HomeMy WebLinkAbout1016 FOXGLOVE VW; MULTI-PERMIT FILE; CB140665; Permit71 City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing/Mechanical/Electrical (PME) Permit
03-24-2014 Permit No: CB140665
Building Inspection Request Line (760) 602-2725
Job Address: 1016 FOXGLOVE VIEW CBAD
Permit Type: PME Status: ISSUED
Parcel No: 2144103000 Lot #: 0 Applied:. 03/24/2014
Entered By: RMA
Reference #: Plan Approved: 03/24/2014
PC M. Issued: 03/24/2014
Inspect Area:
Project Title: KAVOUNASRES- REPLACE GAS LINE
FROM GAS METER TO EXISTING POOLHEATER
Applicant: Owner:
BLUEWATER POOLS KAVOUNAS LAWRENCE E&DEBORAH L G
1315 ENCINITAS BLVD 1016 FOXGLOVE '1W
ENCINITAS CA 92024 CARLSBAD CA 92011
760 753.6369 .
Plumbing Fees $158.00
Electrical Fees. $0.00
Mechanical Fees $0.00
- Other PME Fees
S $0.00
TOTAL PERMIT FEES $158.00
Total Fees: $158.00 Total Payments To Date: $158.00 Balance Due: $0.00
FINAL APPROVAL
Inspector: Date: Clearance:
NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions.' You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition. S • S
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
ITHE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: PLANNING DENGINEERING DBJILDING DFIRE DHEALTH DHAZMATIAPCD
/J\ . Building Permit Application Check No. 0
1635 Faraday Ave., Carlsbad, CA 92008 . Et. VäIUe' 'V C I I Y 0 F Ph:7607602-2719 Fax: 760-6028558 .
CARLSBA it D email: buding@casbadca.gov .
. Pnk7POs
.-Date -77-71 www.carisbad6a.gov
JOB ADDRESS 4' SUITE#/SPACE#/UNIT APN -
1016 ji€ "
CT/PROJECT A .. T#' I,EOi- PHASE A # OF UNITS # BATHROOMS TENANT BUSINESS NAME3 ,, .. CONSTR. TYPE GROUP 1
,
#,BEDRO,OMS 1
.
00C.
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s).
- EXISTING USE '- PROPOSED USE , GARAGE (SF) PATIOS (SF), DECKS (SF) FIREPLACE - AIR CONDITIONING FIRE SPRINKLERS
YES [D#. NO[::] YES DNO . YES NO[:]
APPLICANT NAME I .
Primary Contact L- -
PROPERTYOWNER •0
VVir1
ADDRESS .-. - 13 IS- *s61,4
ADDRESS 0'
0 to 6 .
"TrAT CITY STATE ZIP ZIP CITYC .(d Cv?o\(
PHONE 760 —
(4 (FAX PHONE FAX 0 0
EMAIL . . 0 EMAIL
DESIGN PROFESSIONAL
- ' ''
00
•:
CONTRACTOR BUS. NAME
0 k-• c
ADDRESS . . 0 ADDRESS 0
't3(5 Ix r c1%J• - c 1 j
CITY ' " . STATE ZIP 0 CITY STAT - ZIP 0
PHONE ' ' FAX 0 PHONE )3b3X
0 0 - : EMAIL'-"
'•
EMAIL
0
0 . -- 0 STATE LIC. U
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a
.applicant for such permit to file a signed statement that he is licensed pursuant to
O Business and Professions Code) or that he is exempt therefrom, and the basis for civil penalty of not more than five hundred dollars ($500)).
x 0 '
Workers' Compensation Declaration: I hereby affirm under penally of perjury one of the following declarations:
El I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section '3700 of the Labor Code, for the performance of the Work for Which this permit is issued.. t i have and will maintain workers compensation, as required by Sçction 3700.Ll1re Labor Code, for the performance of the work for which this permit is issued. My workers' compensation in urance rrier and policy
O number are:lnsurancCo. (. f..A/tlf. kk.M4 J...4j Policy No.'..9C1J6 L1 "ALS7___'. Expiration Date
O This section need not be completed if the permit is for one hu'dred dollars ($100) or less.
