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HomeMy WebLinkAbout1344 CYNTHIA LN; ; CB151143; Permit04-24-2015 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Pool Permit Permit No: CB151143 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: PC #: Project Title: 1344 CYNTHIA LN CBAD POOL 1562316000 Lot#: $29,865.00 Construction Type: BEAL RES-BUILD 612 SF POOL/SPA 0 NEW Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 04/15/2015 LSM 04/24/2015 04/24/2015 Applicant: PICTURESQUE LANDSCAPE Owner: BEAL BENJAMIN 3100WILLOWTREE LN ESCONDIDO CA 92027 760-522-9140 1344 CYNTHIA LN CARLSBAD CA 92008 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Electrical Fee Plumbing Fee Strong Motion Fee Green Bldg Standards (SB1473) Fee Renewal Fee Add'l Renewal Fee Other Building Fee Additional Fees $278.29 $0.00 $194.80 $0.00 $33.00 $33.00 $3.88 $2.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $544.97 Total Fees: $544.97 Total Payments To Date: $544.97 Balance Due: $0.00 Inspector: FINAL APR Date: Clearance: NOTICE: Please lake NOTICE that approval of your project includes the "Imposition" 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 sel forth in Government Code Seclion 66020(a), and file the protest and any other required information wilh the City Manager for processing in accordance with Carisbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal aclion lo attack, review, sel aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right lo protest the specified fees/exactions DOES NOT APPLY lo waler and sewer connectton fees and capacity changes, nor planning, zoning, grading or other similar application processing or sen/ice fees in connection with this project. NOR DOES IT APPLY to any fees/fixactions of which vou have previouslv been given a NOTICE similar to this, or as to which the statute of limitations has oreviouslv othenaiise expired. 04-24-2015 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Storm Water Pollution Prevention Plan (SWPPP) Permit Permit No:SW150156 Job Address: Permit Type: Parcel No: Reference #: CB#: Project Title: Applicant: BENJAMIN BEAL 1344 CYNTHIA LN CARLSBAD 92008 858-539-9236 Emergency Contact: BILL THOMAS 1344 CYNTHIA LN CBAD SWPPP 1562316000 Lot#: CB151143 BEAL RES- BUILD 612 SF POOL/SP Status Applied: Entered By Issued: Inspect Area: Tier: Priority: Owner: BEAL BENJAMIN 1344 CYNTHIA LN CARLSBAD CA 92008 ISSUED 04/15/2015 LSM 04/24/2015 1 M 760-522-9140 SWPPP Plan Check SWPPP Inspections Additional Fees $53.00 $224.00 $0.00 TOTAL PERMIT FEES $277.00 Total Fees: $277.00 Total Payments To Date: $277.00 Balance Due: $0.00 FINAL APPROVAL SIGNATURE THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: • PLANNING DENGINEERING • BUILDING • FIRE •HEALTH • HAZMAT/APCD Cqty of Carlsbad ifCJ* ' LOT r ' ' PHASE # Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax:760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov Plan Check No. (2^ ) l<~f 3 Est. Value c^9^^faCg Plan Ck. Deposit (qr<-f. g'Q Date ^-^ I SI I [svyppTTs^^T^ SUITEt/SPACE«/UNIT* /f6 -J^s/ -6dor} CT/PRO#CT # PHASES I # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC GROUP DESCRIPTiON OF WORK: /nc/ude Square Feet of Affected Area(s; P(5C)( 6 'c5^i^ EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIRCONDITIONING FIRESPRINKLERS YESfl* NC| 1 YESj^NoQ YESj |NO| | APPLICANTNAME . I . / / „ PROPERTVOWNERNAME t ^ ^ O / ' 1 ^ W-—W ^^^rrts^^ p X ^ ADDRESS / , ' . 1 ^ ADDRESS ' - • CITY >. / / , STATE ZIP CITY , . STATE ZIP C^lrhc^ 7'^crJ 9 FAX PHONE ^ FAX EM^ DESIGN PROFESSIONAL CONTRACTOR BUS. NAME/^/^^^ . xv« /' / ^ ADDRESS ADDRESS , ^ 1 ~ CITY STATE ZIP CITY , , STATE ZIP PHONE FAX FAX ' EMAIL EMAIL STATE LIC. # STATE LIC.# CUSS CITY BUS. LlA# 1 \ \ K applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law ichapter 9, commending with SectioiwO\o 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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)). WORKERS COMPENSATIOM Workers' Compensation Declaration: / hereby affirm under penalty dperjury one of tfie foliowing deciarations: • 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 wtiich this permit is issued. • I have and will inalntain workers'compensation, as reguired bySection 3700 of the Labor Code, forthe perfonnance of the work for which this permit is issued. My workers'compensalion insurance earner and policy number are: Insurance Co. Policy No. Expiration Date Jhis section need not be completed if the permit is for one hundred dollars ($100) or less. Certificate of Exemption: I certify that in the performance of the work for wtiich this perniit is issued, I shall not employ any person in any manner so as to become subject to the Workere' Compensation Laws of mia. 