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HomeMy WebLinkAbout1095 OAK AVE; MULTI-PERMIT FILE; CB063023; PermitCity of Carlsbad • 1635 FaradayAv Carlsbad, CA 92008 1 1.19-2009 Residential Permit Permit No: CB063023 Building Inspection Request Line (760) 602-2725 Job Address: 1095 OAK AV CBAD Permit Type: RESDNTL Sub Type: SFD Status: EXPIRED Parcel No: 2050202900 Lot #: 0 Applied: 10/19/2006 Valuation: $292,746.00 Construction Type: VN Entered By: LSM ' Occupancy Group: Reference #: Plan Approved: # Dwelling Units: I Structure Type: SFD Issued: Bedrooms: 3 Bathrooms: 3 Inspect Area: Project Title: WORTHING RES- 2692 SF LIVING, Orig PC#: 616 SF GARAGE, 170 SF COVERED PATIO Plan Check # Applicant: Owner: WORTHING INC, B. A.- MAST POKEY FAMILY TRUST SUITE #201 690 CARLSBAD VILLAGE DR 1166 LARKSPUR LN CARLSBAD, CA 92008 CARLSBAD CA. 92008 619-729-3965 Building Permit $1,141.00 Meter Size Add'l Building Permit Fee $0.00 Add'l Red. Water Con. Fee Plan Check . $741.65 Meter Fee Add'l Plan Check Fee $741.65 SDCWA Fee Plan Check Discount $0.00 CFD Payoff Fee Strong Motion Fee $29.27 PFF (3105540) Park in Lieu Fee . $0.00 PFF (4305540) Park Fee $0.00 License Tax (3104193) LFM Fee $0.00 License Tax (4304193) Bridge Fee $0.00 Traffic Impact Fee (3105541) Other Bridge Fee . $0.00 Traffic Impact Fee (4305541) BTD #2 Fee . $0.00 Sidewalk Fee BTD #3 Fee . $0.00 PLUMBING TOTAL Renewal Fee . $0.00 ELECTRICAL TOTAL AddI Renewal Fee . $0.00 MECHANICAL TOTAL Other Building Fee . $0.00 Housing Impact Fee HMP Fee $0.00 Housing lnLieu Fee Pot. Water Con. Fee - $0.00 Housing Credit Fee Meter Size Master Drainage Fee Addi Pot. Water Con. Fee . $0.00 Sewer Fee Red. Water Con. Fee $0.00 Additional Fees Green Bldg Stands (5B1473) Fee ?? TOTAL PERMIT FEES $0.00 $0.00 $0.00 $0.00 $5,327.98 $4,918.13 $0.00 $0.00 $0.00 $0.00 $0.00 $196.00 $60.00 $83.00 $0.00 $4,515.00 $0.0 $0.00 $0.00 $0.00 $17,753.68 Total Fees: $17,753.68 Total Payments To Date: $1,483.30 Balance Due: $16,270.38 FINAL APPROVAL Inspector: 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 you have oreviouslv been aiven a NOTICE similar to this, or as to which the statute of limitations has previously otherwise exoired. Legal Description Lot No. Subdivis 'n Name/Number Unit No. - Phase No. Total # of units - -205 02 c 29 fAssesocs Prcel # Exis ing Use Proposedf Use I (! Y * 2 3 3 ption ofANork SQ FT #of Stories # of Bedrooms # of Bathrooms _ 2 CONTACT PERSON (if diffrnt from appIinii Name . Address - City State/Zip Te]6phonv # Fax# 3APPLI1T intrai. r foor Si 4gtn Nne " P.O. Ex c11', 7()c5 (7472.?O73L/ .Name . Address City . State/Zip Telephone # FA rffi~ (4 -- PROPERTY OWNER . .,. rna- w 1o1 CL5D1 c "wi (7&o)n9-3'u, 7j-b'7q Name - I,) Address City State/Zip ,Telephone if 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. Ariy violation of Section 7031.5 by any applicant for a permit subject th applicant to a vi) penalty of not more than five hundred dollars $5001). -. BA, yi R. BYC tb4t CA 7LaO) 1Z'35 Name .J . , Address - ., City ,, State/Zip Telephone .# State Licen'e'# 3C1 S 7(0LJ. . License Class _____ City Business License it 5-! ZOO on p Box tL4 0-4 W Designer Name jJ Address City State/Zip . Telephone . State License it I I ' . . . •F WORKERS' COM'ENSATIOP1 -. .-_. .