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Home My WebLink About2852 CAMINO SERBAL; ; CB030916; Permit04-01-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Retaining Wall Permit Permit No: CB030916 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 2852 CAMINO SERBAL CBAD RETAIN 2552812500 Lot#: 0 $3,780.00 Construction Type: NEW SHAFFER RES/ 240 SF RETAINING SLOPING BACK FILL - CITY SPEC WALL Status: ISSUED Applied: 03/28/2003 Entered By: CB Plan Approved: 04/01/2003 Issued: 04/01/2003 Plan Check#: Inspect Area: Applicant: THE PALM CO 395 SUNSET DR ENCINITAS CA 92024 760 942-2796 Owner SHAFFER STEVEN J&AMY C 2852 CAMINO SERBAL CARLSBAD CA 92009 1649 04/01/03 0002 01 02 CGP 54.49 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Strong Motion Fee Renewal Fee Add'l Renewal Fee Other Building Fee Additional Fees TOTAL PERMIT FEES $53.49 $0.00 $34.77 $0.00 $1.00 $0.00 $0.00 $0.00 $0.00 $89.26 Total Fees: $89.26 Total Payments To Date:$34.77 Balance Due:$54.49 Inspector: FINAL Date:Clearance: NOTICE: Please take NOTICE that approval of your project includes the 'Imposition* of fees, dedications, reservations, or other exactions hereafter collectively referred to as fees/exactions.* You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 A FOR OFFICE USE ONLY PLAN CHECK EST. VAL. Plan Ck. Deposit Validated By Date Address (include Bldg/Suite tf)Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total # of units Assessor's Parcel it Existing Use Proposed Use ^^Description of Work f SQ. FT. •2-^0$ rfof Stories # of Bedrooms # of Bathrooms 93/28/03 02 Name Address City State/Zip Telephone ff Fax* Q Owner Address City State/Zip Telephone ; gyt:u?yy AddfesName / / / Address City State/Zip Telephone # 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 of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ]*500l).-0k3^^ '-Testy Business License # Address City State/Zip TelephoneDesigner Naifle' State License # fl. WORKERS'COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: f~1 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. "£j 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: .. ./ ""7 s-i/\/ "f . Insurance Company Policy No. /C^^~ / L^^f^(1 Expiration Date f ~~ / ~~ O (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] 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 ($1pOX>00), in adflition/foMa^Dsyof compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees 7. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: Q 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). l~l 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. l~l YES EDNO 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 O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES Q NO Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? d YES d 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. 8. 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(i) 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 CitV 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 180xdays frpm 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 comme^el for a pedbcKof y&Qdbya (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 08/20/2003 Permit* CB030916 Title: SHAFFER RES/ 240 SF RETAINING Description: SLOPING BACK FILL - CITY SPEC WALL Inspector Assignment: PY 2852 CAMINOSERBAL Lot 0 Type: RETAIN Sub Type: Job Address: Suite: Location: APPLICANT THE PALM CO Owner: SHAFFER STEVEN J&AMY C Remarks: CAN YOU FINAL THIS WALL? Phone: Inspector: —'' Total Time: CD Description 69 Final Masonry Requested By: CHRISTINE Entered By: CHRISTINE Comment , / si SSj/Q Associated PCRs/CVs Inspection History Description Act Insp CommentsDate 04/29/2003 66 Grout 04/29/2003 69 Final Masonry 04/23/2003 31 Underground/Conduit-Wiring 04/23/2003 66 Grout 04/02/2003 61 Footing AP JM 2ND LIFT WC JM WC PY AP PY 1ST LIFT AP PY City of Carlsbad Public Works BUILDING PLANCHECK CHECKLIST RETAINING WALL Engineering BUILDING PLANCHECK NUMBER: CB BUILDING ADDRESS: PROJECT DESCRIPTION: Retaining Wall 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. By:Date: DENIAL Please see the attached report of deficiencies marked with 0. 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: ATTACHMENTS Right-of-Way Permit Application ENGINEERING DEPT. CONTACT PERSON NAME: <^Z>Vx -Taniya Barrows^ City of Carlsbad ADDRESS: 1635 Faraday Ave Carlsbad. CA 92008 PHONE: (760) 602-27^ <fcj H:\Dewtopmwl Sewk»s\MASTERS\FORMS -(CHECKLISTS -BUILDING PLANCHECK CKUST FORM - RETAINING WALLS.doc 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 6O2-2720 • FAX (760) 602-8562 BUILDING PLANCHECK CHECKLIST RETAINING WALLS Q Q 1. Provide a fully dimensioned site plan drawn to scale. Show: A. North Arrow D. Easements B. Existing & Proposed Structures E. Retaining Wall (dimensioned from street) (location and height) C. Property Lines 2. Show on site plan: A. Drainage Patterns B. Existing & Proposed Slopes C. Existing Topography 3. Include on title sheet: A. Site Address oj Assessor's Parcel Number "S6>1> SLof £ Legal Descriptioney&s&rtO CLCT<^&&*^ ^ ~~ """ Grading Quantities Cut Fill Import/Export (Grading Permit and Haul Route Permit may be required 4. Project does not comply with the following Engineering Conditions of approval for Project No. Conditions were complied with by: Date: MISCELLANEOUS PERMITS 5. 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: Please obtain an application for Right-of-Way permit from the Engineering Department. H:\Devetopment SMVteriMASTERS\FORMS -\CHECKLISTS -\BUILDING PLANCHECK CKLJST FORM - RETAINING WALLS.doc City of , BUILDING DEPT FF 186.0 2B P.O. BOX 807, SAN FRANCISOXCA, CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: O7-Ot-02 POLO NUMBER; 1847006 - 02 CERTIFICATE EXPIRES: 07-O1-03 SI) TH 395 SlMSiT Dfl ENCINJTAS CA i This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer narned 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 hormai expiration. This certiltcate of insurance is not an insurance policy and does not arrwrid, extend or «lter th« covisrage afforded by the pQlicies listed h€frein.,Nptwithstahdina any requirement term, or cbnditioti of any contract or otheir 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. - : PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: tl,000,000.00 PER OCCURRENCE. EMPLOYER LEQAL NAME MANAGEMENT CONNECTION// STB 300 *. \'\ ',16486 BRNRDO CTR » 3OO SAN DIEGO CA »Sh2ft ^ OUTSOURCE .MANAGEMENT. 08-17-02 THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND