HomeMy WebLinkAbout1753 Buena Vista Way; ; CBRA2018-0060; PermitPermit
Print Date: 10/30/2019
Job Address:
CCityof
Carlsbad
Permit No: CBRA2018-0060
Permit Type:
Parcel No:
1753 Buena Vista Way
BLDG-Associated Permit Resi
1562206500
Work Class:
Lot#:
Single Family Detached
12
Status:
Applied:
Closed -Finaled
03/13/2018
04/17/2019 Valuation:
Occupancy Group:
# Dwelling Units:
Bedrooms:
Project Title:
$463,812.60
1
3.00
VADA FARM
Reference #: DEV02058
Construction Type: VB
Bathrooms: 3.50
Orig. Plan Check#: PC2017-0048
Plan Check#:
Issued:
Permit
Finaled:
Inspector: MColl
Final
Inspection: 10/30/2019 11 :08:00A
Description: VADA FARM: PHASE 1// LOT 12// PLAN lA// 2,867 SF// 205 SF PATIO// 479 SF GARAGE// 124 SF PORCH
Applicant:
MARY NETTLES
5927 Priestly Dr, 110
Carlsbad, CA 92008-8800
760-918-2829
BUILDING PERMIT FEE ($2000+)
BUILDING PLAN CHECK FEE (BLDG)
Owner:
TRUST VADA FAMILY TRUST 03-12-90
1835 Buena Vista Way
CARLSBAD,CA 92008
ELECTRICAL BLDG RESIDENTIAL NEW/ADDITION/REMODEL
GREEN BUILDING STANDARDS PLAN CHECK & INSPECTION
MECHANICAL BLDG RESIDENTIAL NEW/ADDITION/REMODEL
PARK IN-LIEU FEES SF DETACHED & DUPLEX: NW
PLUMBING BLDG RESIDENTIAL NEW/ADDITION/REMODEL
PUBLIC FACILITIES FEES -outside CFO
SB1473 GREEN BUILDING STATE STANDARDS FEE
SDCWA SYSTEM CAPACITY CHARGE 5/8" Displacement
SEWER CONNECTION FEE (General Capacity all areas)
STRONG MOTION-RESIDENTIAL
SWPPP INSPECTION FEE TIER 1-Medium BLDG
SWPPP PLAN REVIEW FEE TIER 1-MEDIUM
TRAFFIC IMPACT Residential Single Fam. Outside CFD
WATER METER FEE 1" Displacement (P)
WATER SERVICE CONNECTION FEE 5/8" DISPLACEMENT (P)
WATER TREATMENT CAPACITY CHARGE 5/8" Displacement
Total Fees: $42,258.26 Total Payments To Date: $42,258.26
Contractor:
CALIFORNIA WEST CONSTRUCTION INC
5927 Priestly Dr, 110
Carlsbad, CA 92008-8800
760-918-6768
Balance Due: $0.00
$1,918.20
$1,235.32
$66.00
$170.00
$92.00
$7,649.00
$182.00
$16,233.44
$19.00
$5,267.00
$960.00
$60.30
$246.00
$56.00
$3,390.00
$282.00
$4,286.00
$146.00
1635 Faraday Avenue, Carlsbad, CA 92008-7314 I 760-602-2700 I 760-602·8560 f I www.carlsbadca.gov
PERMIT INSPECTION HISTORY REPORT (CBRA2018-0060)
Permit Type: BLDG-Associated Permit Residential Application Date: 03/13/2018 Owner:
Work Class: Single Family Detached Issue Date: 04/17/2019 Subdivision:
Status: Closed -Finaled Expiration Date: 04/27/2020 Address:
IVR Number: 10096
Scheduled Actual Date Start Date Inspection Type Inspection No. Inspection Status Primary Inspector
10/29/2019 10/29/2019 BLDG-Final
Inspection
10/30/2019 10/30/2019 BLDG-Final
Inspection
Checklist Item
BLDG-Building Deficiency
BLDG-Building Deficiency
109092-2019
Checklist Item
BLDG-Building Deficiency
BLDG-Building Deficiency
109260-2019
Checklist Item
BLDG-Building Deficiency
BLDG-Building Deficiency
BLDG-Building Deficiency
BLDG-Plumbing Final
BLDG-Mechanical Final
BLDG-Electrical Final
BLDG-Fire Final 107951-2019
Checklist Item
FIRE-Building Final
October 30, 2019
COMMENTS
No superintendent on site, job office locked
See card for pick up
Partial Pass Michael Collins
COMMENTS
No superintendent on site, job office locked
See card for pick up
Passed Michael Collins
COMMENTS
See card for pick up
No superintendent on site, job office locked
Scheduled
COMMENTS
Felix Salcedo
TRUST VADA FAMILY TRUST
03-12-90
1753 Buena Vista Way
Carlsbad, CA 92008
Reinspection Complete
Passed
No
No
Reinspection Incomplete
Passed
No
No
Complete
Passed
Yes
No
No
Yes
Yes
Yes
Incomplete
Passed
No
Page 3o1
PERMIT INSPECTION HISTORY REPORT (CBRA2018-0060)
Permit Type: BLDG-Associated Permit Residential Application Date: 03/13/2018 Owner: TRUST VADA FAMILY TRUST
03-12-90
Work Class: Single Family Detached Issue Date: 04/17/2019 Subdivision:
Status: Closed -Finaled Expiration Date: 04/27/2020 Address: 1753 Buena Vista Way
10096 Carlsbad, CA 92008
IVR Number:
Scheduled Actual Inspection Type Inspection No. Inspection Status Primary Inspector Re inspection Complete Date Start Date
07/31/2019 07/31/2019 BLDG-16 Insulation 099278-2019 Passed Michael Collins Complete
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
08/07/2019 08/07/2019 BLDG-17 Interior 099975-2019 Passed Michael Collins Complete
Lath/Drywall
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
BLDG-18 Exterior 099974-2019 Passed Michael Collins Complete
Lath/Drywal I
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
08/08/2019 08/08/2019 BLDG-23 1 00213-2019 Passed Michael Collins Complete
Gas/Test/Repairs
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
10/03/2019 10/03/2019 BLDG-Final 106410-2019 Failed Michael Collins Reinspection Complete
Inspection
Checklist Item COMMENTS Passed
BLDG-Building Deficiency No superintendent on site, job office locked No
10/07/2019 10/07/2019 BLDG-Electric Meter 106637-2019 Passed Michael Collins Complete
Release
Checklist Item COMMENTS Passed
BLDG-Building Deficiency EMR emailed to SDGE Yes
10/17/2019 10/17/2019 BLDG-Gas Meter 107859-2019 Passed Peter Dreibelbis Complete
Release
Checklist Item COMMENTS Passed
BLDG-Building Deficiency No
10/25/2019 10/25/2019 BLDG-Final 108727-2019 Failed Mlchael Collins Reinspection Complete
Inspection
Checklist Item COMMENTS Passed
BLDG-Building Deficiency See card for pick up No
BLDG-Building Deficiency No superintendent on site, job office locked No
10/28/2019 10/28/2019 BLDG-Final 108913-2019 Partial Pass Michael Collins Re inspection Incomplete
Inspection
October 30, 2019 Page 2 o1
'~ -~--.·· .••·-.. -··· ~~' ~--·-----
PERMIT INSPECTION HISTORY REPORT (CBRA2018~0060)
Permit Type: BLDG-Associated Permit Residential Application Date: 03/13/2018 Owner: TRUSTYADA FAMILY TRUST
03-12-90
Work Class: Single Family Detached Issue Date: 04/17/2019 Subdivision:
Status: Closed -Finaled Expiration Date: 04/27/2020 Address: 1753 Buena Vista Way
IVR Number: 10096 Carlsbad, CA 92008
Scheduled Actual Inspection Type Inspection No. Inspection Status Primary Inspector Reinspection Complete Date Start Date
05/02/2019 05/02/2019 BLDG-21 090634-2019 Passed Tim Frazee Complete
U nderg rou nd/Underf
loor Plumbing
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
05/10/2019 05/10/2019 BLDG-11 091521-2019 Cancelled Tim Frazee Reinspection Complete
Foundation/Ftg/Pier
s (Rebar)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency No
05/30/2019 05/30/2019 BLDG-11 093233-2019 Passed Paul York Complete
Foundation/Ftg/Pier
s (Rebar)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency No
07/01/2019 07/01/2019 BLDG-15 096158-2019 Partial Pass Michael Collins Reinspection Incomplete
Roof/ReRoof (Patio)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Need truss design drawings for AOS4-6. Yes
07/08/2019 07/08/2019 BLDG-13 Shear 096798-2019 Failed Michael Collins Re inspection Complete
Panels/HD (ok to
wrap)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Not ready No
07/11/2019 07/11/2019 BLDG-13 Shear 097210-2019 Passed Paul Burnette Complete
Panels/HD (ok to
wrap)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Not ready Yes
07/23/2019 07/23/2019 BLDG-84 Rough 098385-2019 Passed Michael Collins Complete
Combo(14,24,34,44)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
BLDG-14 Yes
Frame-Steel-Bolting-Welding
(Decks)
BLDG-24 Rough-Topout Yes
BLDG-34 Rough Electrical Yes
BLDG-44 Yes
Rough-Ducts-Dampers
October 30, 2019 Page 1 of
~
~~CIT ~ OF CBRA2018-0060 L~ \7-.