•- - Workers' Compensation Declaration: I hereby affirm under penalty or perjury one of the following declarations: 0 - 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 tle performance of the 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 ssued, My worker's compensation insurance carrier and p licy number are: - - , ,.71 Insurance Corrpany '1tL-+. F'JA_rlCI Policy No.CW 775 2o0t9 Expiration Date / O (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS) C] CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shalinot employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. . - WARNING: Failure to secure workers' c e ation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up -to one hundred thousand dollars ($100,000). in ad n to t cost of compensation, damages as provided for in Section 3706 of the Lab r code, inter at and attorney's fees. SIGNATURE - - \ -' - . - - DATF ____ 7 -, ME— I hereby affirm that I am exempt from the Contractor t\ense Law for the following reason: 0 l:as owner of the property or my employees vith 'ages as their sole compensation, will do the work and the structure is not intended or. offered for sale (Sec. 7044, Businessand Professions Code: The Cctractr'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, pr)videdthat 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 the burden of proving that he did not build or improve for the purpose of sale). 0 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 anowner of property who builds or iniproves thereon, and contracts fcr such projects with contractor(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. 0 YES DNO . - '2. - I (have / have not) signed an application for a building permit for the proposed work. - •• -. 3. 1 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 èoordinate, supervise and provide the major work (include name! address I phone number I 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 . LEIirFUS SECTION' ~,ERM_ITSON11 -. Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or, risk management and preventionS program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? . [:]_-YES 0 NO .Is the applicant or future building occupant required to obtain permit from the air pollution control district or air quality management district? 0 YES 0 NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 -NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT.-BE ISSUED UNLESS THE APPLICANT HAS MET OR ISMEETING THE, REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT, - . - - • - - I hereby affirm that there is a construction lending agency for thi . - I •I work for which this permit is issued (Sec. 30' - - I , LENDER'S NAME - LENDER'S SS_______________________ APPLICCICATION I certify that I have read the application and state thatthe above information is correct and that the infor'mation 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 Cit, 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. - - JUDGIVIENTS. 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 50" deep and demolition or construction of structures over '3 stories in height. • EXPIRATION: Every permit issued by the building Official under the proiisions of this Code shall expire by limitation an&bedome null and void if the building or work - authorized by such permit is not commen c thin 180 days the dale of such permit or if the building or work authorized by such ermitis suspended or abandoned at any time after the work is comme fo a period of 'days (Section 106.4.4 Uniform Building Code) - ' - • • . ' ,- . APPLICANT'S SIGNATURE - DATE /tt jo - WHITE File YELLOW Applicant PINK Finance - --• City of Carlsbad I AUGUST 2, 2007 BROOKS WORTHING PO BOX 1O41 CARLSBAD CA 92018 RE: - APPLICATION DATE: 10/19/2006 PLAN CHECK #: CB063023 ADDRESS: 5021 ASHBERRY RD EXPIRATION DATE: rWi972O07\ PERMIT TYPE: . RESIDENTIAL DESCRIPTION: NEW SFD-2692 SF LIV,616 SF GAF, 170 SF COV PAT You applied to have your plans checked on the date noted above. To date, the related building permit has not been obtained. The original plan review application will expire as no building permit has been issued. Plans submitted and not retrieved from the building department prior to the plan check