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 (&tOO,000), In aaaition to the cost of compensation, damages aa|)rovide^jeplf^ction 3706 of the Labor code, interest and attomey's fees, CONTRACTOR SIGNATURE\/ QAGENT DATE ^^~J^J~"' /jt " rWMen-« UILOER DECLARATION / hereby affimi fhaf / am exempf from Contractor's Ucense Law for fhe foilowing reason: I, as owner of the property or my employees wilh wages as their sole compensalion, will do the worit and the structure is not inlended or offeied for sale (Sec. 7044, Business and Prafessions Code: The Conlractor's jcense Law does not apply to an owner of property who builds or impraves thereon, and who does such work himself or through his own empkiyees, pravided that such impravements are not intended or ottered for ;ale. if, however, the building or improvement is sold wilhin one year of compietion, the owner-builder will have the burden of praving lhat he did nol build or improve for the purpose of sale). Cas owner of the praperty, am exclusively contracling wilh licensed conlractors lo constmct the project (Sec, 7044, Business and Professions Code: The Contrxtor's Ucense Law does not apply to an owner of property wtio builds or improves thereon, and contracts for such projecis with contractor(s) licensed pursuant to the Contractor's License Law), I am exempt under Section Business and Professions Code for this reason: 1.1 personally pian to provide the major labor and materials for construction of the proposed properly improvement QYes I iNo 2.1 (have / have nol) signed an application for a building pemiit for the praposed work. 3.1 have contracted with the following person (finii) to provide the proposed constmction (include name address / phone / contractors' license number): 4, i plan 10 pravide portions of the worts, but I have hired the following person to coortinate, supereise and pravide the major wori< (include name / address / phone / contractors' license number): 5.1 will provide some of the work, but I have conlracted (hired) the following persons to provide the wort( indicated (include name / address / phone / lype of wori(): ^/ jeTpROPERTY OWNER SIGNATURE // QAGENT DATE IT _£_ THIS $BtrtO% i>t>» |«0:Sli.rtf IOE,:(«T1At Is the applicant or future buikling occupant required to submit a business plan, acutely hazardous materials registration fomi or risk management and prevention program under Sections 25505,25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? • Yes • No Is the applicant or fuiure building occupant required to obtain a permit fram the air pollution control districi or air quality management district? O Yes • No Is the facility to be constmcted wilhin 1,000 feet of the outer boundary of a school site? • Yes • No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPUCANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT ,CO;N jETBUCTiON LEWOING AtSMHCY 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). Lenders Name Lender's Address ,l»l»tiCANT CERTIFiCATIOM I certif that I have read tie applkation and state that the above infbrmation is coirect and thatthe infonnation on Ihe plans is accuiate. I agree to complywith all Ci^ ordinances and State laws relating to building constniction. I hereby auihorize representative ofthe City of Carisbad to enter upon the above meniioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CfTY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA An OSHA pemiit is required for excavations ove^' deep and demolition or constaictfon ot stmctures over 3 stories in height. EXPIRATION: Every perniit issued by the Buikling Cffijal under ihe proytejoHSof this Code shall expire by limitatfon and become null and void if the buiWing or vrort( authorized by such pemiit is nol oommenced wilhin 180 days from the date of such pennit or if the bujdfCor volf authoiBSlw^ch pemit is suspended or abandoned at any time after the v«rt( is commenced for a period of 180 days (Sectfon 106.4.4 Unifom Building Code). APPLICANT'S SIGNATURE DATE Inspection List Permit*: CB151143 Type: POOL BEAL RES-BUILD 612 SF POOUSPA Date Inspection Item 08/06/2015 55 Fence/Pre-Plaster 08/06/2015 55 Fence/Pre-Plaster 08/06/2015 59 Final Pool 08/06/2015 59 Final Pool 08/05/2015 55 Fence/Pre-Plaster 08/05/2015 55 Fence/Pre-Plaster 08/05/2015 59 Final Pool 05/29/2015 21 Underground/Under Floor 05/29/2015 23 Gas/Test/Repairs 05/29/2015 31 Underground/Conduit-Wirin 05/29/2015 Inspector PY PY PY PB PB PB 51 Excav/Steel/Bonding/Fence PB Act Rl AP Rl AP Rl NR Rl AP AP AP AP Comments Tuesday, August 11, 2015 Page 1 of 1 PLAN CHECK Community & Economic , "•tk, CITY OF REVIEW Development Department 1635 Faraday Avenue CARLSBAD TRANSMITTAL Carlsbad CA 92008 www.carlsbadca.gov DATE: 04/20/2015 PROJECT NAME: PLAN CHECK NO: 1 SET#: 1 ADDRESS: 1344 CYNTHIA LANE VALUATJON/SPOPE OF WORK: POOL AND SPA PROJECT ID: APN: 156-231-60-00 is plan check review is complete and has been APPROVED by the ENGINEERING Division. By: VALRAY NELSON A Final Inspection by the ENGINEERING Division is required Yes / No This-frian check review is NOT COMPLETE. Items missing or incorrect are listed on the attached checklist. Please resubmit amended plans as required. NOTE; ONLY ITEMS THAT NEED CORRECTION/CLARIFICATION ARE MARKED X, Plan Check Comments have been sent to: PIVIP4GODI@YAHOO.COIVI You may also have corrections from one or more of the divisions listed below. Approval from these divisions may be required prior to the issuance of a building permit. Resubmitted plans should include corrections from all divisions. For questions or clarifications on the attached checklist please contact the following reviewer as marked: PLANNING 760-602-4610 ENGINEERING 760-602-2750 FIRE PREVENTION 760-602-4665 Chris.Sexton@carlsbadca.gov Kathleen Lawrence 760-602-2741 Kathleen.Lawrence@carlsbadca.gov Gregorv.Rvan@carlsbadca.gov Gina.Rul2@carlsbadca.gov Linda.Ontiveros@carlsbadca.gov Cvnthia.Wong@carlsbadca.gov / ValRay Marshall ^ 760-602-2773 ValRay.Marshall@carlsbadca.gov Dominic.Fieri@carlsbadca.gov Remarks: .Anil outslaiidin" issues will be marketl ivilh an I X I Make the necessary correclions for compliance wiUi applicuhle cock's and standards. Suhinil corrected plans andl or specificaUons to the Building dicision for re-sidriiilllal io the Engineering dii'isions. Iteins thill confonn to penntt retjuirements tire marketl tvilli [ ^ [ 1. SITE PLAN Provide a fully dimensioned site plan drawn to scale. Show; / North arrow / Existing & proposed structures / Property line dimensions Easements 0 Show on site plan: / Drainage patterns X X X X ^ Existing & proposed slopes y^xisting topography ' ^Retaining Walls (location and height) Indicate what will happen with soil excavated from pool area. Include on title sheet: 4 X / Site address / Assessor's parcel number Legal description/lot number Grading; Quantities of Cut Fill Import Export Project does not comply with the following engineering conditions of approval for project no; Conditions were complies with by; Date: LOTNO. PARB MAP NO. 14713 REF. NO. E-37 Page 2 of 4 REV 6/2012 2- GRADING PERMIT REQUIREMENTS The conditions that require a grading permit are found in Section 11.06.030 of the Municipal Code., X Inadequate information available on site plan to make a determination on grading requirements. Include accurate grading quantities in cubic yards (cut, fill, import, export and remedial). This information must be included on the plans. If no grading is proposed write: "NO GRADING" Grading Permit required. NOTE: The gradinq permit must be issued and rough gradinq approval obtained priorto issuance of a building permit A separate grading plan prepared a registered civil engineer must be submitted together with the completed application form attached. No grading permit required. 3. MISCELLANEOUS PERMITS N/A RIGHT-OF-WAY PERMIT is required to do work in city right-of-way and/or private work adjacent to the public right-of-way. A separate right-of-way issued by the engineehng division is required for the following: Please complete attached right-of-way application form and return to the engineering department together with the requirements on the attached right-of-way checklist, at the time of resubmittal. Right-of-way permit and pool permit will be issued simultaneously. E-37 Page 3 of 4 REV 6/2012 4. STORM WATER Construction Compliance SIGNATURE NEEDED ON ONE FORIVI E-34 ^ Project Threat Assessment Form complete / incomplete / Requires Tier 1 Storm Water Pollution Prevention Plan. Please complete attached form and return (SW is-oise ) Requires Tier 2 Storm Water Pollution Prevention Plan. Requires submittal of Tier 2 SWPPP, payment of processing fee and review by city. Post-Development (SUSMP) Compliance •D 0 X 'I Storm Water Standards Questionnaire complete incomplete Project is subject to Standard Storm Water Requirements. See city Standard Urban Storm Water IVIanagement Plan (SUSIVIP) for reference. http://www.carlsbadca.qov/business/buildinq/Documents/EnqStandsw-stds-vol4-ch2.pdf Project needs to incorporate low impact development strategies throughout in one or more of the following ways: Rainwater harvesting (rain barrels or cistern) Vegetated Roof Bio-retentions cell/rain garden Pervious pavement/pavers Flow-through planter/vegetated or rock drip line Vegetated swales or rock infiltration swales Downspouts disconnect and discharge over landscape Other; 5. ADDITIONAL COMMENTS E-37 Page 4 of 4 REV 6/2012 CITY OF CARLSBAD STORM WATER COMPLIANCE ASSESSMENT B-24 Development Services Building Division 1635 Faraday Avenue 760-602-2719 www.carlsbadca.gov I am applying to the City of Carlsbad for the following type(s) of construction permit: Building Permit • Riglit-of-Way Permit • My project is categorically EXEMPT from the requirement to prepare a storm water pollution prevention plan (SWPPP) because it only requires issuance of one or more of the following permit types: Electrical Fire Additional Fire Alarm Fixed Systems Mechanical Mobile Home Plumbing Patio/Deck Photo Voltaic Re-Roofing Sign Spa-Factory Sprinkler Water Discharge Project Storm Water Threat Assessment Criteria* 1 Tier 2 • • No Threat Assessment Criteria • My project qualifies as NO THREAT and is exempt from the requirement to prepare a storm water pollution prevention plan (SWPPP) because it meets the "no threaf assessment criteria on the City's Project Threat Assessment Worksheet for Determination of Constmction SWPPP Tier Level. My project does not meet any of the High, Moderate or Low Threat criteria described below. TierJ /- Low Threat Assessment Criteria My project does not