CARLSBAD
Building Division INSPECTION . RECORD 1753 BUENA VISTA WAY
VADA FARM : PHASE 1 // LOT 12 // PLAN 1A // 2,8f,7 SF//
205 SF PATIO// 479 SF GARAGE// 124 SF PORCH
~":°PECTION RECORD CARD WITH APPROVED I '----"ANS MUST BE KEPT ON THE JOB
0 CALL BEFORE 3:00 pm FOR NEXT WORK DAY INSPECTION
0 FOR BUILDING INSPECTION CALL: 760-602-2725
DEV02058
PC2017-0048
1562206500
4/18/2018
OR GO TO: www.Carfsbadca.gov/Building AND CLICK~ON,.
"Request Inspection" -CBRA2018-0060
DATE: 4-
If "YES" is checked below that Division's approval is required 1irior to re uesti_ng a Final Building Inspection. If you have any questions
please call the applicable divisions at the phone numbers provided below. After all required approvals are signed off-fax to
760-602-8560, email to !)Id ins ections@carlsbad<,.~.ru,_y_ or bring in a COPY of this card to: 1635 Faraday Ave., Carlsbad.
IF MARKED 'YES", IT IS REQUIRED PRIOR TO ANY CONSTRUCTION
STORM WATER PRECON MEETING REQUIRED 760-602-2725 Allow 24 hours
IF MARKED "YES", APPROVAL REQUIRED PRIOR TO REQUESTING BUILDING
Fire Prevention 760-602-4660
Planning/Landscape 76~944-8463
CM&I (Engineering Inspections) 760-438-3891
#12 REINFORCED STEEL ,. MASONRY PRE GROUT
GROUT □ WALL DRAINS
#1~ TILT PANELS
#11 POUR STRIPS ----------+-----1--------l #11 COLUMN FOOTINGS
#14 SUBFRAME □ FLOOR □ CEILING
#15 ROOF SHEATHING
#13 EXT. SHEAR PANELS
#16 INSULATION
#18 EXTERIOR LATH
#17 INTERIOR LATH & DRYWALL
#24 TOP OUT □ WASTE □ WTR
#27 TUB & SHOWER PAN
#23 AS TEST □ GAS PIPING
#25 WATER HEATER
#28 SOLAR WATER
BLDG-FINAL
CODE# POOLS
#51 POOL EXCAV / STEEL
#52 PLUMBING
Hr. ELEC /CONDUIT/WIRING
EQUIPOTENTIAL BOND
ff:>O PREPLASTER / FENCE/ ALARMS
#57 GUNITE
BLDG-FINAL
REV 9/17
Date Ins ector
Allow 48 hours
Allow 48 hours
Call before 2 pm
#32OTEMP0RARY
#35 PHOTO VOLTAIC
#38 SIGNS
BLDG-FINAL
CODE # MECHANICAL
#41 UNDERGROUND DUCTS & PIPING
#44 0 DUCT & PLENUM O REF. PIPING
#43 HEAT-AIR COND. SYSTEMS
CODE# COMBO INSPECTION
#81 UNDERGROUND (11,12,21,31)
#82 DRYWALL,EXT LATH, GAS TES (17,18,23)
#83 ROOF SH EATING, EXT SHEAR (13,15)
#84 FRAME ROUGH COMBO (14,24,34,44)
A/S UNDERGROUND VISUAL
A/S UNDERGROUND HYDRO
A/S UNDERGROUND FLUSH
A/S OVERHEAD VISUAL
A/S OVERHEAD HYDROSTATIC
A/S FINAL
F/AR0UGH-IN
F/AFINAL
FIXED EXTINGUISHING SYSTEM ROUGH-IN
FIXED EXTING SYSTEM HYDROSTATIC TEST
FIXED EXTINGUISHING SYSTEM FINAL
MEDICAL GAS PRESSURE TEST
MEDICAL GAS FINAL
Date
