HomeMy WebLinkAbout2062 LADERA CT; ; CB042456; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
08-0()-2004 Pool Permit Permit No: CB042456
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
2062 LADERA CT CBAD
POOL
Lot#: 0 2164821500
$14,000.00 Construction Type: NEW
Status:
Applied:
Entered By:
Reference #: Plan Approved:
ISSUED
06/18/2004
FM
08/05/2004
08/05/2004
Project Title: SHAPIRO RES 400SF POOL
Applicant:
POOLWERKS
2825 MESA DR 92054
760 966-0033
Building Permit
Add'I Building Permit Fee
Plan Check
Add'I Plan Check Fee
Electrical Fee
Plumbing Fee
Strong Motion Fee
Renewal Fee
AddI Renewal Fee
Other Building Fee
Additional Fees
TOTAL PERMIT FEES
Total Fees: $216.71
Inspector:
Owner:
SHAPIRO THERESA
2062 LADERA CT
CARLSBAD CA 92009
Total Payments To Date: $84.82
Date:
Issued:
Inspect Area:
$130.49
$0.00
$84.82
$0.00
$0.00
$0.00
$1.40
$0.00
$0.00
$0.00
$0.00
$216.71
Balance Due:
Clearance:
$131.89
NOTICE: Please take NOTICE that approval of your project includes the "lmpositi s, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3.32.030, Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any
n f h im'I r r
02
City of Carlsbad J d0'->1
0DV.1ll/frl0 1635 Faraday Av Carlsbad, CA 92008
08-D?-2004 Right of Way Permit Permit No: RW040249
Job Address:
Permit Type:
Parcel No:
Start Date:
Insurance Expire:
Liability Insurance:
Reference#:
Location:
Project Title:
Description:
Applicant:
POOLWERKS
2062 LADERA CT CBAD
ROW Subtype: MINOR
2164821500 Lot#: 0
06/02/2005
y
CB042456
Est Complete Date:
Traffic Control Plan: Y
GOP:
SHAPIRO RESIDENCE
POOL
2825 MESA DR 92054
760 966-0033
Total Fees: $230.00
Permit Fee
Additional Permit Fee
Other
Additional Fees
TOTAL PERMIT FEES
Total Payments To Date: $0.00
Status:
Applied:
Issued:
Expired:
Entered By:
ISSUED
08/03/2004
08/05/2004
02/05/2005
TNKB
Balance Due: $230.00
$230.00
$0.00
$0.00
$0.00
$230.00
8231 08/0~ /(jLt r,,1·-,,,,.; ·"'·[ ..,, ... , \,·. '· ~:. :J __
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 Deposit? ___ _
YOU MUST CALL UNDERGROUND SERVICE ALERT (1-800-422-4133) TWO WORKING DAYS PRIOR TO WORK.
UNDERGROUND SERVICE ALERT NO. ______ .. THIS PERMIT IS INVALID WITHOUT THIS NUMBER
IF ANY EXCAVATION OR BORING IS DONE.
?,45) Bo\ FOR OFFICE USE ONLY
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
PLAN CHECK NO. (![>a'-la'I.SC
EST. VAL. I'{ ()ot)
Plan Ck. Deposit € '1. f? tJ.
Validated Bv-'E'-.M=----------
Date G,-/,f-01/
Business Name (at this add 02 01 02
Legal Description Lot No. Subdivision Name/Number Unit No. CQp ~' ,!32 Phase No. Total # of uni 1 -...
Assessor's Parcel # Existing Use Proposed Use
# of Bathrooms
Name Address
lii±i :if.<(i!iiilJC::Al'IT :f!IQ,ciilitr.otor 'l;Ji,Agenft,fr,coirti~iot, ··· Cr0wner
)Name Address
City
-/□::A,9f!Ot':(or>Owner
City
~'
10b~~4't~'
Name Address City
!i,E''"'flllifltl!ildirOl!tl'<IO~i!ilNV:[1!~~,;
State/Zip Telephone# Fax#
State/Zip Telephone#
State/Zip 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 ,i:'olation of Section 7031.5 by any applicant for a permit ~bjects the applic t to a civil ~enalty of not more than five h dred dollars 'q~ ... ~
Name Address
State License # City Bu_siness License #
Designer Name City State/Zip Telephone
State License # _________ _
11,::C:1'i'(i!!lil.il$\i<i!fMl'liNJA'1lON'i,
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
D 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.
