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Home My WebLink About1369 CORVIDAE ST; ; CB031522; Permit06-18-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Pool Permit Permit No Building Inspection Request Line (760) 602-2725 CB031522 Job Address Permit Type Parcel No Valuation Reference # Project Title 1369 CORVIDAE ST CBAD POOL 2156911100 Lot# $10,64400 Construction Type HERSHEY RES-325 SF POOL/SPA 0 NEW Status ISSUED Applied 06/02/2003 RMA 06/18/2003 06/18/2003 Entered By Plan Approved Issued Inspect Area Applicant SOUTHLAND POOL CONSTRUCTION STE#A 1132 EVERGREEN DR 92024 760-944-2808 Owner HERSHEY STEVEN&LISA FAMILY TRUST 10-29-99 1369 CORVIDAE ST CARLSBAD CA 92009 77/16 Ofi/10/03 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Electrical Fee Plumbing Fee Strong Motion Fee Renewal Fee Add'l Renewal Fee Other Building Fee Additional Fees TOTAL PERMIT FEES $10739 $000 $6980 $000 $2000 $2700 $1 06 $000 $000 $000 $000 $225 25 01 - 02 COP 155.45 Total Fees $225 25 Total Payments To Date $69 80 Balance Due $15545 ERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 T.^-piRpJECfINFORMAtiori? FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date Business Name (at this addraii? 06/02/0,1 OUOJ 01Address (include Bldg/Suite #) Legal Description Lot No Subdivision Name/Number Unit No Phase Ntr"--" Total tt of units7 Assessor's Parcel #Use Description of Work' ;2 CONTACT PERSON (if different from applicant) SO. FT #of Stories tt of Bedrooms # of Bathrooms -\A.e*-j n~0wner W City Argent forSwrier State/Zip Telephone tt Fax # Name Address City State/Zip Telephone PROPERTY OWNERS Name H-e.HA.cy Address City (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 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 [$500D Name State License tt MVOH'Z' Address • i^~ License Class 65-5 City State/Zip City Business License # Telephone tt — ^~ Designer Name State License tt Address City State/Zip Telephone Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations J2^ 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 oftRe work for which this permit is issued KL 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 T"3"Pfr~£^ yVWC. Policy No ^t^TT'Z'" 'i&ti ' Expiration Date "~Ql~~QT (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) Q CERTIFICATE OF EXEMPTION I certify that m 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 ($10.0,000) of addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code interest and attorney s fees SIGNATURE <^*flfiS'r' Tkx^. DATE 6l' / £) T'lQfy j,7 sIOWNERrBUlLDER DECLARATION ..... .... ill: ..:Jfc' :.Jfir.. .:.aJI;:. ,:: :!S:: .... ...; IM ;. / i ;l:-h! "-1 .:«... il:;**!:: • I hereby affirm that I am exempt from the Contractor's License Law for the following reason Q 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) Q 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 1 I personally plan to provide the major labor and materials for construction of the proposed property improvement [~| YES l~lNO 2 I (have / have not) signed an application for a building permit for the proposed work 3 I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / 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 number / contractors license number) __ 5 I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work) PROPERTY OWNER SIGNATURE DATE iCOMRLEtEsTHIS SECTION FOR./«W-fl£S/D£(V7Mi BUILDING PERMITS ONLY' " • ^;: / "^ ' , a "i™" """ """ ?,' *" 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? Q YES [H NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES d NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES L~D 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 • ISONSTRUCf JON LENDING AGENCY ....... "•' " ..... *"'"jj- " "~:' •" ""^ '''"," ....... " ' '" ":" '' ............. ~1? ...... :~ fT" ' "tfTS:."' "" "" " 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 7 :^PPLiCANTfCERTJi=iiCATION^ , .':?