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Home My WebLink About1812 OAK AVE; MULTI-PERMIT FILE; CB032975; PermitTOTAL PERMIT FEES $212.49 Total Fees: $212.49 TotI Pment'ToD H/ $174.37 .NBalaiice Due: $38.12 / 3 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 01-15-2004 Pool Permit Permit No: CB032975 Building Inspection Request Line (760) 602-2725 Job Address: 1812 OAK AV CBAD Permit Type: POOL Parcel No: 1562202400 Lot #: 0 Valuation: $9,271.00 Construction Type: NEW Reference #: Project Title: TOLLACK RES 88SF SPA/CAVE GRTTO/FP/GAS/ELEC BBQ/256SF GAZEBO Status: ISSUED Applied: 10/29/2003 Entered By: SB Plan Approved: 11/19/2003 Issued: 11/19/2003 Inspect Area: PD Applicant: SOUTH PACIFIC POOLS 26765 TRANSMIRAS 92692 949-582-7.512 Owner: _----TOLLACKROBERTM&MARlLY6 01/15/04 0002 01. 02 I812OAKAVE COP - CARLSBAD--C-A 92008-\ / / Building Permit / / $99.69 Add'I Building Permit Fee' Plan Check 7/ $64.80 \\ Add'I Plan Check Fee / Electrical Fee / \ / '\ \. $0.00 \ ?'$20.00 Plumbing Fee / $27.00 / . Strong Motion Fee N \ $1.00 Renewal Fee - N.N - /7/ /$000 Add'I Renewal Fee 7... ,- $0.00 Other Building Fee / $0.00 Additional Fees I \./ / ' p I p F1 NAL AP P ROVAL DATE /2), S-CLEARANCE SIGNATURE—i 'A/\ •• . . .. . •. .... .. EOR.OFFICE USE ONLY 1PERMIT APPLICATION - PLAN CHECK NQ ES CIriLSBAD'BUU%ING ERARTM ENT (1 6k-FArab4AV Cair6cad, CAI 9'2' 081 Vandated DeDosit B>2 __MAT ___ Date(p/7? i .................... ,. .— • 1 71-17 Address (include Bldg /Suite #) Business Name (at this addre84..10129103 . 02 Legal Description - Lot No Subdivision Name/Number - - Unit No Phase No CGFotal # of units 49 78 .1 V # .• ....•.,t Assessors Parcel # Existin Proposed Use - I 0. Des 0 7t a s , , , ,9_#o,Bedroorns/ ofBathrooms 101, 111 rent rorri idiant ci Nam ., . •.. ' . . . . . .Address.- .-- .- -.-. - • - City - ........Stete 'p • Telephone # e. •.-- Fde ft 0 r 0 tf r Icon- .......::,.7c7z ssJ v,2,'I2_ (\J Name - •- • • • • • - 'Ar —t- -• ..• •-' • • .City ..,; • -"Telephone JE / (u1i ( °)Lc; 7°M1 Goo XName • • •. Address ..City . StateZp Telephone ft • . . . Sec. ec _7931.5 Business and Professions Code Any City, or County which requires a permit to construct alter improve demolish or repai? any structure prior -to,its i- issuance also requires the applicant for such permit tofile a signed statement that he is licensed pursuant to the provisions of the Contractors 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 fore permit subjects the applicant1toa.civil penaltyof no; more than five hundreddollrs I$500]). . : 6"1 PAF-Poo&JAD 'Name , i • • . '• '••' ;.,Address .., . . ,',City - .e,:State/Zip • , • T.elephbn&# 7~/Z State License # - 5L/Lf 7 .2 License Class /'1r1 C-2.- City Business License #-f__ -. - •• + . • . • • • .." . 1 • - Designer Name-, ,. • • ., fl Address • •: • .: • •- . City.; • • •. State/Zip..; • Telephone State License #,. ,.-'' • •- •• ••, ' • •:.' •• r •t6iWORKERSC'OMPENSATI0N * •Workers'Compensation Declaration: I herebyaffirm under penalty of -perjury, one of the following declarations: • • -. • • - • . -.. • • . -0 have and will,maintain acertificate .of,consent.to self;insure for,,.orkers cOmpensation as. provided by Section 3700.of,the Labor Code,,.forthe.perforniance.,. i of the work for which this permit is issued. • • ...................• • . • . . • . , , - I haVei will' maintain workers"compensation,.as required by Sectior 3700-of the.Labor 'Code, for the.perforrnance'of the work.for' which-this permit is issued My worker's compensation insurance carrier and policy number are Insurance Compafly A-LP 7J'2T&.5 £"aiL.41tJC_ Policy No Expiration Date"/).-/ ,(THIS SECTION NEED, NOT 'BE COMPLETED .IF.THE PERMIT IS FOR ONEHUNDRED DOLLARS -I$100J OR•LESS)• • '• - -' . - •"- • 0 CERTIFICATE OFEXEMPTION: 'I certify that in the performance of the work for which this permit isised,'l slall not eñiIoy aA/pérsOn many manner so as t become subject tohe Workers' Compensation Laws'of California. • • • • . . • • • • • . • . . - . • - '.rft' . '• 1 •. 1WARNlNG: Failure to secure workers" compensation coverage; is unlawful, and shaIIsubject an employer to criminal- penaItiesand civil fines up to one hundred •thousand dollars in additio to he cost of ,corn n as provided for in Section 3106 of the, I bor code, interest and attorney's fees. ;SIGNATURE__• . • • ' OATE ' • pWPRBLJiECIJARAT1ON I hereby affirm that I am exempt from the Contractor s License Law for the following reason $ o I as owner of the proprty or my employees with wagess their sole compensation will do the work and the strcture is not intended or offed for sale (Sec 7044 Business and Professions Code r.The Contractor s License Law does not apply to an wner 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 U l as owner of the property am exclusively contracting with licensed contractors to construct the project (Sec 7044 Business and Professions Code ' The • • • 'Contrc'tor's"License La d6'Tht 'api'to arivrcèr of properIy who bilds oflmproves tlie'h and ontrts f of uch projects with contractor(s) liceed pursuant to the Contractor's License Law) 0 I am exempt under Section Business and Professions Code for this reason I personally plan to provide the major labor and materials for construction of the proposed propertyimprovement 0 YES ONO 2 I (have'/ havenot) sined an application for a building permit for the ii poi work -' • 3. •1 have contracted.withthe.fàllowing person (firm)to próvidethe proposed construction (include name /.address / phone.njriber /,ht'racslicense.riumber):. .••' •• .-• 4' '1 plan to provide portions of the wbrk, but I hive hired the folIoiing personto oOrditsurQiseand provide the' jor work (include name / address'! phone: number / contractors license number) - , 5. will provide some of the work, but I have contracted (hired) the following persons to'prOvidethe work indicated (include name/,a ddress.! phone nu will of work):-. • • • -. •.. • ,... - •••,• •'. : • ..,' .• .... _-t'• PROPERTY OWNER SIGNATURE TO I Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management -and prevention ,pro ram under Sections 25505 25533 or 25534 of the-Pr esley Tanner Hazardous Substance Account Act? 0 YES 0 NO ' ''•- •'!'- •' ' '• '-" '••' 7 .-.; -. Is the applicant or future building occupant required to obtain a permit from th' air pollution control district or air quality management district? 0 YES 0 NO Is the facility to be constructed within 1 000 feet of 0e. outer boundary of a school site? 0 YES ,O ';,NO-, '1F ANY OF THE 'ANSWERS ARE YES, AFlNAL" CERTIFICATE OF OCCUPANCY.MAYN&r BEiISSUED.UNLESS THE APPLICANT HAS MET OR.IS MEETING THE'. ' REQUIREMENTS OF THE,OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROCDISTRICT. - • • • • - •I herebyaffirm that there is a construction lending agency for the pArforrnane of theorkforwhi h this pers is issued Sc • 307(i)Civil Code) LENDER'S NAME* . • ' LENOER'SDRESS J - • :5r. . ,l certify that .1 have.read the application and stàte.that th'e above ihfo'rmi m tion is coiretard that the inforationon the p1ans is accurate.Sl agre'etocomply with all 'e City ordinances and •State.laws..relatingtoebuilding;corist ruction. .l 'hereby-authorize 'representatives ofthe Citi of Carlsbad toYenter upont:the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBADtsAGAINST ALL LIABILITIES, -- .'JUDGMENTS$COSTS AND EXPENSES WHICH MAY INANY'WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THEGRANTING OFTHIS PERMIT - prthiiis construction of structures, ver3 stories in heig'ht" • "' "•' . • ' -. . • . • • • • t_••*•_ .•• . ... EXPIRATION:- Every-permitissued by (he buiIdiiigOffièia( under.c. the proisions of tIlls cbde sha11expire _ byiirita'tiäri and '6eborrie uIl'ànd . void ifthe'building.or work authorized by suchperrnit is not commenced within 180 days from.the.date of such permit or if the building or- work authorized by such'permitissuspended or abandoned at any-time after the work'is'commenced-for aperiodof 180 days'(Section 1O644Uniform Building Code).- ' - '" ' '"- - - •. I - - • - -- • • • I • • '' • .:-.,, • 3 . ' .' '- V APPLICANT'S SIGNATURE DATE - - ' ' •, - As • • . . • -• .., • .... 'r'• . '• '- - • '. 