HomeMy WebLinkAbout2565 DOGWOOD RD; ; CB062478; Permit09-20-2'006
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Pool Permit Permit No CB062478
Building Inspection Request Line (760) 602-2725
Job Address
Permit Type
Parcel No
Valuation
Reference #
Project Title
2565 DOGWOOD RD CBAD
POOL
2131701400 Lot# 0
$1 900 00 Construction Type NEW
SLATERRY RES- 50 SF SPA
Status ISSUED
Applied 08/29/2006
LSM
09/20/2006
09/20/2006
Entered By
Plan Approved
Issued
Inspect Area
Applicant
RQL DESIGNS
2201 HALLADAY ST
SANTA ANA 92707
7147853323
Owner
MELLOR FAMILY TRUST 10-28-99
2565 DOGWOOD RD
CARLSBAD CA 92009
Building Permit
Add'l Building Permit Fee
Plan Check
Add'l Plan Check Fee
Electrical Fee
Plumbing Fee
Strong Motion Fee
Renewal Fee
Add'l Renewal Fee
Other Building Fee
Additional Fees
$3645
$000
$2369
$000
$2000
$2700
$1 00
$000
$000
$000
$000
TOTAL PERMIT FEES $108 14
Total Fees $108 14 Total Payments To Date $108 14 Balance Due $000
DING PLANS
N STORAGE
ATTACHED
Inspector
FIN
Date 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 mu t
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
fees/exactions of which vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired
09-20-2006
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Right of Way Permit Permit No RW060344
Job Address
Permit Type
Parcel No
Start Date
Insurance Expire
Liability Insurance
Reference*
Location
Project Title
Description
2565 DOGWOOD RD CBAD
ROW
2131701400
09/30/2006
Y
Subtype
Lot#
Est Complete Date
Traffic Control Plan
GOP
SLATERRY RESIDENCE
SPA
Applicant
RGL DESIGN AND CONSTRUCTION
202 WOODLAND PARKWAY #116
SAN MARCOS CA 92069
760-591-4235
MINOR
350
Status ISSUED
Applied 09/13/2006
09/20/2006Issued
Expired 09/30/2006
Entered By LO
Total Fees $300 00 Total Payments To Date $300 00 Balance Due $000
Permit Fee
Additional Permit Fee
Other
Additional Fees
TOTAL PERMIT FEES
$300 00
$000
$000
$000
$300 00
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
IF ANY EXCAVATION OR BORING IS DONE
THIS PERMIT IS INVALID WITHOUT THIS NUMBER
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave , Carlsbad, CA 92008
"PROJECT INFORMAT ION"
PERMITS $23 69
PLAN CHECK NO
33
EST VAL
Plan Ck Deposit
Validated By
Date
g.Q
iPA-
Address (include Bldg/Suite #)Business Name (at this address)
Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units
Assessor s Parcel ft Existing Use Proposed Use
Description of Work SO FT #of Stories # of Bedrooms # of Bathrooms
2 CONTACT PERSON (if different from applicant)
Name
APPLICANT .-ID "Contractor
Address
Q Agent 'for Contractor31^
" * City
DjAgent f oriOwiner
State/Zip Telephone Fax #
Name
4;]i*;;-eB.6PERf Y OWNER
Address City State/Zip Telephone #
u X-
fe
Name Address State/Zip Telephone*
5f; CONTRACTOR COMPANY NAME: " ..'" •«• • :ig
(Sec 7031 5 Business and Professions Code Any City or County which requires a permit to construct alter improve demolish or repair any strui ture 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 Codel or that he is exempt therefrom and the basi 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 dollars [$500])
f_Q (_ c-\e.s\ nv> t Ct>r>o"T- z. 2O( •& /fallac]^ ssr~ 5~»/iOTZ* /^na d& ^>g.o fe
Name
State License #^
«Z3i
Address
License Class
2-Z-Ol £>
City State/Zip
City Business License #
Telephone #
J^'S"
Address City State/Zip TelephoneDesigner Name
State License # (g
Sj; WORKERS COMPENSATION
Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations
Q 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
l~l 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 Mv worker s compensation insurance carrier and policy number are *-- ./
ill jii^CCInsurance Company IQ VSOQl^CMCi-o^ Policy No OCKT i X error il^yV tvOUl * Expiration Date *~*rP 5O i tQO £
Vth
V^s
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS)
l~l 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 additioryto th4 cost of compensation damages as provided for in Section 3706 of the Labor code interest and attorney s fees
IGNATURE C^yC^I DATE Sfp ZQ I Z.C&(b
