HomeMy WebLinkAbout1627 CORTE ORCHIDIA; ; CB050191; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Pool Permit Permit No CB050191
Building Inspection Request Line (760) 602-2725
Job Address
Permit Type
Parcel No
Valuation
Reference #
Project Title
1627 CORTE ORCHIDIA CBAD
POOL
2159503100 Lot# 0
$1360000 Construction Type NEW
HOLSTEN RES 400 SF POOL/SPA
plicant
SANDPIPER POOLS INC
Status
Applied
Entered By
Plan Approved
Issued
Inspect Area
2005 S ESCONp.LE>eTBLVD
DA 92025
6194896328
Owner
HOLSTEN TIMOTHY&ANDREA
1627 CORTE ORCHIDIA
CARLSBAD CA 92009
ISSUED
01/19/2005
LSM
01/25/2005
01/25/2005
Building Permit
Add I Building Permit Fee
Plan Check
Add I Plan Check Fee
Electrical Fee
Plumbing Fee
Strong Motion Fee
Renewal Fee
Add'l Renewal Fee
Other Building Fee
Additional Fees
$13049
$000
$8482
$000
$2000
$2700
$1 36
$000
$000
$000
$000
TOTAL PERMIT FEES $263 67
Total Fees $263 67 Total Payments To Date $84 82 Balance Due $17885
0296 01/25/05 0002 01 02
CGP 178.85
BUILDING PLAN^
STORAGE
.ATTACHED
Inspector
FINAL
Date Clearance
NOTICE Please take NOTICE that approval of your project includes tne Imposition of tees dedications reservations or other exactions hereafter collectively
referred to as fees/exactions YOJ nave 90 days from :he date tn.s permit was issued to protest imposition of these fees/exactions li you protest them you must
follow the protest procedures set rortn in Government Code Section. 66020(a) and file the protest and ar.y oiher required information with the City Manager for
processing in accordance with Carlsoad Municipal Code Section 3 32 030 Failure to timely follow that procedure will bar any subsequent legal action to attack
review se: aside vo.d or annul their imposition
You aie hereby FURTHER NOTIFIED thai your right to protest the specified fees/exactions DOES NOT APPLY to water arid sewer connection fees and capacity
changes nor panning zoning grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any
fees/exael'ons of which vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired
01-25-2005
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Right of Way Permit Permit No RW050017
Job Address
Permit Type
Parcel No
Start Date
Insurance Expire
Liability Insurance
Reference*
Location
Project Title
1627 CORTE ORCHIDIA CBAD
ROW
2159503100
11/21/2005
Y
CB050191
Subtype
Lot#
Est Complete Date
Traffic Control Plan
GOP
MINOR
0
Status ISSUED
Applied 01/21/2005
Issued 01/25/2005
Expired 07/31/2005
Entered By TNKB
Applicant
SANDPIPER POOLS INC
HOLSTEN RESIDENCE
PUObASPA
2005..SLESCDNBtDO BLVD
ESCONDIDO, CA 92025
619-489-6328
Total Fees $265 00 Total Payments To Date $000 Balance Due $265 00
Permit Fee
Additional Permit Fee
Other
Additional Fees
TOTAL PERMIT FEES
$265 00
$000
$000
$000
$265 00
0l/25/05 0002 Qi
CGP 265-00
This permit may be revoked by the City Engineer if it is deemed that inadequate progress is being made towards the completion
of the work or if the work does not meet City Standards The applicant may be billed for the cost of any corrective work that the
City must perform
Permit Release Date Released.Cash Deposit7
YOU MUST CALL UNDERGROUND SERVICE ALERT (1 800-422 4133) TWO WORKING DAYS PRIOR TO WORK
UNDERGROUND SERVICE ALERT NO
IF ANY EXCAVATION OR BORING IS DONE
THIS PERMIT IS INVALID WITHOUT THIS NUMBER
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave , Carlsbad, CA 92008
1 PROJECT INFORMATION*
FOR OFFICE USE ONLY
PLAN CHECK NO
EST VAL
Plan Ck Deposit
Validated By.