Date
COPYOFCARD
REQUIRED
Ins ector
Ins ector
SEE BACK FOR SPECIAL NOTES
bl-tA, Inc
land planning, civil engineering, surveying
March 10, 2019
w.o. 944-1289-600
Mr. Tim Frazee
CITY OF CARLSBAD,
Building Inspection Division
1635 Faraday Avenue
Carlsbad, CA 92008
ROD BRADLEY, Urban Planner
RONALD L. HOLLOWAY, Civil Engineer
RE: BUILDING FORM VERIFICATION FOR LOTS 1, 2, 7 AND 8 OF
THE YADA FAMILY FARM SUBDMSION, CT 15-11
Dear Mr. Frazee:
This letter is to attest that BHA, Inc. has staked the locations for the house construction on the
above-mentioned lots. We have checked the locations of the building forms of the proposed
houses and found the horizontal and vertical locations to conform to the grading plans
prepared by our office.
If you have any questions regarding this matter, please contact our office.
Sincerely,
bl-IA, Inc.
12,-..-~
Ronald L. Holloway
Senior Vice President
RCE29271
cc: Jim Hall-California West Communities
K:\Civil 3D\1289\PROD\Survey\Pad-Form Certs\forms\CT 15-11 _ Lots 1-2-7-8 bldg-form-verification.wpd
5115 Avenida Encinas, Suite L o Carlsbad, California 92008-4387 o (760) 931-8700 o FAX (760) 931-7780
b~A,lnc
land planning, civil engineering, surveying ROD BRADLEY, Urban Planner
RONALD L. HOLLOWAY, Civil Engineer
May 10, 2019
w.o. 944-1289-600
Mr. Tim Frazee
CITY OF CARLSBAD.
Building Inspection Division
1635 Faraday Avenue
Carlsbad, CA 92008
RE: BUILDING FORM VERIFICATION FOR LOT 12 OF THE
YADA FAMILY FARM SUBDMSION, CT 15-11
Dear Mr. Frazee:
This letter is to attest that BHA, Inc. has staked the location for the house construction on the
above-mentioned lot. We have checked the location of the building forms of the proposed
house and found the horizontal and vertical location to conform to the grading plans prepared
by our office.
If you have any questions regarding this matter, please contact our office.
Sincerely,
bl-tA, Inc.
·L~{
Ronald L. Ho11oway
Senior Vice President
RCE 29271
~oVESSJo;
"v '?. . '4<
~> ~-~ · RONALD L. · '.-Jc. . t, HOLLOWAY ~
~ : KO. 29271 . gJ
'* * u>~ CJV\\. · ~~ 47' -c:,~· e OF Ci\\.\'t
cc: Jim Hall-California West Communities
K:\Civil 3D\1289\PROD\Survey\Pad-Form Certs\forms\CT 15-1 I_Lots 12 bldg-form-verificntion.wpd
5115 Avenida Encinas, Suite L o Carlsbad, California 92008-4387 c, (760) 931-8700 FAX (760) 931-7780
PROJECT: CALWEST
\
\
\
/
DESC. LOT 12 FORM AS-BUILT
\
\
SCALE
1" = 20'
\
1 / ~~, / a>,\...
