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2229 CORTE ANANAS; ; CB100486; Permit
04-06-2010 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Pool Permit Permit No: CB100486 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: PC#: Project Title: 2229 CORTE ANANAS CBAD POOL 2552614100 Lot#: 0 $21,394.00 Construction Type: NEW PRZESMICKI RES-563 SF POOL/SPA Status: ISSUED Applied: 03/19/2010 Entered By: LSM Plan Approved: 04/06/2010 Issued: 04/06/2010 Inspect Area: Applicant: MISSION POOLS OF ESCONDIDO INC 755 W GRAND AVENUE ESCONDIDO, CA 92025 619-743-2605 Owner: PRZESMICKI STEVEN M 2229 CORTE ANANAS CARLSBAD CA 92009 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Electrical Fee Plumbing Fee Strong Motion Fee Green Bldg Standards (SB1473) Fee Renewal Fee Add'l Renewal Fee Other Building Fee Additional Fees $227.01 $0.00 $147.56 $0.00 $20.00 $27.00 $2.14 $1.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $424.71 Total Fees:$424.71 Total Payments To Date:$424.71 Balance Due:$0.00 BUILDING PLANS 4L IN STORAGE —L ATTACHED Inspector: FINAL/APPROVAL Date: S^'lO Clearance: NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, 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 the:r 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 you have P'eviouslv been given a NOTICE similar to this, or as lo which Ihe statute of limitations has previously otherwise expired. 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717/2718/2719 Fax: 760-602-8558 Permit Application Plan Check No. Est. Value ZJ Plan Ck. Deposit iilPTIOf! OF WpftK: (Please describe present use and prop (Sec y'jji.j liusincss 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 istaiffid praant a> llie 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 oficcuoii /Oil.i ay any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500}). JiJOs'ker:,' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: avii oiid 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. iave 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 workers' compensation insurance carrier and policy . _ Policy No., "i I lie, section need not be completed if the permit is for one hundred dollars ($100) or less. D Oeiiweate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of (.vJiicrnioi. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (£100,000), in li>, ' o't c', compensation damages y, provided for in Section 3706 of the Labor code, interest and attorney's fees / j .C/COIHRACTORSIGNATURE ftt'^/ffiS^f <l^^T) 1^1^ . DATE £> 1/1$I/O / /;,-•/ .:!/)i' dir/ffi/ f/kif / am exempt from Contractor's License Law tor the following reason: U I, ao owner of ilio properly 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, I luwever, 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). ill I, ai; 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 properly who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). & 1 am exornpt 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. O Yes D No -. I (I lavs / hcive not) signed an application for a building permit for the proposed work. '.'• I iiave contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): •••'.: I plan io provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone / contractors' license number): ':•. i will provide nome of the work, bul I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): ,,u PROPERTY OWNER SIGNATURE DATE Is ilie 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? d Yes D No Is ill's applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? d Yes d No i- Hie facility io be constructed within 1,000 feet of the outer boundary of a school site? d Yes a No if- AMY OF THE ANSWERS ARE YES, t EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. isreby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Loncler'o Name Lender's Address ' ''4\J 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 I hereby authorize representative of the City 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. 03HA: 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 ) uO flays irom ilie 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 commenced for a period of 180 days (Section 106.4.4 Uniform Building .':., APPLICAMT'S SIGNATURE DATE J City of Carlsbad Bldg Inspection Request For: 08/24/2010 Permit* CB100486 Title: PRZESMICKI RES-563 SF POOL/SPA Description: Inspector Assignment: PD 2229 CORTE ANANAS Lot: 0 Type: POOL Sub Type: Job Address: Suite: Location: OWNER PRZESMICKI STEVEN M Owner: PRZESMICKI STEVEN M Remarks: Phone: 7607432605X234 Inspector Total Time: CD Description 59 Final Pool Requested By: MICHELE Entered By: JANEAN Act „ Comments Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description 08/06/2010 59 Final Pool 07/15/2010 06/23/2010 05/21/2010 55 Fence/Pre-Plaster 51 Excav/Steel/Bonding/Fence 23 Gas/Test/Repairs 05/18/2010 23 Gas/Test/Repairs 05/18/2010 31 Underground/Conduit-Wiring 05/06/2010 51 Excav/Steel/Bonding/Fence Act Insp Comments CO PD ON CARD AP PD AP PD DECK BONDING AP MC 1 1/4 " GAS LINE, METER THROUGH GARAGE TO ENRTY WAY AREA ONLY AP PD AP PD AP PD City of Carlsbad Public Works — Engineering BUILDING PLANCHECK CHECKLIST POOLS BUILDING PLANCHECK NUMBER: CB /Q BUILDING ADDRESS: PROJECT DESCRIPTION: Pool ASSESSOR'S PARCEL NUMBER:cGAJ/o 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 fSvl^w carefully all comments attached, as failure to comply with instructions in this report can result ir»us/ensjon of permit to build. By:Date 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: KATHLEEN LAWRENCE City of Carlsbad ADDRESS: 1635 Faraday Avenue Carlsbad, CA 92009 PHONE: (760) 602-2741 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (76O) 6O2-272O • FAX (760) 6O2-8562 A STV 2ND^ 3RD/ Q Q Q 5c. A Grading Permit has been applied for: PE2 DWG Grading Inspector sign off by: Date: Q 5d. No Grading Permit required. MISCELLANEOUS PERMITS Q 6. A RIGHT-OF-WAY PERMIT is required to do work in City Right-of-Way and/or private work adjacent tot he 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 / o Page 3 of 3 PLANNING/ENGINEERING APPROVALS PERMIT NUMBER CB 10-0486 DATE 3/19/10 ADDRESS 2229 Corte Ananas RESIDENTIAL ADDITION- MINOR (< 17,000.00) RETAINING WALL VILLAGE FAIRE POOL/SPA TENANT IMPROVEMENT COMPLETE OFFICE BUILDING OTHER POOL, SPA PLANNER Chris Sexton ENGINEER DATE 3/19/10 DATE IHADMINlffll'NTER/PLANNING/EVCINEERlNCAPPROVAlS ^— • .. Client*: 9923 3M1SSPOO1 XCORDw CERTIFICATE OF LIABI PRODUCER Willis Ins Services of CA, Inc 4250 Executive Sq. Suite - 250 La Jolla, CA 92037 858 535-1800 INSURED (Mission Pools of Escondido, Inc. 755 West Grand Avenue Escondido, CA 92025-9990 LITY INSURANCE SSST™ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4 HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE A _^ ^ INSURER* Praetorian Insurance Company JT I /fit INSURER B: Everest National [}( INSURER c: Nationwide Mutual Insurance Co. ^^ INSURER D: INSURER E: MMC# 22292 JKH20 r23787 COVERAGES MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR A C B VDD I NSRC TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY ^J CLAIMS MADE [ x| OCCUR X BI/PD Ded:2,500 GENX AGGREGATE LIMIT APPLIES PER: ~~1 POLICY |~X1 JECrf FlLOC AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS X NON-OWNED AUTOS X Drive Other Car GARAGE LIABILITY ANY AUTO EXCESa/U MBRELLA LIABILITY | OCCUR | | CLAIMS MADE BDEDUCTIBLE RETENTION * WORKERS COMPENSATION AND EMPLOYERS1 LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? If yea. describe underSPECIAL PROVISIONS betow OTHER POLICY NUMBER H01000050402 ACPBA7823469047 7600005127101 POLICY EFFECTIVEDATE (MM/DO/YY) 04/01/10 04/01/10 04/05/10 POLICY EXPIRATIONDATE (MM/DD/YY) 04/01/11 04/01/11 04/05/11 UMTS EACH OCCURRENCE DAMAGE TO RENTEDPREMISES if=f r-^irreroel MED EXP (Any one parson) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGO COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY(Per pereon) BODILY INJURY(Per accident) PROPERTY DAMAGE(Par accident) AUTO ONLY - EA ACCIDENT OTTAU1 4ER THAN ^ AGC FO ONLY: . __AGG EACH OCCURRENCE AGGREGATE X E.L. E.L. E.L. WCSTATU- I lOTO-TORY LIMITS I I ER EACH ACCIDENT DISEASE -EA EMPLOYEE DISEASE - POLICY LIMIT $1. 000.000 $400.000 $5.000 $1. 000.000 $2.000,000 $2.000,000 $1,000,000 $ $ $ $ $ $ $ $ $ $ $ {1,000,000 $1,000,000 d.000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES / EXCLUSIONS A0DED BY ENDORSEMENT /SPECIAL PROVISIONS The Certificate Holder is named as additional insured per attached form CG201 0 07/04 but only for ongoing swimming pool, spa and/or water feature operations for The City of Carlsbad performed by or on behalf of the named insured. ***10 DAY NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM CERTIFICATE HOLDER CANCELLATION City of Carlsbad 1 635 Faraday Ave Carlsbad, CA 92008 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAC _j!3a DAYS WRITTEN NOTICE TO THE CERTlFICAre HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR UABIUTY OF ANY KIND UPON THE INSURER, fTS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Jb*Stti*M*} ACORD 25 (2001/08) 1 Of2 #S637507/M637496 3LDEL © ACORD CORPORATION 1988