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HomeMy WebLinkAbout1534 Magnolia Ave; ; CBR2019-1924; PermitPERMIT REPORT Print Date: 03/25/2020 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Bathrooms: Project Title: 1534 Magnolia Ave BLDG-Residential 2052201500 $ 19,748.96 MAGNOLIA-BRADY Residential Permit Work Class: Demo Lot#: Project#: DEV2018-0010 Construction Type Orig. Plan Check#: Plan Check#: Description: MAGNOLIA-BRADY: DEMO 1,960 SF SFD / / 876 SF GARAGE// 370 SF SHED Applicant: DAVID LOTHER 760-579-1900 FEE BUILDING PERMIT FEE ($2000+) BUILDING PLAN CHECK FEE (BLDG) SB1473 GREEN BUILDING STATE STANDARDS FEE STRONG MOTION-RESIDENTIAL SWPPP INSPECTION FEE TIER 1-Medium BLDG SWPPP PLAN REVIEW FEE TIER 1 -MEDIUM Owner: MAGNOLIA A 3 LLC Total Fees: $ 653.79 Total Payments To Date : $ 653.79 {"Cityof Carlsbad Permit No: CBR2019-1924 Status: Applied: Issued: Closed -Expired 07/23/2019 08/05/2019 PermitFinal Close Out: Inspector: PBurn Final Inspection: Contractor: PEBBLE CREEK COMPANIES 3802 Main St, Ste 10 Chula Vista, CA 91911-6246 619-938-0312 Balance Due: AMOUNT $203.66 $142.56 $1.00 $2.57 $246.00 $58.00 $0.00 Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees /exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees /exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitation has previously otherwise expired. EXPIRED PERMIT PERMIT HAS EXPIREO IN ACCORDANCE WITH c.e.c. SECTION 106.4.4 AS AMENDED BY C.M.C.18.04.030 _ f OAT(_·:_~-~ SIGNAlU~E,<~ )05,.>. l?J Iv Building Division 1635 Faraday Avenue, Carlsbad CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov Page 1 of 1 {cityof Carlsbad RESIDENTIAL BUILDING PERMIT APPLICATION B-1 :::~ :.~::k ~iti~:36 PC Deposit Date ___,J"--#-1,/J.-_3/J-l.j_._lf_ JobAddress u;~4-~~-l\... I Suite: ____ APN: z,o~ -Z-'2-0 -f t; T l &. CT/Project#: z.o\% -f>003 Lot#:. ____ Fire Sprinklers: yes/ no Air Conditioning: yes/ no BRIEF DESCRIPTION OF WORK: 1)...,e..~11, E,_ ~ l -s+ Sf-ru---c.. -h..t...u.,_ S □ Addition/New: _____ Living SF, ___ Deck SF, ___ Patio SF, ___ Garage SF Is this to create an Accessory Dwelling Unit? Yes/ No New Fireplace? Yes/ No, if yes how many? __ D Remodel: ____ SF of affected area Is the area a conversion or change of use ? Yes/ No □ Pool/Spa: ____ SF Additional Gas or Electrical Features? ------------ □ Solar: ___ KW, ___ Modules, Mounted: Roof/ Ground , Tilt: Yes/ No, RMA: Yes/ No, Battery: Yes/ No Panel Upgrade: Yes/ No D Reroof: ------------------------------------ □ Plumbing/Mechanical/Electrical Only: ________________________ _ D Other: ------------------------------------ APPLICANT (PRIMARY CONTACT) Name: }A-Vtd L•+k...c Address: '1602... Mo.~v.. <:,\" ., Sc~.:-\-e \t> City: c.w,._ \J ;~~ State: CA Zip: d) ''" Phone: 760 ~l'f l '?O O Email: 'b4.V {ti Lo-\-\,.....-1@ ~\. u,-.-..,,... DESIGN PROFESSIONAL Name: C,\v,\ ~Wlf'l..~.;, Address: 1\0 U>f~U,006) IJ°"(, S~-t-e. p City: 0Cu1A.s:8..c. State: lit Zip: ,109 Phone: 160 'f Of> ti14 S: Email: J~u .. qe c.ivi,\o..c.c.d2w~ .c.o~ Arct11tect State License: Co 1 ()0 (.,G, -----------f • PROPERTY OWNER Name: ~1"-ol~a. A-~, LL.C kt-{,,._; I?,...,.,,,_ ~'{ o--- Address: 2 f-lo~ <L Sf. • City: R~.rffc'O"I(.. v;tM~te: CJr Zip: 'f 2,6 '!4-- Phone: , , f}o4 -~1(.tt, Email: b ... "'<! pi,u..~\lc,c:.t>~ CONTRACTOR BUSINESS Name: p .. t,I,\ ... ~ ~-~ s. Address: "?f>o2. \,(4-c,...-.. ~, 1 S c..;., +-a \ o City:~\t... V \1,~ State: CA Zip: ,, l C:, l \ Phone: bf q 0 ( ?> :'z ~%4 Email: C,11\Ai' f>olole,CA..U(t..c.o~. Co"1A... State License: 112( '¼o, Bus. License: .... ~ .... L'"'"o=.S::c...._ __ _ \ 2-A4-D11 (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/she 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/she 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}), 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov 8-1 Page 1 of2 Rev. 06/18 ( OPTION A): WORKERS'COMPENSATION DECLARATION: I hearby affirm under penalty of perjury one of the following declarations: □ I have and will maintain a certificate of consent to self-insure for workers' compensation provided by Section 3700 of the Labor Code, for the performance of the work which this permit is issued. □ I have and will maintain worker's compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which th'2:ermit is issued. My workers' compensation insurance carrier and policy number are: lnsuran} Cotpany Name: A"'£\3t&l.~Lf CoA..SIJO.\...\ \.t-0 Policy Ne. l Ao~\ 2.000 f:>'S) -co Expiration Date: '\ O t '2.c) ,1 □ 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 be come subject to the workers' compensation Laws of California. WARNING: Failure to secure workers compensation coverage is unlawful, and shall subject an employer to crlmlnal penalties and clvll fines up to $100,000.00, in addition the to the cost of compensation, damages as provided for in Section 3706 ofthe Labor code, :::::;::G::TURE: ~7Sd-. ~ □AGENT DATE: 23)1/2~, ( OPTION B ): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt from Contractor's license Law for the following reason: □ I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement ls 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). □ r, 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). □ I am exempt under Section ________ Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. □ Yes □ 