HomeMy WebLinkAbout1616 CORMORANT DR; ; CB961296; PermitBUILDING PER MI
09/04/96 09 55
Page 1 of 1
Job Address 1616 CORMORANT DR Suite
Permit Type RETAINING WALL
Parcel No 215-650-04-05 Lot*
Valuation 1,830
Occupancy Group Referenced.
Description 140 SF RETAIN WALL-PER CITY
. SPEC #221+ELECT & GAS TO FIRE PIT
T Permit Mo CB961296
Project No. A9601848
Development No
Appl/Ownr KLAUS & ENYEDI CONCRETE CONST
1715 CATALPA RD
CARL S BAD C A 92009 ........ -
x** Fees Required ***/"' ,, .v^/r,, •
9448 09/04/96 OOOi 01 02
Construction UyptefT NEW 27-00
Status ISSUED
Applied- 07/15/96
Apr/Issue 07/22/96
Entered By RMA
619-931-0445
Collected & Credits * A *
Fees
Adjustments
Total Fees
1,19. o/o-~->.^
u .. '"'"
\
Fee description / /X..^ '"' /
xttpce ...D\ie : \
Unita\ 'v-E^e/-riN
00
92 00
27 00
Ext fee Data
Building Permit / '"~:-"~;:.<
Plan Check ; ('• ; -.
Strong Motion Fee! '\>--V
Other : .......
* BUILDING TOTAL \/.Cv\^//; ^N.,//
Cl •*••'• /
43. 00
28 00
1 00
47 00 ELEC & GA
119 00
CITY OF CARLSBAD
2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161
&*77
PERMIT APPLICATION
City of Carlsbad Building Department
2075 Las Palmas Dr.. Carlsbad. CA 92009 (619) 438-1161
T FEHMIT "1"YHK
From Last 1 (see back) give code of Permit-Type
For Residential Proiects Only From List 2 (see back) give
Code of Structure-Type
Net Loss/Gain of Dwelling Units
PLAN CHECK NO.
EST VAL
PLANCK
VALID BY_
DATE
DEPosrr
2 PROJECT INFORMATION B538 07/-KA"?*. nnni MFOR OFFICE IJSE ONLY'*_*--—:lt rAddressTBuilding or Suite No
Nearest Cross Street A £. (J
LEGAL DESCRIPTION Lot No Subdivision Name/Number Unit No Phase No
CHECK BELOW It- bUBMll 1EL)
D 2 Energy Gales ^ 2 Structural Calcs D 2 Soils Report D 1 Addressed Envelope
ASSESSOR'S PARCEL EXISTING USE PROPOSED USE
DESCRIPTION OF WORK
rj, ^CT
SQ rr / HO ^ l^HC WflY (_ # OF STORIES # OF BEDROOMS # OF BATHROOMS
UJNTAUl' FliKSTJN (.11 dnierent irom applicant;
NAME (last name first)
CITY STATE
ADDRESS
ZIP CODE DAY TELEPHONE
4 APPIJCJVNT JS CONTRACTOR DAGENTTOR CONTRACTOR D OWNER D AGENT FOR OWNER
NAME (last name first) £ My g~D\ £.L&\)S ADDRESS ]~) / £~ C /*Ttf-cV4-
STATE £ ft- ZIP CODE SZ£>O°| DAY TELEPHONE ^ 1 'CITY
5 PROPERTY OWNliK
NAME (last name first) G-«.A-y S
ciTfC&Q.! .g S#T> STATEC^-
ADDRESS
ZIP CODE DAY TELEPHONE JT ~|
o CONTRACTOR
NAME (last name first) £^V£"Q< \^(_ ft\; ^ ADDRESS /"7/j"" C b"\ £ri- ?t4~}
CITY CAfrtLiU^O STATE C/^- ZIP CODE ^ Z O O ^ DAY TELEPHONE °J 3 / <
STATE LIC # VJ Z SV-3 LICENSE CLASS C ^ CITY BUSINESS LIC #
NAME (last name first)
CUT STATE ZIP CODE
3DRESS
DAY TELEPHONE STATE LIC #
7 WORKERS^ COMPENSATION
Workers Compensation Declaration I hereby affirm that I have a certiticate ol consent to sell-insure issued by the Director or Industnal
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 STftT POLICY NO EXPIRATION DATE
Certilicate ol Exemption I certify that in the performance ol 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
SIGNATURE DATE
8 OWNER-BUIIDER DECLARATION
Owner-tiuilder Declaration I hereby allirm that I am exempt Irom the Contractors License Law tor the lollowing reason
D 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 lacense 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)
D 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)
D 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 [S500])
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?
