HomeMy WebLinkAbout1307 Pine Ave; ; CBR2019-0078; Permit{'city of
Carlsbad
Residential Permit
Print Date: 05/20/2019 Permit No: CBR2019-0078
Job Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Group:
# Dwelling Units:
Bedrooms:
Project Title:
1307 Pine Ave
BLDG-Residential
2050521600
$46,207.98
Work Class:
Lot#:
Reference#:
Construction Type:
Bathrooms:
Orig. Plan Check#:
Plan Check#:
Description: PATTERSON: 882 SF POOL & SPA
Applicant:
SWIFT PERMITS
DAVID JONES
15641 Maturin Dr
San Diego, CA 92127-2331
619-884-9188
BUILDING PERMIT FEE ($2000+)
BUILDING PLAN CHECK FEE (BLDG)
Owner:
DARLEEN PETERS
1307 Pine Ave
CARLSBAD, CA 92008
ELECTRICAL BLDG RESIDENTIAL NEW/ADDITION/REMODEL
PLUMBING BLDG RESIDENTIAL NEW/ADDITION/REMODEL
SB1473 GREEN BUILDING STATE STANDARDS FEE
STRONG MOTION-RESIDENTIAL
SWPPP INSPECTION FEE TIER 1 -Medium BLDG
SWPPP PLAN REVIEW FEE TIER 1-MEDIUM
Total Fees: $1,072.57 Total Payments To Date:
Pool
$1,072.57
Status:
Applied:
Issued:
Permit
Finaled:
Inspector:
Final
Inspection:
Contractor:
PACIFIC SUN POOL 'N SPA
8550 Production Ave
San Diego, CA 92121-2288
858-271-8822
Balance Due:
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.
Closed -Finaled
01/11/2019
01/22/2019
CRenf
5/20/2019 9:35:39AM
$0.00
$386.80
$270.76
$41.00
$62.00
$2.00
$6.01
$246.00
$58.00
1635 Faraday Avenue, Carlsbad, CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov
{cicyof
Carlsbad
RESIDENTIAL
BUILDING PERMIT
APPLICATION
B-1
Plan Check ~~gl())'f--aQJt
Est. Value H la, ').Pl 9o
PC Deposit
Date ---t\--1-/-l-ll • ....,/--'l--'9-
JobAddress /~07 'Pit'.I~ A-w. Suite: ____ APN: Z.OS-t,':,-Z..-(Ct.,-oo
CT /Project#: __________ Lot#: ____ Fire Sprinklers: yes/ no Air Conditioning: yes/ no
BRIEF DESCRIPTION OF WORK:
□ 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: 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: ___________________________________ _
D Plumbing/Mechanical/Electrical Only: _________________________ _
D Other: __________________________________ _
APPLICANT (PRIMARY) PROPERTY OWNER
Name: "!Pvro\ 0-or'ES
Address: fa% 9 'lt:i t'\t / (Ql,IY t
City: l,,a \'I ?I Bi State: (,f Zip:
Phone: (pf -L/-"t/8~
Email: °'i)?vrq € s;..,,-ff frr I" r-b:(oM
DESIGN PROFESSIONAL
Name: ________________ _
Address: _______________ _
City: _______ State: ___ ,Zip: ___ _
Phone: ________________ _
Email: ________________ _
Architect State License: __________ _
Name: ;Je::,.se Lu. e\llA. 11\6
Address: [ '2,o J ?i l'le AW!.
City: (",'/"\:>Olq State: (,k Zip: 'f?pq/?
Phone: 'iS5f-G,4 Z.-b'\81
Email: ___________________ _
CONTRACTOR BUSINESS
Name: ___________________ _
Address: __________________ _
City: _______ State: ___ .Zip: ______ _
Phone: __________________ _
Email: ___________________ _
State License: ______ Bus. License: ______ _
(Sec. 7031.S 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 llcensed 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 ls 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 clvll 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
B-1 Page 1 of2 Rev. 06/18
( OPTION A): WORKERS'COMPENSATION DECLARATION:
I hearby affirm under penalty of perjury one of the following declarations:
□ 1 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 ls 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 this permit is issued.
My workers' compensation insurance carrier and policy number are: Insurance Company Name: _____________________ _
Policy No. _____________ Expiration Date: _________ _
□ 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: Fallure to secure workers compensation coverage Is unlawful, and shall subject an employer to
criminal penalties and clvll fines up to $100,000.00, In addition the to the cost of compensation, damages as provided for In Section 3706 of the Labor Code,
interest and attorney's fees.
CONTRACTOR SIGNATURE: _________________ □AGENT DATE: _____ _
( OPTION B ): OWNER-BUILDER DECLARATION:
I hereby affirm that I am exempt from Contractor's License Law for the following reason:
, t, 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).
□ I am exempt under Section ------,-----•Business and Professions Code for this reason:
1. I personally plan to provide the major tabor and materials for construction of the proposed property Improvement. □ Yes □ No
2. 1 (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):
S. I wlll 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: 1/11 J,-,,
CONSTRUCTION LENDING AGENCY. IF ANY:
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: _____________________ 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 hazardous materials registration form or risk management and prevention
program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? □ Yes □ No
Is the applicant or 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 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 CARl5BAD 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 S'O' 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 (Section 106.4.4 Uniform Building Code).
APPLICANT SIGNATURE: ----,JAl,£--"'~e..:c..;q.•_~..:,p,<..:...:::..-::'----------DATE: _....:t+/.....:t_;_l-f-fL/"f.,__ __
1635 Faraday Ave Carlsbad, CA 92008
B-1
Ph: 760-602-2719 Fax: 760-602-8558
Page 2 of 2
Email: Building@carlsbadca.gov
Rev. 06/18
PERMIT INSPECTION HISTORY REPORT (CBR2019-0078)
Permit Typo: BLDG-Residential Application Date: 01/11/2019 Owner: DARLEEN PETERS
Work Class: Pool Issue Date: 01/22/2019 Subdivision: PA TTERSONS ADD
Status: Closed -Finaled Expiration Date: 09/30/2019 Address: 1307 Pine Ave
Carlsbad, CA 92008-1941
IVR Number: 16440
Scheduled Actual Inspection Type Inspection Status Primary Inspector Reinspection Complete
Date Start Date Inspection No.
Checklist Item COMMENTS Passed
BLDG-Building Deficiency No
BLDG-Plumbing Final No
BLDG-Mechanical Final No
BLDG-Structural Final No
BLDG-Electrical Final No
04/01/2019 04/01/2019 BLDG-55 087641-2019 Passed Chris Renfro Complete
Fence/Preplaster
Checklist Item COMMENTS Passed
BLOG-Building Deficiency Yes
BLDG-Final 087505-2019 Failed Chris Renfro Reinspection Complete
Inspection
Checklist Item COMMENTS Passed
BLOG-Building Deficiency No
BLOG-Plumbing Final No
BLOG-Mechanical Final No
BLDG-Structural Final Not ready No
BLDG-Electrical Final No
05/20/2019 05/20/2019 BLDG-Final 092273-2019 Passed Michael Collins Complete
Inspection
Checklist Item COMMENTS Passed
BLOG-Building Deficiency Yes
BLDG-Building Deficiency No
BLOG-Plumbing Final No
BLDG-Mechanical Final No
BLDG-Structural Final Not ready No
BLOG-Electrical Final GFCI protection ok. Landscape lighting is Yes
solar powered
BLDG-Electrical Final No
May 20, 2019 Page 2 of 2
PERMIT INSPECTION HISTORY REPORT (CBR2019-0078)
Permit Type: BLDG-Residential Application Date: 01/11/2019 Owner: DARLEEN PETERS
Work Class: Pool Issue Date: 01/22/2019 Subdivision: PATTERSON$ ADD
Status: Closed -Finaled Expiration Date: 09/30/2019 Address: 1307 Pine Ave
Carlsbad, CA 92008-1941
IVR Number: 16440
Scheduled Actual Inspection Status Primary Inspector Re inspection Date Start Date Inspection Type Inspection No. Complete
01/29/2019 01/29/2019 BLDG-23 082416-2019 Failed Mlchael Collins Reinspection Complete
Gas/Test/Repairs
Checklist Item COMMENTS Passed
BLDG-Building Deficiency No test gauge on site. No
01/30/2019 01/3012019 BLDG~23 082585-2019 Passed Chris Renfro Complete
Gas/Test/Repairs
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
BLOG-SW-Pre-Con 082584-2019 Passed Chris Renfro Complete
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
02/2612019 02126/2019 BLDG-51 084739-2019 Passed Chris Renfro Complete
Excav/Steel(Pools)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
BLDG-52 Pool 084738-2019 Passed Chris Renfro Complete
Plumbing
03/05/2019 03/05/2019 BLDG-11 085247-2019 Passed Chris Renfro Complete
Foundatlon/Ftg/Pler
s (Rebar)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Inspected rebar for above ground wall Yes
forms above pool and spa. OK to pour
03/15/2019 03/15/2019 BLOG-53 086342-2019 Partial Pass Tim Frazee Reinspection Incomplete
EleclCondultlWiring(
Pools)
BLOG-54 086222-2019 Passed Tim Frazee Complete
Equipotential
Bond(Pools)
03/28/2019 03/28/2019 BLDG-57 Gunite 087259-2019 Cancelled Chris Renfro Reinspection Complete
Checklist Item COMMENTS Passed
BLDG-Building Deficiency No
BLDG-Final 087260-2019 Cancelled Chris Renfro Reinspection Complete
Inspection
May 20, 2019 Page 1 of2
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. THE OWNER/CONTRACTOR SHALL RESTORE ALL EROSION
CONTROL DEVICES TO WORKING ORDER TO THE SATISFACTION
OF THE CITY INSPECTOR AFTER EACH RUN-OFF PRODUCING
RAINFALL.
3. THE OWNER/CONTRACTOR SHALL INSTALL ADDITIONAL 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 CERTIFICATE:
I UNDERSTAND AND ACKNOWLEDGE THAT I MUST: (1) IMPLEMENT
BEST MANAGEMENT PRACTICES (BMPS) DURING CONSTRUCTION
ACTIVITIES TO THE 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 TIMES,
COMPLY \l/1TH THIS CITY APPROVED TIER 1 CONSTRUCTION SWPPP
THROUGHOUT THE DURATION OF THE CONSTRUCTION ACTIVITIES
UNTIL THE CONSTRUCTION WORK IS COMPLETE AND APPROVED
BY THE CITY OF CARLSBAD.
-1t\vid :To~s
OWNER(S)/OWNER'S AGENT NAME (PRINT
7JcUPd ~ , OWNER(S)/OWNER'S AGENT NAME ~GN1
I /,t;t /10 ~
E-29
STORM WATER COMPLIANCE FORM
TIER 1 CONSTRUCTION SWPPP
BEST MANAGEMENT PRACTICES (BMP) SELECTION TABLE
Erosion Control Sediment Control BMPs Tracking Non-Slorm Water Waste Management and Materials
BMPs Control BMPs Management BMPs Pollution Control BMPs
C -C C 0 -0 0 :;. C C -0 :;. :;. °' 0 Q) -0 Q) -0 ., C " " C .!. o> E C E C -0 -::, ::, 0 ·c: C. 0 0 0 E L L -0 Q) ::::s -0 ., o> L Q) --:;. L ·3 >, °' .!. '-C Q) L C Q) C: ., ., ., ~ CT L 0 C o> a. Q) L ~ Best Management Practice* o1:I C 015 0 ·a_ ·c: -C a, C L "' L w C 0 CD L 0 Q) 0 Q) :;. :E ., 3 ., ,-'= Q) 0 C OL 0 Q) -Q) 0 -C E ., "O ., ., C Q) C (BMP) Description ➔ ., " ., en ·e ., °' Q) °' CD "6 C o> C -0 ., ~ C ::::s ~ -Q) Q) Q) 0 3c Cc D ::::, ci == Q) " -0 'a LO 11~ -0 >, 0 ., 0 o> Q) ['J E :5 C D CD en·-o> O:;:; Co Q) ::::s D o> D C _E 1l 0 0 Q) Q) 0 Q) 0 ]-L-3: Q) X Q) a:: 0 N a, " OI:;:; ~-5 Q) 0 Q) E .>< ~ .0 E~ =-== 00 == 3: ~:;:; :n ·cg ·c: ~~ "' --0 .c C Q) LL " L Q) ::, -0 :c E ·--0 cO U C Q) -0 0 0 -·-C. 'o Q) Q) ::, L-.0 0 -" •-L 0 ·-0 Q) L " 0 LO ..2 -Q) ~ e L U C 0 0 0 °' .s 0 00 ~8 15 .c Q) -o -0 = C: •-C
Q) ;£ CL en Q) .c -o 0 -L Ul C 3: a: ~u o_ 0 -a.o oo
"' WD en en 0 "' en> <n en a. en a:: a. 0 a. ::::s en ::::s en eno en ::::s
CASQA Designation ➔ r--a, a, "' .... "' <D r--a, 0 N "' r--a, N "' .... "' I I I 'T 'T I I I I I I I 'T I I I I I I I I I I
0 0 0 0 w w w w w w w w g: g: en en <n en ::::s ::::s ::::s ::::s ::::s
Conslruction Activily w w w w en en en en en en en en z z z z 3: 3: 3: 3: 3:
Gradinn !Soil Disturbance
TrenchiM/Excavation
Stocknilinn
Drillina /Borina
Concrete/Asohalt Sawcuttina
Concrete Flatwork
Pavina
Conduit/Pioe Installation
Stucco/Mortar Work
Waste Disoosal
Staaina/Lav Down Area --• Enuinment Maintenance and Fuelinn
Hazardous Substance Use /S.toraae
Dewaterina
Site Access Across Dirt ' . Other (listl:
Instructions:
1. Check the box to the left of all applicable construction 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 construction from the list. Check the box where the chosen activity row intersects with the BMP column.
3. Refer to the CASQA construction handbook for information and details of the chosen BMPs and how to apply \hem to the project.
PROJECT INFORMATION
Site Address: 1361 ?i~ A,..e.
Assessor's Parcel Number: '2.65 -6~2-/ Co -oO
Emergency Contact:
Name: J~St Ll,\elA:>."'O
24 Hour Phone: g6 8 -lo 9 4 -.3'-\0
Construction Threat to Storm Water Quality
(Check Box)
□ MEDIUM ~ LOW
Q) -.,
0 ;.::-C ., Q) ::, E 0 Q)
-0 o>
5o NC oo ::c ::::s
<D .
I ::::s 3:
Q) -.,
o-3: iii ., E
-Q)
Q) "' t; 0
CC oo o::::s
a,
I ::::s 3:
Page 1 of 1 REV 11/17
Print Date: 05/22/2019
Job Address:
Revision Permit
{City of
Carlsbad
Permit No: PREV2019-0039
Permit Type:
1307 Pine Ave
BLDG-Permit Revision
2050521600
Work Class: Residential Permit Revisi Status: Closed -Finaled
Parcel No: Lot#: Applied: 02/22/2019
Valuation: $ 46,207.98 Reference #: Issued: 03/19/2019
Occupancy Group: Construction Type Permit 05/22/2019 Finaled:
# Dwelling Units: Bathrooms: Inspector: CRenf
Bedrooms: Orig. Plan Check#: CBR2019-0078 Final
Plan Check#: Inspection:
Project Title:
Description: PATTERSON: ADD WALL ON TOP OF BOND BEAM, RAISE HOT TUB, DECREASED RADIUS AT THE DEEP END
Applicant: Owner:
SWIFT PERMITS DARLEEN PETERS
DAVID JONES 1307 Pine Ave
15641 Maturin Dr CARLSBAD, CA 92008
San Diego, CA 92127-2331
619-884-9188
FEE
BUILDING PLAN CHECK REVISION ADMIN FEE
MANUAL BUILDING PERMIT FEE
Total Fees: $ 40.00 Total Payments To Date : $ 40.00
Building Division
Contractor:
PACIFIC SUN POOL 'N SPA
8550 Production Ave
San Diego, CA 92121-2288
858-271-8822
Balance Due:
AMOUNT
$35.00
$5.00
$0.00
1635 Faraday Avenue, Carlsbad CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov
·c Cicyof
Carlsbad
PLAN CHECK REVISION OR
DEFERRED SUBMITTAL
APPLICATION
B-15
Development Services
Building Division
1635 Faraday Avenue
760-602-2719
www.carlsbadca.gov
Original Plan Check NumberC'Atf.;26 fl-00±8 Plan Revision Number Pe,ev /26 Jqr603 9
Project Address J3o 7 e·y,e llve
General Scope of Revision/Deferred Submittal: ~A,_02ec.u_,_t-_· ·~· ;,,'--· ~v~J.!:J.._,_,'--"'.:~-l='~i"".-!--~v<-.Ll, ._,_1 ,,,_,_, -----~
/ 1.6 [ ~A,~\ ~\(, -, r ,c,;, 7i;::
CONTACT INFORMATION:
Name '-\e4-?c Li\ e-1/ 4( t Phone
·'' ,'] ., " '-~vb Address i 70 r 1 'r:,.,\f:: t's. '-City Av!, , -.;-:A;r Z. J/ 1 r 'Ir) ,p . , .
Email Address ,)T'f\) .. : '·: !;,Jl,.k'_:-, . / ,:71./'1),,
Original plans prepared by an architect or engineer, revisions must be signed & stamped by that person.
1 . Elements revised: ~ Plans J1 Calculations D Soils D Energy D Other
2. 3.
Describe revisions in detail List page(s) where each
revision is shown
,11·.()\1,~-, l,\JA--''
I -( 1 :1 ';_ -~ ,, , ,. ' 0'),--, . r.c. F'S -,t..._\,J r.,,;::::.i\. 1 •= , /
, i,1\--'.',;:::, _,,, ' 1,.,-..,...-i U.J. )Sr
r•) 6 ~ ,I •7 f.:· "-,-£:_ _ _r-) v.!A-o,, I c. / J ,1· -...,:::.:.,;.: 'i:' r=_c,j l J ,,, ?r.
4. Does this revision, in any way, alter the exterior of the project? ~ Yes 0 No
5. Does this revision add ANY new floor area(s)? D Yes (3 No
6. Does this revision affect any fire related issues? D Yes O No
7. Is this a complete seF '\ ~ Yes D No
£S'Signature _____ -:r=-'-'-----------Date
7 ,') ,1 /j
I 635 Faraday Avenue, Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: building@carlsbadca.gov
www.carlsbadca.gov