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/ 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/ address/ phone/ contractors' 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/ type of work): OWNER SIGNATURE: □AGENT DATE: ______ _ -------------------------- CONSTRUCTION LENDING AGENCY, IF ANY: I hereby affirm thatthere is a construction lending agency forthe performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name: _____________________ Lender's Address: ____________________ _ ONLY COMPLETE THE FOLLOWING SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY: Is the applicant or future building occupant required to submit a business plan, acutely haiardous materials registration form or risk management and prevention program under Sections 25505, 2S533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? □ Yes □ No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ Yes □ No Is the facility to be constructed within 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 APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. APPLICANT CERTIFICATION: I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representative of the Otyof Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CllY OF CARLSBAD AGAINST All LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CllY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.OSHA: An OSHA permit is required for excavations over 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 if 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 period of 180 days [Sectio~ 106.~iluilding Code). APPLICANT SIGNATURE: ~~ 1 1 DATE: ? -Z,. ;,.-/f 1635 Faraday Ave Carlsbad, CA 92008 B-1 Ph: 760-602-2719 Fax: 760-602-8558 Page 2 of2 ' Email: Building@carlsbadca.gov Rev. 06/18 PERMIT INSPECTION HISTORY REPORT (CBR2019-1924) Permit Type: BLDG-Residential Application Date: 07/23/2019 Owner: Work Class: Demo Issue Date: 08/05/2019 Subdivision: Status; Closed -Expired Expiration Date: 02/03/2020 Address: IVR Number: 20542 Scheduled· Actual Date Start Date Inspection Type Inspection No. Inspection Status Primary Inspector 08(07/2019 08(07/2019 BLDG-SW-Pre-Con 099943-2019 Checklist Item BLDG-Building Deficiency 08/08/2019 08/08/2019 BLDG-SW-Pre-Con 100107-2019 Checklist Item BLDG-Building Deficiency March 25, 2020 Cancelled Paul Burnette COMMENTS Failed Paul Burnette COMMENTS .,._,•.-.n, MAGNOLIA A 3 LLC THUM LANDS 1534 Magnolia Ave Carlsbad, CA 92008 Reinspection Complete Reinspection Passed No Rei nspectio n Passed No Compl.ete Complete Page 1 of 1 ( City of Carlsbad CONSTRUCTION WASTE MANAGEMENT PLAN 8·59 Development Services Building Division 1635 Faraday Avenue 760-602-2719 www.carlsbadca.gov Section 4.408.1 and Section 5.408.1 of the 2016 California Green Building Standards requires at least 65% of non-hazardous construction debris is recycled and/or salvaged for reuse. With the submitting of your application for a Building Permit or permit issuance, you must have completed a Construction Waste Management Plan (CWMP) demonstrating how you will recycle a minimum of 65% of the construction waste generated from your project. NOTICE: Applicant (contractor and subcontractors) shall comply with the project's CWMP. It is the Applicant's responsibility to collect all receipts from the facilities that recycle their materials AND all project waste/landfill disposal receipts. When working with the City's franchised hauler, Waste Management, one cumulative project receipt is acceptable. However, it is the Applicant's responsibility to confirm that the bins are collected for C&D Recycling. 1. This project shall generate the least amount of waste possible by planning and ordering carefully, following all proper storage and handling procedures to reduce broken and damaged materials, and reusing materials whenever possible. 2. Waste Management Services can provide 2 roll-off bins, one for commingled construction debris and one for trash. The commingled construction roll-off bin will be taken to a Certified Mixed C&D Processing Facility to sort the material and create receipt{s), to demonstrate the project has met a 65% diversion rate or greater. 3. Applicants with a goal of recycling greater than 65% of the project's total waste should work with, the City's exclusive franchised waste hauler, to develop a more specific CWMP. This plan may include using additional roll-off bins for particular phases of construction (e.g., concrete and wood waste) to ensure the highest waste diversion rate possible. 4. Contractors/subcontractors hauling their own waste as part of their scope of work {e.g., construction clean up companies, etc.) SHALL NOT be excluded from complying with the CWMP and shall provide weight and waste diversion receipts from a Certified Source Separated Recycling Facility. For a current list of Certified Recycling Facilities go to b,ttp://www.sandiego.gov/enviro_nmental-servL~.<?,s/recycling/cd/index.shtml. 