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Home My WebLink About1265 CARLSBAD VILLAGE DR; 210; CB060828; Permit06-14-2006 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Commercial/Industrial Permit Permit No CB060828 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Occupancy Group Project Title 1265 CARLSBAD VILLAGE DR CBAD St 210 Tl Sub Type COMM 1561802100 Lot# $63,741 00 Construction Type Reference # CABRILLO CREDIT UNION-1369 SF SHELL TO CREDIT UNION Applicant BECKY ZONI 4470 CONRAD DR LA MESA CA 91941 619698-6412 0 Status ISSUED V Applied 03/22/2006 Entered By RMA Plan Approved 05/01/2006 Issued 05/01/2006 Inspect Area PC Plan Check# Owner CARLSBAD VILLAGE DRIVE INVESTORS L L C C/O FRANK VIOLI 1241 CARLSBAD VILLAGE DR #100 CARLSBAD CA 92008 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Plan Check Discount Strong Motion Fee Park Fee LFM Fee Bridge Fee BTD #2 Fee BTD #3 Fee Renewal Fee Add'l Renewal Fee Other Building Fee Pot Water Con Fee Meter Size Add'l Pot Water Con Fee Reel Water Con Fee $407 96 Meter Size SO 00 Add'l Reel Water Con Fee $265 17 Meter Fee $0 00 SDCWA Fee SO 00 CFD Payoff Fee $1339 PFF (3105540) SO 00 PFF (4305540) $0 00 License Tax (3104193) $0 00 License Tax (4304193) $0 00 Traffic Impact Fee (3105541) SO 00 Traffic Impact Fee (4305541) $0 00 PLUMBING TOTAL $0 00 ELECTRICAL TOTAL $0 00 MECHANICAL TOTAL $0 00 Master Drainage Fee Sewer Fee $0 00 Redev Parking Fee SO 00 Additional Fees HMP Fee TOTAL PERMIT FEES $000 $000 SO 00 SO 00 $1,16009 $1,07085 $000 $000 $000 SO 00 $000 $3500 $2400 $000 SO 00 $000 $000 9? $2,976 46 Total Fees $2,976 46 Total Payments To Date $2,976 46 Balance Due- BUIL0ING PLANS $000 IN STORAGE ATTACHED Inspector FINAL APPROVAL Date Clearance NOTICE Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as lees/exactions" 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 m 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 vou have oreviouslv been oiven a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired 05-01-2006 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Commercial/Industrial Permit Permit No Building Inspection Request Line (760) 602-2725 CB060828 Job Address Permit Type Parcel No Valuation Occupancy Group Project Title Applicant BECKY ZONI 4470 CONRAD DR LA MESA CA 91941 619698-6412 1265 CARLSBAD VILLAGE DR CBAD St 202 Tl Sub Type COMM 1561802100 Lot# $63,741 00 Construction Type Reference # CABRILLO CREDIT UNION-1369 SF SHELL TO CREDIT UNION 0 Status ISSUED V Applied 03/22/2006 Entered By RMA Plan Approved 05/01/2006 Issued 05/01/2006 Inspect Area Plan Check# Owner CARLSBAD VILLAGE DRIVE INVESTORS L L C C/0 FRANK VIOLI 1241 CARLSBAD VILLAGE DR #100 CARLSBAD CA 92008 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Chec Plan Check DISI Strong Motion F- Park Fee LFMFee Bridge Fee BTD #2 Fee BTD #3 Fee Renewal Fee Add'l Renewal F Other Building F Pot Water Con Meter Size Add'l Pot Water Reel Water Cor $407 96 Meter Size $000 , Add'l Reel Water Con Fee $000 $000 $000 $000 $1,16009 $1,07085 $000 $000 $000 $000 $000 $3500 $2400 $000 $000 $000 $000 99 $2,976 46 Total Fees i uidi raymenis~*i o'uaie "$2;976~46 Balance Due:$0.00 Inspector FINAL APPR0VAL Date Clearance NOTICE Please lake NOTICE/that approval of your project includes the "Impogmon" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions" You have 90 days from the date this permit was issued to protest imposition of these 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 lo attack, review, set aside, void, or annul their imposition You are hereby FURTHER NOTIFIED that your nght 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 qiven a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad CA 92008 0608101-2 0067 03/22/2006 001 11 FOR PLAN CHECK NO EST VAL Plan Ck Deposit Validated By A 8? Address (indude BIdg/Suite #)Business Name (at Ihts address} 2 CONTACT PERSON (if different from applicant) Name Address City State/Zip Telephone # ',3 '_ APPLICANT D Contractor^' ^ D ^Agentjor CgnlraclorlL^ , Ij3~Owner. _ JPftgent for Owner Fax# CONTRACTOR - COMPANY NAME (Sec 7031 5 Business and Professions Code Any City or County which requires a permit to construct alter improve demolish or repair any structure prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor s License Law [Chapter 9 commending with Section 7000 of Division 3 of the Business and Professions Code] or that he is exempt therefrom and the basis for the alleged exemption Any violation of Section 7031 5 by any applicant fora permit subjects the_arpplicant to a civilpenalty of not more than five hundred dollars [$500]) State License #License Class City Add State/Zip City Business License # ^ Telephone # Designer Name •tale License # City State/Zip Telephone # |6 WORKER'S COMPENSATION __ZZ~J Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations D I have and will maintain a certificate of consent to self-insure for workers compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued D I have and will maintain workers compensation, as required by Section 3700 of the labor Code for the performance of the work for which this permit is issued My worker s compensation insurancecarrier and policy number are /i/-7/T^ 1 ** Insurance Company j( /%TC ^yyTZ-^7 Policy No / Z-1 T /fr ^~^c,(^D^ Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) 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 one hundred thousand dollars($100,000), in addjMSnJjXthe cost of compensation, damages are provided for In Section 3706 of the Labor Code, interest and attorney's fees SIGNATURE ^*fa&£&£ {s< ' J-»- ^ DATE_ _^" / - ^-BUILDER DECLARATION ~"_... _. ... .. _ I hereby affirm that I am exempt from the Contractor's License Law for the following reason D I, as owner of the property or my employees with wages as their sole compensation, will d the work and the structure is not intended or offered for sale {Sec 7044 Business and Professions Code The Contractors 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 (or sale If however, the building or improvement is sold within one year of completion the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale) ^l I as owner of