D YES D NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management distnct?
D YES D NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
D YES D NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE LSSUED 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 CDNSTRUCriUN LENDING AGENCY
1 hereby atlirm that there is a construction lending agency tor the perlormance ot the work tor which this permit is issued (Sec 3097(0 Civil Code)
LENDER'S NAME LENDER'S ADDRESS
10 APPL1CAN1 CLKIU-lCAllON
Tceruly that 1 have read the application and state that the above inlormation is correct T 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 TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARISBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS
AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SATO CITY IN CONSEQUENCE OF THE GRANTING OF 11 IIS PERMIT
OSHA. An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stones m 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 authonzed by such permit is not commenced within 365 days from the date of such permit or if the building or work authonzed 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)
APPLICANTS SIGNATURE is>- s /J _ DATE 1~lf^j(,
HTE. File YELLOW: Apphcant PINK: Finance
O
f
PERMIT APPLICATION
City of Carlsbad Building Department
2075 Las Pal«as Dr., Carlsbad, CA 92009 (619) 438-1161
T FtKMIT
From List 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
PLAN CHECK NO.
EST. VAL
PLAN CK DEPOSIT
VALID BY_/
DATE
2. PROJECT DEFORMATION FOR OFFICE USE ONLY
Address
Nearest Cross Street ~~-fo \ t-3
Building or Suite No
LEGAL DESCRIPTION Lot No Subdivision Name/Number
CHECK BELOWIFSUBMITTED
D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D 1 Addressed Envelope
ASSESSOR'S PARCEL EXISTING USE PROPOSED USE
DESCRIPTION OF WORK
SQ FT
C /
# OF STORIES # OF BEDROOMS # OF BATHROOMS
3 UUNTALl PkKSLjN (it different irom applicant;
NAME (last name first)
CITY STATE
ADDRESS
ZIP CODE DAY TELEPHONE
4 APPLICANT HTJONTRACTOR U AOtNT FOR LUN 1RAL1UH UOWNtK U A(jtN 1 1-UH OWNER
NAME (last name first) gjj y (?£> I ICi-ftf} ADDRESS f~f / 3" £ fiTf #<. p Q_ fct> .
' ^ DAY TELEPHONE / '3 /CITY STATE ZIP CODE 0/40'
5 PROPERTY OWNER
NAME (last name first)
CITY STATE
ADDRESS
ZIP CODE DAY TELEPHONE
0 CONTRACTOR
NAME (last name first)
CITY
£>"£-
STATE
T ADDRESS
ZIP CODE DAY TELEPHONE
STATE LIC #
LJESIGNEH NAME (last name tirstj
CITY STATE
LICENSE CLASS
ZIP CODE
CITY BUSINESS UC #
JDRESb
DAY TELEPHONE STATE LIC #
7 WORKER*? COMPENSATION
worKenTCompensation Declaration I hereby attirm that I have a certificate of consent to sell insure issued by the Director ot 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 POLICY NO EXPIRATION DATE
Certiticate ot Exemption I certify that in the performance of the work tor which this permit is issued, 1 shall not employ any person m any manner
so as to become subject to the Workers' Compensation Laws of California
SIGNATURE DATE
8 OWNER-BUILDER DECLARATION
Owner-builder Declaration l nereDy attirm that I am exempt from the Contractors License Law tor tne tollowmg reason
D 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 )
D 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)
D 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, poor 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
CJUMFLETt: THIS btUTKJN FOR NON-RESIDENTIAL BUILDING PERMITS ONLY
Is the applicant or future building occupant required to submit a business plan, acutely hazardous matenals registration form or nsk management and
prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act?