expiration date noted above will be destroyed. The provisions of sections 304 (d) of the Uniform Building Code state: "Section 304 9d) Expiration of Plan Review Applications for which no permit is issued within one year following the date of application shall expire by limitation, and plans and other data submitted for review may thereafter be returned to the applicant or destroyed by the Building Official. In order to renew action on an application after expiration, the applicant shall resubmit plans and pay a new, plan review fee." In order to provide better service, please indicate your handling choice for the plans originally submitted and return this letter to the Building Department. Project Abandoned - I will pick up the plans within 10 days Project Abandoned - Plans may be destroyed If you have any questions, please contact the Building Department at (760)602-2719. Building Department 16.35, Faraday Avenue • Carlsbad, CA 92008 • (760) 602-4660 • FAX (760) 602-8561 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Print Date: 12/18/2017 Residential Permit Permit No: CB032877 www.carlsbadca.gov Job Address: 1095 Oak Av ' Permit Type: BLDG-Residential Work Class: Addition Status: Closed - Withdrawn Parcel No: 2050202900 Lot It: Applied: 10/20/2003 Valuation: $11,891.00 Reference It: ' Issued: Occupancy Group: Construction Type: Finaled: It Dwelling Units: Bathrooms: Inspector: Bedrooms: Orig. Plan Check It: Plan Check It: Project Title: Description: RESDNTL - RAD MAST RESIDENCE 517 SF GARAGE ADDITION Total Fees: Total Payments To Date: Balance Due: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." 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 APPLYto 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 limitation has previously otherwise expired. / / . t ' 1' CC FOR OFFICE USE ONLY PERMIT APPLICATION . '. , PLAN CHECK NO.__________ 'CITY, OF PlawjCk. Deposit A BUILDING DEPARTMENT 0 Validated By_ Date. FORMATIQk 71 - . '.. .. . 6920 10120/03 0fln 'p'• A oR ddress Ii dude Bid uit #1 . Business Name (atthis'address) . . :. CGP 74.81 ,Legal Description Lot No. Subdivision Name/Number ' ' Unit No. Phase No. - Total # of unith Assessor's Parcel # , Existing Use, , Proposed Use -. Descrip io of W k - SQ FT 1.. #of Stories-b - '- ,,#,6f Bedrooms # ofBathrooms I4'cl..'-__4yñ, , ,,, :' I:1_) . 'ri- , '"A .' •'' ' 1'' , C0NTCtI N i't tpianh) L 'T .. ' . 7Zqo Name - - - . Address .-' '.. City State/Zip Tel&phon Fax4 13. APPIIC NT Contra or il A9onI forContractor. AgetfoMS v r il Pñ i O 760 72-''Y//5 Name . Address' . - .. . City State/Zip - Telephone #-,, EEM Name Address f,City - ., State/Zip Tphona # FS. NTRAcOMPAy$NAME ... * .. ... (Sec. 7031.5 Business and rqfessions Code: Any City or County which requires a permit to construct, alter, improve,deroIish or"reair anystructure, 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 theBusiness, and Professions. Code) or tha't.PeJs exempt ticerefrom; and the basis,.for ,the alleged.. exem tion Any v lation f ection 703 .5 by any applicant for a.permit subjects the applicant t a vil pe alty of not more than fi hundred dollars [$5001 'r±'J (44 ' 7)3 'Name ' . ,' .J .''Address' '.i . " . .'" .City . 'f' State/Zip 'Telephone #. i' State License # " License Class . .City Business License # w -I-- .7Q De ugner Name Address City, , , . State/Zip , Telephone 'State License #, " .- .2. ' . , ,' ' 4 , '. , ......