Certificate of Exemption: I certify that in the performance of the work (or which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of
California. IWARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In
addition to the cost of compensation, da en provided for in Section 3706 of the Labor code, interest and attorney's fees.
.. CONTRACTOR SIGNATURE 0 ' [:]AGENT DATE 2L&.( / 1 4-
I hereby affirm that! am exempt from Contractor's License Law for the following mason: .
0
F7 I: as owner of the properly or my employees with wages as their sole compensation, will do the work and the structure is 001 intended or offered for sale (Sec. 7044, Business and Professions Code: The Conlractor's
- License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale).
[] I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of
property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant 10 the Contractor's License Law).
i:i 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 properly improvement DYes DNo
- 2. ((have/have no)) signed an application for a building permit for the proposed work.
(have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number):
I plan 10 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 rumber):
I will provide some of the work, bull have contracted (hired) the following persons to provide the work indicated (include name / address phone type of work): - - -
.PROPERTY OWNER SIGNATURE DAGENT DATE
STATE LIC.# -. . CLASS CITY BUS. LICe
0 (,5O- I. t2iii
permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the the provisions of the Contractor's License Law (Chapter 9, commendingwith Section 7000,of Division 3 of the
the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a
w ZUL iLr C6i LO3Y tLJr
Is the applicant or future building occupant required to submit abusiness plan, acutely -d )us materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the -
Presley-Tanner Hazardous Substance Account Act?,Eyes ZiNo, - -
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? - Eyes KNo S
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-.- -
S
hery al that there is a ccns:w:usn lending agency for he pensrrnan e or the worx this perm uea cc 307 Ci vil Code)
Lender's Narne LnndesAddress
- - S
I certify that I have read the application and state that the above information isconectand that the information onthe plans is accurate. I agree to comply wlib all City ordinances and State laws relating to building construction.
- ihereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspecton purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP, HARMLESS THE CITY OF CARLSBAD
AGAINST ALL UABILflIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. - S
OSHA An OSHA permit is required for excavations over 59 deep and demolitIon ornstmction of structures over 3 stories N heht.
EXPIRATION: Every permit issued by the Building Official under the provisions of this Code'shall expire by INitIation and become null and void if the building or wxk authorized by such permit is not commenced within
180 days from the dale of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the vrk is commenced bra period of 180 days (Section 14 4 Uniform Building Code)
.'APPLICANT S SIGNATURE DATE
Inspection List
Perrnit#: CB140665 Type: PME KAVOUNAS RES-REPLACE GAS LINE
FROM GAS METER TO EXISTING POOL H
Date Inspection _Item Inspector Act Comments
03/31/2014 23 Gas/Test/Repairs PD AP
03/31/201429 Final Plumbing PD AP
03/31/2014 52 Underground Plumbing - RI KAVOUNAS RES
Tuesday, April 01, 2014 Page 1 of 1
City of Carlsbad ,
1635 Faraday Av Carlsbad, CA 92008
08-22-2008 Electrical Permit Permit No: CB081625
Building Inspection Request Line (760) 602-2725
Job Address: 1016 FOXGLOVE VIEW CBAD
Permit Type: ELEC . . Status: ISSUED
Parcel No: 2144103000 Lot #: :0 Applied: 08/22/2008
Entered By: SB
Reference #: ' ..' Plan Approved: 08/22/2008
PC #: . - - . issued: 08/22/2008
Project Title: KAVOUNAS RES-ELECTRICAL TO Inspect Area: PC
ELECTRIC HEATER.
Applicant: Owner: --.
KAVOUNAS FAMILY TRUST 03-13-01 . KAVOUNAS FAMILY TRUST 03-13-01-
1016 FOXGLOVE VW . . . 1016FOXGLOVEVW
CARLSBAD CA 92011 ' - . . CARLSBAD CA 920.11, .
.