O I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My worker's 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)
0 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 workers' compensation coverage is unlawful, and shall 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.
SIGNATURE______________________________ DATE
fl.F ti>WN~,11lll~i:ia'~!l~MtiO!ii'·• --------
1 hereby affirm that I am exempt from the Contractor's license Law for the following 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:
1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO
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. l 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 I 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 I address/ phone number/ type
of work):. __________________________________________________________ _
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? 0 YES O NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES D NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES D 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.
Iii', itC!IJ{S'rf\licTiQ!li.m,!1»riij:)l;~~\1,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(i) Civil Code).
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 Citt 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 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 180 days from the 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 commenc f a d of 180 ays (Section 106.4.4 Uniform Building Code).! d ~ /
'\-.....,.PPLICANT'S SIGNATURE --~'4f.'.L(.£~!".k.&.~--=----------DATE l t/!ll'rl , e'. I fl l ~·
WHITE: File YELLOW: Applicant PINK: Finance
m' City of Carlsbad Bldg Inspection Request
;
i
For: 04/08/2005
Permit# CB042456
Title: SHAPIRO RES 400SF POOL
Description:
Type: POOL Sub Type:
Job Address: 2062 LADERA CT
Suite: Lot 0
Location:
OWNER SHAPIRO THERESA
Owner: SHAPIRO THERESA
Remarks:
Total Time:
Inspector Assignment: JM ---
Phone: 7607432606 EX 235
Inspector: -----
Requested By: MICHELE
Entered By: CHRISTINE
CD Description Act Comment
59 Final Pool ~---------
Associated PCRs/CVs
lns~ection HistO!Y
Date Description Act lnsp Comments
03/22/2005 55 Fence/Pre-Plaster AP JM OK TO PLASTER -ALARMS OK
03/02/2005 23 Gas/TesVRepairs AP JM EQUIP TO BBQ
12/03/2004 23 Gas/Test/Repairs AP JM EQUIP. ONLY
12/03/2004 51 Excav/Steel/Bonding/Fence AP JM ok to gunite (2) lights equip.
12/03/2004 52 Underground Plumbing AP JM
12/03/2004 53 Electric/Conduit'Wiring PA JM
City of Carlsbad
l=lfib ■IWi·lltf•#i•i·ll,14411,1·1
BUILDING PLANCHECK CHECKLIST
POOLS
BUILDING PLANCHECK NUMBER: CB
BUILDING ADDRESS:
CJl.f · d</SlP
';f:.r,.__~ c,.....
PROJECT DESCRIPTION: _P'-o""'o"--1 ________ _
d--l~ -lff z_ -(S/ 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 compl ith instructions in this report can
result in suspe si of permit to build. ,; \ ( f ( I\(\,.
By: --+-,r'""":-\----Date:~
ATTACHMENTS
Grading Permit Application
Grading Permit Checklist
Right-of-Way Permit Application
Right-of-Way Permit Submittal
Checklist and Information Sheet
DENIAL
Plea•~ached report of deficiencies
mark;d :~J~:~<.tnecessary corrections to plans
or specifications for compliance with applicable
codes and standards. Submit corrected plans
and/or specification this office for review.
Date:
________ Date:
7/41/0}-
%'/3/o!J
ENGINEERING DEPT. CONTACT PERSON
NAME: Kathleen M. Farmer
City of Carlsbad
ADDRESS: 1635 Faraday Avenue
Carlsbad, CA 92009
PHONE: (760) 602-2741
1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-2720 • FAX (760) 602-8562 (!}
□
□ □ □
□ □ □
□ □
BUILDING PLANCHECK CHECKLIST -POOLS
SITE PLAN
a fully dimensioned site plan drawn to scale. Show:
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: f. 9--J &e..
~ite Address ...__ 1_ B C'i
~essor's Parcel Number _ 4 / -1-If-/r.Q u
CT;,) Legal Description -C VV,....,.. vf v--U'-1 _---
D. Grading Quantities Cut ____ Fill ___ Import/Export
4. Project does not comply with the following Engineering Conditions of approval
for Project No.