• .,',' , ,,, 6 WORKERS&COMPENSA'TKN Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of thefollowing declarations: 0. I have and will maintain a certificate of consent to,self-insure'for workers' compensation-as pr'ovided by.Section 3700 of the LaborCode,'.for, the performance 'of.the 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 st sued. My worker's compen t' carid n,(jmr r?: •Insurance Company ollcy No:B7 70 Expiration D t1/( Lip ' (THIS SECTION NEED NOT'BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) ' o CERTIFICATE OF EXEMPTION:, icertify that in the performance of the work for which this permit is issued, lshall not employ any person in'ny rnani6r. so'a to become subject to the Workers Compensation Laws of California WARNING: Failure to a cure workers' compensation coverage is unlawful.- and shall subject an-employer 'to-crininaI' peflalties and civil fines "up to onehundred' thousand dollars ($ , 00), in dition to the cost of compensation, damages as provided for in Section 3706 of thq'Labo code, interest and attorney's fees. SIGNATURE ' '. ',". . ' DATE IOf2.Ofrv,i ' r?$JwwEiuIL__b TRIQ '- 'I hereby affirm that I am exempt from t C tractor's License Law for the following reason: •" - -, '. i' , '''-' '' ' ' ' Dl,as owner of the property"orm emp oyees with wages as their sole compensation, will do the work andthe structure is not intended or offered for sale' '(Sec. 7044, 'Business and Professions . The Contractor's License Law does not applytoanowner 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.tha purpose of 'sale). I, as owner of the property, am exclusively contracting with licensed, contractors to construct theproject (Sec. .7044,BusiRess and'Profesions Cd:' The Contractor's" Lice'hs'e La, does' iot apply to an o'wner of rpérty who builds or improves thereon, and ontracfs for such 'ijets with contrafor(s)' licensed pursuant to the Contractors License Law) - :0 I am exempt under Section - Business and Professions Code for this 'reason: personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES; D,N9 ' (have / ha nat)' signed an applicafion for a building permit for the proposed'w'ork. .-I have contracted with the- following. person (firm) to.provide the proposed corstruction. (include name / address /,phone r'umbr'/..co'ntractors license number): '4. I plantO provide po'tiorisof the work, buti havehired the following peroh to'coordiràie', supervise and provide the major'Ork (include name'J'dddress/phone' number/ contractors license number): - r5, , I will provide some of the work, but I have contracted (hired) the following persons to. provide the work indicated (include name,/ address / ph0'ie number /,typei of work): PROPERTY,OWNER SIGNATURE DATE Is the applicant or fjtu' building o'cupant 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 Hazado'us'Substance Account Act? D YES . 0N0. L Is the applicant or. future building occupant required to obtain a permit from the air pollution control district or air-quality management district? .. 0 YES, .0 NO Is the facility to be constructed within 1 000 feet of the outer, boundary of a school site? 0 YES 0 NO ,p - IF ANY OF THE ANSWERS ARE YES, A'FINAL CERTIFICATE OFOCCUPANCY'MAYNOTIBE ISSUED UNLESS THE APPLICANT HASMET OR IS MEETINGTHE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES ND THE AIR POLLUTION CONTROL DISTRICT. f cWNS'ThU'CTION_LENDINGAGENGY 'I hereby affirm that there is a construction lending agency for the performance of the work for which ttiis,permit is issued, (Sec. 3097 CivilCode). LENDER'S NAME " - - '' 'LENDER'S ADDRESS T" AIcANT4çTlFfC'ATIoN" ' certify that-I have'read the application and staté'that the àbova'informãtion is correct andthat,tha information on the plans is acEiirate. I agree iu. comply with all City ordinances. and State lawsrelating to building construction: I hereby authorize representatives, of the ,Cit' 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 ANYWAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT' - OSHA An OSHA prmit is required for excavations over 5 0 deep and demolition or construc'ion of structures over 3 stories in height I EXPIRATION: Every'permit'issued by the building 'OfficiaI'under-thepovisions of this' Code shall expire b limitation-and become null and void 'if th building or work authorized by such permit is not commenc within 0 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 iscomme c pen of 0 days (Section 106.4:4 Uniform Building Code). -. ' - - APPLICANTS SIGNATURE DATE I WH E File "YELLOW: Applicnt' PINK: Fi'nanc" - . - ,, , , •' - 08/2/204 14:00 767290784 B A WORTHING INC PAGE Ml of Carl bad'. 