':..'/
Electric Issue Fee ,--\ $10.00
Single Phase per AMP . 0 •- N. ,-' ,'\ $0.00
- Three Phase per AMP . 0 •1 , •, . -" - .,-) $0.00
Three Phase 480 Per AMP 0 ' $0 .00\
Remodel/Alteration per AMP 0 $0.00
Remodel Fee . , -. " - r" ,/ \ \ $10. 00
Temporary Service Fee '\ ./$0.00
Test Meter Fee . -". -$0.00
Other Electrical Fees .ç$0.00
Additional Fees $0.00
'-S.---- TOTAL PERMIT FEES
. / f I ( J'sJ / $20.00
!
Total Fees: $20.00 Total Payments To Date ,' , '" $20.00 Balance Due: / $0.00
-
RR
. ____ Inspector:____ Clearance: ' 0
NOTICE: Please take NOTICE that approval of your project includes the"Imposition" of fees, dedications, reservations, cr other exactions hereafter collectively
referred to as "fees/exactions. You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in Government Code Section 66020(a), and tile 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 iubsequent 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 limitations has previously otherwise expired.
City of Carlsbad
1635 Faraday Ave., Carlsbad, CA 92008
760-602-2717_-'2718J 2719
Fax: 760-602-8558
0 Plan Check No. C
Eat. Value
Plan Ck. Deposit
Building Permit Application Date
JOB ADDRESS J 4 / y rTEM/SPACE#/UNITO APN
CT/PROJECT f* j LOT C PHASE C C OF UNITS BEDROOMS 1 C BATHROOMS I TENANT BUSINESS NAME TYPE OF CONST. 0CC. GROUP
DESCRIPTION OF WORK: (Please describe present use and proposed use)
e(ed-caJ octe ('o r f'1 -ArQA\4 j?)tA M) 1C,lkr
-
BUILDING AREA (SF) ADDITION AREA (SF)
J
GARAGE (SF) PATIOS (SF) DECKS (SF) I FIREPLACE
YES 0 #_ NOD
I AIR CONDITIONING
YES 0 NOD
i FIRE SPRINKLERS
YES 0 NOD
CONTACT NAME (if Different Fom Applicant) APPLICANT NAME
Ue LJ vc, ADDRESS ADDRESS
Ol(o 1XC3foVe Vi'ej CITY STATE ZIP CITY / I..d' STATE LL ci~bcd CA-' ZIP
PHONE FAX I PHONE
Cl
I
,
9 FAX
EMAIL .' EMAIL qfoc) Co M
OWNER NAME CONTRACTOR BUS. NAME -
DDRESS ADDRESS
CITY E ZIP CITY STATE ZIP
PHONE FAX
-
PHONE
7
FAX
EMAIL EMAIL
ARCH/DESIGNER NAME & ADDRESS STATE LIC. # STATE LIC.# CITY BUS. LIC.#
(ec. 10313 Business and Professions Code: Any City or County, which requires a permit to construct altor improve demolish or repair any suuctnre prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed Jursuant to the provisions of the Cçntractor'e license law {Clsaptor 9, commending with Section 1000 of Division 3 of the Business and Professions Code) or that he a enempe theretrom, and die basin 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 live hundred dollars ($500)).
jg.j rAlliiut.ijii& a i.'vwg
Workers' Compensation Declaration:! hereby affirm under penalty of perjury one'of the following declarations:
- Cl I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Cl I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit Is issued. My workers' compensation insurance corner and policy
number are:
Insurance Co.___________________________________________________________________________ Policy No. Expiration Date This section need not be completed if the permit is for one hundred dollars ($100) or less.
0 CertIficate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of
California. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In addition to the cost of compensation, damages as provided for In Section 3708 of the Labor code, interest and attorney's fees.
AT CONTRACTOR SIGNATURE DATE
OW N ER -B UILDER D1 L4
I hereby affirm that fern exempt from Contractor's License Law for the following reason:
Dl, 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
Ucensetaw 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 sOch lmptowemants are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale).
