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HomeMy WebLinkAbout2843 CAMINO SERBAL; ; CB042959; Permit08-17-2004 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Pool Permit Permit No: CB042959 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 2843 CAMINO SERBAL CBAD POOL 2552812100 Lot#: $26,200.00 Construction Type: MENA RES- 800 SF GUNITE POOL & SPA 0 NEW Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 07/30/2004 KMT 08/17/2004 08/17/2004 9042 08/17/04 000? Applicant: ROCKWEST CUSTOM POOLS 26235 9TH ST 92009 909-314-4376 Owner: MENA II TRUST 11-13-00 2843 CAM»NO SERBAL CARLSBAD CA 92009 >£ 01 CGP 02 275.93 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 TOTAL PERMIT FEES $226.31 $0.00 $147.10 $0.00 $20.00 $27.00 $2.62 $0.00 $0.00 $0.00 $0.00 $423.03 Total Fees: $423.03 Total Payments To Date:$147.10 Balance Due:$275.93 Inspector: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 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 you have Dreviouslv been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 t. PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated By. Date fYTVTtft/ftA flfiAO A-l Address (include Bldg/Suite #)Business Name (apttis address r:»147-10 Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total # of units Assessor's Parcel #Existing Use Proposed Use Description of Work //V<£>&~0< 2. CONTACT PERSON t» drfferant from api SQ. FT.#of Stories # of Bedrooms # of Bathrooms Name 3,^Contractor Address City for Contractor Q Owner Q Agent for Owner State/Zip Telephone Fax* Name Address City State/Zip Telephone # Name ' ' Address City State/Zip Telephone tt 6. CONTRACTOR ^COMPANY NAME (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 oJLSection 7031.5/hy any applicant fora permit subjects, the applicant to, a civil.penalty of not moj^than fjye hundred dollars [$500]). Name Address ^ State License # l5"~5~7 ~? O 2. License Class &*£ <^A-*n&~ Designer Name . Address State License # A-S/A City State/Zip Jelephone # ' »_P City Business License # & fif Oj QtfJ f 7f) A // // f f $~ ' City State/Zip Telephone «. WORKERS'COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: •H 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. D 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 S> / ft"* 22^ ^—<-SA*t^ Policy No. s~77&£> '£- "~ ^£*Qj~ Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) Q 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 7< OWNER-BUILDER DECLARATION ._.._...,. I hereby affirm that I am exempt from the Contractor's License Law for the following reason: l~l 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). l~l 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). C] 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. Q 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 / contractors 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? Q 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? Q YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES Q 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. «t. CONSTRUCTION LENDING AGENCY «~; I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(0 Civil Code). LENDER'S NAME LENDER'S ADDRESS 9. APPLICANT CERTIFICATION -' ... , , ,.--.,.-•-;-', ', 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 corgpiencetpwithin 180 days from tha date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work isjwnTfnencgd-for a period o^i8a4ay^BBCtl9rr'lji,6.4.4 unrfofm Building Code). APPLICANT'S SIGNATQBE DATE WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 10/19/2004 Permit* CB042959 Title: MENA RES- 800 SF GUNITE POOL & Description: SPA Inspector Assignment: JM 2843 CAMINO SERBAL Lot 0 Type: POOL Sub Type: Job Address: Suite: Location: OWNER MENA II TRUST 11-13-00 Owner: MENA II TRUST 11-13-00 Remarks: Phone: 9493103093 Inspector: Total Time: CD Description 59 Final Pool Requested By: ROCKY Entered By: CHRISTINE Comment Date 10/13/2004 09/10/2004 09/10/2004 09/10/2004 09/10/2004 Associated PCRs/CVs Inspection History Description Act Insp Comments 55 Fence/Pre-Plaster 23 Gas/Test/Repairs 51 Excav/Steel/Bonding/Fence 52 Underground Plumbing 53 Electric/Conduit/Wiring AP JM OK TO PLASTER ALARMS OK AP JM EQUIP/BBQ AP JM OK TO GUNITE (2) LIGHTS, DIVE, EQUIP AP JM PA JM City of Carlsbad Public Works - Engineering BUILDING PLANCHECK CHECKLIST POOLS BUILDING PLANCHECK NUMBER: C&&4' BUILDING ADDRESS:CAAAiNJO 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 in suspension of permit to build. Date: DENIAL Please see^ne^ettached report of deficiencies marked witty D. JMake necessary corrections to plans or ^pacifications for compliance with applicable codes and standards. Submit corrected plans and/or specifications to this office for review. ATTACHMENTS Grading Permit Application Grading Permit Checklist Right-of-Way Permit Application Right-of-Way Permit Submittal Checklist and Information Sheet ENGINEERING DEPT. CONTACT PERSON NAME: Linda Ontiveros City of Carlsbad ADDRESS: 1635 Faraday Avenue Carlsbad, CA 92008 PHONE:(760) 602-2790 H.