the property am exclusively contracting with licensed contractors to construct the project (Sec 7044 Business and Professions Code The Contractor s License Law does not apply to an owner of property who builds or improves thereon and contracts for such projects with contractor(s) licensed pursuant to the Contractor s License Law) 0 \ am exempt under Section Business and Professions Code for this reason 1 I personally plan to provide the major labor and matenals for construction of the proposed property improvement D YES P NO 2 I (have/have not) signed an application for a building permit for the proposed work 3 I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number) 4 I plan to provide portions of the work, but I have hired the following person to coordinate supervise and provide the major work (include name I address / phone number / /ontractors license number) „ 5 I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work) PROPERTY OWNER SIGNATURE DATE WHITE File YELLOW Applicant PINK Finance PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave, Carlsbad CA 92008 Page 2 of 2 Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration for or nsk management and prevention program under Sections 25505 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act' D YES )l( NO Is the applicant or luture building occupant required to oblam a permit from the air pollution control district or air quality management district"? D YES a( NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site9 D YES p( NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT [tr^ONSTR'uCTlON LE NDtNGAGENCY ^"Tll"^ — ~" ~™ __~_~_ _ Z^^^ II~ZI1Z^Z^Z -- ' - - "1 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(1) Civil Code) LENDERS NAME LENDER S ADDRESS APPLICANT CERTIFICATION I certify that ) have read the application and state thai the above information is correct and that the information on the plans is accurate I agree to comply wilh all City ordinances and State laws relating to building construction I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection purposes I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIAB1LFT1ES, JUDGEMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OS HA An OSHA permit is required for excavations of 5 0" deep and demolition or construction of structures over 3 stories in height EXPIRATION Every permit issued by the building Official under the provisions of this Code shall expire by limitation and become null and void rf the building or work authorized by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a penod of 180 days (Section 106 4 4 Uniform Building Code) APPLICANTS SIGNATURE //*t-*££-'€>'^c Is*"^ £>s^/ DATE WHITE File YELLOW Applicant PINK Finance City of Carlsbad Final Building Inspection Dept. Building Engineering Planning CMWD Plan Check # Permit # Project Name Address Contact Person Sewer Dist Inspected ^ BV rr Inspected Bv Inspected Bv CB060828 CABRILLO CREDIT UNION-1369 SF SHELL TO CREDIT UNION 1265 CARLSBAD VILLAGE DR #202 SAM Phone 8586880298 CA Water Dist CA --~~7 Date / /£4/-c-~- Inspected £-//£-/«•/ / Date Inspected Date Inspected St Lite/'EtKMy ((«S?/ Date Permit Type Sub Type Lot 0 'C«* Approved -^ — Approved Approved 06/12/2006 Tl COMM Disapproved Disapproved Disapproved Comments City of Carlsbad Bldg Inspection Request For 06/12/2006 PermiW CB060828 Title CABRILLO CREDIT UNION-1369SF Description SHELL TO CREDIT UNION Inspector Assignment PC 1265 CARLSBAD VILLAGE DR 202 Lot 0 Type Tl Sub Type COMM Job Address Suite Location OWNER CARLSBAD VILLAGE DRIVE INVESTORS L L C Owner CARLSBAD VILLAGE DRIVE INVESTORS L L C Remarks Phone 8586880298 Inspector Total Time CD Description 19 Final Structural 29 Final Plumbing 39 Final Electrical 49 Final Mechanical Requested By SAM Entered By CHRISTINE Act \y NT Comments/Notices/Hold Associated PCRs/CVs Original PC# Inspection History • Date Description Act Insp Comments 05/23/2006 84 Rough Combo 05/04/2006 17 Interior Lath/Drywall 05/02/2006 14 Frame/Steel/Bolting/Weldmg 05/02/2006 24 Rough/Topout 05/02/2006 34 Rough Electric 05/02/2006 44 Rough/Ducts/Dampers AP PC ABV CEILING-FIRE OK AP PC PA PC WALLS AP PC PA PC WALLS PA PC DUCTS IN-OUTLETS NOT CHECK ABV CL EsGil Corporation In (Partnership -with government for <Bui fifing Safety DATE 4/27/06 JURISDICTION City of Carlsbad PLAN CHECK NO 06-0828 SET III PROJECT ADDRESS 1265 Carlsbad Village Dr Suite 202 PROJECT NAME Cabrillo Credit Union - TI Q APPLICANT a JURIS a PLAN REVIEWER Q FILE XI The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck The check list transmitted herewith is for your information The plans are being held at Esgil Corporation until corrected plans are submitted for recheck The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person r The applicant's copy of the check list has been sent to XJ Esgil Corporation staff did not advise the applicant that the plan check has been completed Esgil Corporation staff did advise the applicant that the plan check has been completed Person contacted Telephone # Date contacted (by ) Fax # Mail Telephone Fax In Person REMARKS By Doug Moody Esgil Corporation D GA D MB EH EJ Enclosures PC 4/20/06 trnsmtl dot 9320 Chesapeake Duve Suite 208 * San Diego, California 92123 + (858)560-1468 4> Fax (858) 560-1576 EsGil Corporation In (Partnership with government for <Butttfing Safety DATE 4/18/06 JURISDICTION City of Carlsbad PLAN CHECK NO 06-O828 SET II PROJECT ADDRESS 1265 Carlsbad Village Dr Suite 202 PROJECT NAME Cabrillo Credit Union - TI OAEEUCANT a PLAN REVIEWER a FILE The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck XI The check list transmitted herewith is for your information The plans are being held at Esgil Corporation until corrected plans are submitted for recheck The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person XI The applicant's copy of the check list has been sent to Becky Zoni 4470 Conrad Dr, La Mesa, CA 91941 Esgil Corporation staff did not advise the applicant that the plan check has been completed XI Esgil Corporation staff did advise the applicant that the plan check has been completed Person contacted ,BeckyZoni Telephone # 619-698-6412 