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II )L~1A~ APPROVAL
I 'S , J~ DATE~t6 ~EA~AI CE ___ _
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
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2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION PLAN CHECK NO.
City of Carlsbad Building Department
2075 Las PalEs Dr., carlsbad, CA 92009 (619) 438-1161
I. Pi!IOOI IYPE
From list 1 (see back) give code of Permit-Type: ____________ _
For Residential Projects Only: From Llst 2 (see back) give
Code of Structure-Type: ____________________ _
Net Loss/Gain of Dwelling Units
2. PRUJF.Cf INFORMATION FOR OFFICE USE ONLY
7.''og J l-+/61/-I) I Jj6 G 111/ N a~Cross Street "t.
Bu1idmg or SUJte No.
LEGAL lJESCRIP I ION Lot No.
CHECK BEWW IF S0BMII IE~ f
Subct1V1s1on Name/Number Omt No. Phase No.
D 2 Energy Cales □ 2 Structural Gales □ 2 Soils Report O 1 Addressed Envelope
-~
# OF BEDROOMS # OF BA TI!ROOMS
ADDRESS
CI1Y STATE ZIP CODE DAY TELEPHONE
4. APl'U~J UWNIRACIUR DAGEN I FOR CON I RAC I OR
ADDRESS
DOWNER DAGEN I FOR OWNER
NAME (last name first)
CI1Y STATE ZIP CODE DAY TELEPHONE
s. ~l~;,~:,V:el!J}rsr) 7'Zlfrt ,f-/.J4-f.,IJ'i:fTf._ fr4ft1,J{Ess I~<// ff/ bl+~ If) l t
CI1Y ~/Q3,4¢ STATE (A: ZIPCODEq,lL:?Qj'.'DAYTELEPHONE LfJtr,-/j/,/ ,1-,r 4-J:7/
DESIGNER NAME (last name hrst) ADDRESS
CI1Y STATE ZIP CODE DAY TELEPHONE STATE !JC.#
7. WOkkEkk CDMPENSAilON
workers' compensauon .uec1arauon: I hereby affirm that I have a cerutlcate of consent to self-msure issued by the O1rector of lndustnal
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 POLlcYNO. EXPIRATION DATE
cert1t1cate ot t:xempt1on: I certify that m the perfonnance of the work for which this penmt 1s issued, I shall not employ any person many manner
so as to become subject to the Workers' Compensation Laws of California.
SIGNATIJRE DATE
8. OWNmt-BUnnmt bf:COOtAltuN
□
□
Uwner-BuUder Declaration: I hereby afhnn that I am exempt from the Contractor's License Law for the lollowmg reason:
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.).
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).
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 pennit 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 ·s exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031 5 by any applicant for a pennit
subj th applicant to 'vii penalty of more than five hundred dollars [$500]).
SIGNATIJRI! DATE
Is the applicant or future building occupant requir 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?
□YES □NO
Is the applicant or future building occupant required to obtain a pennit from the air pollution control district or air quality management district?
□YES □NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
DYES □ NO
IF ANY OF 11IE ANSWERS AREYES, A FINAL CERTIFICATE OF oa:upANcY MAY NOT BE ISS\JEDAFfERJ\JLY 1, 1989 IJNllSS 11IE APPLICANT
HAS MET OR JS MEIITING 11IE REQUIREMENTS OF 11IE OFFICE OF EMERGENcY SERVICES AND 11IE AIR POI.I.UTION ffiNTII.OL DISTRICT.
9. WNS'IR0CIIUN ffiNDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit 1s issued (Sec 3097(1) CIVIi Code).
LENDER'S NAME LENDER'S ADDRESS
JO. APPUCAN I CERIJFICA'IIDN
I certUY that I have read the appJJcat1on and state that the above information 1s correct. I agree to comply with ail Ctty 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 1U SAVE INDEMNIFY AND KEEP HARMLF.SS 111E CI1Y OF CARISBAD AGAINST AIL LIABILITIES, JUDGMENTS, CDSTS
AND EXPENSES WHICH MAY IN ANY WAY ACDUJE AGAINST SAID CI1Y IN ffiNSEQ\IENCE OF 11IE GRANTING OF 11IlS 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 bys rmit is not commenced within 365 days from the date of such permit or if the building or work authorized by
such pennit is suspended or a don at anx.._ time af the work · o need for a period of 180 days (Section 303(d) Uniform Bui~e~
APPLICANTS SIGNATIJRE --DATE: 2../' C
WHITE: PINK: Finance
0
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB961520 FOR 11/08/96
DESCRIPTION: OPEN AREA-GAR-STORAGE,W/ELEC,
45 SF-MOVE PLUM PIPES,REPLACE WATER HEAT
TYPE: RAD
AV STE:
INSPECTOR AREA PY
PLANCK# CB961520
OCC GRP
CONSTR. TYPE VN
LOT: 58 JOB ADDRESS: 1881 HIGH RIDGE
APPLICANT: ABBEY, RAENETTE
CONTRACTOR:
PHONE: 619 434-1369
PHONE:
OWNER: PHONE:
REMARKS: MW/TOM/434-1369
SPECIAL INSTRUCT: AM PLEASE BEFORE NOON/HE INSPECTOR 'o/'-HAS TO GO TO WORK/
TOTAL TIME:
--RELATED PERMITS--
LVL DESCRIPTION
PERMIT# TYPE
RW960126 ROW
CD
29
39
PL Final Plumbing
EL Final Electrical
STATUS
ISSUED
ACT COMMENTS
fit ____ _
***** INSPECTION HISTORY *****
DATE DESCRIPTION ACT INSP COMMENTS
102996 Exterior Lath/Drywall AP PY
102996 Water Heater/Vents AP PY
102296 Frame/Steel/Bolting/Welding AP PY
102296 Water Heater/Vents AP PY
102296 Rough Electric AP PY
City of Carlsbad
■ #i .,. I I ,14411,i· I •14 ·61 I;, ,14 ,; I
tV.. BUILDING PLANCHECK CHECKLIST Q/
DATE: V. z--, <CJ PLANCHECK NO. CB /.J'2_(5Z-<J
BUILDING ADD ESS: ( 0
PROJECT DESCRIPTION: -.I:>.L-1-J'""--------------------
ASSESSOR's PARCEL NUMBER: __________ EST. VALUE _____ _
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.
