HomeMy WebLinkAbout2852 CAMINO SERBAL; ; CB050337; Permit02-Q9-200S
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Retaining Wall Permit Permit No: CB050337
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
Project Title:
2852 CAMINO SERBAL CBAD
RETAIN
2552812500 Lot #:
$3,680.00 Construction Type:
0
NEW
SHAFFER RES-230 SF RET WALL
PER CITY HANDOUT-SLOPING BACKFILL
Status: ISSUED
Applied: 02/02/2005
Entered By: RMA
Plan Approved: 02/09/2005
Issued: 02/09/2005
Plan Check#:
Inspect Area:
395SUNSET DR
ENCINITASCA 92024
760 942-2796
Owner:
SHAFFER STEVEN J&AMY C REVOCABLE TRUST 03-16-04
2852 CAMINO SERBAL
CARLSBAD CA 92009
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:$0.00 Balance Due:$89.26
BUILDING PLANS
IN STORAGE
~7 ATTACHED
1572 02/09/05 0002 01 02
CGP 89.26
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 attach,
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 previously been given a NOTICE similar to this, or as to which the statute of limitations has oreviouslv otherwise expired.
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
'
FOR OFFICE USE ONLY
PLAN CHECK NO. CA 0 5 /X? ?/
EST. VAL. , __
Plan Ck. Deposit
Validated By
Date d / 2 f (_
Address (include Bldg/Suite #)Business Name (at this address)
Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total # of units
As:'s Parcel Existing Use Proposed Use
Description of Work SQ. FT.#of Stories # of Bedrooms # of Bathrooms
^
*Address City
Cantra.otor Q Agent for Contractor Q Owner Q Agent for Owner'
State/Zip Telephone #Fax #
Name
4. „ PROPERTY OWNER
Address
Address
City
city
State/Zip Telephone #
State/Zip Telephone #Name
5. 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 ($5001).
Name Address
State License # GfEj&f £>& — License Class ^*£*
City StateVzip Telephone »
7 City Business License #/2-*&*5£, 4~ — - , AfLA* J.4A >&&
Designer Name Address
State License »
City State/Zip Telephone
s»
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 th> work for which this permit is issued.
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 <^T/STE- fOJlvfP Policy No. f73%"'l f? " 2-^° T"" Expiration Pate^>7/^> i
(THIS/SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) / (
|J3 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 secuu worisgcajrcompensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars (MjJUn-fiddition to the cost of compensation, damages as provided for in Section 3706 of the Labor/codejnterest and attorney's fees.
___^_ DATE
7, OWNERfBUILDER 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).
Q 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).
Q 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 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
leiSililiW^ R ^Y!;':: •;-. • ;*.::;;: •: " ^-i:; :-.:: '¥W 1-b> " < /i • ?:;! 3:i- ! H K'ffx ^i • ? ;i. ^:. '^ •-• +A • '• 1;
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 Q 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. '
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(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 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 fore>gtf95Qons over 5'0" deep and demolition or construction of structures over 3 stories in height.
EXPIRATION: Every permit issu^cMSythe buiiamCffiiial 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 no^ommefigrftwttffijMtJo 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<£mnje«^Bflfora period of 180 days (Section 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE DATE
WHITE: File YELLOW: Applicant PINK: Finance
UNSCHEDULED BUILDING INSPECTION
DATE //y^ INSPECTOR~
PERMIT # C/V97£J.V<> / PLAN CHECK #
JOB ADDRESS
DESCRIPTION
CODE DESCRIPTION ACT COMMENTS
City of Carlsbad Bldg Inspection Request
For: 03/29/2005
Permit* CB050337
Title: SHAFFER RES-230 SF RET WALL
Description: PER CITY HANDOUT-SLOPING BACKFILL
Inspector Assignment: JM
Type: RETAIN Sub Type:
2852 CAMINO SERBAL
Lot 0
Phone: 7607178358
Job Address:
Suite:
Location: Inspector:
OWNER SHAFFER STEVEN J&AMY C REVOCABLE TRUST 03-16-04
Owner: SHAFFER STEVEN J&AMY C REVOCABLE TRUST 03-16-04
Remarks:
Total Time:
CD Description
62 Steel/Bond Beam
Requested By: PAUL TURNER
Entered By: KAREN
Act Comment
1,<j{J6,tM/ d/i
Associated PCRs/CVs
Date
03/18/2005
03/09/2005
03/09/2005
02/11/2005
Inspection History
Description Act Insp Comments
62 Steel/Bond Beam
12 Steel/Bond Beam
61 Footing
61 Footing
PA JM 1ST LI FT OK
WC JM
AP JM OK TO POUR
CO JM TOO MUDDY
City of Carlsbad
Public Works — Engineering
BUILDING PLANCHECK CHECKLIST
RETAINING WALL
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^pnformance with applicable
codes. Please revie^careTully all comments attached,
as failure to comtw with/Instructions in this report can
result irxstisDenwka-ef^ermit to build. ,
DENIAL
Please see the attached report of deficiencies
marked with DMake 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: KATHLEEN M. FARMER
City of Carlsbad
ADDRESS: 1635 Faraday Ave
Carlsbad, CA 92008
PHONE:(760) 602-2741
H:\WORD\DOCS\CHKLSTVRMainino Wall Building Plandieck CWist Form KF.doc
1635 Faraday Avenue - Carlsbad, CA 92OO8-7314 • (76O) 6O2-2720 • FAX (76O) 602-8562
BUILDING PLANCHECK CHECKLIST
RETAINING WALLS
Q
1. Provide a fully dimensioned site plan drawn to scale. Show:
Arrow / D. Easements
Existing & Proposed Structured E/Ketaining Wall
./ (dimensioned from street) / (location and height)
(^/Property Lines
Show on site plan:
A. Drainage Patterns
B. Existing & Proposed Slopes
C. Existing Topography
3. Include on title sheet:
A. Site Address
B. Assessor's Parcel Number
C. Legal Description
D. 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.
Page 1
H:\WORD\DOCS\CHKLST\Relaining Wall Building Pfancheck Cklist Form OR.doc Rev. 6/26/98
PLANNING/ENGINEERING APPROVALS
PERMIT NUMBER CB
ADDRESS
DATE
RESIDENTIAL ADDITION MINOR
{< $1O.OOO.OO)
TENANT IMPROVEMENT
PLAZA CAMINO REAL
CARLSBAD COMPANY STORES
VILLAGE FAIRE
COMPLETE OFFICE BUILDING
OTHER
PLANNER DATE
( I
ENGINEER DATE
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