Date contacted 4/$/^ (by^W) Fax # 619-741-5098 ^^^ Mail Telephone Fax In Person REMARKS By Doug Moody Esgil Corporation D GA D MB D EJ Enclosures PC 4/11/06 trnsmtldot 9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858) 560-1468 ^ Fax (858) 560-1576 City pf Carlsbad 06-0828 4/18/06 RECHECK PLAN CORRECTION LIST JURISDICTION City of Carlsbad PLAN CHECK NO 06-0828 PROJECT ADDRESS 1265 Carlsbad Village Dr Suite 202 SET II DATE PLAN RECEIVED BY DATE RECHECK COMPLETED ESGIL CORPORATION 4/11/06 4/18/06 REVIEWED BY Doug Moody FOREWORD (PLEASE READ): This plan review is limited to the technical requirements contained in the Uniform Building Code, Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state laws regulating energy conservation, noise attenuation and disabled access This plan review is based on regulations enforced by the Building Department You may have other corrections based on laws and ordinances enforced by the Planning Department, Engineering Department or other departments The following items listed need clarification, modification or change All items must be satisfied before the plans will be in conformance with the cited codes and regulations Per Sec 106 4 3, 1997 Uniform Building Code, the approval of the plans does not permit the violation of any state, county or city law A Please make all corrections on the original tracings and submit two new complete sets of prints to B To facilitate rechecking, please identify, next to each item, the sheet of the plans upon which each correction on this sheet has been made and return this sheet with the revised plans C The following items have not been resolved from the previous plan reviews The original correction number has been given for your reference In case you did not keep a copy of the prior correction list, we have enclosed those pages containing the outstanding corrections Please contact me if you have any questions regarding these items D Please indicate here if any changes have been made to the plans that are not a result of corrections from this list If there are other changes, please briefly describe them and where they are located on the plans Have changes been made not resulting from this list? aYes aNo City of Carlsbad 06-O828 •' 4/18/06 Please make all corrections on the original tracings, as requested in the correction list Submit three sets of plans for commercial/industrial projects (two sets of plans for residential projects) For expeditious processing, corrected sets can be submitted in one of two ways 1 Deliver all corrected sets of plans and calculations/reports directly to the City of Carlsbad Building Department, 1635 Faraday Ave , Carlsbad, CA 92008, (760)602-2700 The City will route the plans to EsGil Corporation and the Carlsbad Planning, Engineering and Fire Departments 2 Bring one corrected set of plans and calculations/reports to EsGil Corporation, 9320 Chesapeake Drive, Suite 208, San Diego, CA 92123, (858)560-1468 Deliver all remaining sets of plans and calculations/reports directly to the City of Carlsbad Building Department for routing to their Planning, Engineering and Fire Departments NOTE Plans that are submitted directly to EsGil Corporation only will not be reviewed by the City Planning, Engineering and Fire Departments until review by EsGil Corporation is complete 8 Provide automatic shut-off controls for lighting as per Title 24, Part 6, Section 131 (d) I was unable to find the building shut off anywhere on the plans? 9 Please have the principle designer complete the LTG-1 -C part 2 of 4 portion of the LTG- 1-C documents The LTG-1-C part 4 of 4 indicates a Lighting control panel that is not shown on the plans and the LTG-1-C part 2 of 4 lighting control portion was not complete. Please correct and complete. 10 Please have the principle designer check the appropriate box(s) in the Statement of Compliance System Acceptance section of the LTG-1-C documents Who will be providing the required LTG-2-A form to the Building Inspector? Please indicate in the LTG-1 -C part 4 of 4 form. To speed up the review process, note on this list (or a copy) where each correction item has been addressed, i e , plan sheet, note or detail number, calculation page, etc Please indicate here if any changes have been made to the plans that are not a result of corrections from this list If there are other changes, please briefly describe them and where they are located in the plans Have changes been made to the plans not resulting from this correction list? Please indicate Yes a No Q The jurisdiction has contracted with Esgil Corporation located at 9320 Chesapeake Drive, Suite 208, San Diego, California 92123, telephone number of 858/560-1468, to perform the plan review for your project If you have any questions regarding these plan review items, please contact Doug Moody at Esgil Corporation Thank you EsGil Corporation In (Partnership -untfi government for (BuiCding Safety DATE 4/3/06 JURISDICTION City of Carlsbad PLAN CHECK NO 06-0828 SET I PROJECT ADDRESS 1265 Carlsbad Village Dr Suite 202 PROJECT NAME Cabrillo Credit Union - TI D APPLICANT a JURIS a PLAN REVIEWER Q FILE The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck XI The check list transmitted herewith is for your information The plans are being held at Esgil Corporation until corrected plans are submitted for recheck The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person XI The applicant's copy of the check list has been sent to Becky Zoni 4470 Conrad Dr, La Mesa, CA 91941 Esgil Corporation staff did not advise the applicant that the plan check has been completed XI Esgil Corporation staff did advise the applicant that the plan check has been completed Person contacted Becky Zoni Telephone # 619-698-6412 Date contacted V3-o\ (by £\} Fax # 619-741-5098 Mail Telephone s^Fax/ (n Person REMARKS M ^ By Doug Moody Esgil Corporationn GA n MB n EJ n PC Enclosures 3/27/06 trnsmtl dot 9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858)560-1468 + Fax (858) 560-1576 City of Carlsbad Q6-0828 4/3/06 PLAN REVIEW CORRECTION LIST TENANT IMPROVEMENTS PLAN CHECK NO 06-0828 OCCUPANCY B TYPE OF CONSTRUCTION V? ALLOWABLE FLOOR AREA