'WHITE Fiji i'ELLOW:AppIicaii 7PlNkFincè " ' '' • •, '. '' . City of Carlsbad Bldg Inspection Request For: 04/13/2005 Permit# CB032975 r Inspector Assignment: PD Title: TOLLACK RES 88SF SPNCAVE Description: GRTTO/FP/GAS/ELEC BBQ/256SF GAZEBO Type: POOL Sub Type: Phone: 7607291600 Job Address: 1812 OAK AV Suite: Lot 0 : Location: Inspector ___________ APPLICANT SOUTH PACIFIC POOLS Owner: TOLLACK ROBERT M&MARILYN S S Remarks: Total Time: Requested By: MARILYN Entered By: CHRISTINE CD Description Act Comment 59 Final Pool 1J Associated PCRs/CVs Inspection History Date Description Act Insp Comments 11/09/2004 59 Final Pool Co JM SEE CARD 11/04/2004 55 Fence/Pre-Plaster AP JM OK TO FILL POOL - ALARMS OK 11/03/2004 55 Fence/Pre-Plaster CO JM NEED ENCAPSULATING COMPOUND @ (2) NICHES 10/07/2004 55 Fence/Pre-Plaster CO PD 10/05/2004 55 Fence/Pre-Plaster NS PI NEED SPECIAL INSPECTION - CALLED 04/01/2004 11 Ftg/Foundation/Piers AP PY PATIO COVER 01/29/2004 11 Ftg/Foundation/Piers AP PD • S 01/28/2004 11 Ftg/Foundation/Piers CO RB ON 1 JTG INSP - SEE NOTICE ATTACHED 01/27/2004 51 Excav/Steel/BondinglFence AP PD 01/21/2004 23 Gas/Test/Repairs AP PD • • 01/21/2004 31 Underground/Conduit-Wiring AP PD 01/21/2004 51 Excav/Steel/Bonding/Fence NA PD 01/14/2004 51 Excav/Steel/Bonding/Fence CA PD - • I OCT-6-2004 14:13 FROM:SQUTH PACIFIC CONSIR 9495827513 TO:176O6ø28560 P.2 — - Southwest hspection anidTestft*;7X2%c.4 10820 South Norwalk Blvd.,, Santa Fe Spfinda, CA 90870 16W) S41-2990 .4714k 52441 Fax (p62) 9402 ' a r 'DATA ON FIELD MACE TEY $tThEN . ; ASTM C31. CuB; eI4. C172 C173 C231. C104 a Ccrcree -- - TZ 4 ia/< C*cPc " zao OW*t -- a'.WWW At Temp. CeT * Time 029 tby '/— iL.fr/ *hl* u ót.t stai,t1n,g piem.e provid, the toflowIncffifor. 7t64' / 4A?iT?0 t 9 9 f g%.. $1414 / - 1WNW J4V//cb 'I Pee Wolm your cent,, #X# we CM pe#orrrdng the testing an Their project QF4 we WN not twetm two resi. w*tfl all b1h ort, pold 1A Mt. Furthermore, If ft'.s above rnromclor is Qt provided the somplev wtnat bO teti td.yov will be charged for the plotup, c"Idws ond nyollcjj e03tL Thank YOU for 'lout comomflon 1 .' A$1M -can, C174 C1e2, 470 C$17#,' C42 ' -- -- -- ___________ ______________ - me LM. AG TEST cm all TESTED NUMEER DM'S DATE• AA •LO . : fib _--- ----- HM O --'-'' iit T I: .* • --- - ..._ - - _______ -. 1T' '-- I$13.NT W,LL NOT BLO eecnnc'o. rccPr ma rini w1n641 AaanmilAf 04-0 of" / port of Special !nspocEo • .. Pr* tNa 4MdrcSJ -• - i_ACfr - I i P, i "I ' .- c4oryp(s) L Uflt.t!_• . •. .. -. 1isp.cdsaDs(t) •_- . (XXXXJCOI1nUQU5 Du;db5 Inpctfon Made nc jd(jLocatioei,... .Contiruous gunite..thsp.otion ó the awi pool @ the abovq address on/-31-ö9 - 'r .,J i143• d4,Zq7,4• Ust Tests Mide,4 .• - ite cv1nder .orttc follow - Total DuRaWan T1i !ici Day; )Jii ttcmz Roqulting Ctrccton fncdc tnouecicd ieiu prcviovsiy 'isted - • - - _j - - - -• •• • --• -' - - r-- •. - ---- -- -. -. •_ - - - - t.7 -. . - -- • - -. To the bell of my k - c k lapc4d w in cd with the Bwthng DeprImcnI roved deslgit - %ions and eppIkbtc wcrkmnship povlslons of the U•C. "upt as not Dato •dni Full Name: ''4J) -• .Regitra:Ion FORM ZL-flJV City of Ca rls bad BUILDING PEANCHECK CHECKLIST POOLS BUILDING PLANCHECK NUMBER CB 0'3 BUILDING ADDRESS: OpE PROJECT DESCRIPTION: Pool S ASSESSOR'S PARCEL NUMBER: ENGINEERING DEPARTMENT APPROVAL DENIAL The item you have submittd for review has been Please see ttached report of deficiencies approved. The approval is based on plans, information marked witlf 0. Make necessary corrections to and/or specifications provided in your submittal; plans or ecifications for compliance with therefore, any changes to these items after this date,- applicable codes and standards. Submit corrected including field modifications, must be reviewed by this plans and/or specifications to this office for review. office to insure continued conformance with applicable codes. Please review carefully all comments attacheI, -. as failure to comply with instructions in thisreport can result in susnsion of permit to build. - By Da IH 9° By Date ii - By: Date: By: •• - Date: ATTACHMENTS ENGINEERING DEPT CONTACT PERSON Grading Permit