DA Right-of-Way permit is required prior to
construction of the following improvements:
DENIAL
Please see the attached report of deficiencies marked
with D. 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 ENGINEERING DEPT. CONTACT PERSON
D Dedication Application
D Dedication Checklist
D Improvement Application
D Improvement Checklist
D Future Improvement Agreement
D Grading Permit Application
D Grading Submittal Checklist
D Right of Way Permit Application
D Right of Way Permit Submittal Checklist
and Information Sheet
0 Sewer Fee Information Sheet
NAME: _______________ _
City of Carlsbad
ADDRESS: 2075 Las Palmas Dr., Carlsbad, CA 92009
PHONE : 16191 438-1161, Ext.
A-4
P-\DOCS\CHKLST\BP0001 .FAM REV 04!30196
2075 Las Palmas Dr.• Carlsbad, CA 92009-1576 • (619) 438-1161 • FAX (619) 438-0894
BUILDING PLANCHECK CHECKLIST
SITE PLAN
1st~d✓ 3rd✓
Ef D O 1. Provide a fully dimensioned site plan drawn to scale. Show:
A. North Arrow D. Property Lines Easements
B. Existing & Proposed Structures E. Easements
C. Existing Street Improvements F. Right-of-Way Width & Adjacent Streets
ff[] □ 2. Show on site plan:
A. Drainage Patterns C. Existing Topography
B. Existing & Proposed Slopes
D D D 3. Include note: 'Surface water to be directed away from the building foundation at a 2%
gradient for no less than 5' or 2/3 the distance to the property line (whichever is less).•
[Per 1985 UBC 2907(d)5).
On graded sites, the top of any exterior foundation shall extend above the elevation
of the street gutter at point of discharge or the inlet of an approved drainage device
a minimum of 12 inches plus two percent" (per 1990 UBC 2907(d)5.).
D D O 4. Include on title sheet
A. Site address
B. Assessor's Parcel Number
C. Legal Description
For commercial/industrial buildings and tenant improvement projects, include: Total
building square footage with the square footage for each different use, existing sewer
permits showing square footage of different uses (manufacturing, warehouse, office,
etc.) previously approved.
EXISTING PERMIT NUMBER DESCRIPTION
P:\OOCS\CHl(I...Sl\BP0001.FRM Page 1 of 4 REV04fJlJ/96
1stv 2ndV □ □ □
□ □ □
□ □ □
BUILDING PLANCHECK CHECKLIST
DISCRETIONARY APPROVAL COMPLIANCE
3rdv'
5. Project does not comply with the following Engineering Conditions of approval for
Project No. __________________________ _
Conditions were complied with by: _______ _ Date: _______ _
DEDICATION REQUIREMENTS
6. Dedication for all street Rights-of-Way adjacent to the building site and any storm
drain or utility easements on the building site is required for all new buildings and
for remodels with a value at or exceeding $ _______ -pursuant to Code
Section 18.40.030.
Dedication required as follows: ___________________ _
Dedication required. Please have a registered Civil Engineer or Land Surveyor
prepare the appropriate legal description together with an 8-1 /2" x 11 " plat map
and submit with a title report. All easement documents must be approved and
signed by owner(s) prior to issuance of Building Permit. Attached please find an
application form and submittal checklist for the dedication process. Provide the
completed application form and the requirements on the checklist at the time of
resubmittal.
Dedication completed by _____________ _ Date: ____ _
IMPROVEMENT REQUIREMENTS
7a. All needed public improvements upon and adjacent to the building site must be
constructed at time of building construction whenever the value of the construction
exceeds $ -pursuant to Code Section 18.40.040.
Public improvements required as follows: _______________ _
Please have a registered Civil Engineer prepare appropriate improvement plans and
submit them together with the requirements on the attached checklist for a
separate plancheck process through the Engineering Department. Improvement
plans must be approved, appropriate securities posted and fees paid prior to
issuance of permit.
