiar with Energy compliance, IECC/HERS Compliance Specialist, ICC GB Energy Code Specialist, RESNET HERS rater certified, certified ICC Residential Energy Inspector/Plans Examiner, ICC Commercial Energy Inspector and/or Plans Examiner, ICC CALgreen Inspector/Plans Examiner, or Green Building Residential Plan Examiner. If an item in the checklist is deemed to be not applicable to a project, or is less than the minimum required by ordinance, check N/A and provide an explanation or code section describing the exception. Details on CAP ordinance requirements are available at each section by clicking on the municipal code link provided. The project plans must show all details as stated in the applicable Carlsbad Municipal Code (CMC) and/or Energy Code and Green Code sections. Project Name/Building Permit No.: Property Address/APN: Applicant Name/Co.: Applicant Address: BP No.: Contact Phone: Contact Email: ro " () v I\..':::::(') () '1 ~ £..ii,o. Cd'.J'Vl Contact information of person completing this checklist (if different than above): Name: Company name/address: Contact Phone: Contact Email: Applicant Signature: __ t__._b-,"---=-.... U-"""C-.....4',_." .... ~-=----"------Date: _______ _ B-50 Page 1 of 7 Revised 05/22 Use the table below to determine which sections of the Ordinance checklist are applicable to your project. For alterations and additions to existing buildings, attach a Permit Valuation breakdown on a separate sheet. Building Permit Valuation (BPV) $ breakdown _______ _ 1 Conatructlon Type □ Residential □ New construction □ Additions and alterations: □ BPV < $60,000 □ BPV 2: $60,000 □ Electrical service panel upgrade only □ BPV 2: $200,000 □ Nonraeldentlal □ New construction □ Alterations: □ BPV 2: $200,000 or additions 2: 1,000 square feet □ BPV 2: $1 ,000,000 □ 2: 2,000 sq. ft. new roof addition Checldlatltltln I Colllpllte Section(•> I NatN: A high-rise residential building is 4 or more stories, including a Low-rise High-rise mixed-use building in which at least 20% of its conditioned floor area is residential use 2A*, 3A*, 18, 28, *Includes detached, newly constructed ADU 4A*, 38, 4A N/A N/A All residential additions and alterations 1A, 4A 4A 1-2 family dwellings and townhouses with attached garages only. *Multi-family dwellings only where interior finishes are removed 1A, 4A* 18, 4A* and significant site work and upgrades to structural and mechanical, electrical, and/or plumbing systems are proposed 18, 28, 38, 48 and 5 I 18, 5 18, 28, 5 Building alterations of 2: 75% existing gross floor area 28, 5 1B also applies if BPV 2: $200,000 OWJdl the appoplala boa, fDIPlan al n«~llld__, lllml, nl plMdl euppcltlngalbMonlanddalunlnlllan• MC I 111 J· 1. Energy Efficiency Please refer to Carlsbad Municipal Code (CMC) 18.21.155 and 18.30.190,and the California Green Building Standards Code (CALGreen) for more infomiation. Appropriate details and notes must be placed on the plans according to selections chosen in the design. A D Residential addition or alteration 2: $60,000 building pennitvaluation. D N/A _________ _ Details of selection chosen below must be placed on the plans referencing CMC □ Exception: Home energy score 2: 7 18.30.190. (attach certification) Year Built Single-family Requirements Multi-family Requirements D Before 1978 Select one option: D Ductsealing D Attic insulation □Cool roof D Attic insulation D 1978 and later Select one option: D Lighting package □ Water heating Package D Between1978and1991 Select one option: D Ductsealing □ Attic insulation □Cool roof D 1992 and later Select one option: D Lighting package □ Water heating package Updated 4/16/2021 3 B. D Nonresidential• new construction or alterations i? $200,000 building permit valuation, or additions.? 1,000square feet SeeCMC 18.21.155and CALGreen Appendix A5 □ NIA AS.203.1.1 Choose one:□. 