meet any of the Significant or Moderate Threat criteria, is not an exempt permit type (See list above) and the project meets one or more ofthe following criteria: • Results in some soil dlsturisance; and/or • Includes outdoor construction activities (such as saw cutting, equipment washing, material stockpiling, vehicle fueling, waste stockpiling). Moderate Threat Assessment Criteria My project does not meet any of the Significant Threat assessment Criteria described below and meets one or more of the following criteria: • Project requires a grading plan pursuant to the Carlsbad Grading Ordinance (Chapter 15.16 of the Carisbad Municipal Code); or, • Project will result in 2,500 square feet or more of soils disturbance including any associated construction staging, stockpiling, pavement removal, equipment storage, refueling and maintenance areas and project meets one or more ofthe additional tollowing criteria: • Located within 200 feet of an environmentally sensitive area or the Pacific Ocean, and/or • Disturbed area Is located on a slope with a grade at or exceeding 5 horizontal to 1 vertical, and/or • Disturbed area Is located along or within 30 feet of a storm drain inlet, an open drainage channel or watercourse, and/or • Construction will be initiated during the rainy season or will extend into the rainy season (Oct. 1 through April 30). T/ef3 - Signif icant Threat Assessment Criteria • My project includes clearing, grading or other disturbances to the ground resulting in soil disturbance totaling one or more acres including any associated construction staging, equipment storage, stockpiling, pavement removal, refueling and maintenance areas: and/or • My project is part of a phased development plan that will cumulatively result in soil disturt)ance totaling one or more acres including any associated construction staging, equipment storage, refueling and maintenance areas: or, • My project is located inside or within 200 feet of an environmentally sensitive area (see City ESA Proximity map) and has a significant potential for contributing pollutants to neariDy receiving waters by way of storm water runoff or non-storm water discharge(s). / certify to the best of my knowledge that the above checked statements are true and correct I understand and acknowledge that even though this project does not require preparation of a construction SWPP, I must still adhere to, and at all times during construction activities for the permit type(s) check above comply with the storm water best management practices pursuantto Title 15 ofthe Carlsbad Municipal Code and to City Standards. "The City Engineer may authorize minor variances from the Stomi Water Threat Assessmenl Criteria in speciai circumstances where it can be shown that a lesser or higher Constmction SWPPP Tier Level is wan'anted. Project Address: / Owner/Owner's Authorized Agent N^e: Assessor Parcel No. OwnBfJOwner s Auttiaized Agent Signature: r Dinner's Autliafized Agent Signature: City Concurrence: • YES 1^0 By: Date: Title: Date: Project ID: B-24 Page 1 of 1 Rev.03/09 CITY OF CARLSBAD CONSTRUCTION THREAT ASSESSMENT WORKSHEET FOR DETERMINATION OF PROJECT'S PERCEIVED THREAT TO STORM WATER QUALITY E-33 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov Construction SWPPP Tier Level Construction Threat Assessment Criteria* Perceived Threat to Storm Water Quality Tiers Tier 3 - High Construction Threat Assessment Criteria High Tiers • Project site is 50 acres or more and grading will occur during the rainy season • Project site is 1 acre or more in size and is located within the Buena Vista or Agua Hedionda Lagoon watershed, inside or within 200 feet of an environmentally sensitive area (ESA) or discharges directly to an ESA • Soil at site is moderately to highly erosive (defined as having a predominance of soils with USDA-NRCS Erosion factors kf greater than or equal to 0.4) • Site slope is 5 to 1 or steeper • Construction is initiated during the rainy season or will extend into the rainy season (Oct. 1 through April 30). • Owner/contractor received a Storm Water Notice of Violation within past two years High Tiers Tier 3 - Medium Construction Threat Assessment Criteria Medium Tiers • All projects not meeting Tier 3 High Construction Threat Assessment Criteria Medium Tier 2 Tier 2 High Construction Threat Assessment Criteria • Project is located within the Buena Vista or Agua Hedionda Lagoon watershed, inside or within 200 feet of an environmentally sensitive area (ESA) or discharges directly to an ESA • Soil at site is moderately to highly erosive (defined as having a predominance of soils with USDA-NRCS Erosion factors kf greater than or equal to 0.4) • Site slope is 5 to 1 or steeper • Construction is initiated during the rainy season or will extend into the rainy season (Oct. 1 through April 30). • Owner/contractor received a Storm Water Notice of Violation within past two years • Site results in one half acre or more of soil disturbance High Tier 2 Tier 2 - Medium Construction Threat Assessment Criteria Medium Tier 2 • All projects not meeting Tier 2 High Construction Threat