HomeMy WebLinkAbout1198 PINE AVE; ; CB930521; Permit. ·1
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CITY OF CARLSBAD
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2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
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PERMIT APPUCATION ~ ~
PLAN CHECK NO.
City of carlsbad Building Department
2075 Las Pal..,. Dr., carlsbad, CA 92009 (619) 438-1161 ESf. VAL. __________ _
PLAN CK DEPOSIT. _______ _ VAUD.BY __________ _
DATE i. PFJlMI I I YPE
A. Cl COmmerc1al Li New Building LI 'tenant Improvement
B • D Industrial D New Building D Tenant Improvement
C ,. Residential D Apartment D Condo LI Single Family Dwelling D Addition/ Alteration
D Duplex C Demolition C Relocation D Mobile Home D Electrical D Plumbing
D Mechanical D PCX>l O Spa D Retaining Wall O Solar D Ocher
2 PRaJECf INFORMATION FOR OFFICE USE ONLY
Building or Suite No.
Nearest Cross Street
LEGAL DEsCRIF'I ION Lot No. Subd1V1s1on Name/Number Unit No. Phase No.
CHECK BEWW IF SUBMII IED:
Cl 2 Energy Gales Cl 2 Structural Gales Cl 2 Soils Report Cl I Addressed Envelope
ASSESSOR'S PARCEL EXISTING USE PROPOSED USE
3. WN IACI PERSON (rdllferent from <Jpphcant)
NAME~-'t-(c,,._,v,<1~ 2. ADDRESS /7,!" €<fte?,H,ocd ,t;,.-,.
CITY Cl(:p,',,s-1'.Le_ STATE ~ ZIPCODEt'20SV
NAME "'7"0" J..o /I' C. CL SIP ,-.bL"J.--
CITY c;,, (_s b&< ef STATE ~
ADDRESS ~9"? c,,.,-/~.i,,n/ t,'//{"J-e P,. p<::j',o,84)( /3&J'-
ZIP CODE fl' 2-c'H> F' DAY TELEPHONE
ADDRESS p. {) , ,B t7)( /':H .P
ZIP CODE "9 -z ,:,-c ,r': DAY TELEPHONE
6. CDN, K
NAME ADDRESS
CITY STATE ZIP CODE
LlCENSE CLASS
DAY TELEPHONE
STATE IJC. # CITY BUSINESS IJC. #
CITY STATE ZIP CODE DAY TELEPHONE STATE IJC. #
7. WOkkRRS' WMPENSA:IION
Workers' Compensation Declarat1on: I hereby afhrm that I have a certificate of consent to seif·tnsure issued by the Director of lndustnal
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 POIJCY NO. EXPIRATION DATE
Certificate of Exemption: I certtfy that tn the performance of the work for which this permit ts issued, I shall not employ any person 1n any manner
so as to become subject to the Workers' Compensation Laws of California.
SIGNATURE DATE
8. OWNEk-BOllDEk bElDJtA:iiuN
Cl
Cl
uwner·HUllder uec1aratton: I hereby affirm that I am exempt from the COntracto?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 Llcense 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 Llcense 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 Llcense Law).
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 Llcense 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 · nt to a civil nalty than five hundred dollars [SSOO]).
SIGNA DATE 5 --;;J.. 7 -7 3
Is the ap r 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?
Cl YES Cl NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
Cl YES Cl NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
Cl YES Cl NO
IF ANY OF 11Il!ANSWERS ARE YES, A FINAi.CERTIFiCATE OFoa:IJPANCY MAYNar Ill! ISSUED AFTER JULY I, 1989 UNIJ!SS TIIEAPPIICANT
HAS M1IT OR IS Ml!IITING 1111! RF.QUIREMENTS OP TIIE OFFICE OP EMERGENCY SERVICES AND 1111! AIR POll.UTION <XJNlllOL DISTRICT.
9. WNSIROCIION LENDLNG AGENCY
I hereby afhrm that there 1s a construction lending agency for the performance of the work for which this permit 1s issued (Sec 3097 (I} C1vtl Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPilcAN I ttkiiFiCAJIUN
I centfy that I have read ffie apphcat1on and state that the aOOve 1nformat1on 1s 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. 1 AI.50 AGREE ID SAVE INDEMNIFY AND KEEP HARMLESS 1111! QTY OP CARISBAD AGAINSf ALL lJABllJTIES, JUDGMENTS, <DSTS
AND EXPENSES WlilCH MAY IN ANY WAY A.CDlUE AGAINST SAID QTY IN OONSEQUENCE OP 1111! GRANTING OP TIIIS 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 the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code). ··=~ ~= ~reSZ7r3
--: File YELLOW: Applicant PINK: Finance
f
City of Carlsbad
M=i• I INll,1·1•24 ·61; I, ,[4111
DATE: 04/26/94
TO: APOSTOLIC ASSEMBLY OF THE FAIT
1198 PINE AV
CARLSBAD CA 92008
RE: BUILDING PERMIT EXPIRATION
PERMIT NUMBER: CB930521
ISSUE DATE: 05/27/93
LAST INSPECTION:
PLEASE CALL FOR AN INSPECTION
IF WORK IS COMPLETE
ADDRESS: 1198 PINE AV
our records indicate that your building permit will expire by limitation
of time on 05/27/94.
The provisions of UBC, Section 303(d) state: "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 one calendar year from the date of such permit,
or if the building or work authorized by such permit is stopped at any time
after the work is commenced for a period of six consecutive calendar months or
if the building or work authorized by such permit exceeds three calendar years
from the issuance date of permit. Work shall be presumed to have commenced if
the permittee has obtained a required inspection approval of work authorized
by the permit by the building official within one year of the date of permit
issuance. Work shall be presumed to be stopped if the permittee has not ob-
tained a required inspection approval of work by the building official within
each six month period upon the initial commencement of work authorized by such
permit.
Before such work can be recommenced, a new permit, or a renewal permit as
specified below, shall be obtained.
1. PERMITS WHERE WORK HAS NOT COMMENCED.
not commenced in the first calendar year from the
permit may be obtained provided:
For permits where work has
date of issuance, a renewal
(A) No changes have been made or will be made in the original plans and
specifications for such work.
(B) That the expiration has not exceeded three years from the original
issuance date.
(C) That the same edition of the model codes is in effect as used in
the initial plan check.
(D) That a fee equal to one-half the amount required for a new permit
be paid.
The renewal permit shall expire three calendar years from the date of initial
permit issuance.
2075 Las Palmas Drive • Carlsbad, California 92009-1576 • (619) 438-1161
d4/26/94 INSPECTION HISTORY LISTING
FOR PERMIT# CB930521
DATE INSPECTION TYPE INSP ACT COMMENTS
06/11/93 Flues/Vents PK NR CORR INCOMPLETE
06/07/93 Flues/Vents PK co SEE NOTICE
06/01/93 Flues/Vents PK co SEE CORR NOTICE
HIT <RETURN> TO CONTINUE •.•
UNSCHEDULED INSPECTION
DATE, __ C_·_.7..._-_5' ... 3...___
PERMIT#~··-----------/}
JOB ADDRESS.------,---~/.~/~?i~'!J'--~~.;;.;.;;."-'~e..=----------------------------
TIME ARRIVE:_~0,._ __ TIME LEAVE: _______ .;._ __
CD LVL
µ--_·
PERMITS
6/15/89
DESCRIPTION
?~flt A~.s.
ACT COMMENTS
C, s:.&:PAC'.E.
--··----------------· ·-·--···
~-......
·:,---··--.. -·-··---"' .,..,. ..
----------------------------------____________________________________ 1 __ _
D APPROVED PLANS SHALL BE ON JOB SITE
BUILDING
D FOUNDATION
D REINFORCING STEEL
D MASONRY
D GROUT-GUNITE
D FLOOR AND CEILING FRAME
D SHEATHING
D FRAME
D EXTERIOR LATH
D INSULATION
D INTERIOR LATH OR DRYWALL
PLUMBING
D UNDERGROUND PLUMBING
D UNDERGROUND WATER
D ROUGH PLUMBING
D TOP OUT PLUMBING
D SEWER AND PUCO.
D TUB OR SHOWER PAN
D GAS TEST
D WATER HEATER
ELECTRICAL
D TEMPORARY SERVICE
D ELECTRIC UNDERGROUND
D ROUGH ELECTRIC
D POOL BONDING
D ELECTRIC SERVICE
D UFER GROUND
D G.F.I.
D SMOKE DETECTOR
MISCELLANEOUS
D PLENUM AND DUCTS
D COMBUSTION AIR
D CONDITIONED AIR SYSTEMS
D SOLAR
D GRADING
D POOL
D PATIO
D SIGN
D OTHER
TIME: _________ _
DATE:
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INSPECTOR -------------------
CITY OF CARLSBAD
BUILDING INSPECTION DEPARTMENT
PHONE -438-3550
Note: Final Inspection Required
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O t hereby affirm that I am licensed under
proYlalons of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code. and my license is in
lull force and eflecl
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I heretJy aflirm tnaT I am e,empt from The Con"ac
!or's License Law lar ihe lo1low1ng reason 1sec 1031 5
!lusmess aM Professions Code A1y c,ty or couniy wh,c~ ·e
qu,res a permll 10 construct alle' ,mprove derTlol,sh o·
-epa,r ony slruclure. prior 10 1\s 1ssJance also requires :he ap-
~l,cant lor such perm,! to 11le a s,~ned stalemert 1na1 ~e ,s
1censed pursuant 10 the prov,s,ons of the Cortracwr s
License Law ,Chaoler 9 commenc,ng w1lh Ser:,on 7000 a: o,v,s,on 3 ol lhe Business and Proiess,ons Codei or I hat,, e, empT lhe,efrom and the bas,s lor the allegea e,empt,on Anv
v1ola1,on 01 Section 7031 5 oy an apol,cant lor a oecm1t suti 1ects the applicant 10 a cw,i pena.ty of not more Than ',·1e n,m
d0ed d01lars IS500!
1_ as ~wner ol the property or my employees ,l'th wage; as tie1r sole compensal,on, w.1, do :he work and the st·uc
lure ,s nm ,ntended or oflered for sdl8 !Sec 7044. Bus·ness
and Professions Code The ConlracTor s License Law does
~ot apply to an owner of oroperly who nuilds or ,mprove~
the,eon and who does such work h1msell or lhr0ugh h1s own
employees pmv1ded that such improvements are not ,ntend-
ed o• of1ered lor saie 1t. however 1ne bulld,ng or improve ment 1s sold w1th1n one year of completion. lhe owner-bu,lde'
will have the burden ot prov,ng that he did not build or ,m
prove for \he pu,pose of sale)
1 as owner ol the pro~erty am exclusively co~\ract1ng
with licensed conlraclors to construe! the pro1ect 1Sec 1044
Business anc Protess1ons Code The Comrac\of s License
Law does not apply to an owner ot properly who bu,lds or ,m
proves thereon and who conlracts 1or each pro1ecls Wl\h a
cantractor(s) license pursuant to the Comrauo,·s 1,cen~e Law)
As a homeowner I am ,mprov,ng my home. and tc,e follow
,ng cond,tions exist 1 The work ,s be,~g performed pno, to sale 2 I have lived ,n my t>ome for twelve months
prior 10 comoleMn ot this work
I have ncl claimed this exemption during the
last three years
B & PC
_ I hereby allirm t~at I have a cert1ticate o' consent to
~elf-1~sure. or a cert1f1ca\e of Worke,s Compensation In
s~rance or a cert1f1ed copy \he-eol 1Sec JBOO. Labor Godel
POLICY ~0
COMPANY
Copy 1s filed w,th the city
Cert1hed copy ,s hereby fu,r,1shed
CERTIFICATE OF EXEMPTION FROM
WORKERS. COMPENSATION INSURANCE
1Th1s section need not be completed ii the permit
1s for one hundred dollars 1$1001 or less)
\{' I cert,fy that 1n the performance ol the work fo, which t0s permit 1s 1ssued. I shall not employ any person 1n any
manner so as to become sub1ect to the Workers· Comoen
sat1on Laws or Cal1forn1a
NOTICE TO APPLICANT If. after making this Cert1t1ca1e
I ol Exemption you should become sub1ec1 \0 the Workers
Compensat,on prov,s,ons of the Labor Code. you must
fort~w,th comply with such prov,s1ons or this pe,n-1t shall L be deemed revoked
![ I hereby at!irm that there ,s a construction lending
agency for the performance ol the v,ork to, which this per
l'1l ,s issued 1Sec 3097 Civil Cadel
Lenaer s Name_
Lender s Address
USE BAU POINT PEN ONLY & PRESS HARD
JOB ADDRESS
/Ii/$'
COT BLOCK
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CARLSBAD BUILDING DEPARTMENT
2075 Las Palrnas Dr., Carlsbad, CA 92009-4859 (619) 438-1161
AV. ST.RO. NEAREST CROSS ST.
DESIGNER'S ADDRESS
APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
APPLICATION & PERMIT
NO
STORIES
CONTRACTORS PHOM #
ST ATE LICENSE NO.
OCC GP EDU
ZONE
VALUATION PERMIT NUMBER
u
0026 02/05 0101 02BldPmt 10-Dc3
GRADING PERMIT ISSUED TYPE
CONST
ace LOAD FIRESPP I I PARKING SPA.Cf: RES UNITS I
I
REDEVELOPMENT
A.REA
-1 -....o Not Valid Unless Machine Certr tied
QTY '
!
I! 7 5°l) ! QTY. MECHANICAL PERMIT· ISSUE PLUMBING PERMIT -ISSUE
EACH f IXTURE TRAP 1------+----------------------
EACH BUlllliNG SEWER
INSTALL FURN UUCTS JP TO 100 000 BTlJ/
I OVER 100.00 rTU ------+------'
SUMMARY/ACCOUNT NUMBER
BUILDING PER~IT
SIGN PERMIT
PLAN CHECK
001-81 J-00-00-8220
00 1-810-00-0J-8?? ·
001-810-00·00·8821
-
EACHWATFR HEATER ANU OR VENT
EACH GAS SYSTEM 1 !U ,t iJUTl_FTS
----L-----· BOILER·COMPRESSOR UP TO 3 ---+I----+--------------
8U1LER ·COMPRESS0R 31} ~--i.---T00T_AL 0L;JM8~~..0_ __ _ ,-.,-,-2-1 0~0-,-0---32-,-,--+ ----/ 0 -..:...::::. -
-
E:.ACH GAS SYSTEM 'j OR MOR[ ,_ _ _,_ __
EACHINSTA~ ALlER.RE:.PAIRWATERPIPE ---
EACH VACUUM BREAKER ----~---
I
I --r
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---t
I ',1~TA. "IR[PLACt --·---+ VENT ~AN SING ,,
t
OUCT
HOOD DUCTS MECH E.XHA ST --------------RELOCATION OF EA ~URNACE HEATER
l '.'IAH:P SOFTNER I----+-----------------e---:l-~)~ __ ~~:~:====~=D~R_Y:E:R:V:EN~T~-~~-~-c----_-_-_-_-_-____ -_-__1 ___ __c__--ll
v TQT/.;l MECHANICAL
/0 :cr-,1 ~--
!UlAl PllJMtllNL
ELECTRICAL
ME:C>-IANICAL
MOBILEHOME
SOLAR
s;RCJNG MOTIC~
FIRE SPR·~,".(LERS
i'UBLIC FACILITIES FEE
BRIDGE FEE
001-81 O-G0-00-82?J,.,,,
•
350-~0-0UN« -~ , -------,
QTY ELECTRICAL PERMIT -ISSUE MOBILE HOME SETUP ~
PARK-1 1J-LIEU 1AREA if>~T,_}-J •. '{:"·,. -:
"' -'~ .~ __ _j__ 1-----1----------------------
~E:WCO~STEAAMPSWl HKR / -------::-----------cJ,L-----
1 PH / I PH -
------------------+-------01
CAR PORT -j-----+----· ----------------+--------'---lL.
AWNING
TIF -~\\~-~..1.i.-'aio~oo-00-8835
LAc-Os-TA--,-,F--.-~;,,= 133-81 o-oo-oo-8835
Lx1sr Bl r1G E:A AMP s~·,n !~R____ / GARAGE ----'---------FMF
-
-
________ _,
--
1 PH .l PH--~----+------+, --+-------------; LICENS_E_T_A_X __
-----+-------------+-------~'<----
001 3"2-0J-O·:-SE2 _,_ _______ _
8E!\100Fl Al llR P[R c:>,r.MfT / , _ __,__ ~_c_c_"--r='------,<'---------l---
T F r,~P Pn t t /UU A',\PS ,,/ / -~,c__----/----+----
1------+----'0-V_E_R_lUUAMPS / --~-------t---------.---+-
1380-519-92-57 -------!---------M FF '-----J ____ _ -;t---+-------
I
l---+-l_E_M_P_O CC UPA rte y 'Jo,u,_A_Y_s_,_ -------+-------I---
1 I CREDIT DEPOSIT - - - --------I lilTAI tlECTRl[:Al !
I
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1
TOTAL FEES PAYABLE /0 0~
1 HAVE CAREFULL y EXAMINED THE COMPLETED ··APPUCATION AND PERMIT'' AND DO HEREBY Expiration Every permit 1i;sued by\!1e8u!ld1ng Otl,c1al under the prov,s,ons of this J
CERTIFY UNDER PENAL TY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code $hall expire by hm1tal!on and become null and void If the bu,ld1ng or work
* AN OSHA PERM:T IS REOUIMO FOR EXCAVATIONS OVER
!f o·· DEEP AND DEMOllTION OR CONSTRUCTION OF
STRUCTURES OVER 3 STORIES IN HEK3HT DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY ANO AGREE !FA PERMIT l~ :;~~~.,z~1 ~y t~uec~~~~~~~ 15
0~o~i~km:~~~~i~:Ct~; ~~~hd~:r:~t~;h:u~~~~~!e~u~~
ISSUED TO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS GOVERNING BUILDING CON La•e•s•eoedoeoeod,s_eotc•eoer.•et•mee,oc,oetteoc,atheo!.-'weoc<>'-""C'COCme,emeo~osco,dS-"lo~,c•,E!"'"C'°"SS.SOSICl.80!L2d.,s·•'--t7-p--------------------------,--~
STRUCTION. WHETHER SPECIFIED HEREIN OR NOT l ALSO AGREE TO SAVE INDEMNIFY AND APPROVED BY
I
DM-2-fS i 1 KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS ANO APPUCANT'S StG~AAJUI E lf,. _...., OWNERD CONTRACTO~ 9/
ExPENsEs wH1cH MAY 1N ANY wAY AccRue AGAINST sA10 c1rY 1N coNsEauENcE oF THE /J A :A . Lv-;_~ _ BY PHONE 0 GRANTING OF THIS PERMIT U-«e/' ,. TIIra/1
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TYPE I DATE INSPECTOR
BUILDING :
FOUNDATION I
REINFORCED STEEL ' MASONRY !
I
GUNITE OR GROUT I
SUB FRAME D FLOOR D CE11LING
SHEATHING D ROOF D S~EAR
FRAME I
EXTERIOR LATH ;
INSULATION I
I
INTERIOR LATH & DRYWALL ! .
' PLUMBING '
D SEWER AND BUCO C FIL/CO
UNDERGROUND D WASTE D WATER
TOP OUT D WASTE D \NATER
TUB AND SHOWER PAN I
GAS TEST :
D WATER HEATER D SOLAR WATER
I
ELECTRICAL :
u ELECTRIC UNDERGROUND [I] UFFER
ROUGH ELECTRIC !
D ELECTRIC SERVICE D TEMPPRARY
D BONDING D POOL I .
I
MECHANICAL ' I
D DUCT & PLEM., D REF. PIPING
HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS :
!
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAWE BEEN APPROVED
FINAL '
PLUMBING I -ELECTRICAL I S'-
MECHANICAL ' \::'.).. I I '
GAS I ' \."'-
BUILDING I '-.S) • -. -" SPECIAL CONDITIONS ' .. \." I -.
' \\ ---
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
INSPECTION
SOILS COMP1_:ANCE
PRIOR TO
f-OLINDATIOr-.. INSP
REQ IF INSPECTORS CHECKED APPROVAL DATE
----t----------------,---STRUCTLIRAL CONCRfTE
OVER 2000 PSI
PRESTRESSED
CONCRF.'E
POST TENS!ONED
-
INSPECTOR'S NOTES
CONCRETE + r--~--~---+----.---~--+-~--~~~~~~~~~~~~~~-~~--j
i=IE'._D WELDING
r------·---------- - -----+-·-------------rllGH STREr.JGTH
ao~ Ts .
f--sP_E_::::_•A_, __ M_A_sc_)N_R_Y ____ ---,----t-------
>---------+----+-----+----I ~-----------~-~------------------1
_;-,1:_fs CAIS=-c~-N~_-----t-·· -----t., ·--1------------f-----------+----___ J_ ______ -+--------
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