1 Outdoorlighting □ .2 Restaurant service water heating (CEC 140.5) □ .3Warehousedocksealdoors. □ .4 Daylight design PAFs □ .5 Exhaust air heat recovery □ NIA AS.203.1.2.1 Choose one:□ .95 Energy budget (Projects with indoor lighting OR mechanical) □ .90 Energy budget (ProjectswithindoorlightingANDmechanical) □ NIA AS.211.1 ** □ On-site renewable energy: □ N/A As.211,3•• □ Green power: (If offered by local utility provider, 50% minimum renewable sources) □ NIA AS.212.1 □ Elevators and escalators: (Projectwith more than oneelevatorortwoescalators) □ N/A A5.213.1 D Steel framing: (Provide details on plans for options 1-4 chosen) □ N/A • Includes hotels/motels and high-rise residential buildings .. For alterations;:: $1 ,000,000BPVand affecting> 75% existing gross floor area, OR alterations that add 2, OOOsquarefeetof new roofaddition: comply with CMC 18.30.130 (section 28 below) instead. 2. Photovoltaic Systems A. D Residential new construction (for low-rise residential building permit applications submitted after 1/1/20). Refer to 2019 California Energy Code section 150.1(c)14 for requirements. If project includes installation of an electric heat pump water heater pursuant to CAP section 38 below(low-rise residential Water Heating), increase system size by .3kWdc if PV offset option is selected. Floor Plan ID (use additional CFA #d.u. Calculated kWdc* sheets if necessary) Total System Size: kWdc = (CFAx.572) / 1,000 + (1.15 x #d.u.) •Formula calculation 'Mlere CFA = conditional floor area, #du= number of dwellings per plan type If proposed system size is less than calculated size, please explain. kWdc Exception □ D □ □ B. D Nonresidential new construction or alterations .?$1,000,000 BPV AND affecting .?75% existing floor area, OR addition that increases roof area by .?2,000 square feet Please refer to CMC 18.30.130 when completing this section. •Note: This section also applies to high-rise residential and hotel/motel buildings. Choose one of the following methods: □ Gross Floor Area (GFA)Method GFA: □ If < 1 O,OOOs.f. Enter: 5 kWdc Min. System Size: D If ~ 10,000s.f. calculate: 15 kWdcx (GFN10,000) ** kWdc **Round building size factor to nearest tenth, and round system size to nearest whole number. Updated 4/16/2021 4 □ Time-Dependent Valuation Method Annual TDVEnergy use:*** ______ .x .80= Min. system size: ______ kWdc ***Attach calculation documentation using modeling software approved by the California Energy Commission. 3. Water Heating A D Residential and hotel/motel new construction. Refer to CMC 18.30.170 when completing this section. Provide complete details on the plans. □ For systems serving individual dwelling units choose one system: □ Heat pump water heater AND Compact hot water distribution AND Drain water heat recovery {low-rise residential only) □ Heat pump water heater AND PV system .3 kWdc larger than required in CMC 18.30.130 (high rise residential hotel/motel) or CA Energy Code section 150.1 (c) 14 (low-rise residential) □ Heat pump water heater meeting NEEA Advanced Water Heating Specification Tier 3 or higher □ Solar water heating system that is either .60 solar savings fraction or 40 s.f. solar collectors □ Exception: □ For systems serving multiple dwelling units, install a central water-heating system with ALL of thefollowing: □ Gas or propane water heating system □ Recirculation system per CMC 18.30.150(8) (high-rise residential, hotel/motel) or CMC 18.30.170(8) (low- rise residential) □ Solar water heating system that is either: □ .20 solar savings fraction □ .15 solar savings fraction, plus drain water heat recovery □ Exception: B. D Nonresidential new construction. Refer to CMC 18.30.150 when completing this section. Provide complete details on the plans. □ Water heating system derives at least 40% of its energy from one of the following (attach documentation): □ Solar-thermal D Photovoltaics D Water heating system is (choose one): □ Heat pump water heater D Electric resistance water heater(s) □ Recovered energy □Solar water heating system with .40 solar savings fraction D Exception: It may be necessary to supplement the completed checklist with supporting materials, calculations or certifications, to demonstrate full compliance with CAP ordinance requirements. For example, projects that propose or require a performance approach to comply with energy-related measures will need to attach to this checklist separate calculations and documentation as specified by the ordinances. Updated 4/16/21 5 4. Electric Vehicle Charging A D