SPRINKLERS'? YES REMARKS DATE PLANS RECEIVED BY JURISDICTION 3/22/06 DATE INITIAL PLAN REVIEW COMPLETED 4/3/06 JURISDICTION City of Carlsbad USE Office ACTUAL AREA 1369sf STORIES 2 HEIGHT OCCUPANT LOAD 36 DATE PLANS RECEIVED BY ESGIL CORPORATION 3/27/06 PLAN REVIEWER Doug Moody FOREWORD (PLEASE READ): This plan review is limited to the technical requirements contained in the Uniform Building Code, Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state laws regulating energy conservation, noise attenuation and access for the disabled This plan review is based on regulations enforced by the Building Department You may have other corrections based on laws and ordinances enforced by the Planning Department, Engineering Department, Fire Department or other departments Clearance from those departments may be required prior to the issuance of a building permit Code sections cited are based on the 1997 UBC The following items listed need clarification, modification or change All items must be satisfied before the plans will be in conformance with the cited codes and regulations Per Sec 106 4 3, 1997 Uniform Building Code, the approval of the plans does not permit the violation of any state, county or city law To speed up the recheck process, please note on this list (or a copy) where each correction item has been addressed, i.e., plan sheet number, specification section, etc. Be sure to enclose the marked up list when you submit the revised plans TENANT IMPROVEMENTS WITHOUT SPECIFIC ENERGY DATA OR POLICY SUPPLEMENTS (1997UBC)ttforw dot City of Carlsbad 06-0828 4/3/06 Please make all corrections on the original tracings, as requested in the correction list Submit three sets of plans for commercial/industrial projects (two sets of plans for residential projects) For expeditious processing, corrected sets can be submitted in one of two ways 1 Deliver all corrected sets of plans and calculations/reports directly to the City of Carlsbad Building Department, 1635 Faraday Ave , Carlsbad, CA 92008, (760) 602-2700 The City will route the plans to EsGil Corporation and the Carlsbad Planning, Engineering and Fire Departments 2 Bring one corrected set of plans and calculations/reports to EsGil Corporation, 9320 Chesapeake Drive, Suite 208, San Diego, CA 92123, (858) 560-1468 Deliver all remaining sets of plans and calculations/reports directly to the City of Carlsbad Building Department for routing to their Planning, Eingmeenng and Fire Departments NOTE Plans that are submitted directly to EsGil Corporation only will not be . reviewed by the City Planning, Engineering and Fire Departments until review by EsGil Corporation is complete 1 Each sheet of the plans must be signed by the person responsible for their preparation, even though there are no structural changes Business and Professions Code 2 Provide a statement on the Title Sheet of the plans stating that this project shall comply with the 2001 editions of the California Building/Plumbmg/Mechanical Codes and the 2004 edition of the California Electrical Code, which adopt the 1997 UBC, 2000 UMC, 2000 UPC and the 2002 NEC 3 Glazing in the following locations should be of safety glazing material in accordance with Section 2406 4 a) Fixed or operable panels adjacent to a door where the nearest exposed edge of the glazing is within a 24-inch arc of erther vertical edge of the door in a closed position and where the bottom exposed edge of the glazing is less than 60 inches above the walking surface 4. Note on the plans "All exits are to be openable from inside without the use of a key or special knowledge" In lieu of the above, in a Group B, F, M or S occupancies, you may note "Provide a sign on or near the exit door, reading THIS DOOR TO REMAIN UNLOCKED DURING BUSINESS HOURS " This signage is only allowed at the main exit Section 1003 3 1 8 5 Please note on the plans "AC Cable is not allowed in A, B, E, H, and I occupancies NM cable is restricted (without City approval) to one and two family dwellings Note on plans that an equipment ground conductor is to be installed in all flexible conduits" 6 Please provide an electrical single line diagram Show new or existing distribution equipment, ampere size and AIC rating of distribution equipment, City of Carlsbad 06-0828 4/3/06 feeder over-current devices size and indicate AIC rating, conduit and conductor size and length, sub-service ampere rating 7 Please provide panel schedules, indicate new and existing loads 8 Provide automatic shut-off controls for lighting as per Title 24, Part 6, Section 9 Please have the principle designer complete the LTG-1-C part 2 of 4 portion of the LTG-1-C documents 10 Please have the principle designer check the appropriate box(s) in the Statement of Compliance System Acceptance section of the LTG-1-C documents To speed up the review process, note on this list (or a copy) where each correction item has been addressed, i e , plan sheet, note or detail number, calculation page, etc Please indicate here if any changes have been made to the plans that are not a result of corrections from this list If there are other changes, please briefly describe them and where they are located in the plans Have changes been made to the plans not resulting from this correction list? Please indicate Yes Q No a The jurisdiction has contracted with Esgil Corporation located at 9320 Chesapeake Dnve, Suite 208, San Diego, California 92123, telephone number of 858/560-1468, to perform the plan review for your project If you have any questions regarding these plan review items, please contact Doug Moody at Esgil Corporation Thank you City of Carlsbad O6-0828 4/3/06 VALUATION AND PLAN CHECK FEE JURISDICTION City of Carlsbad PLAN CHECK NO 06-0828 PREPARED BY Doug Moody DATE 4/3/06 BUILDING ADDRESS 1265 Carlsbad Village Dr Suite 202 BUILDING OCCUPANCY B TYPE OF CONSTRUCTION V? BUILDING PORTION Tl Air Conditioning Fire Sprinklers TOTAL VALUE Jurisdiction Code AREA (Sq Ft) 1369 cb Bldg Permit Fee by Ordinance ^ Valuation Multiplier 4656 By Ordinance Reg Mod VALUE ($) 63,741 • 63,741 $398 96 Plan Check Fee by Ordinance Type of Review Repetitive FeeRepeats 0 Complete Review D Other D Hourly