5. If contractors/subcontractors furnish their own debris boxes as part of their scope of work, they SHALL NOT be excluded from complying with the CWMP and shall provide weight and waste diversion receipts from a Certified Source Separated Recycling Facility. Part 1-Before the Project Begins Prior to issuance of a Building Permit, Applicant must submit PART 1 of the Construction Waste Management Plan (CWMP) Table. a. Submit completed and signed form to City with Building Permit application. Part 2 -During and After the Project Prior to receiving inspection for final sign off of the Building Permit or Certificate of Occupancy, Applicant must submit the fully completed and approved PART 2 of the Construction Waste Management Plan (CWMP) Table. a. Save all receipts and/or documents from reuse facilities, recycling centers, processing facilities, and landfills where materials were taken. b. Complete the Debris Recycling Report (DRR) as your project progresses. Recycling/diversion goals are (at a minimum) 65% of the waste generated by your project. c. Return completed form to: City of Carlsbad Building Division -1635 Faraday Ave, Carlsbad, CA 92008 or your inspector prior to requesting final inspection. Rev. 11/12/18 ------·-------•-"· -· ----------· E:ONSTRUCTION WASTE < ~~ANAGEMENTPLAN ? J . ~\)\_. 'li it B-59 Br...•ilding Division 1635 Faraday Avenue 760-602 2719 w11-1w. carlsbadca. gov Many oi he materials genera q from your pr,oject can be recycled. You ;;Jre requireo to list materials ·hat 'Nill be reused, recycled or disposed from your project. If you have que:.tIon~ about the recycling req irement or comple•if'lg this form, please contact Waste Management at {760) 929-9400, a certified C&D recycler, or the Carlsbad Building Division at (760) 602-2700. Please note: Unless you are ~elf-ha ulin ,._ Waste Management or a roved haulers mus· be used for all construction prQjE?cts within the Cit of Carlsbad. P.:..r l Comp1 ~, ancl submi tn1~ form \II :!n ,pplying ,or ;i Budding Perm· •. :\!ote: Pcm'li ~ \ w1 · 10c t .i comµle ~c' Con~trurti.Jn W;i:;te r ,;in.=ir,er1ent Plt1 . · . Applicant Information · · --· · -•-:--·--• · ---· ·- Permit No. Magnolia-Brady cT201s..0003 CJ3~W-lqJ}roject Title 1534 Ma9nolia Avenue. Calltornla 92008-2624 Project Address ____ _ APN Within 205-220-15 & 205-220-16 Own~• tontr:tctor Applicant Name Galan, Christopher ------0 G) la~r Applicant Address 3802 Main St. Ste. 10. Chula Vista, CA 91911 Phone _ 626 l 298-5932 Applicant Mailing Address (If dl,'fer nt than prOJf!CI address} Project Type (cneck au that aµpr1): ------ __ E-mail Address cg alan@pobblecreekcompanies.co_m ___ _ 3802 Main St. Ste. 10. Chula Vista, CA 919_11 _____ _ ( m l(lill □ Brief Description D mol,tlon or a house and smc1II storage unit. Project Size_ 75.795 sq. 11 (sq,mrr footage) ____ Estimated Cost of Project$ jszs.ooo.ooj Please check the appropriate box: D 1 plan on u!>ing WASTE MA AGEMENT roll-off bin(s) for all m3terials ancl will provide <11 1 receip s after construction. ~ I plan on self-hauling to a certified recycling faclli y and wm provide all receipts after construction. D This is a proposed LEED certified project .ind l plan on separating materials on site in con;unction wit WASTE MA NAG EM ENT. Acknowledgement: I c1mify under penalty of perjury under the laws of the State of California that the informa ion provided 111 and with this form pertains to construction and demolition debris gencr.ited only from the project listed in PI\RT 1. tna: l hrtve reviewed f)e accuracy of the information, and that the information is true and correc 10 i:he be~t of ,y. nowledge and belief. Print Name Christopher Galanc,_ _______ Signature /4. ~,L_ -____ Date 71181'2019 Page 1 of 4 R17, 11/12/18 "::omp ~: , o tab ,;ign<ltUt(>, rind sub 11it thi~ form w,11?11 ,1po ·,-mg for a !::l 1!c, not be 1!.~Ued w1thullt a completl'd Com~r\!c'1' DEBRIS RECYCLING ESTIMATE: Permit No. CT2018-0003 Project Title Magnolia-Brady ---~------------ 1534 Magnolia Avenue, California 92008-2624 APN Within 205-220-15 & 205-220-16 Christopher Fir~I --------- __ Phone ( 626 ) 298-5932 Complete the following table with e timated w;i te tonnage to be generated by your project. 1~ your plan tor con~truct1on waste management. (h;rng s can be made on the fu1dl I e ycle report Goal: the diversion rate shall be 65% by weights of debris. Material Type Comp~ C I {',tj """ of Che /Ob,' ()fl/y ,J only u~lng WAST[ MANAGrMHtr m/1-off b,r.~. Mixed C&D Debris Asphalt & Concrete Brick / 1a sonry I nt e Mi~ed 1,iert Debris Ci1b1nets. Doers, Fixtures, Wmdows {circle aH that ap?ly) C.iri:,c: PJdding i FoJm Carcboard Ceiling Tile (acoustic) Dryw,111 (used. new. sc,ap) LJnt:lscapc Debris (br sh, tret"s, T Estimated Waste Quanti v (tons} 135 Tonr; stumps, etc.) No din. 400 yards of Trees Unpa111ted Wood_&_Pa_l_lc_ts ________ _ Roofing .tateri al~ Sera Metal Stu(CO Otncr· , ixed C&O Oebr,s TOTAL :231 Tons ~o meet o5¼ Diversion Requirement (estimate) A B C Pl,,ce a ( ✓) chec next to it m~ to be reused or salvaged 231 Tons X Place a(✓) c eek next to items to be recycled X 0.65 ::: 150.15 X "j Place a(✓) check next to items to be disposed at landfill tons Toco / Esrimoted Woste from obovl' M1mmum Requ ireo o:version Contractor/Owner Signature d-A/4--Date 7/18/2019 Page 2 of 4 R&v 11112/18 P, ,T ;> Comp.ct~ bdorc fin;il in!>pcction, o ta·n .;: STE MAr-.;AGEMEi.T Jign,i:urt., md 'L ~ .i.iilu,r,g .;:,prov~! DEBRIS RECYCLING REPORT (ACTUAL): ..,.,.,•u•n·.-.