sTl; OWNERJBUiLDEF[pECLARAT)ON :,Ui:! ..JiEf •-""" ,. .7" !..;.£! : 721.. ,.'. . ^i../. :i,. . fe.»...: .,.:!...„
I hereby affirm that I am exempt from the Contractor s License Law for the following reason
n 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 01 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)
n I as owner of the property am exclusively contracting with licensed contractors to construct the project (Sec 7044 Business and Profes ions Code The
Contractors License Law does not apply to an owner of property who builds or improves thereon and contracts for such projects with contiactor(s) licensed
pursuant to the Contractor s License Law)
0 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 QNO
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 / contractois license number)
4 I 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)
5 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)
PROPERTY OWNER SIGNATURE DATE
!^
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? C] YES Q NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? l~l YES l~) NO
Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? l~| YES l~l 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
V CONSTHUCTIOJN LENDING AGENCY . '™i7^? """" .« " JE:I ; ^C ,* ••' ]mi
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)
LENDER S NAME LENDER S ADDRESS
I9"a APPLICANT CERTIFICATION : :. • :;* 7,. '" :%„'%.., •', "'
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 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
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 commenced for a period of 180 days (Section 106 4 4 Uniform Building Code)
APPLICANT S SIGNATURE DATE
WHITE File YELLOW Applicant PINK Finance
Inspection List
Permit* CB062478 Type POOL SLATERRY RES- 50 SF SPA
Date Inspection Item
07/30/2007 59 Final Pool
03/09/2007 53 Electric/Conduit/Winng
03/09/2007 55 Fence/Pre-Plaster
03/06/2007 53 Electnc/Conduit/Winng
Inspector Act
PC Fl
PC WC
PC AP
PC CO
Comments
02/12/200759 Final Pool PC CO
02/12/200792 Compliance Investigation PC AP
09/27/2006 23 Gas/Test/Repairs PC AP
09/27/2006 51 Excav/Steel/Bondmg/Fence PC CO
09/27/2006 52 Underground Plumbing PC AP
09/27/2006 53 Electric/Conduit/Wiring PC AP
PERM GATE TO OPEN OUT BY FINAL
1 )ground wire @ light 2) water in elect
panel 3) gate opens in
NO PRE PLASTER APPROVED
1)INSTALL FENCE/GATE 2) INSTALL
BOND
Monday July 30 2007 Page 1 of 1
City of Carlsbad Bldg Inspection Request
For 03/09/2007
Permit* CB062478
Title SLATERRY RES- 50 SF SPA
Description
Inspector Assignment PC
2565 DOGWOOD RD
Lot
Type POOL Sub Type
Job Address
Suite
Location
OWNER MELLOR FAMILY TRUST 10-28-99
Owner MELLOR FAMILY TRUST 10-28-99
Remarks UNSURE OF WHAT IS NEEDED
Phone 7606449561 OR 51
Inspector
Total Time Requested By ALBERTO
Entered By CHRISTINE
CD Description
53 Electric/Conduit/Wiring
Act Comment
(JJC
Comments/Notices/Holds
Associated PCRs/CVs Original PC#
Inspection History
Date Description
03/06/2007 53 Electric/Conduit/Wiring
02/12/2007 59 Final Pool
02/12/2007 92 Compliance Investigation
09/27/2006 23 Gas/Test/Repairs
09/27/2006 51 Excav/Steel/Bondmg/Fence
09/27/2006 52 Underground Plumbing
09/27/2006 53 Electric/Conduit/Winng
Act Insp Comments
CO PC 1)ground wire @ light 2) water in elect panel 3) gate opens in
CO PC NO PRE PLASTER APPROVED
AP PC
AP PC
CO PC 1)INSTALL FENCE/GATE 2) INSTALL BOND
AP PC
AP PC
City of Carlsbad
Public Works — Engineering
BUILDING PLANCHECK CHECKLIST
POOLS
BUILDING PLANCHECK NUMBER CB
BUILDING ADDRESS £565 BQ^/\[QQb
PROJECT DESCRIPTION Pool
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 comply with instructions in this report can
result m^fcySp^nsion of permit to build
I^FMIAI
Please seethe attaemed report of deficiencies
marked with LT/^Make necessary corrections to
plans at-—speafications for compliance with
applicable codes and standards Submit corrected
plans and/or specifications to this office for review
ATTACHMENTS ENGINEERING DEPT CONTACT PERSON
Grading Permit Application
Grading Permit Checklist
Right-of-Way Permit Application
Right-of-Way Permit Submittal