°' " T" "*:|'s .1 :.. ., :""!SL:....ji! ' ^*.'' ••' ««•• '"! , , ' •..•,.• """",• 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 City of Carlsbad to enter upon the above mentioned property for inspection purposes 1 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 180 days from the daje of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is comme^cesyor a/(5eriod of 180 days (Se^fion 106 4 4 Uniform Building Code) APPLICANT S SIGNATURE DATE WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request m Permit* CB031522 Title HERSHEY RES-325 SF POOL/SPA Description GAS FOR BBQ/ FIREPIT For 12/02/2003 Inspector Assignment PY Type POOL Sub Type Job Address 1369 CORVIDAE ST Suite Lot 0 Location APPLICANT SOUTHLAND POOL CONSTRUCTION Owner HERSHEY STEVEN&LISA FAMILY TRUST 08-29-99 Remarks Phone 7609300797 Inspector Total Time Requested By N/A Entered By ROBIN CD Description Act Comment Associated PCRs/CVs Inspection History Date 1 1/20/2003 1 1/20/2003 08/04/2003 08/04/2003 07/29/2003 07/29/2003 07/29/2003 07/25/2003 Description 34 55 23 52 51 52 53 51 Rough Electric Fence/Pre-Plaster Gas/Test/Repairs Underground Plumbing Excav/Steel/Bonding/Fence Underground Plumbing Electnc/Conduit/Winng Excav/Steel/Bonding/Fence Act AP AP AP we AP AP AP CO Insp PY PY PY PY JE JE JE JE Comments ALARMS OK NEED FINAL BOTH FENCES BONDED CONDUIT ONLY SHOW CORRECTED PLAT PLAN DETAIL - BOND SOUTH FENCE 1127-B7 City of Carlsbad Public Works — Engineering BUILDING PLANCHECK CHECKLIST POOLS BUILDING PLANCHECK NUMBER BUILDING ADDRESS I /TgP^L.C? PROJECT DESCRIPTION Pool ASSESSOR'S PARCEL NUMBER // ENGINEERING DEPARTMENT APPROVAL The item you have submitted for review has been approved The approval is based on plans, information and/or specifications provided in your submittal, therefore, any changes to these items after this date, including field modifications, must be reviewed by this office to insure continued conformance with applicable codes Please review/carefully all comments attached, as failure to comply iwith instructions in this report can result in sus0renB|oryof permit to build By Date Please see marked with plans or spe< applicable codes DENIAL attached report of deficiencies Make necessary corrections to ications for compliance with nd standards Submit corrected plans and/or specifications to this office for review Date Date Date ATTACHMENTS Grading Permit Application Grading Permit Checklist Right-of-Way Permit Application Right-of-Way Permit Submittal Checklist and Information Sheet ENGINEERING DEPT. CONTACT PERSON NAME JOANNE JUCHNIEWICZ City of Carlsbad ADDRESS 1635 Faraday Avenue Carlsbad, CA 92008 PHONE (760) 602-2775 H \WORD\DOCS\CHKLS'nPool Building Plancheck Cklist CHK24 Form BE.doc 1635 Faraday Avenue • Carlsbad, CA 92OO8-7314 • (760) 6O2-2720 • FAX (760) 602-8562 (7 BUILDING PLANCHECK CHECKLIST - POOLS <- ( 7 0 - _?G SITE PLAN 1 Provide a fully dimensioned site plan drawn to scale Show A North Arrow C Property Lines B Existing & Proposed Structures D Easements ite plan /~>^ — ' Tnage Patterns sfify lndlcate wnat Wl" happen with Existing & Proposed Slopes /^ — soil excavated from pool area Existing Topography E Retaining Walls (location and height) Note' If excavated so/7 /s not to be removed from property but regraded on s;te, show proposed elevations and slopes. If any portion of retaining walls are over 4' in height, a separate permit is