Residential New construction and major alterations* Please refer to CMC 18.21.140 when completing this section. D One and two-family residential dwelling or townhouse with attached garage: D One EVSE Ready parking space required D Exception : D Multi-family residential· D Exception • Total Parking Spaces EVSE Spaces Proposed EVSE (10% of total) I Installed (50% of EVSE) I Other "Ready" I Other "Capable" I I I Calculations: Total EVSE spaces= .1 Ox Total parking spaces proposed (rounded up to nearestwhole number) EVSE Installed= Total EVSE Spaces x .50 (rounded up to nearest whole number) EVSE other may be "Ready" or "Capable" *Major alterations are: (1 )foroneand two-family dwellings and townhouses with attached garages, alterations have a building permit valuation~$60,000 or indude an electrical service panel upgrade; (2) for multifamily dwellings (three units or more without attached garages), alterations have a building permit valuation~ $200,000, interiorfinishesare removed and significant site work and upgrades to structural and mechanical, electrical, and/or plumbing systems are proposed. *ADU exceptions for EV Ready space (no EV ready space required when): (1) The accessory dwelling unit is located within one-half mile of public transit. (2) The accessory dwelling unit is located within an architecturally and historically significant historic district. (3) The accessory dwelling unit is part of the proposed or existing primary residence or an accessory structure. (4) When on-street parking permits are required but not offered to the occupant of the accessory dwelling unit. (5) When there is a car share vehicle located within one block of the accessory dwelling unit. B. D Nonresidential new construction (includes hotels/motels) D Exception : ____________ _ Please refer to CMC 18.21.150 when completing this section Total Parking Spaces Proposed EVSE (10% of total) I Installed (50% of EVSE) I Other "Ready" I Other "Capable" I I I Calculation: Refer to the table below: Total Number of Parking Spaces provided Number of required EV Spaces Number of required EVSE Installed Spaces □ 0-9 1 1 □ 10-25 2 1 □ 26-50 4 2 □ 51-75 6 3 □ 76-100 9 5 □ 101-150 12 6 □ 151-200 17 9 □ 201 andover 10 percent of total 50 percent of Required EV Spaces Calculations: Total EVSE spaces= .1 Ox Total parking spaces proposed (rounded up to nearestwhole number) EVSE Installed= Total EVSE Spaces x .50 (rounded up to nearest whole number) EVSE other may be "Ready" or "Capable" Updated 4/16/2021 6 5. D Transportation Demand Management (TOM): Nonresidential ONLY An approved Transportation Demand Management (TOM) Plan is required for all nonresidential projects that meet a threshold of employee-generated AOT. City staff will use the table below based on yoursubmitted plans to determinewhetheror noryourpermit requires a TOM plan. lfTOM is applicable to your permit, staff will contact the applicant to develop a site-specific TOM plan based on the permit details. Acknowledgment: Employee ADT Estimation for Various Commercial Uses Office (all)2 20 Restaurant 11 Retai'3 8 Industrial 4 Manufacturing 4 Warehousing 4 1 Unless otherwise noted, rates estimated from /TE Trip Generation Manual, 1()1hEdition 13 11 4.5 3.5 3 1 2 For all office uses, use SANDAG rate of 20 ADT/1,000 sf to calculate employee ADT 3 Retail uses include shopping center, variety store, supermarket, gyms, pharmacy, etc. Other commercial uses may be subject to special consideration sample ca1cu1at1ons· Office: 20,450 sf 1. 20,450 sf/ 1000 x 20 = 409 Employee ADT Retail: 9,334 sf 1. First 1,000 sf= 8 ADT 2. 9,334 sf -1,000 sf= 8,334 sf 3. (8,334 sf/ 1,000 x 4.5) + 8 = 46 Employee ADT I acknov.1edge that the plans submitted may be subject to the City of Carlsbad's Transportation Demand Management Ordinance. I agree to be contacted should my permit require a TOM plan and understand that an approved TOM plan is a condition of perm rt issuance. ApplicantSignature: ~ A,}~ Date: _____ _ Person other than Applicant to be contacted for TDM compliance (if applicable): Name(Printed): Ro 1 Nv ltv"/1 Phone Number: ____ _ Email Address: Co II (\ u :1\,(.... /\ Q l Ii< h IJ() ' Cd,?? Updated 4/16/2021 7