Checklist and Information Sheet
NAME Linda Ontiveros
City of Carlsbad
ADDRESS 1635 Faraday Avenue
Carlsbad, CA 92008
PHONE (760) 602-2773
C \Save stuff heraBUILDING PLANCHECK CKLIST FORM POOLS doc
1635 Faraday Avenue • Carlsbad, CA 92OO8-7314 • (760) 6O2-272O • FAX (76O) 602-8562
Q Q
Q Q
Q Q
RD/
Q
BUILDING PLANCHECK CHECKLIST - POOLS
SITE PLAN
1 Pro\lHe a Jully dimensioned site plan draw
h Arrow
isting & Proposed Structures
Shqy/ on site plan
amage Patterns
xistmg & Proposed Slopes
Existing Topography
operty Lines
asements
jidicate 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
Retaining Wall Permit CB Applied for Approved
3 Include on title sheet
ite Address
Assessor's Parcel Number
C Legal Description
D Grading Quantities Cut Fill Import/Export
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
GRADING PERMIT REQUIREMENTS
Date
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 2 of 3
C \Save stuff nereNBUlLDING PLANCHECK CKLIST FORM POOLS floe
1
Q
STV QiMI
Q
3
Q
RD/
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
lease complete attached Right-of-Way application form and return to the
Department together with the requirements on the attached Right-
heckhst, at the time of resubmittal
Permit and Pool Building Permit will be issued simultaneously
Page 3 of 3
C \Save stuff here\BUILD!NG PLANCHECK CKUST FORM POOLS doc
PLANNING/ENGINEERING APPROVALS
PERMIT NUMBER
ADDRESS u
RESIDENTIAL
RESIDENTIAL ADDITION MINOR
« $10,000.00)
TENANT IMPROVEMENT
PLAZA CAMINO REAL
CARLSBAD COMPANY STORES
VILLAGE FAIRE
COMPLETE OFFICE BUILDING
OTHER
PLANNE DATE
ENGINEER DATE
Docs/Mtsforms/Plannmg Engineering Approvals
BOUOOOOB
CERTIFICATE OF LIABILITY INSURANCE 09/20/2006
Pho«ei (819)260-0660Contractors First Ihsurance Services, Inc
1419 North San Fernando Bhsd Suite 210
Burbank, CA 91*U
License*. OE61983
INSURED
RGt Design and Construction
202 Woodland Parkway #116
San Marcos, CA 9^069
THIS CCRTIF1CATE 13 ISSUED A3 A MUTTER OP INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIEB BELOW
INSURERS AFFORDING COVERAGE
Burlington Insurance Co
INSURER e Virginia Surety Company,
INSURER C
Inc.
INSURER 0-
INSURER 6,
^ranr
COVERAGES
i CSRTIFH
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED
ANY REQUIREMEMT TESM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
POLICIES AGGREGATE LIMITS SHOfoM MAY HAVE BEEN REDUCED BY PAID CLAIMSi_L-'alJL-l-1 ' •"•"• " ...•—.^—^ L.. „, r __^^ • i> >• — i __.-.^ia'Ti
NOTWITHSTANDINGGATE MAY BE ISSUED OR
EXCLUSIO JS AND CONDITIONS OF SUCH
GENERAL LIABILITY
CLAIMS MADE [Xj 06
POLICY NUMBER
539B002134
:CUR
GEN L AGGREGATE IJMIT APPLIES PER:
JTl POLICY I ISS^ n^o
AUTOMOBILE LIABILITY
ANY AUTO
SCHEDUIJSD AUTOS
HIRED AUTOS
NON-OWNEOAUTOS
GARAGE UABIUTY
I ANY AUTO
09/30/2005
LIMTTS
09/30/2009 EACH OCCURRENCE
MED6XP(Any<
PERSONAL » fO INJURY
PSOOJCTS COUP/OP MK?
COMBINED SINO E LIMIT
1.000.000
UJ!PiQOO_
5 5.000
1.000.000
1.000.000
Included
BOO LY INJURY
(P»r acooerej
i PROP6RTYOAM.(Per OE
AUTO ONLY 6« «XJIO|Mr
OTHER THAN
AUTO ONLY-
FA ACC
IOCCUR I | CLAIMS MKDE
EACH OCCURRE ICE
AOORBQAT6
B
OCDUCT1BLS
| RETENTION t
WORKERS COMPENSATION AND ( [\
eMPl0VEHS> LIABILITY \ I \
ANY PROPHIBTOIWAflTNeR«>«CUTiV(LlOFFlCER/MBUBFR 5WLUOE07 p-~^
b?IQ» [_
11/2006 03/01/2007
E L EACH ACCP Ml i 1.000.000
E L DieeACE E/1.000.000
E L. OlSEASe POUCY LIMIT s 1
WTH6R
I
OeSCWPTION Of OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS AOOCO BY ENDORSEJMNT (SPECIAL PROVT9tO«9
Ceitincale holdwr» ndnied Additional insured as respects to tne General Llaoiiity Policy
Endorsement Attached
•10 Day Notice of Cancellation in the Event of Non-payment of Premium
I
CERTIFICATE HOLDER CANCELLATION
City of Carlsbad '
1635 Faraday Avenue
Carlsbad, CA 92008
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE OAMCCUED BEFORE TUB EXPIRATION
DATE THEREOF THE ISSUING USURER WU ENOEAVI It TO HUM. 10 DAVIS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE Eft, HUT FAILURE TO DO SO SHALL
ITtON OR UABUTY Or ANY Mlf* PON THE W SUREB, ITS AOENTS OR
ACORD 25 (2001/08)SACOR
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