Application - NAME: Ian iya Barrows Grading Permit Checklist •• City of Carlsbad • -. Right-of-WayPermit Application • S - Right-of-Way Permit Submittal - ADDRESS: 1635 Faraday Avenue Checklist and Information Sheet Carlsbad, CA 92008 . PHONE (760) 602-2773 H:\Developrnenl Services\MASTERS\FORMS -\CMECKLISTS -'BUILDING PLANCHECK CKLIST FORM - POOLS.doc Rev. 8/22/98 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-2720. FAX (760) 602-8562 4'7 5Z3 C BUILDING PLANCHECK CHECKLIST - POOLS SITE PLAN 3RD,/, 1. PrOvide fully dimensioned site plan drawn to'scale. Show: -- (NorthArrow '.. Property Lines $k4c.) c(Ot, Existing &.Proposed Structures .. Easements ()• :2. Show on site plan: - . • •,- - rainage Patterns (~D.",'Ind~icate what will happen with xistihg & Proposed Slopes soil excavated from pool area Existing Topography E. Retaining Walls (location and height) Note:' If excavated soil is'not to be removed from property but regraded on. site, show proposed elevations5 and slopes. • - If any portion of retaining walls are over 4' in height, a separate permit is required Retaining Wall Permit CB .Aplied for Approved 3 Include on title sheet 41 A Site Address .Assessor's Parcel Number egal Description GradngQuantities Cut Fill Import/Export a) If gradi ng is not required write "No Grading' on plot plan 4. Project does not .cbrnply with the following Engineering Conditions of approval forProjectNo. ;5 S Conditions were complied with by Date GRADING PERMIT REQUIREMENTS 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: Ircludê accurate grading quantities (cut, fill, import, export) I 5b. Grading Permit required. Aseparate grading plan prepared by a registered Civil Engineer must be submitted together with the completed application form - . attached. . . - . • 5 * Note: ,,Thè Grà ding Permit must be isued and rough grading approval obtained prior to issuance of a Building Permit Page 2of3 H:\Deve!opment Services/MASTERS/FORMS -ICHECKLISTS -\BUILOING PLANCHECI( CKLIST FORM- POOLS.doc • . Rev. 8/22196 S. .., . .. - i STv 2ND/ RDj U U - U 5c. A Grading Permit has been applied for: PE2 DWG Grading Inspector sign off by: Date: U U - U 5d. No Grading Permit required. MISCELLANEOUS PERMITS : U U 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 Lp --1 - Engineering Department together with the requirements on the attached Right- .j.2tcV- OO of-Way checklist at the time of resubmittal Right-of-Way Permit and Pool Building Permit will be issued simultaneously. U U U 7: Remarks - - . - - -t -- . -- . -. 45', •.'. - . - . - Rage 3of3 5 H:DeveIopment Sesvices\MASTERS\FORMS -\CHECKLISTS 4BUILDING PLANC-(ECK CXLIST FORM - POOLS.doc - ' -. ' Rev. 8122106 PLANNING DEPARTMENT •I ' * BUILDING PLAN CHECK REVIEW'CHECKLIST Ave Plan Check No.CB'-2Q7 Address ' Planner Rebecá'Vazuez - Phone(760) 602-4625. APN: •' ' ''' Type of Project & Use. ('zft Density: DU/AC 0 C3 . Zoning:______ General Plan:_________ Facilies.Manàgement Zone: CFD (in/out) #_Date of participation Remaining net dev acres (For, non-résidentiaI evelpment Type. of: b land used created by: this CV Circle One' permit: . '• U 3 U * . ' ' Legend: Item Complete fl Item Incomplete - Needs your action LI LI 0 Environmental Review Required:` 'YES NO TYPE DATE OF COMPLETION Compliance with conditions of approval? If not state conditions which require action - Conditions of Approval: * 0 0 0 - Discretionary Action Rquired: , ,YES ___ NO 'TYPE APPROVAL/RESO:NO. "' ' DATE -N ._, PROJECT NO OTHER RELATEDCASES Compliance with conditions or approval'? If not, state conditions which require action Conditions of Approval: 0 0 0 , 'Coastal Zone Assessment/Compliance Project site located in Coastdl Zone? YES - NO CA Coastal Commission Authority? YES' NO____ If California Coastal Commission Authority: Contact them at - 7.575 Metropolitan Drive, SUite 103, San Diego' CA 92108:4402; (619) 767-2370' . Determine Status (Coastal Permit Requfted or Exempt): Coastal Permit Determination Form already completed? 'YES NO____ If NO, complete Coastal Permit Determination Form now. Coastal'Permit Determination Log f_ ' ' • ' ' '•. • . Follow-Up Actions .