Structural Only Hour Esgil Plan Review Fee Comments $259 32 $223 42 Sheet 1 of 1 macvalue doc DATE IU& BUILDING ADDRESS City of Carlsbad Public Works -- Engineering BUILDING PLANCHECK CHECKLIST PLANCHECK NO PROJECT DESCRIPTION ASSESSOR'S PARCEL NUMBER /j'6'EST VALUE ENGINEERING DEPARTMENT APPROVAL DENIAL The item you have submitted for review has been approved The approval is based on plans, information and/or specifications provided in your subrnitta! therefore any changes to these items after this aate, including field modifications, must be reviewed by this office to insure continued conformance with applicable codes Please review carefully all comments attached, as failure to comply with instructions in this report can result in suspension of permit to build U A Right-of-Way permit is required prior to construction of the foffowing improvements Please see the attached report of deficiencies marked with D Make necessary corrections to plans or specifications for compliance with applicable codes and standards Submit corrected plans and/or specifications to this office for review By By By Date Date Date By FOR OFFICIAL USE ONLY AUTHORIZATION TO ISSUE BUILDING PERMg. Date 1 ATTACHMENTS Dedication Application Dedication Checklist Improvement Application Improvement Checklist Neighborhood Impiovement Agreement Grading Permit Application Grading Submittal Checklist Right-of-Way Permit Application Right-of-Way Permit Submittal Checklist and Information Sheet ENGINEERING DEPT CONTACT PERSON Name _ KATHLEEN M. FARMER City of Carlsbad Address 1 635 Faraday Avenue, Carlsbad, CA 92008 Phone (760) 602-2741 __ ^^ ___ CFD INFORMATION Parcel Map No Lots Recordation Carlsbad Tract CA 92OO8-7314 • (76O) 6O2-272O • FAX (760) BUILDING PLANCHECK CHECKLIST SITE PLAN Provide a fully dimensioned site plan drawn to scale Show North Arrow EK Existing & Proposed Structures / G^ /C/Existing Street Improvements /H, / Property Lines (show all dimensions) I. Easements Show on site plan n n Right-of-Way Width & Adjacent Streets Driveway widths Existing or proposed sewer lateral Existing or proposed water service Existing or proposed irrigation service Drainage Patterns 1 Building pad surface drainage must maintain a minimum slope of one percent towards an adjoining street or an approved drainage course 2 ADD THE FOLLOWING NOTE "Finish grade will provide a minimum positive drainage of 2% to swale 5' away from building " B Existing & Proposed Slopes and Topography C Size, type, location, alignment of existing or proposed sewer and water service (s) that serves the project Each unit requires a separate service, however, second dwelling units and apartment complexes are an exception D Sewer and water laterals should not be located within proposed driveways, per standards 3 Include on title sheet A Site address B Assessor's Parcel Number C Legal Description For commercial/industrial buildings and tenant improvement projects, include total building square footage with the square footage for each different use, existing sewer permits showing square footage of different uses (manufacturing, warehouse, office, etc ) previously approved EXISTING PERMIT NUMBER DESCRIPTION Show all existing use of SF and new proposed use of SF. Example: Tenant Improvement for 3500 SF of warehouse to 3500 SF of office. r\Katriy'MASTERS\Buil<iiriQ Plancheck CWst Form (Generic) doc BUILDING PLANCHECK CHECKLIST iST ,ND RD D 3 n DISCRETIONARY APPROVAL COMPLIANCE 4a Project does not comply with the following Engineering Conditions of approval for Project No D C3 D 4b All conditions are in compliance Date DEDICATION REQUIREMENTS D 5 Dedication for all street Rights-of-Way adjacent to the building site and any storm drain or utility easements on the building site is required for all new buifdings and for remodels with a value at or exceeding $ 17.000 . pursuant to Carlsbad Municipal Code Section 18 40 030 Dedication required as follows Dedication required Please have a registered Civil Engineer or Land Surveyor prepare the appropriate legal description together with an 8 Vz x 11" plat map and submit with a title report All easement documents must be approved and signed by owner(s) prior to issuance of Building Permit Attached please find an application form and submittal checklist for the dedication process Submit the completed application form with the required checklist items and fees to the Engineering Department in person Applications will not be accept by mail or fax Dedication completed by Date [HI IMPROVEMENT REQUIREMENTS 6a All needed public improvements upon and adjacent to the building site must be constructed at time of building construction whenever the value of the construction exceeds $ 82.000 . pursuant to Carlsbad Municipal Code Section 1840040 Public improvements required as follows __ ____ Attached please find an application form and submittal checklist for the public improvement requirements A registered Civil Engineer must prepare the appropriate improvement plans and submit them together with the requirements on the attached checklist to the Engineering Department through a separate plan check process The completed application form and the requirements on the F \Farnier\KATHY\MASTERSi8uilding Planchecfc Cklst Form (Generic) doc 1ST D ,ND RD3a BUILDING PLANCHECK CHECKLIST checklist must be submitted in person Applications by mail or fax are not accepted Improvement plans must be approved, appropriate securities posted and fees paid prior to issuance of building permit Improvement Plans signed by Date 6b Construction of the public improvements may be deferred pursuant to Carlsbad Municipal Code Section 1840 Please submit a recent property title report or current grant deed on the property and processing fee of $ 400 00 so we may prepare the necessary Neighborhood Improvement Agreement This agreement must be signed, notarized and approved by the City prior to issuance of a Building permit Future public improvements required as follows D D 6c Enclosed please find your Neighborhood Improvement Agreement Please return agreement signed and notarized to the Engineering Department Neighborhood Improvement Agreement completed by Date D D D 6d No Public Improvements required SPECIAL NOTE Damaged or defective improvements found adiacent to building site must be repaired to the satisfaction of the City Inspector prior to occupancy D D D D GRADING PERMIT REQUIREMENTS The conditions that invoke the need for a grading permit are found in Section 11 06 030 of the Municipal Code 7a Inadequate information available on Site Plan to make a determination on grading requirements Include accurate grading quantities in cubic yards (cut, fiJ! import, export and remedial) This information must be included on the plans. 