-\DtvriOf»wnt S«vlc««MSTERS\FORMS -\CHECKUSTS -\BUILDWG PLANCHECK OUST FORM - POOLS Joe 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (76O) 6O2-2720 • FAX (76O) 6O2-8562 D D D or LOT BUILDING PLANCHECK CHECKLIST - POOLS SITE PLAN 1. Provide a fully dimensioned site plan drawn to scale. Show: Arrow isting & Proposed Structures roperty LinedSUxnA^ &> r recAr d «r««i£ In Easements 2. Show on site plan: AM3rainage Patterns ( 0/%idicate what will happen with 18/Existing & Proposed Slopes ^--^soil excavated from pool area ©r Existing Topography Ef 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: ^Site Address sessor's Parcel Number '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 H:\Dwdopnwnt S«vfctlMlMSTERS\FORMS -CHECKLISTS -VULOMG PtANCHECKCKUSTFORM-POOLS.doc 2 ND"D D 5c. A Grading Permit has been applied for: PE2 DWG Grading Inspector sign off by: Date: D D 5d. No Grading Permit required. MISCELLANEOUS PERMITS D D 6. A RIGHT-OF-WAY PERMIT is required to do work in City Riaht-of-Wav 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:\0wdopmml S*vk»»\MASTERStFORMS -"CHECKLISTS -\BUUHNG FtANCHECK CKUST FORM - POOLS Joe PLANNING/ENGINEERING APPROVALS PERMIT NUMBER CB ADDRESS 2-3 DATE ^RESIDENTIAL ) ^^_^ -^ RESIDENTIAL ADDITION MINOR « $10,000.001 TENANT IMPROVEMENT PLAZA CAMINO REAL CARLSBAD COMPANY STORES VILLAGE FAIRE COMPLETE OFFICE BUILDING OTHER PLANNER DATE ENGINEER DATE Oocs/Misrorms/Plannino Engineering Approvals JCATE OF LIABILITY INSURANCE 202 »60-943-1970 OP ID JT ROCKW-1 DATE<MM/DD/YYYY) 07/21/04 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A: Neitclem Wholesale Insurance INSURER B: NAIC# INSURER C: INSURER D: INSURER E: CERTIFICATE HOLDE* City of,,,it's off*! , 1200 Ca**i yi,4 Carlsbad 1/08) 0 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING THER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR *IBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH »Y PAID CLAIMS. ;Y NUMBER POLICY EFFECTIVEDATE (MM/DD/YY) 06/07/04 POLICY EXPIRATIONDATE (MM/DD/YY) 06/07/05 1 I ! i LIMITS EACH OCCURRENCE UAMAUk 1 U KbN 1 tUPREMISES (Ea occurence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE(Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN EAACC AUTO ONLY: AQG EACH OCCURRENCE AGGREGATE WC STATU- : OTH-TORY LIMITS I ER E.L. EACH ACCIDENT EL DISEASE - EA EMPLOYEE $ 1,000,000 $300,000 s 10, 000 I 1,000,000 s 2, 000, 000 $2,000,000 $ s s $ $ $ $ $ $ $ $ $ $ $ EL. DISEASE - POLICY LIMIT $ S ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ditional insured. 11 be given for nonpayment of premium. CANCELLATION CITYCLB 1 *~^ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. /-) / AUTHORIZED REPRESENTATIVE/ / / / /] Brian M. Kai^e^ /r~V^^rJs7&[/\ 3RPORATION 1988 POLICYHOLDER COPY P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807 COMPENSATION INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 07-21-2004 CITY OF CARLSBAD DEPT OF BUILDING & SAFETY 1200 ELM STREET CARLSBAD CA 92008 GROUP: vPOLICY NUMBER: 17>0672-2004 CERTIFICATE ID: 3 CERTIFICATE EXPIRES: 04-30-2005 04-30-2004/04-30-2005 This is to certify that we have issued a valid Worker's Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer. We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions, and conditions, of such policies. C. AUTHORIZED REPRESENTATIVE PRESIDENT STANDARD POLICY EXCLUSIONS: INDIVIDUAL EMPLOYERS, HUSBAND AND WIFE EMPLOYERS, EMPLOYEES COVERED UNDER CPL INSURANCE AND EMPLOYEES EXCLUDED UNDER CALIFORNIA WORKERS COMPENSATION LAW. EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. EMPLOYER CHICO, JAMES G AND COLLINS NOTMA JEAN DBA: ROCKWEST CUSTOM POOLS 26235 9TH ST STE 33 HIGHLAND CA 92346 SCIF 10262E Accept this certificate only if you see a faint watermark that reads 'OFFICIAL STATE FUND DOCUMENT* [RFC.SJ]PRINTED: 07-21-2004 PAGE 1 OF1 ii gi w 13 gfe 1is §