D YES D NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
D YES D NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
D YES D NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS TI IE APPLICANT
HAS MET OR IS MEETING Tlffi: REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT
«T CONSTRUCTION LEND1NU AGENCY
1 hereby attirm that there is a construction lending agency tor the performance ot the work tor which this permit is issued (i>ec 3097(i) Cml Code)
LENDER'S NAME LENDER'S ADDRESS
10 APPUCAN1 ChKllriCAnUN
1 certify that 1 have read the application and state that the above information is correct 1 agree to comply with all Cay 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 TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS
AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SATO 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 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 aj/'any tune after the work is commenced for a period of 180 days (Section 303(d) Uniform BuJdmg C
/I DATE * — 'APPLICANTS SIGNATURE uddi
^
WHITE. File YELLOW Applicant PINK: Finance
City of Carlsbad
Building Department
DATE: 02/21/97
TO: KLAUS & ENYEDI CONCRETE CONST
1715 CATALPA RD
CARLSBAD CA 92009
RE: BUILDING PERMIT EXPIRATION
PERMIT NUMBER: CB961296
ISSUE DATE: 07/22/96
LAST INSPECTION:
PLEASE CALL FOR AN INSPECTION
IF WORK IS COMPLETE
ADDRESS: 1616 CORMORANT DR
Our records indicate that your building permit will expire by limitation
of time on 03/04/97.
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,
specified below, shall be obtained.
a new permit, or a renewal permit as
1. PERMITS WHERE WORK HAS NOT COMMENCED. For permits where work has
not commenced in the first calendar year from the date of issuance, a renewal
permit may be obtained provided:
(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.
2O75 Las Palmas Drive • Carlsbad, California 92OO9-1 576 • (619)438-1161
02/21/97 INSPECTION HISTORY LISTING
FOR PERMIT# CB961296
DATE INSPECTION TYPE
09/18/96 Final Masonry
09/18/96 Final Masonry
09/18/96 Final Masonry
09/05/96 Gas/Test/Repairs
08/19/96 Final Electrical
08/19/96 Final Electrical
08/19/96 Final Masonry
08/19/96 Final Masonry
07/31/96 Footing
07/31/96 Footing
07/29/96 Grout
07/23/96 Footing
07/23/96 Footing
INSP ACT COMMENTS
RI
PY
PY
DC
RI
DC
RI
DC
RI
DC
DC
RI
DC
RI
NS
NS
AP
RI
AP
RI
AP
RI
AP
CA
RI
AP
MW/KLAUS
LOCKED GATE
LOCKED GATE
MW/KLAUS/931-0445
CONDUIT ONLY
MW/KLAUS/931-0445
MW/KLAUS/898-5327 PG
PER CONTRACTOR
MW/KLAUS
HIT <RETURN> TO CONTINUE...
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB961296 FOR 07/31/96
DESCRIPTION: 140 SF RETAIN WALL-PER CITY
SPEC #221
TYPE: RETAIN
JOB ADDRESS: 1616 CORMORANT DR
APPLICANT: KLAUS & ENYEDI CONCRETE CONST PHONE:
CONTRACTOR: PHONE:
OWNER: PHONE:
REMARKS: MW/KLAUS/898-5327 PG INSPECTOR ]/
SPECIAL INSTRUCT: DID NOT SAY WHAT TYPE OF INSP
INSPECTOR AREA DC
PLANCK# CB961296
OCC GRP
CONSTR. TYPE NEW
STE: LOT:
619-931-0445
GATE CODE #1123
TOTAL TIME:
CD LVL DESCRIPTION
61 MA
ACT COMMENTS
***** INSPECTION HISTORY *****
DATE DESCRIPTION
072996 Grout
072396 Footing
ACT INSP
CA DC
AP DC
COMMENTS
PER CONTRACTOR
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT* CB961296 FOR 08/19/96
DESCRIPTION: 140 SF RETAIN WALL-PER CITY
SPEC #221 AND ADD ELECTRIC CIRCUIT
TYPE: RETAIN
JOB ADDRESS: 1616 CORMORANT DR
APPLICANT: KLAUS & ENYEDI CONCRETE CONST PHONE:
CONTRACTOR: PHONE:
OWNER: PHONE:
INSPECTOR AREA DC
PLANCK# CB961296
OCC GRP
CONSTR. TYPE NEW
STE: LOT:
619-931-0445
REMARKS: MW/KLAUS/931-0445
SPECIAL INSTRUCT: GATE CODE #1123
INSPECTOR
PG 898-5372
TOTAL TIME:
CD LVL DESCRIPTION ACT COMMENTS
39
69
EL Final Electrical
MA Final Masonry
***** INSPECTION HISTORY *****
DATE DESCRIPTION
073196 Footing
072996 Grout
072396 Footing
ACT INSP
AP DC