7b Grading Permit required A separate grading plan prepared by a registered Civil Engineer must be submitted together with the completed application form attached NOTE The Grading Permit must be issued and rough grading approval obtained prior to issuance of a Building Permit Grading Inspector sign off by Date D D 7c Graded Pad Certification required (Note Pad certification may be required even if a grading permit is not required ) F \FarmerTKATHV\MASTERS\Buikling Plancheck CKlst Form (GBnertc) doc ,ND ,RD1ST n n n n n BUILDING PLANCHECK CHECKLIST 7d No Grading Permit required 7e If grading is not required, write "No Grading" on plot plan MISCELLANEOUS PERMITS 8 A RIGHT-OF-WAY PERMIT is required to do work in City Right-of-Way and/or private work adjacent to the public Right-of-Way Types of work include, but are not limited to street improvements, tree trimming, driveway construction, tying into public storm dram, sewer and water utilities Right-of-Way permit required for D D INDUSTRIAL WASTE PERMIT If your facility is located in the City of Carlsbad sewer service area, you need to contact the Carlsbad Municipal Water District, located at 5950 El Cammo Real, Carlsbad, CA 92008 District personnel can provide forms and assistance, and will check to see if your business enterprise is on the EWA Exempt List You may telephone (760) 438-2722, extension 7153, for assistance Industrial Waste permit accepted by Date NPDES PERMIT D n a a a a 10a Storm Water Requirements Applicability Checklist Completed 10b Priority Determination and compliance D Priority Project D Subject to Standard Permanent Storm Water BMP's D Exempt D D 11 D Required fees are attached No fees required WATER METER REVIEW 12a Domestic (potable) Use Ensure that the meter proposed by the owner/developer is not oversized Oversized meters are inaccurate during low-flow conditions If it is oversized, for the life of the meter, the City will not accurately bill the owner for the water used • All single family dwelling units received "standard" 1" service with 5/8" service F f a rmsAKATHYViMSTERS^B ultimo Plancheck Ckbl Form (Generic) doc ,ST n n n 12b BUILDING PLANCHECK CHECKLIST • If owner/developer proposes a size other than the "standard", then owner/developer must provide potable water demand calculations, which include total fixture counts and maximum water demand in gallons per minute (gpm) A typical fixture count and water demand worksheet is attached Once the gpm is provided, check against ,the "meter sizing schedule" to verify the anticipated meter size for the unit • Maximum service and meter size is a 2" service with a 2" meter • If a developer is proposing a meter greater than 2", suggest the installation of multiple 2" services as needed to provide the anticipated demand {manifolds are considered on case by case basis to limit multiple trenching into the street) Irrigation Use (where recycled water is not available) All irrigation meters must be sized via irrigation calculations (in gpm) prior to approval The developer must provide these calculations Please follow these guidelines 1 If the project is a newer development (newer than 1998), check the recent improvement plans and observe if the new irrigation service is reflected on the improvement sheets If so, at the water meter station, the demand in gpm may be listed there Irrigation services are listed with a circled "I", and potable water is typically a circled "W" The irrigation service should look like STA 1+00 Install 2" service and 1 5 meter (estimated 100 gpm) If the improvement plans do not list the irrigation meter and the service/meter will be installed via another instrument such as the building plans or grading plans (w/ a right of way permit of course), then the applicant must provide irrigation calculations for estimated worst-case irrigation demand (largest zone with the farthest reach) Typically, Larry Black has already reviewed this if landscape plans have been prepared, but the applicant must provide the calculations to you for your use Once you have received a good example of irrigation calculations, keep a set for your reference In general the calculations will include. • Hydraulic grade line • Elevation at point of connection (POC) • Pressure at POC in pounds per square inch (PSI) • Worse case zone (largest, farthest away from valve • Total Sprinkler heads listed (with gpm use per head) • Include a 10% residual pressure at point of connection In general, all major sloped areas of a subdivision/project are to be irrigated via separate irrigation meters (unless the project is only SFD with no HOA) As long as the project is located within the City recycled water BUILDING PLANCHECK CHECKLIST 1ST 2ND 3RD service boundary, the City intends on switching these irrigation services/meters to a new recycled water line in the future Q LH D 12c Irrigation Use (where recycled water is available) 1 Recycled water meters are sized the same as the irrigation meter above 2 If a project fronts a street with recycled water, then they should be connecting to this line to irrigate slopes within the development For subdivisions, this should have been identified, and implemented on the improvement plans Installing recycled water meters is a benefit for the applicant since they are exempt from paying the San Diego County Water Capacity fees However, if they front a street which the recycled water is there, but is not live {sometimes they are charged with potable water until recycled water is available), then the applicant must pay the San Diego Water Capacity Charge If within three years, the recycled water line is charged with recycled water by CMWD, then the applicant can apply for a refund to the San Diego County Water Authority (SDCWA) for a refund However, let the applicant know that we cannot guarantee the refund, and they must deal with the SDCWA for this n CH D 13 Additional Comments: 7 (~ D D ENGINEERING DEPARTMENT FEE CALCULATION WORKSHEET Estimate based on unconfirmed information from applicant Calculation based on building plancheck plan submittal Address Bldg Permit No Prepared by Date Checked by Date EDU CALCULATIONS List types and square footages for all uses Types of Use .