I, as owner of the property, am exclusivrely contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's license Law does not apply to an owner-of property
who builds or Improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's license Law). - -
0 I am exempt under Section Business and Professions Code for this reason:
I personally plan to provide the major labor and materials for construction of the proposed property improvement DYes 0 No -
I (have I have not) signed an application for a building permit for the proposed work. - -
I have contracted with the following person (firm) to provide the proposed construction (include name address / phone/contractors' license dumber):
I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name I address / phone / contractors' license number):
I will provide some of the work, bull have nlracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work):
PROPERTY OWNER SIGNATURE .,JO-L'1Ct°Z - DATE
COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS 0 N L Y
Is the applicant or future building occupant required -to submit a business plan, acutely hazardous materials registration form or risk management and prevention progratu under Sections 25505, 25533 or 25534 of the
Presley-Tanner Hazardous Substance Account Act? - 0 Yes 0 No - Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? DYes 0 No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 Yes 0 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. -
I hereby affirm that there is a construction lending agency for the performance of the work this permit is Issued (Sec. 3097 (i) Civil Code).
Lender's Name Lenders Address -
-
;,.APPLICANT CERTIFICATION
I certify that I have read the application and slate that the above in 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 City of Carlsbad to enter upon the above mentioned property for inspection purposes. I.ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANDEXPENSES WHICH MAY IN ANYWAY-ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA- An OSHA permit is required for excavations over 50' 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 lithe 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 (Section 106.4.4 Uniform Building Code). -
-
'APPLICANT'S SIGNATURE /&-f--1Q\ 1L LA'7.—LV.a C. - 1 DATE
-
iti of Carlsbad Bldg Inspection Request
(LB For: 10/09/2008 -0
Perrnit# CB081625 Inspector Assignment: PC
Title: KAVOUNAS RES-ELECTRICAL TO
Description: ELECTRIC HEATER
Type: ELEC Sub Type:
Phone; 7609189925
Job Address: 1016 FOXGLOVE VIEW
Suite: Lot 0 0
Location: Inspector:
OWNER KAVOUNAS FAMILY TRUST 03-13-01
Owner: KAVOUNAS FAMILY TRUST 03-13-01
• Remarks: between 9&12 please s 0fr
Total Time: Requested By: DEBORAH
• Entered By: KATHY
CD Description Act Comment
53 EIeconduftMiring
Comments/Notices/Holds
Associated PCRs/CVs Original PC# 0 0
Inspection History'
Date Description Act lnsp Comments -
0 0
x7g7çOZ) —
A-- OtO7
.0 I:LThI.N G PER M IT .Permit No: 'C3980810.
0'3/19/98",15,: 54 Project No A9801068
Page 1 of 1 Development No
'Job Address: 1016 FOXGLOVE VIEW . Suite:'
Permit Type ELECTRICAL 5235 03/19/98,'0()01 01 02
Parce'l.. No: ?14-410-30-0- ..... • . ..Lot#: •. .CPSMT . 'tlO.'OO
Valuation ,- 0 ConstructionType . NEW
Occupancy Group Reference# Status ISSUED
Description: ADD RECEPTICAL IN GARAGE.FOR. . Applied: 03/19/98.
FREEZER&CEILINGLIGHTS IN 3 BEDROOMS Apr/Issue':, 03/19/98.'
- . . " ' •-.- * 'Enter'ed By:RMA
Appl/Ownr : 5.KAVOUNAS, DEBORAH . 760 918-9925 •. • . 1016 FOXGLOVE .VIEW - . . . .. . - .•.. • ...
CARLSBAD CA 92009 A . •.
• Fees Reuired ***,*Feesoflecte'd & Credits ---------------------
(Z7
---------------
Adjustments: a 7
o
.0.0 . Totairedi s: - :. . .00
Tot1 Fees: f .1J.oO .Tot a 'S .00
I. .• . B-1cid Due: 10:00
Fee description — / Ext.fee Data
--------------------------
•
INCORPORATED
1952
M11 IN
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PERKa... •.' / - tOB44
SGU
DAIE
FINAL APPPOVAL
INSP. DA
CLEARANCE_
- - - •. .
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'
. ' . A • CITY OF. CARLSBAD . •
2075 Las Palmas'Dr,Carlsbad, CA92009 (619) 4381.161 .
4 • '.. •1 ,. a - - , p •
4
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PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(760) 4381161
FOR OFFICE USE ONLY
PLAN CHECK
EST. VAL.
Plan Ck. Deposit
Validated
1. PROJECT INFORMATION
101 (o i9rJo/e
_.- Address (include BIdg/te #1
Legal Description Lot No.