Assessment Criteria Medium Tierl Tier 1 - Medium Inspection ThreaiAssessment Criteria V Medium 1 Tierl • Project is located within the Buena Vista or Agua Hedionda Lagoon watershed, within or directly adjacent to an environmentally sensitive area (ESA) or discharges directly to an ESA • Soil at site is moderately to highly erosive (defined as having a predominance of soils with USDA-NRCS Erosion factors kf greater than or equal to 0.4) • Site slope is 5 to 1 or steeper Construction is initiated during the rainy season or will extend into the rainy season (Oct. 1 through April 30). • Owner/contractor received a Storm Water Notice of Violation within past two years • Site results in one half acre or more of soil disturbance V Medium 1 Tierl Tier 1 - Low Inspection Threat Assessment Criteria Low Tierl All projects not meeting Tier 1 Medium Construction Threat Assessment Criteria Low Exempt - Not Applicable -Exempt *The city engineer may authorize minor variances from the construction threat assessment criteria in special circumstances where it can be shown that a lesser or higher amount of stomi water compliance inspection is warranted in the opinion of the city engineer E-33 Page 1 of 1 REV 4/30/10 ^ CITY OF CARLSBAD STORM WATER STANDARDS QUESTIONNAIRE E-34 Development Services Land Development Engineering 1635 FaradayAvenue 760-602-2750 www.carlsbadca.gov INSTRUCTIONS: To address post-development pollutants that may be generated from development projects, the City requires that new development and significant redevelopment priority projects incorporate Permanent Storm Water Best Management Practices (BMP's) into the project design per the Cit/s Standard Urban Stormwater Management Plan (SUSMP). To view the SUSMP, refer to the Engineering Standards (Volume 4, Chapter 2) at www.carisbadca.qov/standards. Initially this questionnaire must be completed by the applicant in advance of submitting for a development application (subdivision, discretionary permits and/or construction permits). The results of the questionnaire detennine the level of stomn water standards that must be applied to a proposed development or redevelopment project. Depending on the outcome, your project will either be subject to 'Standard Stomiwater Requirements' or be subject to additional criteria called 'Priority Development Project Requirements'. Many aspects of project site design are dependent upon the storm water standards applied to a project. Your responses to the questionnaire represent an initial assessment of the proposed project conditions and impacts. City staff has responsibility for making the final assessment after submission of the development application. If staff detennines that the questionnaire was incorrectly filled out and is subject to more stringent stonn water standards than initially assessed by you, this will result in the return of the development application as incomplete. In this case, please make the changes to the questionnaire and resubmit to the City. If you are unsure about the meaning of a question or need help in detennining how to respond to one or more of the questions, please seek assistance from Land Development Engineering staff. A separate completed and signed questionnaire must be submitted for each new development application submission. Only one completed and signed questionnaire is required when multiple development applications forthe same project are submitted concurrently. In addition to this questionnaire, you must also complete, sign and submit a Project Threat Assessment Form with construction permits for the project. Please start by completing Step 1 and follow/ the instructions. When completed, sign the form at the end and submit this with your application to the city. STEP1 TO BE COMPLETED FOR ALL PROJECTS To determine if your project is a priority development project, please answer the following questions: YES NO 1. Is your project LIMITED TO constructing new or retrofitting paved sidewalks, bicycle lanes or trails that meet the following criteria: (1) Designed and constructed to direct storni water runoff to adjacent vegetated areas, or other non-erodible permeable areas; OR (2) designed and constructed to be hydraulically disconnected from paved streets or roads; OR (3) designed and constructed with penneable pavements or surfaces in accordance with USEPA Green Streets guidance? / < 2. Is your project LIMITED TO retrofitting or redeveloping existing paved alleys, streets, or roads that are designed and constructed in accordance with the USEPA Green Streets guidance? ( y If you answered "yes" to one or more of the above questions, then your project is NOT a priority development project and therefore is NOT subject to the storm water criteria required for priority development projects. Go to step 4, mark the last box stating "my project does not meet PDP requirements" and complete applicant information. If you answered "no" to both questions, then go to Step 2. E-34 Page 1 of 3 Effective 6/27/13 CITY CARLSBAD O F STORM WATER STANDARDS QUESTIONNAIRE E-34 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov To detennine if your project is a priority development project, please answer the following questions: YES NO 1. Is your project a new development that creates 10,000 square feet or more of impervious surfaces collectively over the entire project site? This includes commercial, industrial, residential, mixed-use, and public development projects on public orpnvate land. Is your project creating or replacing 5,000 square feet or more of impervious surface collectively over the entire project site on an existing site of 10,000 square feet or more of impervious surface? This includes commercial, industrial residential, mixed-use, and public development projects on public orpnvate land, Is your project a new or redevelopment project that creates 5,000 square feet or more of impervious surface collectively over the entire project site and supports a restaurant? A restaurant is a facility that sells prepared foods and drinks for consumption, including stationary lunch counters and refreshment stands selling prepared foods and drinks for immediate consumption. Is your project a new or redevelopment project that creates 5,000 square feet or more of impervious surface collectively over the entire project site and supports a hillside development project? A hillside development project includes development on any natural slope that is twenty-five percent or greater. Is your project a new or redevelopment project that creates 5,000 square feet or more of impervious surface collectively over the entire project site and supports a pari<ing lot. A parking lot is a land area or facility for the temporary parking or storage of motor vehicles used personally for business or for commerce. Is your project a new or redevelopment project that creates 5,000 square feet or more of impervious surface collectively over the entire project site and supports a street, road, highway freeway or driveway? A street, road, highway, freeway or driveway is any paved impen/ious surface used for the transportation of automobiles, trucks, motorcycles, and other vehicles. Is your project a new or redevelopment project that creates or replaces 2,500 square feet or more of impervious surface collectively over the entire site, and discharges directly to an Environmentally Sensitive Area (ESA)? "Discharging Directly to" includes flow that is conveyed overiand a distance of 200 feet or less from the project to the ESA, or conveyed in a pipe or open channel any distance as an isolated flow from the project to the ESA (i.e. not commingles with flows from adjacent lands).* Is your project a new development that supports an automotive repair shop? An automotive repair shop is a facility that is categorized in any one of the following Standard Industrial Classification (SIC) codes: 5013, 5014, 5541, 7532-7534, or 7536-7539. Is your project a new development that supports a retail gasoline outlet (RGO)? This category includes RGO's that meet the following criteria: (a) 5,000 square feet or more or (b) a project Average Daily Traffic (ADT) of 100 or more vehicles per day. 10. Is your project a new or redevelopment project that results in the disturbance of one or more acres of land and are expected to generate pollutants post construction? 11.1s your project located within 200 feet of the Pacific Ocean and (1) creates 2,500 square feet or more of impen/ious surface or (2) increases impervious surface on the property by more than 10%? If you answered "yes" to one or more of the above questions, you ARE a priority development project and are therefore subjed to mplementing structural Best Management Practices (BMP's) in addition to implementing Standard Stom Water Requirements such as source control and low impact development BMP's. A Stonn Water Management Plan (SWMP) must be submitted with your application(s) for development. Go to step 3 for redevelopment projects. For new projects, go to step 4 at the end of this questionnaire, check the "my project meets PDP requirements" box and complete applicant Information. If you answered "no" to all of the above questions, you ARE NOT a priority development project and are therefore subject to implementing only Standard Storm Water Requirements such as source control and low impact development BMP's required for all development projects. A Stonn Water Management Plan (SWMP) is not required with your application(s) for development. Go to step 4 at the end of this questionnaire, check the "my project does not meet PDP requirements" box and complete applicant information. E-34 Page 2 of 3 Effective 6/27/13 CITY OF Ci ALR LSBAkD STORM WATER STANDARDS QUESTIONNAIRE E-34 Development Services Land Development Engineering 1635 FaradayAvenue 760-602-2750 - www.carlsbadca.gov TO BE COMPLETED FOR REDEVELOPMENT PROJECTS THAT ARE PRIORITY DEVELOPEMENT PROJECTS ONLY Complete the questions below regarding your redevelopment project: YES NO Does the redevelopment project result in the creation or replacement of impervious surface in an amount of less than 50% ofthe surface area ofthe previously existing development? f^ If you answered "yes," the