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. 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 1 of 2
••
1 sT✓ 2ND✓ 3RD✓
o· ·o 0
0 0
0 0 0
5c. A Grading Permit has been applied for:
PE2 DWG
Grading Inspector sign off by: Date:
5d. No Grading Permit required.
MISCELLANEOUS PERMITS
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:\Developmenl Services\MASTERS\CHECKLIST5'Buikllng Planchectl Ctdlst fOflll• POOLS.doc Rw. 8122196
CONDITIONAL WAIVER AND RELEASE UPON FINAL PAYMENT
[California Civil Code § 3262(d) (3)]
This form complies with professional standards in effect January 1-December 31, 2004
Upon receipt by the undersigned of a check from _T_er_es_a_S_h_a..:.p_ir_o _______________ _
(Your Customer)
in the sum of$ 606.71 payable to Poolwerks ------(Amount of Check) (Payee or Payees of Check)
and when the check has been properly endorsed and has been paid by the bank upon which it is drawn,
this document shall become effective to release any Mechanic's Lien, Stop Notice, or Bond right the
undersigned has for the job of ..:T..:.•re=•ac.cS:c:ha=pir=-o=-------------------------
(Ownc.-)
located at 2062 Ladora Ct. , Carlsbad, Ca. 92009
(Job Description)
This release covers the final payment of the undersigned for all labor, services, equipment and/or material
furnished on the job, except for disputed claims for additional work in the amount of$ O -------Before any recipient of this document relies on it, the party should verify evidence of payment to the
undersigned.
D~ =
Poolwerks
(Company Name)
Particia J. Moerke , Office Manager
(Name/Title)
NOTE: This release is in accordance with the California Civil Code Section 3262 (d)(3). It is not effective until the check that
constitutes final payment has been properly endorsed, and has cleared the bank.
PLANNINC/ENGINEERING APPROVALS
PERMIT NUMBER CB () v(-.1 ~ ~ {g DATE Q(J '1--1,,, 0 ~
ADDRESS 'l,.0 Co 1 L itf.)f ru}
RESIDENTIAL ADDITION MINOR
( < $10,000.00)
OTHER
TENANT IMPROVEMENT
PLAZA CAMINO REAL
CARLSBAD COMPANY STORES
VILLACE FAIRE
COMPLETE OFFICE BUILDING
-------------------
PLANNER ~-·_W½_---'-----• DATE
ENGINEER DATE ---------------
Does/Mllifoffl\5/Pt.mning Engineering ApprovafS
C8042456 2062 LADERA CT CBAD
SHAPIRO RES 400SF POOL
POOL
!_ot# POOLWERKS
r -/ 3-0'1
l'.) (! 1¥-tfo f k;,. 1 DwNV' -ft, f,k _; ,f.sJ /-o /kJ
_______ BUILDING
________ p: ANM1NG
-------ENGINEERING
TO FROM
FIRE APPRIFORM
HEA.tTrtOEPT
HA~>,.1,-,,T I A.IRQUAL
OTt->tR SEWER DtS1R
SCHOOi.FORM
~~e°a~SHEET
roj il(6r-b:lsto/ trd~ 00-tt ti, & do,,,_ ~~~; ,
{dJ = "~ ;,tu. .,/LAA;~ v«/2'.f oV,,,,-5 &f<-,,~ ~ 1.
' .. I-~. ..