*' •f- '* - - •, - ". '. " Stamp Building Plans as "Exempt' or "Coastal Permit Required" (at minimum Floor Plans) Complete Coastal Permit Determination Log as needed ••*' LI LI 0 - _'.'.' ' - -.- ''•. '- .-'- 1 -• -' Inclusionary Housing Fee required:, YES .- NO- (Effective date of lncki'sonary'l-ousing Ordinance - May 21, 1993.) \ .:--•• . " '- -.--'J -' D6taN, Entry Completed? YES - 'NO ' - -- • ' - ' • "(A/P/Ds Acti'iity Maintenance, 'éntèrCB#, toOlbar, Screens, 'Housing Fees; 'Construct Housing YIN, Enter Fee, UPDATE!) ' ' - -' ' - - '• " ' ' H:\ADMiN\cOUNTER\BldgPlnchkRevChkist - - -' ' • - ' • ' ' ' •' Rev 9/01 ' Site Plan O El 0 1 Provide a fully dimensionaNsite plan drawn to scale Show North arrow, property lines easements, existing and proposed structures, streets, existing street Improvements, right-of-way width, dimensional setbacks and existing topographical lines (including all side and 'rear yard slopes). - U 0 0 2 Provide legal description of property and assessor's parcel number. -• -. _.1 Policy 44 - Neighborhäod Architectural Design Guidelines El El El 1 Applicability YES NO________ O 0 El 2 Project complies YES NO________ C - Zoning C O El. 1. Setbacks: • Front: Required! Shown - Interior Side Required Shown Street Side Required Shown • Rear:. - Required - Shown Top of slope Required Shown _______________ I\ Front: • Required 2P- Shown >2O / \ - Interior Side:. Required Shown - Street Side Required / 'Shown 5 \ Rear Required Shown 73' / Structure separation Required. Shown El El El 3 Lot Coverage * Required Shown El L El El 4 Height Required Shown l it El El El -'• - .--'- •-* 1 5 Parking Spaces Required Shown (breakdown by uses for commercial and industrial projects required) Residential Guest Spaces Required Shown 'vicfr hi/j iy o -,ir4ci-, v- Rre (yç/(pg ,&(7c27,o/)O OK TO IS H:\ADMIN\COUNTER\BldgPInchkRevChklst Rev 9/01 n w aw or. Cdif cO dment respect IG which thIS cilfRt 01 msuthnøe má1e ied or may pertm fttw insurance aftbrded by the policies descnbed hern-is subject to all the terms, excIusSns and ô,ndqiOns of such icies 4Z ALJThORIZEDREPR NTIVE .. PRESIDENT ENPLOYER'S LThBILII!Y_LII1T iNCLtJDING DEFENSE COSTS. $1, ø@, øø@ ?ER I3CIJRRENCE ACORD9 CERTIFICATE OF LIABILITY INSURANCE . FAX ThiS CERTIFICATE IS ISUEI) AS A PJIA1TER OF TION 09/15/200 (?49)34*-7400 (949)348-2373 OIlLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Alpel Insurance Agency; Inc.. HOLDER. THIS CERTIFICATE DCESNOT AMEND. WOW OR 26522.. La Alameda, Suite 190 AL1ER THE COVERAGE AFFORDED øV THE POUcIESBELoW. Mission Viejo, CA 92691 INSU AFFORDING COVERAGE Stove Daniels INSURED South Pacific construction RGLIKERpt Environmental 4 Casualty Ins 26765 Tr.siras II5U - Mission Viejo, CA 92692 Imstwo3t POWER o: COVERAGES . . THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO11MTHSTANOThIG ANY REIROMMIM. TERM OR COMMON OF ANY CONTRACT GROTI 0OCI(T'MTh RESPECrTO Vd4ICH THIS CEKftrATE MAY BE ISSUED OR WAY PI AM,YHE INSUIWICE AFFORDED BY TM POLICIES DESCRMW lEREDi IS SUB.ECT10 ALL TIE TERMs, EXCUJS1ONS AND CONDITIONS OF SUCH POUCIES. AGGREGATE LMTS SHOV*I MAY KOWE BEEN REDUCED BY PAID CLASS.' lY OP BI8URAN ... A e.ALu*muJY . :. M8 ME EJOWN 020*15009*3 . I . 08/15/2002 .• 08/15/2003 HOicE. . $ 1,000,000 $ 50,000 $ 11000 .PERSOMAL & ACV "JURY I s 1,000,000 J . caN.GGiE . $ 2,000,000 GitAGORE1ELS1ITAPPLEB .- ry flwc PIiO0UCTS-CP AGO $ 1.000,000 AU70100BLELIABLnY . . • (Ee.ie $ USE BALL POINT PEN ONLY &PRESS HARD " , ' " . 'APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. Di hêreb affirm that lam licensed under -- , o - 'provIéIons of Chapter,9 (commencing with Section 7000) of Division '3 of the Business"-; and Professions code, and my license is in I.,. full force and effect. Lic. No.'