HomeMy WebLinkAbout1412 CRESSA CT; ; CB960619; PermitBUILDING PER MI
04/03/96 10 04
Page 1 of 1
Job Address- 1412 CRESSA CT Suite
Permit Type GUNITE POOLS AND SPAS
Parcel No 215-621-25-00 Lot#-
Valuation 0
Occupancy Group Reference*
Description INSTALL IN-GROUND FIBERGLASS
SPA W/ SEP EQUIPMENT
Permit No CB960619
Project No A9600864
Development No
6842 04/03/96 0001 01 02
C-PRfl
Appl/Ownr • SAN DIEGO HOT TUBS
P O BOX 500233
SAN DIEGO CA 92150
Construction Type ' "'WEW
Status ISSUED
Applied 04/03/96
Apr/Issue 04/03/96
Entered By RMA
619-486-2797
•*** Fees Required **** A A Fees Collected & Credits * * A-
Fees: 80 00
Adjustments .00
Total Fees 80. 00
Fee description
Total Credits:
Total .Payments:
Balance Due .
.Units Fee/Unit
00
00
80 00
Ext fee Delta
Other
A BUILDING TOTAL
80. 00 80 00 PERMIT FEE
80 00
CITY OF CARLSBAD
2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161
PERMJT APPLICATION
City of Carlsbad Building Department
2075 Las Pains Dr., Carlsbad, CA 92009 (619) 438-1161
1 PERMIT TYPE
From Ust 1 (see back) give code of Permit-Type
For Residential Proiects Only From List 2 (see back) give
Code of Structure-Type
Net Loss/Gam of Dwelling Units .
2. PROJECT INFORMATION
PLAN CHECK NO.
EST.VAL
PLAN CK DEPOSIT
VALID BY ft A-'•*" M7Jfr:
FOR OFFICE USE ONLY
Address
Nearest Cross Street
Suite No
LEGAL DESCRIPTION Lot No Subdivision Name/Number Unit No
CHhCK BhLOW IP-SUBMITTED
D 2 Energy Gales ^B-3J>tructural Calcs D 2 Soils Report D 1 Addressed Envelope
ASSESSOR'S PARCEL EXISTING USE PROPOSED USE
DESCRIPTION OF WORK
SQ FT # OF STORIES # OF BEDROOMS # OF BATHROOMS
3 LUNIAUI FtKauiM (H different from applicant;
NAME (last name first) \^
CITY , ^""STAIE.
ADDRESS
ZIP CODE
4 APPLICANT >"sJ]uNlKAt;iUK Q ACitN 1 H_W CUN 1HAUIUH
NAME (last name firet)^^/?^^ /'^^DRESS
CITY STATE ZIP CODE
DAY TELEPHONE
QOWNhR LJAGEN1 FOR OWNtH
DAY TELEPHONE tyJf'v?,/^'/?? 7*
CITY DAY TELEPHONE
O UJNIKAL.IUK
NAME (last name first)
CITY
STATE UC #
5
STATE C^T ZIP CODE<£^^/<£y'DAY TELEPHONE 7^0te7eZ^SS S
'^//^/^ f -*72 / <-7/OJ?vO / -^77 ^X'gCENSE CLASS /~Z CITY BUSINESS UC # /c^U'L/C'S /
NAME (last name tirst)ADDRESS
CITY
7 WORKERS' UUMPENSA'IION
STATE ZIP CODE DAY TELEPHONE STATE LIC #
Workers'Compensation Declaration I hereby altirm that I have a certiticateot consent to sell insure issued by the Director oJ Industrial
Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certifie
by the Director of the insurer thereof filed with the Building Inspection Department (Secjion 3800, Lab
INSURANCE COMPANY ,5UCYNO TION DATE
Certiticate of Exemption I certify that in the performance of the work For wnicn this permit is issued, I shall not employ any person in any manner
so as to become subjectso^the Workers' Compensation Laws of California
SIGNATURE
OWNER-BUILDER DECLARATION _
uwner-buiider Declaration 1 nereoy amrm tnat 1 am exempt from trie (jontractors License Law lor the following reason
D I, as owneXof 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 N(. however, the building or improvement is sold within one year of completion, the owner-builder will have the burden
of proving that he dioNi^t build or improve for the purpose of sale )
O 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 Ucense^w does not apply to an owner of property who builds or improves thereon, and contracts for such projects
with contractor(s) licensed pursuaqt to the Contractor's License Law)
D I am exempt under Section ^v Business and Professions Code for this reason
(Sec 7031 5 Business and Professions CodeNAny City or County which requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requiresxhe applicant for such permit to file a signed statement that he is licensed pursuant to the
provisions of die Contractor's License Law (ChapteN^, commencing with Section 7000 of Division 3 of the Business and Professions Code)
or that he is exempt therefrom, and the basis for thehal{eged exemption Any violation of Section 7031 5 by any applicant for a permit
subjects the applicant to a civil penalty of not more thaninvehundred dollars [$500])
SIGNATURE v ^^ DATE
COMPUTE THIS SEL'MUIM NJR NON-RESIDENTIAL BUILDING PERMITS ONLY
Is the applicant or future buildm^Qccupant required to submit a business plan, acutely hazardous materials registration form or nsk management and
prevention program under Sections26505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act?