„___ Sq Ft /Units Types of Use 'Sq Ft /Units APT CALCULATIONS List types and square footages for all uses Types of Use Sq Ft /Units Types of Use ___Sq Ft /Units EDU's EDU's ADT's ADT's FEES REQUIRED WITHIN CFD D YES (no bridge & thoroughfare fee in District #1, reduced Traffic Impact Fee) D NO PARK AREA & #D 1 PARK-IN-LIEU FEE FEE/UNIT D 2 TRAFFIC IMPACT FEE ADT's/UNITS D 3 BRIDGE AND THOROl ADT's/UNITS D 4 FACILITIES MANAGE UNIT/SQ FT D 5 SEWER FEE EDU's X NO UNITS FEE/ADT = $ = $ JGHFARE FEE tfENT FEE (DIST X ZONE X #1 DIST #2 FEE/ADT FEE/SO FT /UNIT DIST #3 ) = $ = $ BENEFIT AREA EDU's X FEE/EDU FEE/EDU D 6 SEWER LATERAL ($2,500) D 7 DRAINAGE FEES PLDA_ ACRES = $. = $_ = $ HIGH /LOW X FEE/AC = $ D 8 POTABLE WATER FEES UNITS CODE CONNECTION FEE METER FEE SDCWA FEE IRRIGATION Word\Pocs\M!sforms\Fee Calculation Worksheet I of 2 PLANNING DEPARTMENT BUILDING PLAN CHECK REVIEW CHECKLIST Plan Check No CL Planner Erin Endres Address \ 7^)6 f /^ VAjfaaJ(\A l Phone (760) 602- _525 APN _ Type of Project & Use Zoning General Plan CFD (in/out) #_Date of participation Net Project Density DU/AC Facilities Management Zone Remaining net dev acres Circle One (For non-residential development Type of land used created by this permit ) Legend: ^ Item Complete D Item Incomplete - Needs your action Environmental Review Required: YES NO TYPE DATE OF COMPLETION " Compliance with conditions of approval9 If not, state conditions which require action Conditions of Approval Discretionary Action Required: APPROVAL/RESO NO PROJECT NO YES NO DATE TYPE OTHER RELATED CASES Compliance with conditions or approval? If not, state conditions which require action Conditions of Approval CD Coastal Zone Assessment/Compliance Project site located in Coastal Zone? YES NO_ CA Coastal Commission Authority1? YES _ NO If California Coastal Commission Authority Contact them at - 7575 Metropolitan Drive, Suite 103, San Diego CA 92108-4402, (619) 767-2370 Determine status (Coastal Permit Required or Exempt) Coastal Permit Determination Form already completed'? YES NO 1 ~ * , If NO, complete Coastal Permit Determination Form now Coastal Permit Determination Log # N^ Follow-Up Actions: 1) Stamp Building Plans as "Exempt" or "Coastal Permit Required" (at minimum Floor Plans) 2) Complete Coastal Permit Determination Log as needed D D Inclusionary Housing Fee required: YES NO (Effective date of Inclusionary Housing Ordinance - May 21,1993) Data Entry Completed? YES NO (A/P/Ds, Activity Maintenance, enter CB#, toolbar, Screens, Housing Fees, Construct Housing Y/N, Enter Fee, UPDATE') H \ADMIN\COUNTER\BldgPlnchkRevChklst Rev 9/01 Site Plan: O 1 Provide a fully dimensional site plan drawn to scale Show North arrow, prop'ertyjmes; easements, existing and proposed structures, streets, existing street improvements, right-of-way width, dimensional setbacks and existing topographical lines (including all side and rearVyard slopes) C] ' 2 Provide legal description of property and assessor's parcel number "*">* D K] D D Policy 44- Neighborhood Architectural Design Guidelines 1 Applicability YES NO 2 Project complies YES NO D D D a n Zoning: 1 Setbacks Front Interior Side Street sTde Rear Top of slope 2 Accessory structure Front Interior Side Street Side Rear Structure separation Required . Required, Required Required Required setbacks Required Required Required Required Required Shown . _Shown_. - =-—**_ - Shown Shown Shown Shown Shown Shown Shown Shown 3 Lot Coverage 4 Height; 5 Parking Required Required Spaces Required ^2. Shown Shown Shown (breakdown by uses for commercial and industrial projects required) Residential Guest Spaces Required ' Shown Additional Comments Correction #1 - Please show on sheet 1 the total number of parking spaces provided and required on site for each use per Chapter 21 44 CJk5rffi^o>ifl*^]l^ aj^ej^^lfo>ssrinew^^c?^ jjafenaj tStek T5 OK TO ISSUE AND ENTERED APPROVAL INTO COMPUTER, H \ADMIN\COUNTER\BldgPlnchkRevChklst Rev 9/01 \ Carlsbad Fire Department Plan Review Requirements Category TI, COMM Date of Report 03-24-2006 Reviewed by Name Address Permit # CB060828 Job Name CABRILLO CREDIT UNION-1369 SF Job Address 1265 CARLSBAD VILLAGE DR CBAD St 202 -INGOMPfaETE Tbentem^e^a^ave^ubnatted-fep^evi«w-i9-inoomploto Atthio timo, this office cannot. adequately-6ondu<^^v*ew4o^eteHHffle'<3emphan<^^ carefully^l»comments^ttaehed--^ease^esttbmi*^ -te-th is-egfiee-fern'-ev-iew-and-appro val Conditions: Cond CON0001193 [MET] APPROVED THIS PROJECT HAS BEEN REVIEWED AND APPROVED FOR THE PURPOSES OF ISSUANCE OF BUILDING PERMIT THIS APPROVAL IS SUBJECT TO FIELD INSPECTION AND REQUIRED TEST, NOTATIONS HEREON, CONDITIONS IN CORRESPONDENCE AND CONFORMANCE WITH ALL APPLICABLE REGULATIONS THIS APPROVAL SHALL NOT BE HELD TO PERMIT OR APPROVE THE VIOLATION OF ANY LAW Entry 03/24/2006 By gr Action AP -**^,* ^005 ACCEPTANCE REQUIREMENTS FOR CODE"CC.VPLiANCc Lighting Control Acceptance Document _ __ LTG-2-A Fcr.Ti 1 of 1^ i f , v K <"" V. \ v ^> T * \•^_ ^ o r * \ ' O V^ r - <* \~V ^_\ -v' a rx i —- ^ - 0 /^ A a a X Select Acceptance Test ^rdicate lighting control systems 1 Occupancy Sensor Names/DeSfgnaticrs o/ .r-e accucjoie .651:, ceiow) 2 Manual Oaylighting Controls 3 Automatic Time Switch Controls B Equipment Testing Requirements Check and verify those items applicable to setectedjystem Occupancy Sensor - Step 1 Simulate an unoccupied condition Lights ccntrclled by occupancy sensors turn off within a maximum of 30 minutes from start of jn unoccupied condition per Standard Section 119(d) TKc czc^papit sei sor ices not