Attached please find an application form and submittal checklist for the public
improvements requirements. Provide the completed application form and the
requirements on the checklist at the time of resubmittal.
Improvement Plans signed by: ____________ _ Date: __ _
P:\DOCS\CHKLSnBP0001.FRM Page 2 of 4 REV 04/30/96
1st✓ 2nd✓ 3rd✓
DD □
BUILDING PLANCHECK CHECKLIST
7b. Construction of the public improvements may be deferred pursuant to code Section
1 S.40. Please submit a recent property title report or current grant deed on the
property and processing fee of $. _________ so we may prepare the
necessary Future Improvement Agreement. This agreement must be signed, notarized
and approved by the City prior to issuance of a Building Permit.
Future public improvements required as follows:, ____________ _
Improvement Plans signed by: ___________ _ Date:. ____ _
0 0 D 7c. Enclosed please find your Future Improvement Agreement. Please return signed and
notarized Agreement to the Engineering Department.
Future Improvement Agreement completed by: ____________ _
Date: _______ _
0 D D 7d. No Public Improvements required. SPECIAL NOTE: Damaged or defective
improvements found adjacent to building site must be repaired to the satisfaction of
the City Inspector prior to occupancy.
GRADING PERMIT REQUIREMENTS
The conditions that invoke the need for a grading permit are found in Section 11.06.030
of the Municipal Code.
0 0 D Sa. Inadequate information available on Sife Plan to make a determination on grading
requirements. Include accurate grading quantities (cut, fill import, export).
0 0 D Sb. 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.
Grading Inspector sign off by: ________ _ Date: ____ _
D D D Sc. No Grading Permit required.
P:\OOCS\CHKLS1\Bf'0001,FFM Page 3 of4 AEV<M/30/ll0
1st✓ 2nd✓ 3rd✓
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BUILDING PLANCHECK CHECKLIST
MISCELLANEOUS PERMITS
9. 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. Types of work include, but are not limited
to: street improvements, trees, driveways, tieing into public storm drain, sewer and
water utilities.
Right-of-Way permit required for _________________ _
A separate Right-of-Way permit issued by the Engineering Department is required for
the following: _______________________ _
D D D 10. A SEWER PERMIT is required concurrent with the building permit issuance. The fee
is noted in the fees section on the following page.
0 0 0 11. INDUSTRIAL WASTE PERMIT is required. Applicant must complete Industrial Waste
Permit Application Form and submit for City approval prior to issuance of a Permit.
Industrial waste permit accepted by: _______ _ Date: ___ _
P:\OOCS\CHKI..Sl\Bf'0001.FRM Page 4 of4 REV 04/30/96
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PLANNING DEPARTMENT
BUILDING PLAN CHECK REVIEW CHECKLIST
Plan Check No. CB C/b ~/§:J-O Address 1/9/ fo34 fiJJe.. AuflJ(/e..
Planner V ~ N Phone (619) 438-1161 ext. ___ _
(Name)
APN: JOIJ ... 5f 5",L(O -------'-------'-------------------
Type of Project and Use: __ S_ti_.;/2._;..___-______________ _
Zone: 12,-A' IO Facilities Management Zone: __ 1......_ __ _
CFO (i~/6fit}7# _________ _
cir~ (If property in, complete SPECIAL TAX CALCULATION
WORKSHEET provided by Building Department)
Legend
~ Item Complete
(g Item Incomplete -Needs your action
Environmental Review Required: YES NO A-TYPE ___ _
DATE OF COMPLETION: ________ _
Compliance with conditions of approval? If not, state conditions which require action.
Conditions of Approval _____________________ _
Ep D D Discretionary Action Required: YES NO --X,-TYPE ___ _
APPROVAL/RESO. NO. ______ DATE _____ _
PROJECT NO. ____ _
OTHER RELATED CASES: __________________ _
Compliance with conditions or approval? If not, state conditions which require action.
Conditions of Approval _____________________ _
(#jJ □ □ California Coastal Commission Permit Required: YES~ NO -$.
DATE OF APPROVAL: ______ _
San Diego Coast District, 3111 Camino Del Rio North, Suite 200, San Diego, CA 92108
(619) 521-8036
Compliance with conditions of approval? If not, state conditions which require action.
Conditions of Approval _____________________ _
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lncluslonary Housing Fee required: YES __ NO -¥--
(Effective date of lnclusionary 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:
c30' ;;?-I' Front: Required Shown
Int. Side: Required B' Shown I I '
Street Side: Required -Shown
Rear: Required /o I Shown Lj '] I
2. Lot Coverage: Required 1=.40"/o Shown L "t 0 r)/o
3. Height: Required £... 3'-=>' Shown L-30'
4. Parking: Spaces Required 7_ Shown L.
Guest Spaces Required -Shown
Additional Comments -I ·r l 29hr.
OK TO ISSUE AND ENTERED APPROVAL INTO COMPUTER r/4,.J Lytvcf-
K:\ADMIN\COUNTER\PLANCKFRM 1-17-96