___________ Class - .g—:- . ', . I hereby affirm that I am exempt, from the Cenlrac- - for's License Law for the following reason (Sec. 7031.5 Business'and Professions Code:. Any city or county which re- ., quires a permit to construct, alter, improve, demolish, or, A' repair any structure,, prier toils issuance also requires the ap- plicant for such permit to Ole a signed statement that he is licensed pursuant to he provisions of the Contractor's License law (Chapter 9 commencing with Section 7000 01 . Division 301 the Busipess and Professions Code) or that is ex- empt therefrom and the basis for the alleged exemption. Any violation 01 Section 7031.5 by an applicant for a permit sub' - )ects the applicant to a civil penalty of not more than tine hun- dred dollars ($500). ' ' -• .0 I, as owner at the property, or my employees with wages as (heir sole compensation, will do the work, and the struc- ""lure is net intended or offered for sale (Sec._7044, Business .j ,' and Professions Code: The Contractor's License Law does 5 not apply to an owner at property who builds or improves -_ - thereon and who does such work himself or through his own * " employees, provided that such improvements are not intend- -w • ad or offered for sale. If, however, the building or improve - Z moot Is sold within one year 01 completion, the owner-builder will have the burden 01 proving that he did net build or im- 0 '- prove for the purpose of sale). , - 'e — . '. ,,',i- - . 't I, as owner of the property, am eaclusively contracting (191fk.liceosed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's license Law does not apply loan owner of property who builds or 1w- -. e,i'l proves, thereon, and who contracts for each projects with a B) . ' cont' rac 'ceo or oaot to the Contractor's license - Z law). erfn( - - , r LI As a homeowner lam Improving my home, and the 10110w- 4 . 't ing conditions ,exist: ' -I .0, .A', - —, The work is being performed prior to sate. I have lived in my home tar 'twelve months prior to compietluo at this work. " " ' w 3. I 'have not claimed this exemption during .the - 0 - ' last three yEars. * 0 lam exempt undecSec. - ' ' , B & P.C. ' • for this reason - -' 0 I hereby affirm that I have a certificate of consent to self-insure., or ' a Icenlificate of Workers' Compensation Insurance, or a certified copy thereof' (Sec. 3800. Labor Code). , ,POLICY NO. 'COMPANY '-S 10 (I) 0 Copy is flied With the city.! - Z G. -• "'' , -. 'W , Certified copy is hereby furnished" . • '.' ' 'I Z. o •. ,CERTIFICATEOF EXEMPTION FROM.. r JWORKERS' COMPENSATION INSURANCE - '(This section need not be completed ii theperrrrit Lu , .. -is troIf e hundred dolIas ($100) or less) I le - rI 0,1 cerflfy that lIre performance of the work' Ion'.',-. JO ' which this permit is issued. I shall not employ any - person in any manner so as 10 become subject to the Workers', Compensation Laws of Calif 0mb. ' t.,, , . '°• a'-I (, .' . -, '-NOTICE, TO APPLICANT:,lt. after making this Cent-. m h..&ticate of Exeplion, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with - such ,provisions or this permit shall be deemed revoked -.J ,u'.,.,, ' 0 l hereby' a llrm that there' Is a construction I IeedIng.agency 10, the performance of the work [or which this permit is issued (Sec, 3097. Civil Codel zl - Lender's Name L Lender's Address ' 4 CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 1 1200 Elm Carlsbad California 92008-1989 (619) 438 5525 JOB ADDRESS ' - , AV. ST. DATE OF APPLICATION BUSINESS LICENSE # ,' VALUATION , uS,' PERMIT NUMBER' RD. ZONE .. . OWNER'S NAME ' OWNER'S PHONE CONTRACTOR' ' CONTRACTORS PHONEC OWNER'S MAILING ADDRESS CONTRACTOR'S ADDRESS LICENSE NO. PLAN 1.0. # , BLDG USE CODE' .- LOT BLOCK SUBDIVISION ASSESSOR PARCEL NO. DES GNER DESCRIPTION OF WORK LICENSE # STANDARD PLAN # BUILDING SO. FOOTAGE i. DESIGNER'S DO R - )170 DE IGNERS PHONE -. F/P FNO STORIES OCc EDU IF , - - A' ,FIRE SPR CENSUS TRACT GPLAND USE PARKING SPACE RES UNITS I GRADING PERMIT ISSUED.r' REDEVELOPMENT ', - TYPE,. ,OCC LOAD: - I AREA .' CONST Y ND vDND YO NO QTY PLUMBING PERMIT ISSUE '':-.---o , QTY '-' MECHANICAL ISSUE I , '' ' " SUMMARY/ACCOUNTNUMBER - .5 '2 EACH FIXTURE TRAP INSTALL FURN DUCTS UP TO 100,000 BTU BUILDING PERMIT 01-00-00-8220 -'' "EACH BUILDING SEWER ' ' .' -, , -.v - , . '.IOVER 100,000 BTU • ' • - SIGN PERMIT'- - - 01-00-00-8221 , EACH WATER HEATER AND/OR VENT - , wo BOILER/COMPRESSOR'UP TO 3HP ' . ' . • - '' PLANCHECK /1'00'008806 EACH GAS SYSTEM 1 TO 4 OUTLETS '- '' * . BOILER/COMPRESSOR 3-15 HP " * - , . '. - .cu TOTAL PLUM -' - 1 - 01-00-00-8222 - EACH GAS SYSTEM 5 OR MORE ' - - • METAL-FIREPLACE • - - -.