• Acknowledgement I certify under penalty of perjury under the laws of the State of California that the information provided in and with this form pertains to construction and demolition debris generated only from the project listed in PART 1, that I have rev,ewed the accuracy of the informatior , and that the information is true and correct to the best of rny knowledge ano belief. -- Permit No. Print Name - Address Date - .._., ... ltlh'■:• Use this Final Log below to track loads of materials a they leave the job site . @(6)SAVE RECEIPTSIO'©' lndicdtt> Fl NAL QL1ant1trP<; ,n tons for f",Kh mi!lctial and ~ave receipt~ and document<; from facilt ies where material 1<; tilk<>n Ad d,t,on.af Pro1ect log, p.ages are av.-rlable 1f ,,ecessary. Use Crty Corwer~1on able to coovNt volume to tons A B C Date Material Type Actual Amt Actual Amt Actual Amt Destination Facility Reused or Recycled Disposed in (Name, Add•ess, Plione) Salvaged Landfill £!OJEPI~ Palomar rronsfe, !>Coc1on, 5960 f.l 01/05/2018 Concrete (broxe11) 5Wn~ Ccmino Real . -(760) 603-0153 --·- ---- I ----. - I I ---' I I I I I -I I I ,. -I --- "·TOTAL .IL,·•- 2: 65% Diversion Rate Achieved I = % :!i6S%0 --rocol of columns A+ R rotm' of columns A + 8.,. C DIVERSION Contractor/Owner Signature Date - Attach the following documentation to this Report: Return completed form an d documentation to: . Orlg,n.il recycling •1cieh l tickets. landfill weigh tick t~ Ci ty of Carlsbad . Original oonation receipts with photo~ .ind/or ilern,zcd descriptions Building D1v1slon (lSl Hoon . Any o ner rele\•;;tnt mforrnat1on to support Recycling Repon 1635 Faraday Avenue C11rl;bad, CA S200S Page 3 of 4 Rev I II, 2/l 8 Conversion Table for Common Construction Waste This document is informational only. It is here to help you convert truckload quantities to ton:., if necessary. Column A Column B Column C Category Material Volume Tons[Unit Tons Maxed Debris Conwuction cy X 0.18 ----- Demol1t1on ---Cy )( 1.19 Asphalt/Concrete Asphalt {broken) cv X 0.70 Concrete (broken) c-; )( 1.20 Concrete (solid slab) Cy X 1.30 ---- Srrtk/Maso·1ry/T, e Br.ck (broken) C't' X 0.70 Brick (whole, palletized I <-y X 1.51 - Masonry brick (broken► cy X 0.60 ~ Tile sq ft X 0.00175 - Building Materials (cabinets, doors, windows, etc.) cy X 0.15 Cardboard (flat) cy X 0.05 - Carpet By souarn foot SQ ft X 0.0005 8y lubic yard cy l( 0.30 Carpe, Padding/Foam sq ft X 0.000125 - Ceiling Tiles Whole (palletiled) cy X 0 0003 - Loose cy X 0.09 -: D•ywa,I (new or used) l/2" (bv square foot) SQ ft X 0.0008 S/8" (by ~quare foot) sq ft X 0.00105 - Demo/used (by cu. yd.) Cy X 0.25 Landscape Debris (brush, trees, etc.) cy X 0.15 Asphalt Composition Shingles, asphalt Shingle cv X U.2.1 - Unpainted Wood/PallN~ By board foot bd ft X 0.00137S - By cubic yard cy X 0.15 - Trash/Garbage Cy X 0.18 Other icstim~:ed weighti <Y X estim-1te ---- cy X es:imate <:y X estimate - cy X estimate - Total all Pc1ge 4 of 4 .. .. (city of Carlsbad DEMOLITION REQUIREMENTS B-9 Development Services Building Division 1635 Faraday A venue 760-602-2719 www.carlsbadca.gov A permit for demolition of a structure can be issued after approval and issuance of a grading permit. Please contact the bulldlng division with questions on the demolltlon process. The following items must be completed prior to Issuance of a demolition permit. ~□ ~□ Completed BuiJdjng Permit ApplJcation (Form B-1): A demolition permit may only be issued to the owner of the property or the State Licensed Contractor that is doing the work. Four (4) sets of plans: Building, Planning, Engineering and Fire division will review and comment/approve the submittal. Letter from Property Owner: The contractor must provide a letter, signed and dated by the property owner, giving permission for the building to be demolished. Demolition Asbestos Certification: This certification must be completed, signed and have the correct square footage of the structure being demolished, as well as its use. -~ San Diego Regional Hazardous Materials Questionnaire: For ALL demolition projects, proof of application to County of San Diego Air Pollution Control District must also be provided. Asbestos or lead paint remediation must occur prior to issuance of a demolition permit by the City Sa)" Diego Gas and Eleetric: Applicant must provide a letter from San Diego Gas and Electric stating that the utilities have been disconnected. Waste Management Plan (Form B-59): Comply with California Green Code waste disposal and recycling management program (65%). Section 4.408.1 and Section 5.408.1. Complete the attached 8-59, Waste Management Plan which estimates the waste to be recycled. Public Property: If applicable provide plans and details demonstrating measures to protect public property and walkways. Additional items that may be required: 1. Water Agency: Arrange for appropriate Water Agency to remove water meter unless construction of replacement structure is to begin shortly, 2. The Planning Division will determine if the structure is in the Village Review area, the South Carlsbad Review area, the Coastal Zone or if discretionary mitigation conditions apply. (760) 602- 4610 3. The Land Development & Engineering Division will determine if a Haul Route, Right-of-Way Permit or Storm Water Permit is required. (760) 602-2750. 4. Fire Department may need the use of the building for training purposes. (760) 602-4665. Rev. 11/12118 1";""""'-0 rr,w : I ( ·. o o o-,...,,-- 4 Ws (fn ~cah-) 'I, s~L p\OV\ * scW.Jvle o't t,-\-nxlvres fu ~ d.emo~J W/ Sf at"\J ½~ ~ ti ~Lt· 111 f o : MJ 1ts'it. $ , po wJ ~ °' ssoc; J ~) k ¥--seop<-ot wA + s.1-o.