Assessor's Parcel #
C
-
cre-er ('Cc
Description of Work
sd'i q
Name (at this address)
Subdivision Name/Number Unit No. Phase No Total S of units
f Proposed Use
Bedrooms 4 of Bathrooms
2 CONTACT PERSON (If different from sppllcsnt) - '". "' _- -
Name' Address City State/Zip Telephone 4 Fax 4
3 APPLICANT 0 Contractor 0 Agent for Contractor 0 Owner 0 Agent for Owner
Name Address City State/Zip Telephone 4
4.OPERTYOWN
tci'io ?2I c
Name Address ' City ' State/Zip Telephone 4
S CONTRACTOR COMPANYNAME - -
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law
IChapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code] or that he is exempt therefrom, and the basis for the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$5001).
Name Address City State/Zip Telephone 4
State License 4 License Class City Business License S
Designer Name Address City State/Zip Telephone
State License S
6 WORKERS COMPENSATION - -
Workers' Compensation Declaration: I hereby 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 as provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
C] I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My worker's compensation insurance carrier and policy number are:
Insurance Company Policy No._____ Expiration Date__________________
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*1001 OR LESS)
CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shell not employ any person in any manner so as
to become subject to the Workers' Compensation Laws of California.
WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars (8 100.000). In addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, Interest and attorneys fees.
SIGNATURE DATE
7 OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
0 I, as owner of the property or my employees with wages as their sole compensation, will do the work and the Structure is not intended or offered for sale
(Sec. 7044, Business and Professions Code:. The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does
such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or Improvement is
soj,ølthln one year of completion, the owner-builder will have the burden of proving that he did not build or Improve for the purpose of eels).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The
Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed
pursuant to the Contractor's License Law).
C1 I am exempt under Section Business and Professions Code for this reason:
1. r
(hav
ally plan to provide the major labor and materials for Construction of the proposed property improvement. 0 YES []NO
. 2. / have not) signed an application for a building permit for the proposed work.
3. I have contracted with the following person (firm) t9provide the proposed constructio,Q (include name / eddrqs / phone numbei c ..J/o4'.4 Fn -k7.4.' ce .i. 64
I plan to provide portions of the work, but I have hired the following person to càordinate, supervise and provide the major work (includ name I address / phone
number / contractors license number):
I will provide, some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type
of work):
PROPERTY OWNER SIGNATURE 4JkT7,A 4cj )c,ya'c 'LDATE 3./j g
COMPLETE THIS SECTION FOR NON-RESIDEN7FAL BUILDING PERMITS ONLf '
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention
program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES 0 NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES 0 NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 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.
'8 CONSTRUCTION IENDING AGEIJCY TT
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code).
LENDER'S NAME LENDER'S ADDRESS___________________________________________________________
9 APPLICANT CERTIFICATION " •' p'"no
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 representatives of the Cite of Carlsbad to enter upon the above mentioned
property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL 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 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 365 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 a work is commenced for a period of 180 days (Section 108.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE= DATE '1L Y-JY& DATE
WHITE: File YELLOW: Applicant PINK: Finance
CITY OF CARLSBAD
INSPECTION REQUEST
PERNIT# CB980810 FOR 04/07/98 INSPECTOR AREA
DESCRIPTION: ADD RECEPTICAL IN GARAGE FOR PLANCK# CB980810
FREEZER&CEILING LIGHTS IN 3 BEDROOMS 0CC GRP
TYPE: ELEC CONSTR. TYPE NEW
JOB ADDRESS: 1016 FOXGLOVE VIEW STE: LOT:
APPLICANT: KAVOUNAS, DEBORAH PHONE: 760 918-9925
CONTRACTOR: PHONE:
OWNER: PHONE:
REMARKS: C/DEBRA/918-9925 INSPECTOR Air
SPECIAL INSTRUCT:
TOTAL TIME:
--RELATED PERMITS-- PERNIT# TYPE STATUS
CB980791 MECH ISSUED
CD LVL DESCRIPTION ACT COMMENTS
34 EL Rough Electric
***** INSPECTION HISTORY *****
DATE DESCRIPTION ACT INSP COMMENTS
-
B U I L D I N G •P E R'M I T Permit No.: CB980791
03/1.7/98 16:43 . - . - Pro jedt No: A9801040
Page lof 1 - •- .