structural BMP's required for Priority Development Projects apply only to the creation or replacement o impervious surface and not the entire development. Go to step 4, check the "my project meets PDP requirements" box and complete applicant information. Ifyou answered "no," the structural BMP's required for Priority Development Projects apply to the entire development. Go to step 4, check the "my project meets PDP requirements" box and complete applicant information. CHECK THE APPROPRIATE BOX AND COMPLETE APPLICANT iNFORMATiON My project meets PRIORITY DEVELOPMENT PROJECT (PDP) requirements and must comply with additional stonnwater criteria per the SUSMP and I understand I must prepare a Storm Water Management Plan for submittal at time of application. I understand flow control (hydromodification) requirements may apply to my project Refer to SUSMP for details. My project does not meet PDP requirements and must only comply with STANDARD STORMWATER REQUIREMENTS per the SUSMP. As part of these requirements, I will incorporate low impact development strategies throughout my project. Applicant Information and Signature Box AddressL Accessor's Parcel Number(s): Applicant Title Date: This Box for City Use Only City Concurrence: NO Date: ••;^:7I^ '"0^15114^ * Environmentally Sensitive Areas include but are not limited to all Clean Water Act Section 303(d) impaired water bodies; areas designated as Areas of Special Biological Significance by the State Water Resources Control Board (Water Quality Control Plan for the San Diego Basin (1994) and amendments); water bodies designated with the F?ARE beneficial use by the State Water Resources Control Board (Water Quality Control Plan for the San Diego Basin (1994) and amendments); areas designated as preserves or their quivalent under the Multi Species Conservation Program within the Cities and County of San Diego; and any other equivalent environmentally sensitive areas which have been identified by the Copermittees. E-34 Page 3 of 3 Effective 6/27/13 CITY OF CARLSBAD STORM WATER COMPLIANCE FORM TIER 1 CONSTRUCTION SWPPP E-29 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov STORM WATER COMPLIANCE CERTIFICATE My project is not in a category of pemiif types exempt from the Construction SWPPP requirements My project is not located inside or within 200 feet of an environmentally sensitive area with a significant potential for contributing pollutants to nearby receiving waters by way of stonrn water runoff or non-storm water discharge(s). My project does not require a grading plan pursuant to the Carlsbad Grading Ordinance (Chapter 15.16 ofthe Carisbad Municipal Code) My project will not result in 2,500 square feet or more of soils disturbance including any associated constmction staging, stockpiling, pavement removal, equipment storage, refueling and maintenance areas that meets one or more ofthe additional following criteria: • located within 200 feet of an environmentally sensitive area or the Pacific Ocean; and/or, • disturbed area is located on a slope with a grade at or exceeding 5 horizontal to 1 vertical; and/or • disturbed area is located along or within 30 feet of a storm drain inlet, an open drainage channel or watercourse; and/or • construction will be initiated during the rainy season or will extend into the rainy season (Oct. 1 through April 30). I CERTIFY TO THE BEST OF MY KNOWLEDGE THAT ALL OF THE ABOVE CHECKED STATEMENTS ARE TRUE AND CORRECT. I AM SUBMITTING FOR CITY APPROVAL A TIER 1 CONSTRUCTION SWPPP PREPARED IN ACCORDANCE WITH THE REQUIREMENTS OF CITY STANDARDS. I UNDERSTAND AND ACKNOWLEDGE THAT I MUST: (1) IMPLEMENT BEST MANAGEMENT PRACTICES (BMPS) DURING CONSTRUCTION ACTIVITIES TO THE MAXIMUM EXTENT PRACTICABLE TO MINIMIZE THE MOBILIZATION OF POLLUTANTS SUCH AS SEDIMENT AND TO MINIMIZE THE EXPOSURE OF STORM WATER TO CONSTRUCTION RELATED POLLUTANTS; AND, (2) ADHERE TO, AND AT ALL TIMES, COMPLY WITH THIS CITY APPROVED TIER 1 CONSTRUCTION SWPPP THROUGHOUT THE DURATION OF THE CONSTRUCTION ACTIVITIES UNTIL THE CONSTRUCTION WORK IS COMPLETE AND APPROVED BY THE CITY OF CARLSBAD. ^7f /^ y ER(S)/DWNER'S AGENT NAME I (PRINT) /^VV^f?( (S)/OWNER'S AGENT NAME (SIGNATURE) DATE 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 FIAIN IS EMINENT. 2. THE OWNER/CONTRACTOR SHALL RESTORE ALL EROSION CONTROL DEVICES TO WORKING ORDER TO THE SATISFACTION OF THE CITY ENGINEER AFTER EACH RUN-OFF PRODUCING RAINFALL 3. THE OWNER/CONTRACTOR SHALL INSTALL ADDITIONAL EROSION CONTROL MEASURES AS MAY BE REQUIRED BY THE CITY ENGINEERING OR BUILDING INSPECTOR DUE TO UNCOMPLETED GRADING OPERATIONS OR UNFORESEEN CIRCUMSTANCES WHICH MAY ARISE. 4. ALL REMOVABLE PROTECTIVE DEVICES SHALL BE IN PLACE AT THE END OF EACH WORKING DAY WHEN THE FIVE (5) DAY RAIN PROBABILITY FORECAST EXCEEDS FORTY PERCENT (40%). SILT AND OTHER DEBRIS SHALL BE REMOVED AFTER EACH RAINFALL. 5. ALL GRAVEL BAGS SHALL BE BURLAP TYPE WITH 3/4 INCH MINIMUM AGGREGATE. 