~'t CA~G\ O.."-1¥ ~MP ,ie""' S fuf&.J 0J ► ().~ ~\'i,COl'\V\..lc-h, fo-r l,J / S /t:_ . OFFICE USE O LY JUL 2 3 2D19 SAN DI EGO REG IONA L HAZARDOUS MATERIALS QUESTIONNAIRE RECORD ID# ________________ _ PLA CHECK It _________________ _ Bus 1ess Co .. ac, ~ i3, <-G <.IUE " a, M~ '.) CV"\ v-, ":> to'D N r 0 ~ \CJ ~ Pro1ect Address, I1"1dudP su, e1 Cit Sl:11e ·, 4 Mo.~/\OJ~ c""''l''':,-a ~· _c A .~a ,ing Address (1 ude su,te) C,•y State 3Bo? MA> ::. r s-i: ... 10 C\.-\v1.--. ::i:STA c A .L 7•r. Cl'lde q2og:,. 7 Zip Code q,C-\ ,~ BP OA-T- o-2-<-tb sq3-z --l ii \?, i,J I • 22.v ·15 t:..:..05--22'0-H;;i Pro1ec1 Contact Applica·1l ~-rna,~I ~"-1,~-- _Cr\}, ,.:';>,v?HG R. 6AL.A'l:'4 ~ _ Cja\av.'.': ... G,.1-.-+~ .. ~~~~-==-'':-'-~~~....,__,--:=c--~,--~=-:..,,.__ ____ _, The following quostlol'ls represent tho facility's activities. NOT the specific project description ro ec'ts within Ute Cit of S.:in Occup.:incy Rating: Facility's Square Footage 1'r-cl.1d1rg prooosed ,i·oIee:1 l: 1 Explosive or Blast,r,g Agents 2 Compressed Gases 3 Fiammable:Combusllb'e Liquids d Flammable Solids 5 Organ,c Pe o.,des 9 Water Reaches 6 Ox.diiers 10 Cryogenics 7 Pyropt>oncs 11 H,ghly Tox,c or To,uc Materials 8 Unstable Re3ct ·,es 12 Radioac1ives 13 Corros, es 14 Ott er Health Hazard 15 None of Thcs-0 PART II: SAN DIEGO C U 1;1..'!!sbons is yes, app.Ica ! mus1 oomact t!-e County of · n D,ei;o Hazard:ius .. atenals D1v1s1on :>:>00 O·,erland Avenue Call (!!58) 505-6700 prior to e i55uance o' 3 buUdi<1g pefTT'• FEES ARE REOULRED Pro,ect Completion Oa:e E~ectcd Da'IO o' Occ.,pancy 0 C.iARPE emp I 1 2 3 4 5 6 7 s YES NO 0 (for new conslruchon or remcdehng proi ds) I~ your bus ni:ss 11&,ed on ihe reverse s:<le of 1h s form? (check .i1I th:11 npply 1 ii] W·II your business dispose of Hazardo;.1s Substances or .1ed,cal Waste in any arrounl? D 0 0 D C D Wdl your business stoie or handle Ha1.ardous Substar-ccs '"quant:tie~ greater th3n or e1:1ual 10 55 g,~fior,; 500 pounds an:l/or 200 cubic feet? W,11 your bu iness store or llandlc carcinogens1,eproduc~ve to•"'s in ""Y qu,mltty? Wdl your b-usir ess use an ex;st,ng or ms!all a underground sloiage tanK? Will your o.isil"ess store or h.ilndle Regul3tec Subst.lrces (CalARPi? W,11 your business •;se or install () Haz· reou~ \\'.:isle i ank System f It,e 22 A cle 10)7 ~ /;ii your sir, ss store ooiro!oum ,n Ian s or ::o t.o•ners at your tacmty v.,:h a toial :aeol y s1tn1.;e :;ap,1-:i:y eqJa' :o or g aler 'h3n 320 gallons'l (Cailfor'l!a·s Ab-oveg•our-.d Petrotcu'l'l Storage Act) :J CalA P Requ,rud CJ C:alARP Complcit ,,, .• ;J ~ PART Ill: SAN DIEGO COU TY AIR POLLUTIO CONTRO DISTRICT (Af'CDI: l he lo,iov.,ng ques~,ons aro ,ntend~-d to rdom,fy lhe majorit-1 of Olf 1)0 lution fSSues at the o•anning sage You• project may reciu·re addi ional measures not identiied by these queslio 1:; Som res,dem,al pro1ects may be exempt from APCD r0<1 •rement~ If yos 1s answor d for 0111\cr qucst,ons I, 2 or 5 or for mo,e comprehel"ls1ve require,ienls please contact APCD at ap;dco,rp~o;ccour.t•, c.a go, (858) SSS-2650 or 10124 Old Grovo Rood San Diego CJ\ 92131 2 3 5 6 YES 0 l:l D D D D \' lit the project disturb 100 square feel or more of exIstIng bu1ldIng ateno!s? Will any load supporting sttuelu al me bers be-removed? (A $WER ONLY IF 0UE$li0\! or 2 IS YESJ Has an asocstos SuNey beer performed b/ an ind •,id,,al 1'131 has passed an i:oPA-.ippro·,ed bu, ,ng irospector course" (ANSWER ON?. Y rF OUESTJO or 2 IS YES1 Based on ine survey resu,ts will the pro1e::I d,:.turb any as~es!os co la,ningmarc1iaI7 If yes iJ nohfica11on may be reqwred al leas! 10 wor1<.ing days p•ior to commercing asbestos remo·,al Add Jionall;· a nohfical1':ln may be requ11ed pror to 11-,e re-n::i al or a load su0oorting slruc; •al meMber s l re:;;.ardless of thv o·cson;;c er ~bl·&tos 'Nill the proJect or assoc,ated construcnor equ,pment emit a r con1am,nanl!>., Seo IM rev rs-, s,de of this form for tyP1cal eQ ipmer1 requiring an APCO permit If yes contac1 APCD prior to the issuance o' a building perm,! 0 □ D (ANS\1VER ON Y IF OUESTI0'\15 IS YESI w,11 the pro,ec or associated conslrudon equ prrert be Iocat d •~t111n I COO feet of a school bouncar,? Briefly dcscnbe bJsiness ac11,1l1ies 6nefly describe p·op!>sed prcictt ~"'-'0 C 0 h...,..w. I b \d ~ ,'\t-' '''\J'€ -~.-, ,., Y)C·~~. De""" e ,_ 1) S -"' .\e -£c....,.1l'1 h .... ..c. .' 7 / I i. V i'1 Dale FIRE DEPART .~E T OCCUPA CY Cl ASSl"ICATION BY DATE I I EXEMPT OR NO FURTHER INFORMAflON REQUIRED R(L~AStO ~OR B,ltL .. CllHG PERMJi BUT 1,10-FOR OCCl/PANCV REL~AS~O FO'l OCCUPANCY CO'-r,. --Y -i \ro· .,uO~Pfb,._ CO _,r,. -v .H."Cl A:>::O cm. ·.rv -io\10 A?CC .I,.' vs -,~,, ~ 11(;/{;_ ;i ~ 0 t l :-1· !.'!' • (:,. -. "'1;.. r,f (\ 0 'A st.Jmp ,n 1r. s bo• onl e• mplr. hJsinesses from complettrs o· i.pda!