DevelopmentNo:
Job Address: 1016 FOXGLOVE VIEW -' Suite: -
Permit Type: MECHANICAL. - . 5131 03/17/98 0001 01 02
Parcel No: 214-41.0-30-00 . Lbt#: . C-PRMT 4400-
Valuation: . 0 . . Construction Type: NEW
Occupancy Group: . Reference#:. ..- -. Status: ISSUED
Desc'ription: REPLACE FM) ADD NEW A/C W/40 . Applid:; 03/17/98
AMP CIRCUIT . . : .. Apr/Issue: 03/17/98
-
- Entered By: JM
Appl/Ownr : .JACKSON BLANC 619 236-1121 .. . ;. .
1970 COLUMBIA STREET
SAN DIEGO.CA 92101. . - . •. . :
*** Fees Required Fe èQollected & Credits ..
Fees: 4 4 o4?
Adjustments:
• / .010 TQtai/redits: .00
Total Fees: T44.0.0 - .Totaavcjt's: . .00
Brue:
44.00
Fee aescription c!S Ext fee Data
Install Furff/Duct (Msps 1- 9.0 9.00
Other :00 20 ELEC
INCORPORATED
-.• -- .. •, I
.•. .. • FINALAPPPfl\./AL --
INS
CLEAPANCE____
I . • . . - I
- . • •
CITY OF CARLSBAD
- 2075 Las Palmas Dr.,Car1sbadCA 92009 (619) 438-1161 • - -. - . -
-
5- •.
IS' .• • . _.•
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(760) 438-1161
FOR OFFICE USE ONLY
PLAN CHECK NO.___________
EST. VAL.
Plan Ck. Deposit
Validated By j\iT1
Date
PROJECT INFORMATION
iot FoEo1 VW .
Address (include Bldg/Suite I) Business Name (at this address)
Legal Lot No. Subdivision Name/Number Unit No. Phase No. Total S of units
Assessor's Parcel S Existing Use Proposed Use 400 44 - 40
Description of of Work SQ. FT. tof Stories S of Bedrooms 0 of Bathrooms
CONTACTERSON (H dtferent°fvom sppiicsnjl ------....--
Name . Address City State/Zip Telephone S Fax S
APPLICANT 0 Contractor
Name Address City State/Zip Telephone S
PROPERTYOWNE
.. o.
Name Address . Address City State/Zip Telephone S
S CONTRACTOR COMPANY NAME
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to Its
issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law
(Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he Is exempt therefrom, and the basis toir the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the appcant to a civil penalty of not more than five hundred dollars ($50011.
*ej SAW PIQ (0) Gig. E3' iili'
Name Address City State/Zip Telephone S
State License S j3(o ( License Class City Business License 4dc'- I a t4a.f&'
Designer Name Address City State/Zip Telephone
State License S
£ WORKERS COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent toself-lnsure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit Is
issued. My worker's compensation insurance carrier and policy number are:
Insurance Company . C., W. Policy No.Avo 02_. Expiration Date
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 101001 OR LESS)
CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as
to become subject to the Workers' Compensation Laws of California.
WARNING: Failure to secure work$rs' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil time up to one hundred
thousantibidoll 0001, In addition to the cost of tion, demiges as provided for In Section 3706 of the Labor code, Interest and attorney's fees.
SIGNATURE _____
. 7 OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
o 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. It, however, the building or Improvement Is
sold within one year of completion, the owner-builder will have the burden of proving that he did not build or Improve for the purpose of asIa).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The
Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law).
0 I am exempt under Section ______________ Business and Professions Code for this reason:
I personally plan to provide the major labor and materials for Construction of the proposed property Improvement. 0 YES ONO
. I (have / have not) signed an application for a building permit for the proposed work.