ingger a false 'on trom movement adjacent to the controlled space or from HVAC operation c jSignal sensitivity js adequate to achieve desjreg^controf Step 2 Simulate an occupted condition a Status indicator or annunciator operates correctly Lights controlled by occupancy sensors turn on when Immediately upon an pccupted condition OR (this requirement is mutually exdusrve with Step cJSensor Tidicates sj?ace is "occupied" andjights turn on manually Step^3 System returned to inibal operating conditions Manual Day lighting Controls - Step 1 Manual switching control At least 50% of lighting power in daylrt areas is separately controlled from other lights b The amount of light delivered to the space is uniformly reduced Step 2 System returned to initial operating conditions Automatic Time Switch Controls - Step 1 Simulate occupied condition a AHJights can be turned on and off by theirj^spective area control switch Verify the switch only operates lighting in the ceiling-height partitioned area in which the switch is located ighl|Ti^_'urri jff per Seciion 131 (dj Manual override sw.fcn allows unjy (he iigfits in the selected cei/mg height partitioned space where the ovemde switch is located, to turn on or remain on until the next scheduled shut off occurs c Ajl npn-exemptJighUng turns off Step 3 System returned to initial operating conditions Note' Shaded areas do not apply for particular tost procedure Applicable Lighting Control Systems C. PASS / FAIL Evaluation fcheck one): D D PASS All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes) FAIL Any applicable Construction Inspection responses are incomplete OR there is one or more negative {N - no) responses in any applicable Equipment Testing Requirements section. Provide explanation below Use and attach additional oaaes if necessary 2005 Nonresidential Acceptance Forms Apr! 2005 12005 ACCEPTANCE REQUIREMENTS FOR CODE COMPLIANCE Lighting Control Acceptance Document LTG-2-A Form ^ of PRO.EC N— • r •$. J, ^-7. PROJECT ACCFESo TESTING AUTHORITY LIGHTING CONTROL SYSTEM NAME / DESIGNATION TELEPHONE DATE "' •" ' Checked by/Da» • Enforcement Agency Use Intent.Lights are turned off when not needed per 1 19(d) 4 131(d) [Construction Inspection 1 Instrumentation to perform test includes but not limited to a Light meter b Hand-held amperage and voltage meter c Power meter 2 Occupancy Sensor Construction Inspection Q Occupancy sensor has been located to minimize false stgnate D Occupancy sensors do not encounter any obstructions that could adversely effect desired performance, D Ultrasonic occupancy sensors do not emit audible sound (119a) 5 feet from source 3 Manual Day lighting Controls Construction Inspection K ***** r J- , I - * "llA""*^D If dimming ballasts are specified for Itght fixtures within the daylrt area, make sure they * meet all the Standards requirements, including "reduced flicker operation" for manual ?•• ^.tVir^r^ dimming control systems 4 Automatic Time Switch Controls Construction Inspection ." -'";' *? * '^" ' . *' ' * '» a Automatic time swrtch control is programmed for (check all)- _, < . l*v l~\ D Weekdays O Weekend a Holidays *""*' b Document for the owner automatic time switch programming (check all} D Weekdays settings D Weekend settings D Holidays settings O Set-up sett,rgs D Preference program setting O Venfy the correct time and date is properly set in the time swrtch D Venfy the battery Is installed and energized „ t ,^f ,,<-, , -v - . . ^-^ ^"s;-^"'''--^^;^'J ' D Override hme limrt is no more than 2 hours - v-Y,. /- V'^v'srxs C - ''''-\^J'^'^ vT^"^ C'^'^'T^^v' $&*£•$£1 *' " ^ i ~-- 4 ***f»^-*F^-*J? i^Jt t-^J*1 yi'StfiW. .' (/^Tffrtrt1^ ^ ** ^ f ^ ^ * "v;1^ = j_~',- -" V? ,J f**-?-r>"». v^^-.. ii.'-^v^1;:.?."^^"^^^^^^^Certification Statement: I certify that all statements are true on this LTG-2-A form indudinp^the r.- * ff^.;t**:'" J .^;t PASS/FAIL Evaluation " "1-H- -^ r *"* " * ' - ", T^ , - ^ 'J^V I affirm I am eligible to sign this form under the provisions described in the Statement of Acceptance on form LTG-1-A Name * ~- - * * * *; ; t'f"^^j'^».,^^i'!'"^>'" -./l1-^' Company Signature Date 2005 Nonrestdential Acceptance Forms Apnl 2005 Majy-01-OG 1O:O1A p . 02 COMPENSATION NSURANCE POLlCYHOLDER COPY PO BOX 420807, SAN FRANQSCO.CA 94142-0807 FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE 04-11-2000 GROUP POLICY NUMBER: TZ147SO-20O5 CERTIFICATE ID 73CERTIFICATE EXPIRES 08-01-30OB 09-01-2OC6/08-01-20OQ SD CITY OF CARLSBAD jeas FARADAY AVf CARLSBAD CA 020O8-73H SO This is to certify that we hane iSSUdd a valid Workers' Compensation Insurant* policy in a form appro\'60 by the California ln*ur»nc* Commissioner la the emplayar fiamed, bftlow for the policy period indicated This policy is not subject to cancellation by Che Fund except upon 3O days advance written notice to lha employer Wi will also give you 3Od«ys advance none* should this policy be canceflad prior to its normal expiration This ceTii1ic»\8 ol insurance is not ef> insursnce policy and does not amund, expand or slier the by the policy list»(J herein Notwithstanding any requirement t»rm or condition of any contract or olhar with raspect to which this certificate of insurance may be issusd or to which It may pertain, (he afforded by the policy dascnbed horem is subject to all the terms, exclusions and conditions of such policy PRESIDENT UNLESS INDICATED OTHERWISE BY ENDORSEMENT, COVERAGE UNDER THIS POLICY EXCLUDES THE FOLLOWING, THOSE NAMED IN THE POLICY DECLARATIONS AS AN INDIVIDUAL EMPLOYER OR A HUSBAND AND WIFE EMPLOYER. EMPLOYEES COVERED ON A COMPREHENSIVE PERSONAL LIABILITY INSURANCE POLICY ALSO AFFORDING CALIFORNIA WORKERS' COMPENSATION BENEFITS. EMPLOYEES EXCLUDED UNDER CALIFORNIA WORKERS' COMPENSATION LAW • EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS- tl.OOO.OOO PER OCCURRENCE ENDORSEMENT #209S ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE OS-O1-1S91 IS ATTACHED TO AND FORMS A PART OF THIS POLICY EMPLOYER HALL. WAYNE DBA H H CONSTRUCTION 707B MISSION GORGE RD SAN DZEQO CA 09120 SD 3-051 PRINTED [SM;, CN] 04- 12-2006 May -O1-06 1O:O1A P .01 C ftf S o00o-4o oo £LJ-5« go 0 b b10 D Q g o: Jg co um < i _O O CO I-