Date
5? ^/, 1? 3L
//
Address (include Bldg/Suite #)Business Name (at this address)
Legal Description Lot No Subdivision Name/Numberlion Name/Numb(
9F/7
Unit No Phase No Total # of units
Assessor s Parcel #Existing Use Proposed Use
Description of Work SQ FT
2 CONTACT PERSON (if different from applicant)
/3/T
#of Stories # of Bedrooms
jO0t<Gjl
# of Bathrooms
;g^7^.3^f
Address CityVT" ' ' ^*i~~~3 APPLICANT:JjE] Contractor S"Agent for Contractor;;^-:Q Owner [] AgeriOor Owner
State/Zip Telephone #Fax #
Nanfe
4 PROPERTY OWNER
Address City State/Zip Telephone #
Name
5 CONTRACTOR
::::•:.. . "."!•=
d-A face.?
Address City State/Zip
COMPANY NAME
Telephone #
:;«"?* '
(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 I $5001)
State License #
^
-£
Address
License Class
„
^ — J
City State/Zip Telephone #
City Business License # \ ^j O *^ 1 I ^\
Designer Name Address City State/Zip Telephone
State License #
"6 WORKERS' COMPENSATION :s"a"s" ™*' :«:: ^iX:i .*Mhi.::.., J" ""
Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations
l~| 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
l~| | 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 earner and policy number are
Insurance Company j^T/frf1^- /f-CAA-^te-l Policy No / "S ^ y / P*/1 "~~£JIX*f Expiration Date_
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS)
l~| 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 become subject to the Workers Compensation Laws of California
WARNING Failure to secure workersc»pJpensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars ($100 000) in addfjforrfo the costoi-eomp^nsation damages as provided for in Section 3706 of the Labor code interest and attorney s fees
SIGNATURE >r— S T^^^-gg»»-t^<-^ (~-£^&, —•£, _— DATE
7 :IibWNER BUIL^b DECLARATION " " ••" iip ""'"^ .." ""::...
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)
0 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) ^t
C] I am exempt under Section _ Business and Professions Code for this reason
99-^. m/MO/fT1 I personally plan to provide the major labor and materials for construction of the proposed property improvement Q YtS' "QNO
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
"COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY *3ll ' *
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 [U 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? CJ YES Q 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
if CONSTRUCTION, LENDJNG AGENCY , „ I
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(0 Civil Code)
LENDER S NAME _ LENDER S ADDRESS _
9
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 CitV 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
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 buildmg'Dfficial undgjjjne provisions of this Code shall expire by limitation and become null and void if the building or work
authorized by such permit is not commencfd^rtfiiri 1 80 day,s>ffop(rTne 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 commej
APPLICANT S SIGNATURE
106 4 4 Uniform Building Code)
DATE
WHITE File YELLOW Applicant PINK Finance
City of Carlsbad Bldg Inspection Request
For 06/10/2005
Permit* CB050191
Title HOLSTEN RES-400 SF POOL/SPA
Description
Inspector Assignment PY
1627 CORTE ORCHIDIA
Lot 0
Type POOL Sub Type
Job Address
Suite
Location
APPLICANT SANDPIPER POOLS INC
Owner HOLSTEN TIMOTHY&ANDREA
Remarks
Phone 7604896328
Inspector
Total Time
CD Description
59 Final Pool
Associated PCRs/CVs
Requested By MICHELE
Entered By CHRISTINE
Act Comment
Inspection History
Date Description
06/07/2005 59 Final Pool
05/13/2005 31 Underground/Conduit Wiring
05/13/2005 55 Fence/Pre Plaster
04/05/2005 53 Electric/Conduit/Wiring
03/25/2005 21 Underground/Under Floor
03/25/2005 23 Gas/Test/Repairs
03/25/2005 51 Excav/Steel/Bondmg/Fence
Act Insp Comments
CO
AP
AP
PA
AP
AP
AP
JM
PY
PY
PY
PY
PY
PY
LOW VOLT <1 OFT
ALARMS OK
CONDUIT ONLY
REBAR PRIOR TO GUNITE
CLEAN MUD OFF
City of Carlsbad
Pub:J ic Wo r ks -- E n g 1 n ee ri n g
BUILDING PLANCHECK CHECKLIST
POOLS
BUILDING PLANCHECK NUMBER CB 05"-