D YES
Is the applicant or future building occupanfrequired to obtain a permit from the air polluDon control district or air quality management district?
D YES D NO
Is the facility to be constructed within 1,000 feet of tttesouter boundary of a school site?
D YES D NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFlCATfrQF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1,1989 UNLESS THE APPLICANT
HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
9 LUNMHUlllUN
1 hereby allirm that there Bsgconstrucuon lending agency tor the performance of the worK tor which tnis permit is issued (bee 3097 UJ Civil Code)
LENDER'S NAME DER'S ADDRESS
10 ArPUCAnl (JEH llrlCA 1HJN
I certify tnat l nave read tne application and staiejnat the atxjve information is correct I agree to comply with all City ordinances ana State laws
relating to building construction I hereby authonze representatives 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
AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT
OSIIA. An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stones 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 permiMs not comnienced wjthin 365 days from" the date of such permit or if the building or work authorized byxsuch permit is suspended or abandoned.a^^njgrffme.jKter the Work is comrnena£jf,for a period of 180 days (Section 303(d) Uniform Building/Code^
APPLICANTS SIGNATURE
WHITE: File YELLOW:: A^j^ant PINK: Finance
CITY OF CARLSBAD
' INSPECTION REQUEST
PERMIT* CB960619 FOR 04/17/96
DESCRIPTION: INSTALL IN-GROUND FIBERGLASS
SPA W/ SEP EQUIPMENT
TYPE: POOL
JOB ADDRESS: 1412 CRESSA CT
APPLICANT:
CONTRACTOR:
OWNER:
SAN DIEGO HOT TUBS PHONE:
PHONE:
PHONE:
INSPECTOR AREA
PLANCK! CB960619
OCC GRP
CONSTR. TYPE NEW
STE: LOT:
619-486-2797
REMARKS: MW/CHUCK
SPECIAL INSTRUCT:
INSPECTOR
TOTAL TIME:
—RELATED PERMITS—
CD LVL DESCRIPTION
59 SW Final Pool
PERMIT* TYPE STATUS
SE940082 SWRSD ISSUED
ACT COMMENTS
fv
***** INSPECTION HISTORY *****
DATE DESCRIPTION ACT INSP
040996 Underground/Under Floor AP TP
040996 Underground/Conduit-Wiring AP TP
040996 Gas/Test/Repairs AP TP
COMMENTS
GAS LINE
COMPENSATION
NSURANCE'
PO BOX 807; SAN FRANCISGO;CA 94 10 T-08Q7. ;--"., ;•• " ' ' ' "" - ' '-'
F"UND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE 08-01-95
POLICY NUMBER- 0709212--95
CERTIFICATE EXPIRES 08-01-96 ' .-
SO
CITY OF CARLSBAD
ATTN: BUILDING DEPARTMENT
2075 LAS PALMAS DRIVE ' '
CARLSBAD CA 9200g-i»859 ' "
JOB ALL OPERATIONS
This is to certify that we have issued a valid Workers' Compensation insurance-policy in-'a form approved by the
California Insurance Commissioner to the employer named below .for-the policy period indicated.. ,, ",-. v • ' ' '•
This policy is not subject to cancellation by the Fund except upon 30 days''advance-written notice to the employer
We will also give you 30 days' advance notice should this policy be cahceiled.'Tbribr to its normal expiration '-. ••<
This certificate of insurance is npt an insurance policy^ arid "does-not amend,-;extend-or "alter the coverage afforded
by the policies listed herein Notwithstanding any requirement, .term,, or condition of. any contract.or other document
with respect to which this certificate of insurance may:be-'issued or may pertain; the insurance afforded by the
policies described herein ts subject.to att the terms, exclusions and.conditions;.:of such policies' s-:s.;--.'.' .'•"- J,
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS., .loOO.OOO.OO PER OCCURRENCE
ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS < NOTICE: EFFECTIVE 08/01/95 IS ATTACHED TO AND
FORMS A PART OF THIS POLICY • ••_„., •-;•"'>, <• ,,;• ..-;';-, . Wv^'^-'vi^'-" : "' •'''•-•- ' ;'; : "-::™~"-i *'" ••.:•.'•:"•' •' ••
'•• • "''' '• "•-' ••" ''-''-- 4-':r ' ": '- ''" "'''~'
. _ * • :•"'. • A-.^. ;, -;"'".• •-..-,••
'"-'••' ••''.">'""**•'" ', '• tj- %1""'.
., ..
EMPLOYER LEGAL NAME
SAN DIEGO HOT TUBS
P 0 BOX 500233
SAN DIEGO CA 92150
RUBACKY, CHARLES (PARTNER) AND
SMITH, TOM (PARTNER)
PR1NTFD O7-19-95
THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND SCIF 10285 (REV. 2-S5)
City of Carlsbad
Building Department
WORKERS' COMPENSATION DECLARATION
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.
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 carrier and policy number are
INSURANCE COMPANY POLICY NO EXPIRATION DA
.....J/L.
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED
DOLLARS ($100) OR LESS)
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
•• C. workers compensation laws of California
Signature Date
Warning: Failure to secure workers' compensation coverage is unlawful, and shall be
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 3706 of the Labor Code, Interest and attorney's fees.
March 3, 1995
2O75 Las Palmas Dr • Carlsbad, CA 92009-1576 • (619) 438-1161 • FAX (619) 438-O894