•r 9 a H3;:ordous M.;1eriat!. Bus ness Olar, Other perm tling requl•el'T"<>r1s Ta, s: Ii apol~· ~•~1-91 /1 •9 18 , ~e~ ft &n.9\e {'a.M 1 C:1, s DEMOLITION ASBESTOS CERTIFICATION ADDRESS: 1534 Magnolia Avenue, California 92008-2624 USE OF BUILDING TO BE DEMOLISHED: Residential Single-Family Home SQUARE -FEET 2,500 sq.ft X: NUMBER OF STORIES _1 ____ _ PROPERTY OWNER: Magnolia A3, LLC ---------------------------ADDRESS: 5 Hoya Street, Rancho Mission Viejo, CA 92694 PHONE 914-584-2041 APPLICANT: Pebble Creek Companies, General Contractor ADDRESS: 3802 Main St. Ste.10. Chula Vista, CA 91911 PHONE 626-298-5932 Section 19827.5 of California Health and Safety Code states in part: "A demolition permit shall not be issued by any city ... as to any building or other structure except upon receipt from the permit applicant of a copy of each written asbestos notification regarding the building that has been required to be submitted to the United States Environmental Protection Agency or to a designated state agency, or both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations, or the successor to that -part. The permit may be i-s-sued without the applicant submitting a copy of the written notification if the applicant declares that the notification Is not applicable to the scheduled demolition project." As applicant for a demolition permit in the City of Carlsbad, I certify that; I have read the excerpt from Section 19827.5 of the Health and Safety Code provided above; the information I have provided on this form is true and correct; and I further certify the following: ( x) On the attached p.a-10 pages are copies of all written asbestos notifications regarding the above referenced building that are required to be submitted to the United States Environmental Protection Agency or to Part 61 of Title 40 of the Code of Federal Regulations, or successor to that part. ( ) I declare that the written asbestos scheduled demolition project. d-);J.,L _- Applicant's Signature notification is not applicable to the 7/18/19 Date Rev. 11/12118 ECS ENVIRONl\!IENTA_L, INC. , SPECIALIZING IN LEAD -MOLD -ASBESTOS \VV\l\·\'.ECS-EN VIRONMENTA LSERVICES.COM July 16, 2019 Tim Belcher ASE Contracting, Inc. 1985 Friendship Drive, Suite J El Cajon, California 92020-1141 RE: Asbestos PCM Air Clearance Inspection 1534 Magnolia Avenue, California 92008-2624 Hallway -Drywall Flooring Dear Mr. Belcher; D ✓ This report documents the findings from the Asbestos PCM Air Clearance Inspection conducted by AHERA Certified Building Inspector, Mason Riley, working under the direction of Bond L. Mccowan, Sr. CAC on July 13, 2019. The air samples were collected within the hallway, after the removal of drywall flooring. Air sample results indicate that all samples passed clearance criteria. Should you have any questions after reviewing the conclusions contained within this report, please do not hesitate to contact ECS Environmental, Inc. ECS remains available to assist you in any way possible. Sincerely, ECS Environmental, Inc. Bond L. Mccowan, Sr. Certified Asbestos Consultant Attachments: Air Sampling Data Sheet 4876 SA TA MONICA AVE, SUITE 172 ~ SA DIEGO, CA 92107 (0) 1-8OO-Stl-6364 (F) 480-719-4-465 WWW.ECS-E VIRONMENTAlSERVICES.COM ECS Environmental1 Inc. Telephone: (800) 511-6364 Fax: (480) 719-4465 4876 Santa Monica Avenue #172 San Diego, California 92107-2811 . AIR SAUPUNG PATA SHEET PROJECT NAME: I ~ 3 t./ . k\\91\0 t ~ o. 1-\v{ 1 Carl S ~o.~ SITE: H-a \l ~ / ABATEMENT caNTRAcroR: ArF ·--------,....---------- SAMPLES COLLECTED BY:._~.,..·-~I){\._. __.._p;_..• t{./j ___________ _ TURN AROUND TIME: ~?::wet P9v'f RESULTS TO: ..... ~_· _~: ___ t ___________ _ PHONE· . FAX· Start End Aver&ge Run Sample AREA FlowRale Flow Rate Flow Rate Start End lime Volume Fbersl Samole# orCLR ~ ....... Locallon llrm\ fan\ Cbnl 1lme lime (Mins} (Lltef's\ Fl8lds l.abRe&uts Commnts 0"0 \ C \4{\.\' v'~ -4 i.,s-J .75' K?'> --fl:i') li,b f'lJ.'1-11/w e,.~,:J. ".,,~.c -'.J _J VlfFI ~~ el J b (6.\\ \c. ~1/Jt) L , 1J1 ""tf t -- l.iO. b \,I &I\\(., ~,oo c .. o\~t ~ _,,, -. SIGNATURE:~ ~~ -Date: 7_/l z,11 TITLE: /?~b1//d4k -jjjz..-, Relinquished~;~~ l';~ Date: 1/ 11/l~ / , ,,, Delivered to/by:. _________ _ Date:. ____ _ Lab Received by: __________ _ Date:. ____ _ Fed-Ex:. ___________ _ APCD ___... ____________ - AIR POUJJno CO'ffllOL OIURIC r CCU'llY Gf UN 1llU B 10124 OLD GROVE ROADJUL 2 3 SAN DIEGO, CA 92131 PHONE: (858) 586-~~5~ '-l apcdcom p@sdcounty.ca .99v I Fee/Receipt NOTIFICATION OF ASBESTOS REMOVAL, RENOVATION, AND DEMOLITION OPERATIONS comp.eted by (=-i11 ar.ie/rtt!e): Chris Galan ____ Company: Pebble Creek Companies NOTIFICATION 0 Original 0 Rev1s1on 0 Cancellation D Courtesy 0 Other (specify): ______ _ ~ lnd,ca~e type ~r ev,s,oo) (l) Demoht,on 0 ncrease ,n asbestos amount (o,eater th~n l0%l 0 Ordered Demol,uon PROJECT TYPE 0 Emergency Removal FACILITY INFORMATION D Emergenc\• Demolrllon I Facility Name: Magnolia Avenue 0 Change in start/end Cate □ Renovation (reriova1: 0 Planned Renovatron (arm a1) Ad ress: 1534 Magnolia Avenue Su:te/Rcom# ( 1f applrcablc) Cross Street(s}: Brady Cir City: Carlsbad Zip Code: 92008 Facility Owner: Magnolia A3, LLC Mdress: 5 Hoya Street City/Stale/Zip: Rancho Mission Viejo, CA 92694 Contact: Ben Ryan Title: Managing Member Pnone No. (619) 804-5768 Building Size($<!. ft.): 1428 Bwld,ng Age (years): 69 Number of loors: 1 Number of units: 1 Building prior/present use: D Com, erc,a, D Hospital □ Industnal D Office 0 K-12 School ' 0 Public Bldg. 0 Residential □ Shi[! 