A'd ~ -ft> (Jf c,,t._ ~uJ FAo k' -~ YJ)J\_ ~-u\.d. ~ euz,
½ \s \ o '-" · ~~
C)' t[(;m ~ 51 ~~ 7b
~ 1 we<l2Q
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
10-22-2004 Plan Check Revision Permit No:PCR04169
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
2062 LADERA CT CBAD
PCR
Lot#: 0 2164821500
$0.00 Construction Type: NEW
Status:
Applied:
Entered By:
Reference #: Plan Approved:
Project Title: SHAPIRO RES-REVISE POOL, REMOV
RET. WLLS & CHANGE CONTRACTORS
Applicant:
MISSION POOLS OF ESCONDIDO INC
755 W GRAND AVENUE
ESCONDIDO, CA 92025
619-743-2605
Plan Check Revision Fee
Additional Fees
Owner:
SHAPIRO THERESA
2062 LADERA CT
CARLSBAD CA 92009
Issued:
Inspect Area:
Total Fees: $0.00 Total Payments To Date: $0.00 Balance Due:
Inspector:
FINAL APPROVAL
Date: Clearance:
ISSUED
10/01/2004
KMT
10/22/2004
10/22/2004
$0.00
$0.00
$0.00
NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter coUectively
referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these feeS/exactions. If you protest them, you must
fo!\ow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any
fees/exactions of which vou have nreviouslv been niven a NOTICE similar to thi" or as to which the statute of limitations has oreviouslv otherwise exnired.
FOR OFFICE USE ONLY
PLAN CHECK No.P~~½ ((QC,
EST. VAL. lq 880--
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
15j5 Faraday Ave., Carlsbad, CA 92008
Ori ; C80l-f2-ct» Plan Ck. Deposit B
Validate~! -_a r I
Date IQ.i I I 0
Business Name (at this address)
Subdivision Name/Number Unit No. Phase No. Total # of units
Proposed Use
Name
'D1~-'QltO!l1!!~l!l!-N'('0Rl!i'0i;rn: :,:pr er'! "
(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
exemptiol,. Any 'liiolation of Se n 7031 5 by any a plicant for a PW'{"it s jects the applic t to civil penalty .i;,f not more than (i e hundr. d dollars [$ 001). ~
) . ,✓--' " ~ -~ • ~ -c-1-,,,-·
Name Address City State/Zip T:.!ehone #
State License # ..:5,::R/il0 License Class C ,--5 ('.3 City Business License #,.. .z?,. ;,ii2 2 (_!_ I/
Designer Name Address City State/Zip Telephone
State License # _________ _
J,;z~$!!'®i{ll¥IHL;;:2:'v,:,i
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
0 I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
I'/ I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
~ed. My wo,ke,•s co'.!!pensat;on ;nsu,ance ;!";er end po· y numbe, a,e, !· . / ..-
Insurance Company .,-: -. -1 Policy No. M (,,/((,-•; 20 Expiration Date t/lL, vc<, J
!THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100] OR LESS)
D 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.
SIGNATURE..l:/l-:L.1:t.:.::G:::t~:'.'C-!L.Li"?:2.':l.4.d.'..J.~===:_-________ _ ~i,12!1!Wfllilbllltafl@i!ll'A'll#/lll:i'fii';
I hereby affirm that I am exempt from the Contractor's License law for the following 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 ere 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:
1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. D YES ONO
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. 1 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): ________________________________________________ _
6. 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): __________________________________________________________ _
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? 0 YES D NO
ts the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 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 UNLESS THE APPLICANT HAS MET OR IS MEETING THE
REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
~~!i•,111>N!!f,fl!J~1>N:~i'i!ri!li~!l~C.YL'•' ,.
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code).
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 Gitt 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 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 180 days from the 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 com enced for a period of 180 d (Sectioo 106 4.4 niform Building Code). /4 /4 / ~ , _-, 2--/'J L APPLICANT'S SIGNATURE t:.;,t'L,{C'.:,{.1~~'!.L;:'._,/:2,Zl.,(._LLL________ DATE -:.L__.:7\ ~ (_ ' WHITE: File YELLOW: Applicant PINK: Finance
'
City of Carlsbad
l:lfitili♦fi·ii~t-#i,1·11114411,1·1
BUILDING PLANCHECK CHECKLIST
POOLS
BUILDING PLANCHECK NUMBER: cBOL/--2-Lf:5h
BUILDING ADDRESS: 2fXI 2 1/DEl"f'-Cvvri
PROJECT DESCRIPTION: Pool --------------
ASSESSOR'S PARCEL NUMBER: 2 I fo-4-f> 2 -/ 6
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
;:ult in sLOsion of pe it to build. /it It~ I() (
ATTACHMENTS
Grading Permit Application
Grading Permit Checklist
Right-of-Way Permit Application
Right-of-Way Permit Submittal
Checklist and Information Sheet
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:
By:
By:
_________ Date:
_________ Date:
Date: ---------
ENGINEERING DEPT. CONTACT PERSON
NAME: Linda Ontiveros
City of Carlsbad
ADDRESS: 1635 Faraday Avenue
Carlsbad, CA 92008
PHONE: (760) 602-2790
H:\Oevelopmeot SefVices\MASTERS\FORMS-\CHECKLISTS •\8UILOING PLANCHECK CKLIST FORM. POOLS.doc
Rev. 8/22196
1635 Faraday Avenue• Carlsbad, CA 92008-7314 • (760) 602-2720 • FAX (760) 602-8562 @
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j)v\! &M . I ~3--9 jJJJ' )11):5 BUILDING PLANCHECK CHECKLIST -POOLS
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SITE PLAN
1. Provide a fully dimensioned site plan drawn to scale. Show:
A. _,North Arrow /4.operty Lines Y. Existing & Proposed Structures ~;ements
2. Show on site plan:
A. Drainage Patterns
B. Existing & Proposed Slopes
C. Existing Topography
D. Indicate what will happen with
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.
Applied for Retaining Wall Permit CB
3. Include on title sheet:
-----____ Approved
A. Site Address
B. Assessor's Parcel Number
C. Legal Description
D. Grading Quantities Cut Fill lmporVExport
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: 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. Include accurate grading quan_tities (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 Sefvices\MASTERSIFORMS -\CHECKLISTS -\BUILDING PLANCHECK CKLIST FORM -POOLS.doc Rev. 8122196
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D D D
D D D
5c. A Grading Permit has been applied for:
PE2 DWG
Grading Inspector sign off by:
5d. No Grading Permit required.
MISCELLANEOUS PERMITS
--------Date:
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 SeNiceslMASTERS'FORMS -\CHECKLISTS ,\BUILDING PLANCHECK CKLIST FORM -POOLS.doc Rev. 8122198
PLANNINC/ENCINEERINC APPROVALS
PERMIT NUMBER)<' Ff;/'-_Ol./• /IJ1DATE ID• O'l •IJ Cf
ADDRESS '20b 2 t/Jet>£PA Gr · ·
<f"t.:.m:.)
RESIDENTIAL ADDITION MINOR
( < $10,000.00)
TENANT IMPROVEMENT
PLAZA CAMINO REAL
CARLSBAD COMPANY STORES
VILLAGE FAIRE
COMPLETE OFFICE BUILDING
OTHER ___________ -'----------
-~
PLANNER~----~-~------DATE ID -IJ '-I -() y
ENGINEER _______ _ DATE ---------
"""'•'u1,-, .. __,in1 ....... ;,.,. r .... 1 .. -· ............ ,.-,.
CONDITIONAL WAIVER AND RELEASE UPON FINAL PAYMENT
[California Civil Code § 3262(d) (3)]
This form complies with professional standards In effect January I-December 31, 2004
Upon receipt by the undersigned of a check from _T_er_e_sa_S_h_a..:.p_ir_o _______________ _
(Your Customer)
in the sum of$ 606. 71 payable to Poolwerks ------------------------(Amount of Check) (Payee or Payees of Check)
and when the check has been properly endorsed and has been paid by the bank upon which it is drawn,
this document shall become effective to release any Mechanic's Lien, Stop Notice, or Bond right the
undersigned has for the job of _T_ere_sa_S_ha~pir_o ______________________ _
(Owner)
located at 2062 Ladera Ct. , Carlsbad, Ca. 92009
(Job Description)
This release covers the final payment of the undersigned for all labor, services, equipment and/or material
furnished on the job, except for disputed claims for additional work in the amount of$ O -------Before any recipient of this document relies on it, the party should verify evidence of payment to the
undersigned.
Dated: 09-11-/04
JK/iii-~-'gnature) •
Poolwerks
(Company Name)
Particia J. Moerke , Office Manager
(Name/l'itle)
NOTE: This release is in accordance with the California Civil Code Section 3262 (d)(3). It is not effective until the check that
constitutes final payment has been properly endorsed, and has cleared the bank.
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