07/30/2004 * WORTHING INC, B. A. SUITE #201 690 CARLSBAD VILLAGE DR CARLSBAD, CA 92008 Re: Application Date: 10/20/2003 0:00:00 Plan Check #: C803277 Ad&55 i5OAK AV - - .-• -.. ..... •.. Expiration Date 10/19/2004 0:00:00 Perniit Type: RESONIL Description: MAST RESIDENCE 517 SF GARAGE ADDITION You applied to have your plans checked on the date noted above To date the related building permit has not been obtained. The original plan review application will expire as no building permit has beenlesued. - Plans submitted and not retrieved from the building. department pr/or-to the plan cheek expiration date noted above YAJI bstrov, The provlslàns of sections 304 (d) of the Uniform Building Code Mate: "Section 304 9d) Expiration of Plan Review Applications for which no permit is issued within one year following the date of application shall expire by limitation, and plans and other data submitted fot review may thereafter be returned to the applicant or destroyed by the Building Official, 1flbjdr-to rcnect on -en- appcat a xptio.the appiiaall resubmit' plans and pay a new plan review fee." In order to provide better service, please indicate your handling choice for the plans originally submitted and return this letter to the Building Department. Project Abandoned'- I will pickup plane within 10 days .. Project Abandoned - Plans may be destroyed. If you have any questions, please contact the Building Department at (760) 602-2702. Robin Nusohy Building Department 1635 Fare aY Avenue Carlsbad, CA 92008-7314 (760) 802-2710 FAX (780)602-8560 City of Carlsbad 1 ' 1635 Faraday Av Carlsbad, CA 92008. Plumbing/Mechanical/Electrical (PME) Permit 10-28-2013 Permit, No: CB 132658 Building Inspection Request Line (760) 602-2725 Job Address: 1O95 OAK AVCBAD Permit Type: PME Status: ISSUED Parcel No: 2050202900 Lot #: 0 Applied: 10/28/2013 Entered By: SKS Reference #: . Plan Approved: 10/28/2013 PC #: . Issued: 10/28/2013 Inspect Area: Project Title: MAST RES - NEW 200 AMP METER - PANEL AT EXISTING LOCATION Owner: "MAST POKEYFAMILY/TRUST 1166 LARKSPURLN 'CARLSBAD CA Applicant: MAST POKEY FAMILY TRUST 1166 LARKSPUR LN CARLSBAD CA '92008 760-518-8833 Plumbing Fees so.00 Electrical Fees I r—_ / ' . - ' )$158.00 Mechanical Fees /$0.00 Other PME Fees ,çi ç / \ ft$0.00 TOTAL PERMIT FEES $15860 Total Fees: $158.00 Total PayrnentsT'?Dat'e: 1 (.$158.00 -BaIance Due: / $0.00 INCORPORATED 1952 / / :I 7' /O FINAL APPROVAL .o',"' lnsDector: 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 V. ITHE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: EPLANNING DENGINEERING EJBUILDING DFIRE DHEALTH DHAZMATIAPCDI V . . Building Permit Application '. Plan Check No.C43 • 1635 Faraday . Ave., Carlsbad, CA 92008 Est. Value C T Y 0 F Ph: 760-602-2719 Fax: 760-602-8558 . . CARLSBAD . email: binldingcasbadca.gov epo Date,t7/i'ff) www.carisbadca.gov P7 lOB ADDRESS . . . SUITE#/SPACE#/UNIT# APN I..O5 01K A-Vt * Ci CT/PROJECT # LOT # . . PHASE a a OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE 0CC. GROUP. pESCRIPTION OF WORK: Include Square Feet of Affected Area(s) ' -tcoK NELL) zoo A--tf &-L I CI1I i,ur2edm,ij EXISTING USE - . . PROPOSED USE GA,RAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS :. . V V . V . YES #. NOII YES IJNOIJ YESII NO[::] APPLICANT NAME (Primary Contact) . .. V V V •. V V APPLICANT NAME (Secondary Contact) V. V. V ADDRESS ., V V• V V . ADDRESS ••' V. V - V V CITY. . .. .. STATE . ZIP CITY . . . STATE ZIP PHONE ....................... FAX . -. . PHONE I EMAIL Al EMAIL JtbPERTY Q&NER NAME .. . V CONTRACTOR BUS. NAME V . / ADDRESS V ADDRESS ' Ke-/-Jer 4-7j 7 iid I. CITY . STATE . ZIP CITY . . . . . STATE ZIP . EHONE, FAX PHONE FAX - \- EMAI . V V • ( Dr&L -y;r'Je EMAIL . . ' ARCH/DESIGNER NAME & ADDRESS . . . . STATE LIC. #. STATE LIC.# . . CLASS CITY BUS. LlC.#uz (Sec. 7031.5Business 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, commendingwith Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, the basis for the Any Section 7031.5 by for and alleged exemption. violation of any applicant a permit subjects the applicant to i civil penalty of not more than five hundred dollars ($500)). . 4 ' V Workers' Compensation Declaration: thereby affirm under penally of fe4ur/ one of the following declarations: EJI have and will maintain a certificate of consent to self-insure forworkers' comensaton as provided 3700 of the Labor Code, for the performance of the work for which this permit is issued.......- Iii I have and will maintain workers' compensatior,as req'uired by Section 3700 of the Labor Code, for the performance of the Ark for which this permit is issued. My workers' compensation insurance carrier and policy . . . 3 . . • ,. . . . . number am: Insurance Co. V . . Policy No. . _V V . Expiration Date This section need not be completed if the permit is for one hundred dollars,($100) or less. []Certiflcate of Exemption: I certify that in the performance of'thework for wtrichthis 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 un)aful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (111,100,000), in &.additiori to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. V V •, V Ae CONTRACTOR SIGNATURE V ' J AGENT DATE t7 CD .5 V I hereby affirm that tam exempt from Contractor's License Law for the following reason.- 1, 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). ., 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 Contractors License Law) - I am exempt under Sechon _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 Dyes DNO I (have / have not) signed an application for a building permit for the proposed work. . • • . , • : ' -. I have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): • V I plan to provide portions of the work, butl have hired the following person to coordinate, supervise and provide the major work (include name I addrviss I phone / contractors' license number): I will provide some of the work, but) have contracted (hired) the following persons to provide the work indicated (include name/address! phone / type of work): \ . • V • .. -. V .PROPERTY c.&..._.L?L./'1.,l,J DAGENT DATE-' 25- . V V • • ' V , , . , • • V . V mn . 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? LYes No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? j Yes No Is the facility to be constructed within 1,000 feel of the outer boundary of a school site? I - 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. I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name : Lender's Address - -- I certify that I have read the application and state that the above Information is cenactand that the information on the plans is arxirate. I agree to cromplywtth all City ordinances and State laws relating to building construction. I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned properly for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE Cmi' OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CITY INCONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA.An OSHA permit is requited for excavations over 69 deep and demolition or construction of structures over 3 stories is height. - EXPIRATION: Every permit issued by the ing Offisial under the provisbns of this Code shall expire by limitation and bocorne null and void if the building or work authorized bysuth permit is not commenced within 180 days from the date of such permit or if th ilding orwork authorized by such permit is suspended or ndoned atany time after the work is commenced for a period of 180 days (Section 106.4.4 Unifuni, Building Code). APPLICANT'S SIGNATURE (2a4- DATE J o 2' H" 1T STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occ'upancy will be requested at final inspection. IIJ CERTIFI C A T E (Comme r c ial ..Proje c ts POn ly) Fax (760) 602-8560, Email buiIdina).car1sbadCa.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CO#: (Office Use Only) -4 CONTACT NAME OCCUPANT NAME . . . ADDRESS . BUILDING ADDRESS CITY STATE - ZIP - - CITY STATE ZIP Carlsbad CA PHONE - FAX - EMAIL - . . OCCUPANT'S BUS. LIC. No. . DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) T ASSOCIATED CB# - '"MAIL TO: CONTACT (Listed above) U7 OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) NO CHANGE IN USE/ NO CONSTRUCTION MAIL/ FAX TO OTHER: - CHANGE OF USE / NO CONSTRUCTION APPLICANT'S SIGNATURE . DATE . . . .... .. . . . Inspection List Permit#: CB132658 Type: PME MAST RES - NEW 200 AMP METER PANEL AT EXISTING LOCATION Date Inspection Item Inspector Act Comments 10/29/2013 33 Service Change/Upgrade - RI 10/29/201333 Service Change/Upgrade PD AP 10/29/2013 39 Final Electrical PD AP (FlY OF CAPLSBA BUILDING DEPARTMENT a-37 OWNER Ruth E. Simpson MAIL 1 ADDRESS L095 Oak Ave. CITY Carlsbad TEL. NO. 729 3594 PLUMBER Arrow Service Co. Inc. ADDRESS 6424 Mission Gorge Rd. CITY San Diego TEL. NO. 21 3531 STATE CARLSBAD BUSINESS LICENSE NO. LICENSE NO. C36 176711 7553 NO. ITEM FEE TOILET @ $1.25 BATH TUB @' 1.25 SHOWER @ 1.25 WASH BASIN @ 1.25 KITCHEN SINK @ 1.25 DISHWASHER @ 1.25 LAUNDRY TUB on TRAY @ 1.25 AUTOMATIC WASHER @ 1.25 WATER HEATER & VENT © 1.50 GAS SYSTEM I TO 15 .30 EA. ADD, © 1.50 FLOOR-DRAIN OR SINK @ 1.25 LAWN SPRINKLER @ 2.00 MISC. WATER PIPING © 1.50 GARBAGE DISPOSAL © 1.00 VACUUM BREAKER OR BACK FLOW DEVICES I TO 5 © 2.00 GRADING PLAN YES [] NO 0 PERMIT $ 2 00 TOTAL FEE $ .50 I ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I AM PROPERLY REGISTERED AND LI- CENSED AS RE D BY THE CITY OF CARLSBAD AND STATE OF C ORNI R THAT I AM THE LEGAL OWNER OF THE AB E DESCRI D RESIDENTIAL PROPERTY. SI GNATUR fe jnc. OF PERMI -, 40LUMBIN6 PERMIT - APPLICATION *2468 5°33**** ***350 BUILDING ADDRESS NEAREST CROSS ST. GROUP I ZONE Inspection Record APPROVALS DATE INSPECTORS SIGNATURE UN-DER _FLOOR _WORK ROUGH PLUMBING GAS PIPING GAS VENTS PLUMBING FIXTURES MISC. GAS TEST UTILITY CO. NOTIFIED FINAL VALIDATION This is a Plumbing Permit When Property Filled Out, Signed and Validated. Permit void if work is not commenced within 60 days of date of issuance. VALIDATION ' .a-- LATERAL CHARGE COMPUTATION . STANDARD 4" (Max. H./30', V. 1101- 0 V E R 30' H. i-/ ® FT. OVER 10'V.' -.-- FT: - 4 - - STANDARD 6" (Max. H. 30',,V. 101 OVER.30' H.-@, OVER 10'V. _____ ______ FT. TOTAL CONSTRUCTION COST SERVICE CHARGE (REPAVING ETC.)-_7__. - TOTAL LATERAL CHARGE_' - .., .._; ,____•4 4 .r :4 APPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM . '. -7 f ENGINEERING DEPARTMENT N? SE 1907 BUILDING DEPT L CITY OF CARLSBAD 729-1181 EXT. 35 - . ISSUED BY FOR APPLICANT TO FILL IN - . - •-. - DATE ISSUED - - BUILDING ADDRESS• /oqs 2A Au' OWNER 1L'iJFo ILr'JE MAILING -. - ADDRESS J A{fI1u/1. CONTRACTOR ,10,0 4P ../ • - CONTRACTOR'S ADDRESS NEW BUILDING - EXISTING BUILDING LEGAL DESCRIPTION 4 . 