BUILDING ADDRESS (A -
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 with instructions in this report can
result in suspension of permit to build
Date
DENIAL
Please see it=rcjN attached report of deficiencies
marked wit^TJyMake 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
By
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 Taniya Barrows
City of Carlsbad
ADDRESS 1635 Faraday Avenue
Carlsbad, CA 92008
PHONE (760) 602-2773
H ^Development Servicos\MASTERS\FORMS \CHECKLISTS \BUILDING PLANCHECK CKLIST FORM POOLS doc
Rev 8/22/96
1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (76O) 602-2720 • FAX (760) 602-8562
CT 44-11-
Q Q
a
Q Q Q
Q Q
BUILDING PLANCHECK CHECKLIST - POOLS
SITE PLAN
1 Provide a fully dimensioned site plan drawn to scale Show
A North Arrow
B Existing & Proposed Structures
2 Show on site plan
A Drainage Patterns
B Existing & Proposed Slopes
C Existing Topography
C Property Lines
D Easements
D llndicate what will happen with
i. /soil excavated from pool area
E Retaining Walls
(location and height)
Note If excavated soil is not to be removed from property but regraded on
site, 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
A Site Address
B Assessor's Parcel Number
C Legal Description
D Grading Quantities Cut Fill Import/Export
a) If grading is not required, write "No Grading" on plot plan
4 Project does not comply with the following Engineering Conditions of approval
for Project No
Conditions were complied with by
GRADING PERMIT REQUIREMENTS
Date
The conditions that invoke the need for grading permit are found in Section 11 06 030
of the Municipal code
5a Inadequate information available on Site Plan to make a determination on
grading requirements Include accurate grading quantities (cut, fill, import,
export)
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 3
H \Development Services\MASTERS\FORMS \CHECKLISTS \BUILDING PLANCHECK CKLIST FORM POOLS doc
3RD/
Q 5c A Grading Permit has been applied for
PE2 DWG
Grading Inspector sign off by Date
Q 5d No Grading Permit required
MISCELLANEOUS PERMITS
Q 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
7 Remarks
Page 3 of 3
H \Development Semces\MASTERS\FORMS \CHECKLISTS \BUILDING PLANCHECK CKLIST FORM POOLS doc
so
POLICYHOLDER COPY
5 SAN FRANCiSCO,CA 94442-0807
J^.OF WORKERS' COMPE^ISATION INSURANCE
* _. i. M J
ISSUE 4)AT& 12-01-2OO4 QKJUP-
-POLICY NUMBER
IBc
STATE LICENSE BOARD SO \,
IPErtSftTiplLiBUdF ^ "v _-_ * - V
r V «*Wf* »j,ww>jQ ^ £ -^ ~ -'^^ " * * C 'V
SACft/WENTO £A 95826 > € ^ -
\ V / P 0 BOX 26000 * |
1326164-2OO4 ~
12-01-2005
; , 12-Ot-2OO4/12-O1-2OO5
•* Z
"-- *~ LlCE»si NUMBER. * 481997
~ .INCEPTION; DATE. 12-01-20O4
D O.: SO
This is to certify that we haw issued a vahd Workers' Compensation^ insurance policy m a form approved by the
Calif orma Insurance Coflrwnisstonw to tfw employer natoecf below -for the policy period indicated.
This poficy is not object to cwfoeltetion fay the Fund «xcept upon 3Od*ys? advjrtce wrrttwi notice to the employer
, '— M»^ _ --=-\- .
We wtli also flwe you 3O^ "Wys* «hnBn?fr notice sbouicT this ;poficy to« cartcelled pnor to its- normaT expiration
This certificate of
by the poVcte fewith respect to
ce fes j>t>t*poRcy-and does not amend} extend" or alter the coverage afforded
tt terra, or cond
deserfced herein i$ subject to alf the terms^ fe'x
of any contract or othef document
or may fcurtin. the insurance afforded by the
and concbboDS of such policies.
EMPLOYE'S LIABILITY LIMIT INCUOIN8 DEFBUSC COSTS: 41 .OOO^OOO.OO MR OCCUTWENCE1 "• r -V " * » *§ "'*.. v
anojcsEKin- JZD^ EiniTLE&;«^il$^$T&fioL^RS': Ntrr%& EFFECTIVE 12-01-2004 is «TTAO«D TO AND
i FORKS A.PART'OR--"THIS POtTPF.^f" | 't "?£. -' " "" -\ ' / * - " * ' ', *-
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PLANNING/ENGINEERING APPROVALS
DFPMIT IUIIMBEP CH /5fl
ADDRESS
(DATE
RESIDENTIAL ADDITION MINOR
«$10VOOO.OO)
TENANT IMPROVEMENT
PLAZA CAMINO REAL
CARLSBAD COMPANY STORES
VILLAGE FAIRE
COMPLETE OFFICE BUILDING
OTHER
PLANNER DATE
ENGINEER DATE
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