6. ADEQUATE EROSION AND SEDIMENT CONTROL AND PERIMETER PROTECTION BEST MANAGEMENT PRACTICE MEASURES MUST BE INSTALLED AND MAINTAINED. SPECIAL NOTES PROJECT INFORMATION Site Address: t'SMW^ ^2xy*4Hr>ACi^ IJKS Assessor's Parcel Number: ^ SZg-^^31 - Project ID: SC*) \>5'n\^y Constmction Permit No.: Estimated Constmction Start Dafe Project Duration Months ^ Emergency Contact: 7^ "^2.^' /fiO Name: ~(^U(\<M.O ^4 hour Phone: 7^^^^^^ ^^N^C' Perceived Threat to Stonm Water Quality Medium Q Low If medium box is checked, must attach a site plan sheet showing proposed work area and location of proposed structural BMPs For City Use Only CITY OF CARLSBAD STANDARD TIER 1 SWPPP Approved By: ^Jgl.V^'> Date: E-29 Page 1 of 3 REV 4/30/10 Erosion Control BMPs Sediment Control BMPs Best Management Practice (BMP) Description Geotextiles & Mats Wood Mulching Earth Dikes and Drainage Swales Slope Drains Silt Fence Sediment Trap Check Dam Fiber Rolls Gravel Bag Berm street Sweeping and Vacuuming Sandbag Barrier Storm Drain Inlet Protection Stabilized Construction Ingress/Egress Stabilized Construction Roadway Water Conservation Practices Paving and Grinding Potable Water/Irrigation Vehicle and Equipment Cleanina Material Delivery and Material Use Stockpile Management Spill Prevention and Control Solid Waste Manaaement Hazardous Waste Manaaement Concrete Waste Manaaement CASQA Designation Construction Activity EC-7 EC-8 EC-9 EC-11 SE-1 SE-3 SE-4 SE-5 ' SE-6 SE-7 SE-8 SE-10 TR-1 TR-2 NS-1 NS-3 NS-7 NS-8 WM-1 WM-2 WM-3 WM-4 WM-5 WM-6 WM-8 y Grading/Soil Disturbance Trenching/Excavation Stockpiling Drilling/Boring Concrete/Asphalt Saw cutting Concrete flatwork Paving Conduit/Pipe Installation Stucco/Mortar Wori< Waste Disposal Staging/Lay Down Area Equipment Maintenance and Fueling Hazardous Substance Use/Storage Dewatering Site Access Across Dirt Other (list): Trading Control BMPs Non-Storm Water Management BMPs Waste Management and Materials Pollution Control BMPs Instructions: Begin by reviewing the list of constmction activities and checking the box to the left of any activity that will occur during the proposed constmction. Add any other activity descriptions in the blank activity description boxes provided for that purpose and place a check in the box immediately to the left ofthe added activity description. For each activity descrribed, pick one or more best management practices (BMPs) from the list located along the top of the form. Then place an X in the box at the place where the activity row intersects with the BMP column. Do this for each activity that was checked off and for each of the selected BMPs selected from the list. For Example - If the project includes site access across dirt, then check the box to the left of "Site Access Across Dirt". Then review the list for something that applies such as "Stabilized Construction Ingress/Egress" under Tracking Control. Follow along the "Site Access Across Dirt" row until you get to the "Stabilized Construction Ingress/Egress" column and place an X in the box where the two meet. As another example say the project included a stockpile that you intend to cover with a plastic sheet. Since plastic sheeting is not on the list of BMPs, then write in "Cover with Plastic" in the blank column under the heading Erosion Control BMPs. Then place an X in the box where the "Stockpiling" row intersects the new "Cover with Plastic" column. To learn more about what each BMP description means, you may wish to review the BMP Reference Handout prepared to assist applicants in the selection of appropriate Best Management Practice measures. The reference also explains the Califomia Stonnwater Quality Association (CASQA) designation and how to apply the various selected BMPs to a project. E-29 Page 2 of 3 REV 4/30/10 CITY OF CARLSBAD PLANNING DIVISION BUILDING PLAN CHECK APPROVAL P-29 Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.ffov DATE: 4-15-15 PROJECT NAIVIE: PROJECTID: PLAN CHECK NO: CB 15-1143 SET#: 1 ADDRESS: 1344 Cynthia Lane APN: 156-231-60-00 ^ This plan check review is complete and has been APPROVED by the Planning Division. By: Chris Sexton A Final Inspection by the Planning Division is required • Yes ^ No You may also have corrections from one or more of the divisions listed below. Approval from these divisions may be required prior to the issuance of a building permit. Resubmitted plans should include corrections from all divisions. • This plan check review is NOT COMPLETE. Items missing or incorrect are listed on the attached checklist. Please resubmit amended plans as required. Plan Check APPROVAL has been sent to: pmp4godl@yahoo.com For questions or clarifications on the attached checklist please contact the following reviewer as marked: PLANNING 760-602-4610 ENGINEERING 760-602-2750 FIRE PREVENTION 760-602-4665 X Chris Sexton 760-602-4624 Chris.Sexton@carlsbadca.gov r j Chris Glassen 760-602^2784 Christopher.Glassen@carlsbadca.gov [ 1 Greg Ryan 760-602-4663 Gregorv.Rvan@carlsbadca.gov Gina Ruiz 760-602-4675 Gina.Ruiz@carlsbadca.gov [ ] ValRay Marshall 760-602-2741 ValRay.Marshall@carlsbadca.gov Cindy Wong 760-602-4662 Cynthia.WMg@carlsbadca^gov • Linda Ontiveros 760-602-2773 Linda.Ontiveros@carlsbadca.gov Dominic Fieri 760-602-4664 Dominic.Fieri@carlsbadca.gov Remarks: