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HomeMy WebLinkAbout2420 CAMINO VIDA ROBLE; ; CB140311; Permit02-10-2014 City of Carlsbad 1635 Faraday Av Carlsbad.CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No:CB140311 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC #: Project Title: 2420 CAMINO VIDA ROBLE CBAD PME Status: 2131101600 Lot#: 0 Applied: Entered By: Plan Approved: Issued: Inspect Area: JEHOVAHS WITNESS CHURCH ELECTRIC ONLY TO UP- LIGHT MONUMENT SIGN AT ENTRY. SIGN NOT OVER 6 ' HIGH ISSUED 02/10/2014 RMA 02/10/2014 02/10/2014 Applicant: Owner: PALOMAR CONGREGATION OF JEHOVAHS WITNESSES VISTA PALOMAR CONGREGATION OF JEHOVAHS WITNESSES VISTA ATTN: GARY HULBERT ATTN: GARY HULBERT P 0 BOX 130845 P 0 BOX 130845 CARLSBAD CA 92013 CARLSBAD CA 92013 760 518-0422 Plumbing Fees Electrical Fees Mecfianical Fees Other PME Fees $0.00 $158.00 $0.00 $0.00 TOTAL PERMIT FEES $158.00 Total Fees: $158.00 Total Payments To Date: $158 00 Balance Due: $0.00 Inspector: FINAL APPROV 7/2-^ Date: VAL . Clearance: NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively refen-ed 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 attacl<, 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 previously been given a NOTICE similar to this, or as to which the statute of limitations has previouslv othen/vise expired. THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMmSSUANCE: nPLANNING •ENGINEERING OBUILDING nPIRE OHEALTH nHAZMAT/APCD 40§> CITY OF CARLSBAD Building Permit Appiication 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: buiidingtgcarlsbadca.gov www.carlsbadca.gov Plan Check No. Est. Value Plan Ck. Deposit Date SWPPP JOB ADDRESS CT/PRWECT # I LOT # j PHASE # |# OF UNITS |#BEDI SUITE*/SPACE#/UNITl> 243- aZ>- -^D PHASE* I#OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: /nc/ude Square Feet of Affected Areafs) EXISTING USE )/).(> fV^l^ PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YES|~|# NO| I AIR CONDITIONING YES I I NO I I FIRE SPRINKLERS YES I |NO| I APPUCANTNAME (Primary Contact) APPUCANTNAME (Secondary Contact; ADDRESS ADDRESS STATE ZIP CITY STATE PHONE FAX PHONE FAX PROPERTY OWNER NAME , . ^ li^f fl i- "To. 1^^ is^wr t<d^69^r-^ CITY , STATE ZIP CITY CONTRACTOR BUS. NAME STATE 4^ STATE ZIP PHONE , EMAIL ' FAX PHONE FAX EMAIL CITY BUS. LIC.# (Sec. 7031.5 Business and Professions Code: Any City or County wtiich requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicantfor such permit to file a signed statement that he is licensed pursuantto the provisions ofthe Contractor's License Lawichapter 9, commendingwlth Section 7000 of Division 3 ofthe 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 applicantfor a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)). Woriiers' Compensation Oec\iri6ot\: I hereby affimi under penalty ofpetjutyone of the following declarations: • 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 perfonnance of the work for which this pemiit is issued. • I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, forthe perfonnance of the work for which this permit is issued. My workers' compensation insurance canier and policy number are: Insurance Co._ PolicyNo.. Expiration Date _ This section need not be completed if the permit is for one hundred dollars ($100) or less. I I Certificate of Exemption: I certify that in the perfonnance of the work for which this pennit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Califomia. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred tiiousand dollars (&100,000), in addition to the cost ot compensation, damages as provided for In Section 3706 of the Labor code. Interest and attomey's fees. CONTRACTOR SIGNATURE • AGENT DATE / hfreby affinn that I am exempt from Contractor's Ucense Law for the following reason: I, as owner of the property or my employees with wages as their sole compensation, will do the work and the stmcture is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner ot 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 constmct the praject (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 pjgonally plan to provide the major labor and materials for construction of the proposed property improvement HylYes I INO 2. Iflhava/ have not) signed an application for a building pennit for the proposed work. ' ^ 3.1 have contracted with the following person (firm) to provide the proposed constmction (include name address / phone / contractors' license number): 4.1 plan to provide portions of the wort(, but I have hired the following person fo coordinate, supen/ise and provide the major work (include name / address / phone / contractors' license number): 5.1 will provide some of the work, bul I have contracted (hired) the following persons lo provide the work indicated (include name / address / phone / type of work): PROPERTY OWNER SIGNATURE _0 AGENT DATE FOR MON Is the applicant or future building occupant required to submit a business plan, xutely 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 constnicted 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. CONSTRUCTION I, E 1 hereby affirm that there is a construction lending agency for the perfomnance of the wo* this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address ,|P, I, I C A N. T C e R TI ,F I CATI OU I certity that I have lead the application and state thatthe above intbimation is conectand that the Infonnation on the plans is accurate. I agiee to comply with all City ordinances and State lavs relating to building constniction. I hereby authorize representatlvB ofthe City of Carisbad to enter upon the above menttoned property fbr inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND l€EP HARIVILESS THE CITY OF CARLSBAD AGAINST Aa UABILmES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMfF. OSHA: An OSHA pemnit is required fbr excavations over 5'0' deep and demolition or constmction of stmctures over 3 stories in height, EXPIRATION: Every pemiit Issued by the Building Ofiicial under the provisions of this (Me shall expire by limitation and become null and void If the building or wori< aulhorized by such pemiit is not commenced within 180 days from the date of such pernilt or jf^ building or vnri< auttjjilzed by such peripj( Is suspended or abandoned at any tme afterthe vwrk is commenced for a pertod of 180 days (Section 106.4,4 Unifbmi Building (Dode), ygS"APPLICANT'S SIGNATURE DATE STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. Fax (760) 602-8560, Email buildinq(5)carlsbadca.q0V or Mail the completed form to City of Carisbad, Building Division 1635 Faraday Avenue, Carisbad, Califomia 92008. C0#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE CITY STATE ZIP Carlsbad CA PHONE OCCUPANT'S BUS. LIC. No. DEUVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAILTO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAIL / FAX TO OTHER: ASSOCIATED CB#- NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION JSSAPPLICANT'S SIGNATURE DATE Inspection List Permit*: CB140311 Type: PME JEHOVAHS WITNESS CHURCH ELECTRIC ONLY TO UP- LIGHT MONUME Date Inspection Item Inspector Act Comments 07/18/2014 89 Final Combo PY AP Monday, July 21, 2014 Page 1 of 1 PROPERTYOWNER APPLICANtV««,^ :^ ^ , NAME <PRINTORTYPE) NAME (PRINT OR TYPE) MAILING ADDRESS MAILING ADDRESS 17* HILL. T^^p CITY STATE ZIP TELEPHONE CITY STATE ZIP TELEPHONE 1 CERTIFY THAT 1 AM THE LEGAL OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. \ CERTIFY THAT 1 AM THE REPRESENTATIVE OF THE LEGAL OWNER AND THAT ALL THE ABOVE INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. SIGNATURE DATE /SIGNATURE / / / DATE / PLANNER CHECK LIST 1. 2. 3. 4. 5. 6. Field checl< by planner. Within maximum length, area. Style consistent with Sign Program and/or Specific Plan criteria, if applicable. Location: In right-of-way *V In visibility triangle at comer Pole and monument signs to be checked by Transportation Engineering, for visibility issues. When approved route copy to Data Entry /ffl^ Date: \^^'^^ APPROVED: Planner: p-11 Page 4 of 4 Rev. 10/13 r Crrtlficste eX ComplUace (Sieii Liehtiaj;) (PiiSelrf*) SLTG-1C i>».< n/OEi'is ?n«oiA*bni CAMINOVIDARaBi.ECAfCf»An rhur of S«r('aaanK(Mn ln<r«- ^ifM • AnmUaBii I'rarart'WinB^Ln-'ttnl ffttm-1*.B«B^I OBrptojtfc i ifttmyttumtti^ This Qnificate of CMaplwn^e ncjudetthe foilo«'ne con^Nincra fchecli aU ttis: tfr'V^ ^IhlMMlMnryMenBnstlJEti'oncC'aHinli) ^Mmimuni Ail-nmHiihimi! Prmf • specifir Lr^iiif Sonnsek 1. CertUicatr of C«n^ia»cc I>eci*rado« Statement iHtis au? t>ci cm. cxi orctuiSb rcmi i I CMtiiy iffidiff pontty ol pct^y. kouet to IHMI i of'riK Maic oi' C^ltltmia, lti<: mloniuOiun pt<ivKloJ uu ihu lurm is wte aiul I HI difiUr awlix' Di vMion j of Ihe Califann BtwucB anf ProfisMKiiw Cock ts tc^m tnstxHKihili^- fcr tfie tiflitir.^ dwipr. Tbw Ccnificar; iTrCMnfAncc kientifie« ihc li|Mne mnuick and pertonincc ipccifKUiuni. nrmmd tm camp^wm w>th liUc24,Pmi I ard bpT'thcCuLfwmiCadecrfReft^Kmv TW dcaifcii Keatnch rviBevnueit on HinCxililutc nfCMoiiluiiKaiv uaiMiar wi'Ji Hw iufoniwHiiin'ridedhi dncwnKM ftH desyn on the other iHi|<(K»ble cimtpiuacc fomh. wcrUliuUs. oelrviatiuK pfaa- and <^ifiui:iiiM t^Tiae^ in L'U: ra&fcnnriit iceBrv for appnnrtt witfc thu tnuioing pennit asnltcanoD. AAfctw: 15^'^ Cit ftMr \Ssii iMUMatioa DvcUratiM sUlenacBl • L tedity nnda powSty nt>eniaiy, Kuln-tlit: lawn, uf ihc SIHU ofCaUhiini^ die mfcinHtkn pruvHlnl tni tiiis km iMiiis an.1 eumxL • I air. cUfMe tuakr Division 3 of the budans oitd frofcasMMs Code k< aeoqX Kspons^ilKv* for muttuecon. o( an ratbonzcd icfiKwrarivc nf the pcrwa iMpowihte fnr erartnioian •pptk-attle Goiki Bfld rcfMktKmx, ana ctw vwnHatim i> coawtleni wiib ibe plm am tperificMkiw nvovol ti>' the «MtD>Mm.tH aiiirK;y. • 1 certify that the ic^uirrmniiRdctiikti on thii ixnifiMicorCamplunKi; have • l»ii;ctMiirT'4ial r nimpjuil. Nfncd copy u'ifais ItiflalhKion Omi(K3Kc Khc huildwy owner at «cupBiKy. ^ ^ , Pam'lSlFnuiHr CERTIFICATE OF COMPLIANCE, SIGN LIGHTING CtrHfltmu of COMPIUBCC (Slen Lishttne) (Pxee3or4) SLTG-IC iuMUxM»Mu-cw>E!iLAiUi.caiaiwn; 4.MnlMiiin Allnwed licUiiiePvwt'rMHIuMl af OHBiri anci' Ctx^amt •fCemplkmet and FtddlM^MtimEMrc CbccUiM C'ianpt=tc thx fmn if thm mt mgm wtttj ihc oMtMnnn IgW"!!"**' "^^I Bfoowptx^i*. (Con of thu Cif-^natc of ComnliaQoe if lhar arc aiOH aairti the bpcvifit Uittaitnit wurxi IMWWI of CM|ili«ti.T A B r I) : H 1 e • 11—F-Y,'K f 1 El! ?H A: ^ 111 !( — IN i £ B ' ? I'll O ! u Sigi. DcNcfiptiofi SHSNUOfTimS o • « B F • • D i C n » Aa Baton daviiMuM wf lb( MU. 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(j AM-aned iccaalwii to UC •txiiw.oiSliCid.'ir 1 '. rhupafcdovbcTbs aeic JtfrKOMtattkjiv CERTIFICATE OF COMPLIANCE, SIGN UGHTWG Certifkite ef Compliance (Sieii Liehtiasl (Pue 2 of 4> SLTG-IC l*ri9f« >.aaK K/MGOOtit r¥iJ. • CMLSOAC, CA Kn^U 3. 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STYLE: DUNN EDWARDS #DEC756 WEATHERED BROWN. LETTERING SIZES (TYP EA. LANGUAGE): LINE 1: 5" LETTERS W/6-INITIAL CAP LINE 2: 3" LETTERS LINE 3: 4" LETTERS W/5" INITIAL CAP 4. (N/A) 5. (N/A) e. MONUMENT UGHTING - HAOCO #WA2+I-F232CW-E (2-32w T8=56w) 7. EXISTING ELECTRICAL PULLBOX 8. EXISTING ELECTRICAL LIGHTING PANEL 9. PROVIDE 3/4- PVC CONDUIT WITH 2#1D, 1#10 GND (A-23). BURY 24'' BELOW GRADE 10. EXISTING CONDUIT BURIED 24- BELOW GRADE 11 -PERMA-POSr JUNCTION CONDUIT. 12. CONCRETE FOOTING B" ROUND x 12" DEEP 01/01/2013 12/27/2013 N UJ m LU ?o Oi (O 7 o I «^ < o 111 . CC CO in < < X IS o o CD z Q < m CO - < O I 111 _J CQ O O) ^§ < CM Q 05 >< OO 5< < m ow O ty S o m 1- co < 1- o UJ h- S s X z o LU UJ OL X m < UJ 5 ^ CO < O DATE: 02/25/2013 DRAWN BY: RBC SCALE: AS NOTED A1.7 C^/VO 3/J