CA DC
AP DC
COMMENTS
PER CONTRACTOR
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB961296 FOR 07/23/96 INSPECTOR AREA
DESCRIPTION: 140 SF RETAIN WALL-PER CITY PLANCK# CB961296
SPEC #221 OCC GRP
TYPE: RETAIN CONSTR. TYPE NEW
JOB ADDRESS: 1616 CORMORANT DR STE: LOT:
APPLICANT: KLAUS & ENYEDI CONCRETE CONST PHONE: 619-931-0445
CONTRACTOR: PHONE:
OWNER: PHONE:
REMARKS: MW/KLAUS INSPECTOR
SPECIAL INSTRUCT: GATE CODE #1123*********************'**********
TOTAL TIME:
CD LVL DESCRIPTION ACT COMMENTS
61 MA Footing
***** INSPECTION HISTORY *****
DATE DESCRIPTION ACT INSP COMMENTS
UNSCHEDULED BUILDING INSPECTION
»
DATE 7 /6- 7 / f6 INSPECTOR
PERMIT # yb/el 7& PLAN CHECK*
JOB ADDRESS / 6 /6
DESCRIPTION
TIME ARRIVE: TIME
CODE DESCRIPTION ACT COMMENTS
STATE OF CALIFORNIA—THE RESOURCES AGENCY PETE WILSON, Governor
CALIFORNIA COASTAL COMMISSION
SAN DIEGO COAST AREA
3111 CAMINO DEL RIO NORTH SUITE 200
S.^N DIEGO, CA 921081725
(6,9) 521-3036 EXEMPTION LETTER
DATE:
NAME: fclC(fsA £tfjrpJ*l
/fr
LOCATION:
PROJECT:
This is to certify that this location and/or proposed project has been
reviewed by the staff of the Coastal Commission. A coastal development permit
is not necessary for the reasons checked below.
_ The site is not located within the coastal zone as established by the
California Coastal Act of 1976, as amended.
The proposed development is included in Categorical Exclusion
No. _ adopted by the California Coastal Commission.
The proposed development is judged to be repair or maintenance
activity not resulting in an addition to or enlargement or expansion
of the object of such activities (Section 30610(d) of Coastal Act),
The proposed development is an improvement to an existing single
family residence (Section 30610(a) of the Coastal Act) and not
located in the area between the sea and the first public road or
within 300 feet of the inland extent of any beach (whichever is
greater) (Section 13250(b)(4) of 14 Cal . Admin. Code.
The proposed development is an improvement to an existing single
family residence and is located in the area between the sea and the
first public road or within 300 feet of the inland extent of any
beach (whichever is greater) but is not a) an increase of 101 or more
of internal floor area, b) an increase in height over 101, or c) a
significant non-attached structure (Sections 30610(a) of Coastal Act
and Section 13250(b)(4) of Administrative Regulations).
(OVER)
Page 2
The proposed development is an interior modification to an existing use
with no change in the density or intensity of use (Section 30106 of
Coastal Act).
The proposed development involves the installation, testing and placement
in service of a necessary utility connection between an existing service
facility and development approved in accordance with coastal development
permit requirements, pursuant to Coastal Act Section 30610(f).
The proposed development is an improvement to a structure other than a
single family residence or public works facility and is not subject to a
permit requirement (Section 13253 of Administrative Regulations).
The proposed development is the rebuilding of a structure, other than a
public works facility, destroyed by natural disaster. The replacement
conforms to all of the requirements of Coastal Act Section 30610(g).
Other:
Please be advised that only the project described above is exempt from the
permit requirements of the Coastal Act. Any change in the project may cause
it to lose its exempt status. This certification is based on information
provided by the recipient of this letter. If, at a later date, this
%! formation Is^foMmd to be incorrect or 'iiiff€G>.5?p3iete» thrs better will become
invalid, and any development occurring at that time must cease until a coastal
development permit is obtained.