0 Univ./College 0 Other: --PROJECT INFORMATION ·- - FACIUTY Individual who EPA Approved Butldi g SURVEY conducted Survey: John L Payne Inspector Course 25387 f xp1rilt1on date: INFORMATION Certrhcat,01, Number: _______ _ ~~~~ny: C Young Associates ~~~1:~~s: 1042 Skylark Dr, La Jolla, CA 92037 ,~tig8) ~45-7029 D Survey not conducted because suspect materi31s presumed to contain asbestos (asbes~os to oe handled/disposed o' ;)er Rule 1206) rs Asbcsros P··esent? / Will the a~bestos be removed? j Wrll the burldrng be demoltshed? C Ye~ ~Ji Asbestos amount to be removed (sq. ft.): Ye~ :J No ':l, Prev. removed Fri blc Surface Area : ____ _ Category I Surface Area: Category II S rtace Area: Fac,llty (ZI Yes Facility Component: Fac11tty Component: Component: ____ _ Poor Conmt1011: D Yes ::J o 1--R-ev-i-sed--A-,,,-0-u_nt_s ________________ _ Poor Conclition: C Yes D No if a rev1ston Asl>estos Remova Removal Start Date. ________ _ Demo t on Operation Demo Start Date: 08/05/2 19 C No I Total (sq. ft.) Regulated Asbestos Containing Materials to be Removed: Removal End Date: Demo End Date: 09/20/2019 _______ _ For revisions only For revisions on y -----------1 Rev,sed Removal Start Date· _________ _ Revised Demo Start Date: __________ _ Rev,sea emoval Ena Date: Revised De~111.,_,o'""E::.an~d'-'P"'"a"'t'-"e-'--: ----------------4 Removal Contractor: I .ime: ASE Cont racting , Inc Phone No: (619) 258-7290 Contact Person. im Berche' .A.daress: 1985 Friendship Or, Suite J City/Seate/Zip: Ef Cajon , CA / -itle: ~::;!'~~~: ·,anie BTS EQu1prnent Un11mited Inc Phone O (619) 324-7065 ..:.o;1Lact Pe·son: ~O"ru.a 3·,,a m Jr Adoress: 13465 Camino Canada 106-501 City/State/Zip: El Cajon I Title: Project Mgr "Asbestos Su<veys arE' requ,r~ prior to Renovat,on or Dcmol1t1on. A copy of ttie sun,ey mu~t be ma1nt.i1,ed or,~ LC to, tile oura·1on of th~ e-0-1=-.. -...J Rev. 12/2017 Page 1 or 2 NOTIFICATION OF ASBESTOS REMOVAL, RENOVATION, AND DEMOLITION OPERATIONS (PG. 2) .-Waste Transporter (asbestos) Waste Transporter (non-asbestos) ~.une: i'.ame: BTS Equipment Unlimited, Inc. Address Address: 13465 Camino Canada 106-501 - City/State/Zip: City/State/Zip. El Cajon, CA 92021 -Contact Phone: Contact Ronnie Swaim jr Phone: (61 9) 726-4192 Person: 0erson: Landfill Site (asbestos) Landfill Site (non-asbestos) Name: Name: EDCO Disposal - Add,ess; Address: 6670 Federal Blvd I -I City/State/Zip· City/Stclte/L1p: Lemon Grove/Ca/91945 I Co:itact Phone: Cont.Kt Lupe [ onorc: (619) 287-7555 =>er_~_Q"'' Pers.on: Asbestos Detection Procedures Che<:k the procedures and analyt,c-al rneth-Ods use<i to detect the prcscnceof asoestos. - !1:l Survey El I P~pection r TC•·• C PCM E Sulk Sampling 0 PLM 0 Other: Describe work practices and engineering controls to be used. Check applicable methods below: -A:ib!:~51:i B!:Dl51¥i!I erau:tl!:ti Dgmolltion Work erng;is;S::i ::J Water D lnfrared 1''.d<'.hines 0 Hammers '.J Exp1os1011/lmp!os1011 a Amended Water D Pry 8ars 0 Axes :J Jntent,o,,al Burn ng Cl Cutting Saw □ NegrH,vc. A,r Machines D Shoveli. ~ Skid Loaders/bobcats/Top LoilderS L Pressure Water 6la5t 0 I ull containr,ent 0 Bulldo,e, '.J Cranes (wreck,ny :MIi, damshell. 0 Bead Blast 0 3 Stage Deacon 0 Backlloes buckel) 0 Other· ft-:.ev.t .. •• ~'\',,1!n h,. 41.0h. ["· Floor Buf•e· 0 Glove Bag --~-- r Term,nator'v 0 Critical Barners □ Hf:.PA vacuum 0 Other: For Ordered Demolition provide a copy of the order and complete th-e information below: Agency Authorizing j n tle: Name: Person: Date of Date Ordered Phone: r\,An,• In"~-··" Contingency Plan Describe actions to be followed 1r unexpected c1sbestos ,s found during demol1tiontc1batement or If nonfr1able asbestos rnatenal becomes; crumbled, pulvenzed or re<iuced to i>0wder. If unexpected hazardous materials are believed to be 'ound. said wor\\ w,ll be stopped BTS 100 s•te !oreman w 11 ·1ot1fy BTS" office who w1U then advise the General Contractor of current f,ndsngs Hazardous survey will tnen oe conduc:ed by cert '.ea ab to oorrorm IP.!<,'.in,i ;ino 1rtP.nttfv n;i1;irrtc; wnprp" olan fnr ,,.mnvi,I w,111:,,-r.r.-11t"9 _ _i!_t..,'lt rP.'\1111« r.omP h:,r.k nn:<.1hv.-fn· h,i~>1rnt:,,1!'. mAf Prml<i I cemty that an individual trained in u,e prov1s1ons or this regulation (Rule 1206 (()(8)) will be on Traini ng Certification s,:e durin9 asbesto-., removal ana evidence that the required traini:1g li!S bee1 accomplished ~Y th,-, ~-----------4-'p::...e.:..r.:;.s.:;.o_n_v_,_ill_b.:..e;.;._a_v_a_llable for inspection dt1ring normal business hours_. ___________ _ D<1te · 07/19/2019 f~~~~.~O:;t~r) Christopher Galan I ~~~:;:;i;;,~~O•J ~,4~,h_., J.u'.-u l Information Certification By signing this form I certify that the information on this form ,s complete and correct. As !>1gf\tttory I am acc.e tin le al responsibility for the 1nformat1on on th,s form"'·------------ Date: 07/19/2019 ;~~!..=!~) Christopher Galan S gnaturi~: 1-;, ~ , ., • I {0."Yne-r/Ope,,at_"'_' ___ ·. -"_-_.,,_,,_~_;1"_=_• _.,_ ..• _·«_•"' ___ _, Ong ral not1",cat•on~ ml.st t>e SL.brr1t:e:i to U·1c Dt~tn:.t at lc,➔~l 10 ~vorl(1og day~ i:;r:or lo rcriiovd or ccn . .., •t C'l. ~~v1"iec rc1 fi~J~1:in:, r••J~t I,;(,.• submitted one· lo the orioina• start oate. The 01stnct must receive payment by close of t>us1ne5s of tne next ,•1ork1n9 ddy "'ter the errect1VP date of th(' not1f1cat,on. The o,smct con~1dcrs subM1ltcd Not,f cations. (or1g1nal and rev,seo) w thou: the required fee(s) iJ5 state~ n Rule 40(1)(2) lo L>e <:on,-1:JCrt'C invalid Not rications shall expire with n 365 dav~ 'rorn trc cffccl ve d-,ce. Rev 1212017 Page 2 of 2 t!'1JG,. 