- - - - - -:-' " -. 'ELECTRICAL — -- ' 01-00-001223 1 EACH INSTAL., ALTER. REPAIR WATER PIPE,, -. S C VENT,FAN SINGLE DUCT - - : ' - , .' ' - MECHANICAL • ' 0100'008224 - 1171 EACH VACUUM BREAKER MECH EXHAUST - H000/OUCTS . MOBILEHOME , 01 00008225 WATER SOFTNER .__. RELOCATION OF EA FURNACE/HEATER -' - MOBILEHOME PARK (NSP EACH'ROOF DRAIN (INSIDE) . , - - I. ' - - .. I , ' ' ' * - • SOLAR - '. -01-00-00-8226 . • - - '" — ... TOTAL MECHANICAL * ___-., ., - . -- '," ,' '-' :,. - - . ...• STRONG MOTION 80-92-33-0519 g ( I ' ',TOTAL PLUMBING * -. 'L FIRE SPRINKLERS - .._. - ..01-00-00-8227 QTY - t,_, -. ,.' - * -- r ELECTRICAL PERMIT ISSUE'- h '• _< '., OTY ' , ' -PUBLIC - %SOLAR ISSUE . - FACILITIES FEE - ' 32-00-00-8923 • BRIDGE FEE NEWCONST EA AMP/SWTJBKR : ' ' -- COtLECTORS• _' .'', -. . SCHOOL FEE-.DISTRICT,., . -' - . r1 PH ' ' 3 PH - STORAGE TANKS __0 ' _ Carlabadac 809221 0519 EXIST BLDG EA AMP/SWT/BKR ' ROCK STORAGE ' " ' - a Enclnllai' 8092220519 .1 PH •' , ~3 PH 4,, -, 'PUMP, . ,.•: -'.'.. ' -SanDjeguj(o ,r-80-92-23-0519 REMODEL/ALTER PER CIRCUIT '" '' PLAN CHECK FEE '? ' San Marcs - 80-92-24-0519 • TEMPPoLEr200 AMPS , — *_-,"' ç "--• .,,A.p - . ,A ••.4 '.-'_-'- . , - -. - , ,,•••,• _S-•* . • - OVER 200 AMPS -' , " ' ' ..,:. • - ' .' . .' ' TEMP OCCUPANCY (30 DAYS) t - r - . .4-So 1 ' S ' - - TOTAL ELECTRICAL' 1 TOTAL SOLAR TOTAL FEES PAYABLE I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION'ANO PERMIT" AND 00 HEREBY 0 Expiration. Every permit issued by the Building Official under the provisions olfrIs * AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall ire ll nd If the or work authorized by such permit is not commenced within 180days from theclate ofsuch -5'0- DEEP AND DEMOLITION OR CONSTRUCTION OF DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS permit, or lithe building or work authorized by such permit is suspended or STRUCTURES OVER 3 STORIES IN HEIGHT BUILDING CON ISSUED TO COMPLY WITH ALL CITY COUNTY AND STATE LAWS GOVERNING abandoned at any time after the work is commenced for a period 01180 days.____________________________________ STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND APPL A T'S SI AT ri APPROVED BY ' °' - - - - DATE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND , URE o ONTRACTOR , - , .'.: - ---pu . , -. ,,, ,.:,-:r.5 • , - * "kJ EXPENSES WHICH MAY IN ANY BY PHONE 0 . GRANTING OF THIS PERMIT. WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE - i - - '1 •" - e' - .•'••-l" ' ' ' . p S - ' - S - ' F ' , , . ' 5_ -• I' 'INSPECTION TYPE , DATE, INSPECTOR BUILDING FOUNDATION .• - REINFORCED STEEL MASONRY GUNITE OR GROUT FLOOR & CEILING SUB FRAME SHEATHING -• .5,. ______ _________ FRAME l EXTERIOR LATH INSULATION INTERIOR LATH & DRYWALL -- _ PLUMBING SEWER AND BL/CO PLUMBING UNDERGROUND PLUMBINGTOP OUT TUB AND SHOWER PAN - t GAS TEST - ELECTRICAL - - TEMPORARY POWER fw ELECTRIC UNDERGROUND ROUGH ELECTRIC ELECTRIC SERVICE BONDING " G F . - SMOKE DETECTOR MECHANICAL - DUCT & PLEM., REF. PIPING I - HEAT - AIR COND.'- SOLAR SYSTEMS-.' VENTILATING SYSTEMS - CALL FOR FINAL INSPECTION W-IEN•. ALL APPROPRIATE ITEMS ABOVE HA.VEBEENAPPROVED.( JOB SITE FINAL PLUMBING FIELD INSPECTION RECORD 5 4. c .]• * r ' I REQUIIED SPECIAL INSPECTIONS.'——-,. - INSPECTION IF INSPECTORS DATEAPPROVAL INSPECTOR'S NOTES REQ. 44• - __ — CHECKED t SOILSCOMPLIANCE PRIORTO- FOUNDATION INSP- . - ,' -- - - .- . - + STRUCTURAL CONCRETE . OVER 2000 PSI PRESTRESSED -. - - ' ' ' " • CONCRETE Jkl -POST TENSIONED • . . . " -, . .- . * CONCRETE' -- '• ---- -_---.- b- - •! FIELD WELDING • 4. ' ' -- '- ' -. . ' I • HIGH STRENGTH - - 1' - BOLTS 14 SPECIAL MASONRY - - PILES'CAISSONS ' _& & •• 4 4, - '-f' • ________ -__________ ________ 1 •. 5, .4. .5 - 04, 4,- k 4 -. i'' -. ' '-''' ' -$t ii "Y 1'\','"' :'.-? -, 4:'•'• -.'-• ''--- L ' • . . .• - - — -- I -. I ELECTRICAL - , • I '4" / / :-' / - •.. 