I have contracted with the following person (firm) to provide the proposed construction (Include name I address / phone number / contractors license number):
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 I phone number*1 contractors license number):
I will provide some of the work, but I have contracted (hired) the following persons to provide the work Indicated (Include name I address I phone number / type of work):
PROPERTY OWNER SIGNATURE DATE
COMPLETE TI THIS SECON FOR NON.RESJDEYTiAL BUILDING PERMITS ONL'?"
Is the applicant or future building occupant required to submit s business plan, acutely hazardous materials registration form or risk management and prevention
program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES 0 NO
Is the applicant or future building occupant required to Obtain a permit from the air pollution control district or air quality management district? 0 YES 0 NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 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.
t8. ... .....-' ......
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued (Sec. 3097(i) Civil Code).
LENDER'S NAME LENDER'S ADDRESS________________________________________________________ 9 . - APPLICANT CERTIFICATION -"T
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 representatives of the Clt' of Carlsbad to enter upon the above mentioned
property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL 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 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 365 days from the date of such permit or If the building or work authorized by such permit is suspended
or abandoned-efvyji ark is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE DATE
File YELLOW: Applicant PINK: Finance
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB980791 FOR 04/07/98 INSPECTOR AREA
DESCRIPTION: REPLACE FAU ADD NEW A/C W/40 PLANCK# CB980791
AMP CIRCUIT 0CC GRP
TYPE: MECH CONSTR. TYPE NEW
JOB ADDRESS: 1016 FOXGLOVE VIEW STE: LOT:
APPLICANT: JACKSON BLANC PHONE: 619 236-1121
CONTRACTOR: a I , PHONE:
OWNER: PHONE:
REMARKS: C/DEBRA/918-9925 INSPECTOR
SPECIAL INSTRUCT:
TOTAL TIME:
--RELATED PERMITS-- PERMIT# TYPE STATUS
CB980810 ELEC ISSUED
CD LVL DESCRIPTION ACT COMMENTS
43 ME AirCond/Furnace Set AL
INSPECTION HISTORY *****
DATE DESCRIPTION ACT INSP COMMENTS
- -- '0 B U I L D I N G P E RM I T Permit No: •CB951127
086/95 08:47 Project No: A9501635
Paé 1 of 1 , Development No:
Job Address: 1016. FOXGLOVE VIEW Suite:
Permit Type: PLUMBING 4 - Parcel No: 214-410-30-00 Lot#:
Valuation: 0 ,
Construction Type: VN * 32.2 08/16/95 0001 01 02,
Occupancy Group: ' Reference#:' Str€T: ISSUE1500
Description: WATER HEATER REPLACEMENT Applied: 08/16/95
Apr/Isue: 08/16/95
Entered By:MDP
Appl/Ownr : AJ FOSTER INC.' - .619 697-4151
2819 CENTRAL AVE , • - :
. ', SPRING VALLEY, CA. 91977
Fees Réuired *** Fees Collected & Credits ----------------------------
----Fees:\ 27.0
'. .0 -. .
TotiCredits: .00
-: Tbtal Fees: 247._0,0 - Tot2jRynits: • .00
.- • • /.•..-•. 0 • __S,
BanceDue: 27.00.
Fee descri Al ption I • ',U nit-tThee/Wnit • Ext fee Data
_4'•\" .'
Enter "Y" for Plumb nfIué' Fee ''\ 20.00 Y
Each Water Heate nd/Vnt >, 1 7.00
* PLUMBING TOTAL _____ • 27.00
INCORPORATED - I) 1952
FINAL APPROVAL
DATE INS
C"LE PRANCE
0 CITY OF CARLSBAD .. 0 • -
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
- •0 •- • - 0
PRM1T APPUCATION PLAN CHECK NO.
City of Carlsbad Building Department
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 ESE VAL
PLAN CK DEPOSIT
From List I (see back) give code of Permit-Type:
For Residential Projects Only: From List 2 (see back) give
Code of Structure-Type: SF'R -
Net Loss/Gain of Dwelling Units
PROJECT INFORMATION FOR OFFICE USE ONLY
Address 1016 Foxglove View Building or Suite No.
Nearest Cross Street -
LEGAL DESCRIPTION Lot No. Subdivision Name/Number Unit No. Phase No.
CHECK BELOW IF SUBMIITED:
02 Energy Calcs 02 Structural Calcs 02 Soils Report 0 1 Addressed Envelope
ASSESSOR'S PARCEL EXISTING USE PROPOSED USE
DESCRIPTION OF WORK Water Heater Replacement 50 Gallon
-
SQ. Fr. # OF STORIES # OF BEDROOMS # OF BATHROOMS
WN IA(1 PFHbUN (ii ditterent from applicant)
NAME (last.name first) Mitchell, Filothea ADDRESS 1016 Foxglove View
CITY STATE ZIP CODE Q.)flflQ DAY TELEPHONE
NAME (last name first) Kristy Foster ADDRESS 2819 Central Ave.
CITY Spring Valley STATE CA ZIP CODE 91977 DAY TELEPHONE 697-4151
PROPERlY OWNER
NAME (last name first) ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
CONTRACTOR
NAME-(last name first) A & J Foster, Inc. ADDRESS 2819 Central Ave.
CITY Spring Valley STATE CA ZIP CODE 91977 DAY TELEPHONE 697-4151
STATELIC.# pç UCENSECLASS CITY BUSINESS UC.# _j 24a?
DESIGNER NAME (last name first)
CITY STATE ZIP CODE DAY TELEPHONE STATE UC. #
WORKERS' CDMPENSA1TON
Workers' Compensation Declaration: I hereby affirm that I have a certificate 01 consent to sell-insure issued by the Director of Industrial
Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified
by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C).
INSURANCE COMPANY
Certificate 01 Exemption: rtt!3J 11c tv POLiCY NO. EXPIRATION DATE c_i _q e pertormnce 01 the work tor which this permit is issued, I shall not employ any person in any manner
so as to become subject to the Workers' Compensation Laws of California.
SIGNATURE DATE
Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractors License Law tor -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 is sold within one year of completion, the owner-builder will have the burden
of proving that he did not build or improve for the purpose of sale.).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions
Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects
with contractor(s) licensed pursuant to the Contractor's License Law).
E3 I am exempt under Section Business and Professions Code for this reason:
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the
provisions of the Contractor's License Law (Chapter 9, commencing with Section 7000 of Division 3 of the Business and Professions Code)
or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars [$500]).
SIGNATURE DATE
COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY:
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and
prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act?
DYES ONO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
DYES 0 N
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
DYES 0 N
IF ANY OF THE ANSWERS ARE YES A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFFER JULY 1, 1989 UNLESS THE APPUCANT
HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTIUCr.
WNSI1{UCI1ON LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance 01 the work for which this permit is issued (Sec 3097(i) Civil Code).
LENDER'S NAME None LENDER'S ADDRESS
APPLICANT CERI1FI(flON
I certify that I have read the application and state that the above information is correct. I agree to comply with all City ordinances and State laws
relating to building construction. I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection
purposes. I ALSO AGREE 10 SAVE INDEMNIFY AND KEEP HARMLESS THE CUY OF CARLSBAD AGAINST ALL UABIIJTLES, JUDGMENTS COSTS
AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CI1Y 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 365 days from the date of such permit or if the building or work authorized by
such permit is suspended or abanjipned at any time afççr the w9rk is commenced for a period of 180 days (Section 303(d) Uniform Builiqg Code).
APP ucrs SIGNATURE / q 2— . DATE:
0
,CITY OF CARLSBAD -
INSPECTION REQUEST
PEPMIT# CB951127 FOR 08/31/95 - INSPECTOR AREA
DESCRIPTION: WATER HEATER REPLACEMENT PLANCK# CB951127
OCCGRP
TYPE: PLUM CONSTR. TYPE VN
JOB ADDRESS: 1016 FOXGLOVE VIEW STE: LOT:
APPLICANT: AJ FOSTER INC. PHONE:-'619 697-4151
CONTRACTOR: PHONE:
OWNER: PHONE:
REMARKS: MW/438-1347 - - INSPECTOR
SPECIAL INSTRUCT:
TOTAL TIME:
CD LVL DESCRIPTION ACT. COMMENTS
25 PL Water Heater/Vents
***** INSPECTION HISTORY *****
DATE DESCRIPTION ACT INSP COMMENTS
- - I