61.,,,'E A~ Sempra Energy utility" .ll .1L 3 0 2019 ') Notice of Service Disconfijnuance PERMIT DEPARTMENT, CITY OR COUNTY OF: Carlsbad SERVICE WILL BE DISCONTINUED TO: ADDRESS: 1534 Magnolia Avenue BY: (Date) July 29, 2019 !XI ELECTRIC METER NO. 5614260 !XI GAS METER NO. 142409 ALL SERVICE LINES WILL BE REMOVED. THIS BUILDING CAN BE MOVED OR RAZED AFTER THE ABOVE DATE. SAN DI EGO GAS & ELECTRIC BY: CA::j~ PHONE: 760.480.7728 __________ _ DATE: July 30, 2019 STORM WATER POLLUTION PREVENTION NOTES 1. ALL NECESSARY EQUIPMENT AND MATERIALS SHALL BE AVAILABLE ON SITE TO FACILITATE RAPID INSTALLATION OF EROSION AND SEDIMENT CONTROL BMPs WHEN RAIN IS EMINENT. 2. 1HE OWNER/CONTRACTOR SHALL RESTORE ALL EROSION CONTROL DEVICES TO WORKING ORDER TO THE SA llSF ACTION OF THE CITY INSPECTOR AFTER EACH RUN-OFF PRODUCING RAINFALL. 3. THE OWNER/CONTRACTOR SHALL INSTALL ADDlllONAL EROSION CONTROL MEASURES AS MAY BE REQUIRED BY THE CITY INSPECTOR DUE TO INCOMPLETE GRADING OPERATIONS OR UNFORESEEN CIRCUMSTANCES WHICH MAY ARISE. 4. ALL REMOVABLE PROTECTIVE DEVICES SHALL BE IN PLACE AT THE END OF EACH WORKING DAY WHEN THE FIVE (5) DAY RAIN PROBABILITY FORECAST EXCEEDS FORTY PECENT ( 40%). SILT AND OTHER DEBRIS SHALL BE REMOVED AFTER EACH RAINFALL. 5. ALL GRAVEL BAGS SHALL CONTAIN 3/4 INCH MINIMUM AGGREGATE. 6. ADEQUATE EROSION AND SEDIMENT CONTROL AND PERIMETER PROTECTION BEST MANAGEMENT PRACTICE MEASURES MUST BE INSTALLED AND MAINTAINED. 7. THE CITY INSPECTOR SHALL HAVE THE AUTHORITY TO ALTER THIS PLAN DURING OR BEFORE CONSTRUCTION AS NEEDED TO ENSURE COMPLIANCE WITH CITY STORM WATER QUALITY REGULATIONS. OWNER'S CERTIFICAIB: 1 UNDERSTAND AND ACKNOWLEDGE THAT I MUST: (1) IMPLEMENT BEST MANAGEMENT PRACTICES (BMPS) DURING CONSTRUCTION ACTIVITIES TO IBE MAXIMUM EXTENT PRACTICABLE TO AVOID THE MOBILIZATION OF POLLUTANTS SUCH AS SEDIMENT AND TO AVOID THE EXPOSURE OF STORM WATER TO CONSTRUCTION RELATED POLLUTANTS; AND (2) ADHERE TO, AND AT ALL TlMES, COMPLY WITH THIS CITY APPROVED TIER 1 CONS1RUCTION SWPPP THROUGHOUT THE DURATION OF THE CONSTRUC110N ACTIVITIES UNTIL THE CONS1RUCTION WORK IS COMPLElE AND APPROVED BY THE CITY OF CARLSBAD. 1> AV to LD-rtt::~lZ-· OWNER(S)/OWNER'S AGENT NAME (PRINT) t SIGNAWRE E-29 STORM WATER C.OMPLIANCE FORM TIER 1 CONSTRUCTION SWPPP BEST MANAGEMENT PRACTICES (BMP) SELECTION TABLE Erosion Control· Sediment Control BMPs Tracking Non..storm Water Waste Management and Materials BMPs Control BMPs Management BMPs Pollution Control BMPs ·-- I c:: I C: C 0 .... ..... I 0 0 ::;:::; C: I "O :;::; ::;:::; (I) "O C: I C: C7l 0 E C: (I) "O en ! u u C: .!= C7l E c:: .... 0 .... ::i :::l 0 ·;:; a. 0 0 E .$! L. ,.__ ::;:::; "O ,._ ·3 (I) 0 ::i: "Ort! I O> L ...., ..... C: '->, O'> O> C: Cl) L C: (I) .s {I) "' rn ~ ·;:; CT ,._ 0 C: 015 a. (I) ·c c: rn C: L. w !!: 0 Best Management Practice* ~ c:: 0 CD 'ii. .... 0 (I) 0 .... (.!) Q) C: :c (/) 3: en ~ Q) 0 C: (_) (I) ..... ~ Q) 0 :;:::; ...., J E Q) O'> ·a c: 0 L. en "O O'l i "O C/l :::e C: Q) C: (BMP) Description ➔ rn u Q) en O'), O'> rn O'> C C: 0 ~ ..., Q) Q) (I) 3 C: ~~ c:: C: ::J "3 ~ (I) u ... C '6 0 ,.__ 0 "O >, 0 f/) 0 ~E :5 C: Cl CD en·-O'> Cl•-~o (_)Cl) Oo O> Q) (I) :::!, C) 01 C. e:::: .... E 0 ..... N rtl Q) 0 Q) □ = ,.___ 3; Q) X 0 Q) 111 E (rl = rn =3 u c,,~ ~-~ ·-C, C. a.. e 2 l E .:,,{_ J .n ,._•-..0 ·c O> -c ..c C: LL u L. Q) ::, -0 --. Q) ·--o Q) ..... C: 0 u C: ... 0 .:,,{_ -0 0 0 ..... ·-'o Q) (I) :J L.. .... ..Cl L.. .c 0 1, e -~ ~ 0 ·-0 Q) L.. Q) u _ .... 0 ... 0 .... Q) 0 '-u C 00 0 O> ...., .s:: Q) ..., 0 .... 0 = C: ·-c:: (I) i 0 L.. v.i Q) ..c ~ '-.... 0 0 +'"-vi C: .Eo 0 CU-o..., Cl .... 0. 0 oo {!) WC er, (.) Cl cn> U1 cnn. (/) a,:: 3= a.. ll..O a.. >o ~cn :::e en cno en :::::;;; CASQA Designation ➔ r--Q) CJ) ~ tr) ..t-IO <D r--ro 0 N tr) r--to .,.... c-i r<) ..t-IO ... .,.... .--.... ..... 6 I I I! I I' I I ~ I I I I I I I I I l l I I I (_) (.) f3 w I.J.J I.J.J I.J.J, w w w g: ~ (/) (/} (/) (/) :::E :::i': i :::,, ~ Construction Activity L,,J LLl w (/} (/) (/J (/) en (/) en u, z z z ::z: ·3: 3: 3: 3l:: Gradinq/Soil Disturbance ✓ v ✓ V v ✓ V v' Trenchino/Excavatfon ' Stockoilina i Drillina/Borina Concrete/ Asoh alt Sawcutting Concrete 0Flatwork Paving Conduit/Pioe Installation Stucco/Mortar Work I Waste Disoosal i Stoaina/Lav Down Area Eauioment Maintenance and Fuelina Hazardous Substance Use/Storacie Dewaterina I Site Access Across Dirt I Other (list): I . I Instructions: 1 1. Check the box to the left of all applicable construcpon activity (first column) expected to occur during construction. 2. Located along the top of the BMP Table is a list of BMP's with it's corresponding California Stormwater Quality Association (CASQA) designation number. Choose one or more BMPs you intend to use during constructior from the list. Check the box where the chosen activity row intersects with the BMP column. 3. Refer to the CASQA construction handbook for info1malion and details of the chosen BMPs and how to apply them to the project. i i PROJECT INFORMATION Site Address: IS:~+ ~o.r&~ Ave. Assessor's Parcel Number: 1,,,0 '5" -2-ZO-l ~ f ( lo Emergency Contact: Nome: G1.Ln1 Av-1'\1 \.B 24 Hour Phone: bl9 '!:z8-o ~\ 2- Construction Threat to Storm Water Quality (Check Box) 0 MEDIUM ~W Q) -+-' rn 0 ;::: _. C: rn Q) ::i E 0 Q) 'U 0, 5c N C: c,O :::r:::::!!: [C) I :::e 3: Q) .... rtl 0-+-' ~ C: Q) m E .... Q) Q) r::r, t, 0 c:; c:; oo (.)~ co I :::e 3= v Page 1 of 1 REV 11/17