required Retaining Wall Permit CB _ Applied for _ Approved _ 3 Include on title sheet Site Address Assessor's Parcel Number Legal Description D Grading Quantities Cut Fill Import/Export a) If grading is not required, write "No Grading" on plot plan Q 4 Project does not comply with the following Engineering Conditions of approval for Project No _ Conditions were complied with by _ Date _ GRADING PERMIT REQUIREMENTS The conditions that invoke the need for grading permit are found in Section 1 1 06 030 of the Municipal code Q 5a Inadequate information available on Site Plan to make a determination on grading requirements Include accurate grading quantities (cut, fill, import, export) Q 5b Grading Permit required A separate grading plan prepared by a registered Civil Engineer must be submitted together with the completed application form attached Note: The Grading Permit must be issued and rough grading approval obtained prior to issuance of a Building Permit Page 2 of 2 H \WORD\DOCS\CHKLST\Pool Building Plancdeck CWist CHK24 Fom BE doc <\ ST/ oND/ oRD/\ * C. O Q 5c A Grading Permit has been applied for PE2 DWG *W Grading Inspector sign off by "_ Date Q 5d No Grading Permit required MISCELLANEOUS PERMITS Q 6 A RIGHT-OF-WAY PERMIT is required to do work in City Right-of-Way and/or private work adjacent to the public Right-of-Way A separate Right-of-Way issued by the Engineering Department is required for the following Please complete attached Right-of-Way application form and return to the Engineering Department together with the requirements on the attached Right- of-Way checklist, at the time of resubmittal Right-of-Way Permit and Pool Building Permit will be issued simultaneously Q Q 7 Remarks H IWORDlDOCSlCHKLSTTPool Building Plancheck Cklis! CHK24 Forni BE doc PLANNING/ENGINEERING APPROVALS PERMIT NUMBER CB DATE ADDRESS RESIDENTIAL TENANT IMPROVEMENT RESIDENTIAL ADDITION MINOR « $10,000.00) PLAZA CAMINO REAL CARLSBAD COMPANY STORES VILLAGE FAIRE COMPLETE OFFICE BUILDING OTHER PLANNER DATE ENGINEER DATE Docs/Mlsforms/Plannmg Engineering Approvals Sent By RD HANSON INSURANCE AGENCY, 1 760 747 1074 , Apr-16-03 3 30PM; '9<4 Lt)/-<;UHJ 1J i f Page 1 /1 NO 529 D002 POL'CYHOLDER COPY STATE p ° BOX 420B07. SAN FRANCISCO, CA 94142-0807 COMPENSATION FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE 1$, 2003 GROUP. 000229 POLICY NUMBER 345S2-2003CERTIFICATE 10, S CERTIFICATE EXPIRES. 04-01-2004 04-0I-2003/04-01-2004 CONTRACTORS STATE LICENSE BCMlD WORKERS' COMPENSATION P 0 BOX 26000 SACRAMENTO Cft 9582S #810422 iHCRPtlON 04-01-03 ZT> CSC This is to certify that w» have issued a vaW Worker's Compensation insurance pokey in a form approved by the California Insurance Commissioner lo the employer namod below for the policy period indicated This policy la notsubjeti-to cancellation by the Fund exwpt upon 10 days advance wittert ngtice to tne employer We will ateo give you 10 days advance natc* should this policy be wncafled pnw to its nom^l expiration Thte cartrficdte of msuranbo is ngt an insurance policy and does not amend, extend or after the coverage afforded by (he poltow listed h«roln Notwrttistanding any reqmrefnent. term or cofidKlon of any contract cr othor document wtth respect to which this wrbfiwtB of insurance may t» issued or may pertain, the insurance afforded by the policies dwcnbed herein Is subject to ell the term:., exclusions, and conditions, of such policies hVTXOWZED REPRESENTATIVE EMPLOYER'S KABXWW LIMIT rNCLODINCJ DBFHJSE COSTS $1,000,000 PER OCCTOREHCE EMPLOYER AKS EOOLS CONSTRUCTION, INC 1132 HVERGBBBN DR » B BNCINITAS CA 92034 / O I OO d2 Q <>< ir> ctO CM —<n m LL »- CO ^S ce enm ill <O I O