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HomeMy WebLinkAbout2165 DICKINSON DR; ; CB120598; Permit04-18-2012 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Pool Permit Permit No: CBl20598 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: PC #: Project Title: 2165 DICKINSON DR CBAD POOL 2081820200 Lot#: $26,305.12 Construction Type: 0 NEW WHITE RESIDENCE 646 SF POOL/SPA //GAS TO FIREPIT & BBQ Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 04/04/2012 JMA 04/18/2012 04/18/2012 Applicant: WHITE TIMOTHY M 2165 DICKINSON DR CARISBADCA 92008 760-*535-9912 Owner: WHITE TIMOTHY M 2165 DICKINSON DR CARLSBAD CA 92008 Building Permit Add'l Building Pennit Fee Plan Check Add'l Plan Check Fee Electrical Fee Plumbing Fee Strong Motion Fee Green BIdg Standards (SB1473) Fee Renewal Fee Add'l Renewal Fee Other Building Fee Additional Fees $288.01 $0.00 $201.61 $0.00 $30.00 $30.00 $2.63 $1.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $553.25 Total Fees: $553.25 Total Payments To Date: $553.25 Balance Due: $0.00 Inspector: FINALAPPROVAL Date: C^Z^^/'Z-Clearance: NOTICE: Please take NOTICE that approval of your project includes the Imposition" of lees, dedications, reservations, or other exactions hereafter collectively referred to as lees/exactions." You have 90 days from the date this pennit 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 lees/exactlons of which vou have previously been given a NOTICE similar to this, or as to which Ihe statute of limitations has previousiv othenvise expired. 04-18-2012 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Storm Water Pollution Prevention Plan (SWPPP) Permit Permit No:SW120106 Job Address: Permit Type: Parcel No: Reference #: CB#: CBl 20598 2165 DICKINSON DR CBAD SWPPP 2081820200 Lot#: Project Title: Priority: Applicant: WHITE TIMOTHY M 2165 DICKINSON DR CARISBADCA 92008 760-*535-9912 WHITE RESIDENCE 646 SF POOL/SPA //GAS TO FIREPIT & BBQ M Status: Applied: Entered By: Issued: Inspect Area: Tier: Owner: WHITE TIMOTHY M 2165 DICKINSON DR CARLSBAD CA 92008 ISSUED 04/04/2012 JMA 04/18/2012 1 Emergency Contact: TIM WHITE 760-535-9912 SWPPP Plan Check SWPPP Inspections Additional Fees $50.00 $210.00 $0.00 TOTAL PERMIT FEES $260.00 Total Fees: $260.00 Total Payments To Date: $260.00 Balance Due: $0.00 FINAL APPROVAL DATEiiilAz^CLI SIGNATURE CITY OF CARLSBAD Building Permit Appiication 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 www.carlsbadca.gov Plan Check No. Est. Value J^^, "^OS^ ( Plan Ck. Deposit Date «-//<^f t^ SWPP JOBADDRESS SUITE#/SPACE#/UNIT# CT/PROJECT# ^6 # BEDROOMS # BATHROOIVIS TENANT BUSINESS NAME CONSTR. TVPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) EXISTING USE PROPOSED USE f^oo\ GARAGE (Sl=) 35o PATIOS (SF) \ eo DECKS (SF) 75 FIREPLACE YES 5t #_i NOD AIR CONDITIONING YES i)l NO O FIRE SPRINKLERS YES • No)^ APPUCANT NAME (Primary Contact) APPLICANT NAME (Secondary Contact) ADDRESS CITYA. . I STATE ADDRESS STATE ZIP CITY STATE ZIP PHONE EMSIL . PHONE FAX EMAIL PROPERTY OWNER NAME TY OWNER NAIVIE \ V . CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY STATE CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LiC. # STATE LiC.# CLASS CITY BUS. LIC.# (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 doiiars ($500)). VVorkers' Compensation Declaration: / hereby affirm under penally of peifury one of fhe foiiowing declarations: ^ I have and will maintain a certificate of consent to self-insure for woricers' compensation as pmvided by Section 3700 of the Labor Code, for the perfomiance of the work tor which this permit is issued. • I have and will maintain iworkers' compensatian, as required by Section 3700 of the Labor Code, for the perfomiance of the work for which this permit is issued. My woricers' compensation insurance carrier and policy number are: Insurance Co. Policy No. , Expiration Date This section need not be completed ifthe pemiit is for one hundred dollars ($100) or less. O Certificate of Exemption: I certlly that in the performance of Ihe work for which this pennit is issued, I shall not employ any person in any manner so as to become subject to the Woriters' Compensatian Laws of California. WARNING: Failure to secure workers' compensatian 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. JS^ CONTRACTOR SIGNATURE •AGENT DATE OWNER-BUILDER OECLA R A TION / hereby affirm fhal / am exempf from Contractor's License Law for the foiiowing reason: • I, as owner of the property or my employees vflth 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 worit 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 «fill 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: 1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement • Yes • No 2.1 (have / have not) signed an application for a building pemilt for the proposed worit. 3.1 have contracted with the following person (firm) to provide the proposed construction (Include name address / phone / contractors' license number): 4.1 plan to provide portions of the work, but I have hired the following person to coordinate, supen/ise and provide the major worit (include name / address / phone / contractors' license number): 5.1 will provide some of 6^ worit, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of worit): •AGENT DATE I PROPERTY OWNER SIGNATURE CO mp fCTE T-H.l S-'S E.CT1 O'l"* ' FO.R-- H'&M'^nMS%.a%nYtM.t^''BUtl.'t) I N;©-P E R flfl I ts. ,o:*i 1.1 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? OYes ONo Is the applicant or future building occupant required to obtain a permit 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? • Yes • 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. C O MS T R iyiC TION LMNDlHiS A> I hereby affirm that there is a constmction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address APPLICANT CER T I F I C A T I O N I certif tliat I have lead the application and state that the above InfbimatiDn is conect and that the Infomiation on the plans Is accurate. I agree to comply with all Cily oidlnances and State laws relating to building constmction. I hereby authorize representative of the City of Cartsbad to enter upon the above mentioned property for inspectbn puiposes. 1 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 CFTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA pennit is required for excavattons over 5'0' deep and demolitton or constmctton of stmctures over 3 stories in height EXPIRATION: Every pennit issued by Ihe Buikiing Ofltoial under Ihe provistons of this Code shall expire by limitatton and become null and vokl if the buikiing or worit authorized by such pennit is not commenced within 180 days fiom the date of such pemiK or if the buiding or vrortt authorized by such pemiit is suspended or abandoned at any time after the wortt is commenced fbr a period of 180 days (Sectton 106.4.4 Unifonn Buikiing Code). ygfAPPLICANT'S SIGNATURE DATE Inspection List Permlt#: CB120598 Type: POOL WHITE RESIDENCE 646 SF POOUSPA //GAS TO FIREPIT & BB Date Inspection Item Inspector Act Comments 06/20/2012 59 Final Pool -Rl 06/20/2012 59 Final Pool PB AP 06/11/2012 55 Fence/Pre-Plaster -Rl 06/11/2012 55 Fence/Pre-Plaster PB AP 05/11/2012 51 Excav/Steel/Bonding/Fence PB AP 05/10/2012 23 Gas/Test/Repairs PB AP 05/10/2012 31 Underground/Conduit-Wirin PB AP Thursday, June 21, 2012 Page 1 of 1