Truly yours,
By:
Title:
000 IF
City of Carlsbad
Engineering Department
BUILDING PLANCHECK CHECKLIST
RETAINING WALL
BUILDING PLANCHECK NUMBER. CB
BUILDING ADDRESS <2p/Z /H£> ft A/j
PROJECT DESCRIPTION- Retaining Wall
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
carefHilly all comments attached, as failure to
jly wjjh; instructions in this report can result
ispe^onym/permit to build
/ v Date
V
DENIAL
Please see the attached report of deficiencies
marked with LJ Make necessary corrections to
plans or specifications for compliance with
applicable codes and standards Submit corrected
plans and/or specifications to this office for
review
By Date
By Date
By Date
ATTACHMENTS
LJ Right of Way Permit Application
ENGINEERING DEPT. CONTACT PERSON
NAME: MICHELE MASTERSON
City of Carlsbad
ADDRESS. 2075 Las Palmas Drive
PHONE. (619)438-1161. Ext. 4315
P \DOCS\CHKLST\WALL REV 04/18/96
2O75 Las Palmas Dr • Carlsbad, CA 92OO9-1576 • (619) 438-1161 • FAX (619) 438-O894
BUILDING PLANCHECK CHECKLIST - RETAINING WALLS
SITE PLAN
1 stv/ 2noV SrdV'
d CH D 1. Provide a fully dimensioned site plan drawn to scale. Show.
A North Arrow C. Property Lines
B Existing & Proposed Structures D Easements
(dimensioned from street) E Retaining wall (location and height)
L~H CH [H 2. Show on site plan
A. Drainage Patterns
B Existing & Proposed Slopes
C Existing Topography
D L"H D 3. Include on title sheet
A Site address
B. Assessor's Parcel Number
C. Legal Description
D Grading Quantities Cut Fill Import/Export
(Grading Permit and Haul Route Permit may be required)
L"H D 4 Project does not comply with the following Engineering Conditions of approval for
Project No
Conditions were complied with by Date
MISCELLANEOUS PERMITS
D D D 5 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 permit issued by the Engineering Department is required
for the following1
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.
p \Docs\cmasT\wAu. Page 1 REV 04/18/96
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PLANNING DEPARTMENT
BUILDING PLAN CHECK REVIEW CHECKLIST
Plan Check No CB Address j)
Planner David Rick Phone (619) 438-1161 ext 4328
(Name)
APN
Type of Project and Use
Zone Facilities Management Zone
CFD (in/Putt #
circle (If property in, complete SPECIAL TAX CALCULATION
WORKSHEET provided by Building Department)
Legend
Item Complete
Item Incomplete - Needs your action
Environmental Review Required: YES
DATE OF COMPLETION
NO TYPE
Compliance with conditions of approval7 If not, state conditions which require action
Conditions of Approval
Discretionary Action Required: YES
APPROVAL/RESO NO
PROJECT NO
NO
DATE
OTHER RELATED CASES
Compliance with conditions or approval? If not, state conditions which require action
Conditions of Approval
D California Coastal Commission Permit Required: YES ^ NO
DATE OF APPROVAL
San Diego Coast District, 3111 Cammo Del Rio North, Suite 200, San Diego, CA 92108
(619) 521-8036
Compliance with conditions of approval9 If not, state conditions which require action
Conditions of Approval
E/CD D Inclusionary Housing Fee required: YES
D
D
M D D
Q/D D
D
NO
(Effective date of Inclusionary Housing Ordinance - May 21, 1993)
Site Plan:
1 Provide a fully dimensioned site plan drawn to scale Show North arrow, property
lines, easements, existing and proposed structures, streets, existing street
improvements, right-of-way width, dimensioned setbacks and existing topographical
lines
2 Provide legal description of property, and assessor's parcel number
Zoning:
1 Setbacks
Front
Int Side
Street Side:
Rear
2 Lot Coverage
3 Height
4 Parking
Guest
Additional Comments
Required
Required
Required
Required
Required
Required
Spaces Required
Spaces Required
Shown
Shown
Shown
Shown
Shown
Shown y/''
Shown
Shown
OK TO ISSUE AND ENTERED APPROVAL INTO COMPUTER DATE
K \ADMIN\COUNTER\PU\NCK FRM 1-17-96
City of Carlsbad
Building Department
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations.
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
• B 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 DATE
(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 y"? 4 <>' 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
2075 Las Palmas Dr • Carlsbad, CA 92009-1576 • (619) 438-1161 • FAX (619) 438-O894
CERTIFICATE OFl WORKERS' COMPENSATIO
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^^CARLSBAD,SCA$200S
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KLAUS ENYEDJ CONCRETE CONSTRUCTION
THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND SCIF 10282 (REV. 3-95)
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