\
\
\ 10905
\ 177.96
✓ rS
,;-:~\ \
/
\ \
\ \
/
/
/
/
/
/
/
/
/
SURVEY DATE: 5/28/19
Page 1 off
GEOSOILS, INC. W.0.: 7377-C-SC
Geotechnicsf. Coastal -Geologic-Environmental DATE: 04/22/19
NAME: TODD
HOURS: 2.5
FOOTING TRENCH OBSERVATION SUMMARY
CLIENT NAME: CAL-WEST PROJECT NAME: ______ Y.:_A_D.:_A ____ _
LOCATIONfTRACT: YADA PL. CARLSBAD, CALIF
UNIT/PHASE/LOTS: LOTS 1,2.7,8,AND 12
REFERENCED GEOTECHNICAL REPORT: 6927-A-SC DATED AUGUST 3, 2015
OBSERVATION SUMMARY
TG INIT!ALS -------04/22/19 DATE -------
TG INITIALS -------04/22/19 DA TE
TG IN1TIALS --------04/22/19 DATE
TG INITIALS -------
04/22/19 DATE -------
A representative of GeoSoils, Inc. observed on site soil and footing conditions. Soil conditions in the trench
are generally free of loose soil and debris, non-yielding and uniform, and plumb; and are in general
conformance with those indicated in the geotechnical report
A representative of GeoSoils, Inc. observed and reviewed footing excavation depth/width. Footing
excavations generally extend to proper depth and bearing strata. and are in general conformance with
recommendations of the geotechnical report.
A representative of GeoSoils, Inc. reviewed footing setbacks from slope face (if applicable). The setback was
in general accordance with the recommendations of the geotechnical report.
CONSULT THE PROJECT STRUCTURAL ENGINEER ABOUT GRAVEL FROM UTILITY LINE
ADJACENT NE CORNER OF LOT 12.
NOTES TO SUPERINTENDENT/FOREMAN
1. Footing excavations should be cleaned of loose debris and thoroughly moistened just prior to placing concrete.
2. Based on expansion potential of underlying soils, presoaking of soil below slabs may be recommended. Consult the
geotechnical report for presoaking recommendations. We note that clayey soils may take an extended period time for
such, and the contractor should schedule accordingly. ·
3. In the event of a site change subsequent to our footing observation and prior to concrete placement (i.e. heavy rain, etc.),
we should be contacted to perform additional site observations and/or testing.
4. This memo does not confirm the minimum footing dimension as required by the project structural engineer's design, if
different from the geotechnical report.
NOTES TO BUILDING INSPECTOR
Soil compaction test results, as well as depth of fill, relative compaction, bearing values, corrosivity, and soil expansion index test results are
contained in the As-Graded Geotechnical or Final Compaction Report provided at the completion of grading.
DIGITAL DELIVERY: JIM HALL
,1?J.' /:'/}_ o../ /7 v~D~.
Representative of GeoSoils, Inc.
Construction Testing & Engineering, Inc.
Inspection I Testing I Geotechnical I Environmental & Construction Engineering I Civil Engineering I Surveying
INSPECTION REPORT PAGE 1 OF 1
CTE JOB NO. 10-14654 ------
REPORT NO.
PROJECT NAME Had a Family Farm subdivision
ADDRESS 121835 Buena Vista Way Lot 12
Carlsbad, ca
INSPECTION MATERIAL IDENTIFICATION
ARCHITECT
ENGINEER
CONTRACTOR
OTHER
JD
California West
INSPECTION DATE 29may2o19 ------------
PLAN FILE/OTHER
BLDG. PERMIT/OTHER CBRA2018-0060
□
~
□
~
□
□
□
□
□
CONCRETE CONC. MIX NO. & lb/in2
REINF. STEEL GROUT MIX NO. & lb/in2
MASONRY MORTAR TYPE & lb/in2
P.T. CONCRETE REINF. STEEL GR./SIZE
FIELD WELDING STRUCTURAL STEEL
SHOP WELDING HIGH-STRENGTH SOLT
BATCH PLANT MASONRY BLOCK
EXP.ANCHOR OTHER
OTHER
MATERIAL SAMPLING
□ CONCRETE □ MORTAR 0 GROUT 0 FIREPROOFING O MASONRY BLOCK
0 REINFORCING STEEL 0 STRUCTURAL STEEL 0 BOLTS □ OTHER
INSPECTIONS PERFORMED, MATERIAL IDENTIFICATION, PROGRESS, WORK REJECTED, REMARKS
PLEASE NOTE ANY RE-INSPECTION TESTING, OR OTHER PROJECT ISSUES.
Performed final rebar and PT inspection for lot #12. AU rebar checked for size, grade, lap, placement, clearance and coverage. All PT
tendons checked for count, placement and drape. All hold downs placed per plans. All work complies with page PT1 of the approved
plans. All trash and non structural material to be removed from the pour area prior to concrete placement.