5 5 MECHANICAL GAS '' ,:" ' i.';. - . ': k'--.'-- -. -"7. BUILDING • . , ' - ' -' ' . - . ' - - . . - - :. . SPECIAL CONDITIONS CERTOFOCCUPANCY ISSUED -______ __________ . I •h. ,• - -y . , _____ I&. - - .5 .5 --5--- * -- 5- -.-.-.--•-'-. -- - , - .. — 5.- '- ---5 . -.5 . S . .... - '. ' .' , ._-•'- , . ., •. '- . - r . s - - ' . , _5•._•. ATENTION PIJPERI'Y OWNER An "ownr-bulder" building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest' " ppportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received I personally plan to provide the major. .labor arid materials for construction of. the proposed property nriprovement (yes or no) fl p 2 I have not) utii.rf signed the application for a building permit 3 I have contracted with the following person (firm) to provide the proposed construction Name Phone____________________________ Address Contractors License No City_________________________ 4 I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work 0 I AID Name Phone______________ Address % O5r 4 Contractors License No Zj 1/3' City Qo7g 5 I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated - - Name • • • • Address • • Phone • Type of Work Signed: Property Owner Social Security Nber Date I E1CI-1 SUBCONTRACTOR WILL BE INSTRUCTED TO OBTAIN A CITY OF C4RLSBAD BUSIMESS LICENSE AND FURNISH •A CERTIFICATE OF WORKMAN'S CONPE13ATION TO THE CITY OF CARLSBAD. • . • .... . : •: • • Initials 1200 ELM AVENUE TELEPHONE ,CARLSBAD• CALIFORNIA 92008 .. .. 714-438-5525 Qritp of QCartbab Dear Property Owner:,'.I,. An application for a building permit has been submitted in your name listing yourself ..' as. the builder of the property Jimprovements specified. For your protection you should be aware that as "owner-builder "'you are the responsible party of record on such a permit. Building permits are not required to be signed by the property owners unless they are pe±'sonafly performing their own work. If your work is being performed by saiieone other.. than yourself, you may protect yourself. from possible liability if that person applies for the proper permit in his or her name Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the City of Carlsbad. They are also required by law to put their license .,number on all permits for which they apply. If you plan to) do -your oyc work, with the' exceion1 f ri9scade ti you 'plan to subcontract, you should !be aware of the follqwing -ipformation for your benefIt and pro- tection.. If .you employ or otherwise engage any per6ns other- than youriinmediate family, and t1-eork"('including material and other costs) is $200 or more for the entire project, and such persons are not licensed as contractors or sux ' on,ta,etors, tjri ,may be an em- ployer. If you are an employer, you must register with the state and fedéraliojernment as an employer and you are subject to several obligations including state and. federal incane withholding, federal social security taxes, workers' compensation insurance, dis- ability insurance costs, and unemployment contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. -. For specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U. S. &nall Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. . If the structure is intended for sale, property owners who are not . licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcortractor,'on1y under"ljmited conditions. . . A frequent practice of unlicensed ersons proeihg to be contractors is to secure an "owner-builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permtts are not required to be signed by property owners unless they are performing their own work personally. Informa- tion about licensed contractors may be obtained by contacting the Contractors State License Board in your corrnunity or at 1020 N Street, Sacramento, CA. 95814. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER-BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING .PERJVflT 'WILL NOT BE ISSUED UNTIL THE VERIFICATION IS RETURNED • Very truly yours, •. • • • - •• Building Department • - • • • City of Carlsbad • • • S • • - -----------------