0/4- REMARKS: - • . LINE COST. DATA :-- ....... - / I -( I Cfase /c'14 I ASSESSMENT DI ST NO FRONTAGE _______COST PER FT. • TOTAL't) OTHER LATERAL LOCATION . . CONNECTION FEE . , •. - I NO JrTOTAL21L) UNITS_ COST PER UNIT ( - PUMP STATION. FEES . . •. •-. .--:. ____ : •E) .'. - NO. UNITS _______COST PER UNIT' TOTAL . ST. . ,. - • -'_-o,. - - .TOTALCHARGES(LATERALETC.) LATERAL NO. ______________ INSTALLATION DATE - . • - • . . • . - - __________________ . . .-.•. .• •. INSPECTOR \,4 '. • :.. . e.' . -. ' .t-'. PLUMBING PERMIT APPLICATION City of CARLSBAD, CALIFORNIA 92008 . App/iëanttc'ompIete n urnbredpacej.onIy. . Phone 7.29-1181. :. Permit * / r TjL JOB ADDRESS . .. . .. . . C41 JII TOTAL FEES $ SIGNATURE or OWNER IIF OWNER BUILOERI (DATE) p. WHEN PROPERLY VALIDATED (IN THIS SPACE)'THIS IS YOUR PERMIT . PLAN CHECK VALIDATION cx. ' M.o . , cAsH...PERMIT•.VALIDATION CK. M.O. CASH - H .. -. • L - .. . -. -. 5I . . .. 'aX - LEGAL - LOT NO. . . LB .- TRACT -. - . . •• . . .- OWNER . MAIL.ADORE.SS ,. ZIP . PHONE 2 - 7 C NTRACTOR, . f.,., ., ' MAIL ADDRESS . . PHONE .' -. TATE.LIC. CITY LIC. NO. 3 6' ARCHITECT OR DESIGNER . - MAIL ADDRESS .1 , PHONE LICENSE NO. 4' . .. ENGINEER . MAIL ADDRESS PHONE . LICENSE NO. 5 • .... ./.. COMPENSATION (NS. C RRIER MAIL A DRESS . -. BRANCH USE OF BUILDING 8 Class of work: LI NEW ['<'OOhTION' [1 ALTERATION DREPAIR ,... . . , 9 Describe work H / r Id PERMIT FEES -. No . Type of Fixture or Item ' Fee SPECIAL' CONkITINS: WATER CLOSET (TOILET) $ BATHTUB - LAVATORY WeSH BASIN) . . . . . .. SH OW ER KITCHEN SINK OISP B " & / L., DISHWASHER .,P.,LICTIONACCEPOY PLANS.ECK .. / APPROVED FOR ISSUANCE BY; . LAUNDRY TRAY . CLOTHES WASHER - WATER HEATER DAT.E NOTICE URINAL,..' -OR INKINGFOUNTAIN THIS PERMIT BECOMES NULL AND VOID IF,WORK OR CONSTRUC- TION'AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS,OR IF . FLOOR—SINK OR DRAIN • CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SLOP SINK PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED. , I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS GAS SYSTEMS NO. OUTLETS - - WATER PIPING & TREATING EQUIP. I APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS WASTE INTERCEPTOR - - TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF :A -PERMIT DOES NOT VACUUM BREAKERS -. - PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING - 'LAWN SPRINKLER SYSTEM CONSTRUCTION 'OR THE PERFORMANCEOF CONSTRUCTION. SEWER - LLf' NUMBER CLEANOUTS " CESSPOOL SEPTIC TANK & PIT - '-.7/ -, - ..f•, - - ROOF DRAINS'.- . SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) FEE- INSPECTION REPORTS DATE ITEM ,.. ... REMARKS . . . INSPECTOR Ik USE SPACE BELOW FOR. NOTES, -FOLLOW-UP, ETC ..• • •-. . . - T:J• p .- -- .•. / REQUEST FOR INSPECTION TIME:_________ INSPECTQR____________________ PERMIT NO. ______________ DATE:_37 ____________ OV''JER ADDRESS /~2 BUILDING El FOUNDATION El REINFORCING STEEL El MASONRY - - El GROUT-GU NITE El FLOOR AND CEILING FRAME El SHEATHING El FRAME El EXTERIOR LATH El INSULATION El INTERIOR LATH OR DRYWALL El FINAL V -1 El UNDERGROUND PLUMBING El UNDERGROUND WATER El ROUGH PLUMBING El TOP OUT PLUMBING SEWER AND PL/CO 11 TUB OR SHOWER PAN El GAS TEST El WATER HEATER El FINAL * V ELECTRICAL 1 El TEMPORARY SERVICE El, ELECTRIC UNDERGROUND El ROUGH ELECTRIC El POOL BONDING El ELECTRIC SERVICE El CEILING HEAT- ED G.F.I. El SMOKE DETECTOR El FINAL- V MISCELLANEOUS El PLENUM AND DUCTS ' El COMBUSTION AIR El PATIO Cl SIGN, El GRADING El DRIVEWAY El CONDITIONED AIR SYSTEMS El REFER PIPING El FINAL V READY FOR INSPECTION: DMONDAY ESDAY DWEDNESDAY DTHURSDAY 0 FRIDAY V DA.M. D P.M. SPECIAL INSTRUCTIONS REQUESTED BY PHONE NO.________________ V PERSON TAKING REPORT_________________