Certification of Compliance: All work, unless otherwise noted, compiles with applicable codes and tha approved plans and speclflcatlons.
PRINTED NAME M.G.Sulham
CERTIFICATION NO. 5281716/SO1026 ------------SIGNATURE ~L:-
---------
1441 Montiel Road, Suite 115 Escondido, CA92026 Ph (760) 746-4955 I Fax (760) 746-9806 I www.cte-inc.net
'------------------------------------------
( City of
Carlsbad
CERTIFICATION OF
SCHOOL FEES PAID
8-34
Development Services
Building Department
1635 Faraday Avenue
760-602-2719
www.carlsbadca.gov
This form must be completed by the City, the applicant, and the appropriate school districts and returned to the City
prior to issuing a building permit. The City will not issue any building permit without a completed school fee form.
Project Name -"-Y-'-A=Dc..c.A...:..;_F;_;A;;_R=M;.:___ _____________________ _
Building Permit
Plan Check Number PC2017-0048 // CBRA2018-0060-LOT 12
Project Address: 1753 Buena Vista Way
A.P.N _1....,5...,,6.....,-2 .. 2..,0._-6,._,5,._-..._00..__ ____________________ _
Project Applicant CARLSBAD BUENA VISTA 12, LP
(Owner Name)
Project Description: _1 _S_F_D _________________________ _
Building Type
Residential: 1 NEW DWELLING UNIT(S)
2,867 Square Feet of Living Area in New Dwelling/s
Second Dwelling Unit: Square Feet of Living Area in SDU
'
Residential Additions: Net Square Feet New Area
Commercial/Industrial: Net Square Feet New Area
City Certification of
Applicant Information, Shay cVet'll Date November 30, 2018
SCHOOL DISTRICTS WITHIN THE CITY OF CARLSBAD
rzl Carlsbad Unified School District
6225 El Camino Real
Carlsbad CA 92009 (760-331-5000)
LJ Encinitas Union School District-
By appointment only
101 South Rancho Santa Fe Rd
Encinitas, CA 92024
(760-944-4300 x1166l
0 Vista Unified School District O San Marcos Unified School District
1234 Arcadia Drive 2 5 5 P i c o Ave S t e . 1 0 0
Vista CA 92083 (760-726-2170) xt San Marcos, CA 92069 (760-290-2649)
2222 Contact Katherine Marcelja (By Appt Only)
LJ San Dieguito Union High School District-By Appointment Only
684 Requeza Dr.
Encinitas, CA 92024
(760-753-6491 X 5514)
Certification of Applicant/Owners. The person executing this declaration ("Owner") certifies under penalty of perjury
that (1) the information provided above is correct and true to the best of the Owner's knowledge, and that the Owner
will file an amended certification of payment and pay the additional fee if Owner requests an increase in the number
of dwelling units or square footage after the building permit is issued or if the initial determination of units or square
footage is found to be incorrect, and that (2) the Owner is the owner/developer of the above described project(s), or
that the person executing this declaration is authorized to sign on behalf of the Owner. •
Signature: _r1_____.,__;J_{'/4_a_w_1 ___ Date:
I t I
B-34 Page 1 of 2 Rev. 03/09
SCHOOL DISTRICT SCHOOL FEE CERTIFICATION
(To be completed by the school district(s))
***************************************************************************************************
THIS FORM INDICATES THAT THE SCHOOL DISTRICT REQUIREMENTS FOR THE
PROJECT HAVE BEEN OR WILL BE SATISFIED.
SCHOOL DISTRICT:
The undersigned, being duly authorized by the applicable School District, certifies that
the developer, builder, or owner has satisfied the obligation for school facilities. This is
to certify that the applicant listed on page 1 has paid all amounts or completed other
applicable school mitigation determined by the School District. The City may issue
building permits for this project.
SIGNATURE OF AUTHORIZED SCHOOL
DISTRICT OFFICIAL
TITLE
NAME OF SCHOOL DISTRICT
DATE
PHONE NUMBER
B-34 Page 2 of 2
CARLSBAD UNIFIED SCHOOL DISTRICT
6225 EL CAMINO AEAt
CARLSBAD, CA 92009
Rev. 03/09