HomeMy WebLinkAbout1750 KALMIA Cir; ; CB980377; PermitB ll I L D I N G
VJ/1bl98 16~29
Paqe 1 of
Job Address 115''0 1'.Ar.A'O\A C.,,r
Permit Type, ~nI
Parcel No: ~lS ( ,)-( l -l,O
Valuation: o
P E R M I T
Suite:
Lot#:
Perm1 t No: : <, . 7
Project No: A~JOUJ77
Development No: [•EV-,Lt,u~
Constiuction Type:
Occupancy Group: Reference#: r i lli.;t Status:
NEW
ISSIJED
02/~0/Yl3
0~16/98
RMA 131-00
Description: 405 SF RETAIN WALL-PER ICBO
: SPECS-#221-POINSETTIA HILL
Appl/Ownr : WESTERN PACIFIC
2385 CAMINO VIDA ROBLE STE
CARLSBAD CA 92009
**->-Fees Required ***
Fees:
Adjustments:
Total Fees:
Fee description
Other
* BUILDING TOTAL
107
CITY OF CARLSBAD
Applie<l:
5083 03J..\6fi81000leo:.t.
EntereO-mNr,
760 929-1600
.00
.00
131.00
Ext fee Data
131.00 PERMIT
i31.00
PP'1VAL
D.\t :. tr-/'(~ 77
2075 Las Pal.mas Dr., Carlsbad, CA 92009 (619) 438-1161
FOR OFFICE USE ONLY
I
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
PLAN CHECK NoJJ;fO , 177
EST. VAL. _s;--;-1f-t-1!:t4--------
Plan Ck. Deposit--~------
Validated By M--(760) 438-1161
Date Jc/ i0/1{{
1. PROJECT INFORMATION
Business Name (at this address) cr93--o3
Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units
;;;;;~'2f1£.rA1AiLNC.-LuA-u... s~S-L1J #of Stories # of Bathrooms
CONTACT PERSON (If different from applicant) t 'l
Eli,... o v1 1•1(.o/
Name Address City State/Zip Telephone# Fax#
3, APPLICANT_[] Contractor O Agent for Contractor ll}e'vvner O Agent for Owner
0e&TEtt!!:/ l-1t<,lFt (' /..kiu s ,..,t 6-~£ 14'3 l'o-c.J"Ol-4.'T:
Name Address City State/Zip Telephone#
4. PROPERTY OWNER
~E: A-~ A. 'PPLl C t4Al-r-
Name Address City State/Zip Telephone#
5. CONTAACTOR • 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. A y 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 ($5001).
t.AM.C..O ,J £ s ~ ' Name Address City State/Zip Telephone #
State License # /p J.:nt:29: License Class ::B ~ Business License # /203"S"O f C4sE.. Gi,oµ.,p 4:S± tl:w'-( ID/ '$bLA~A-l:>E,4.(_£/ CA fz¢o1 9-/oo ~ 'iZ_lf-lls,C()
Designer Name Address City State/Zip Telephone
State License # C 90 '.39::
6. WORKERS' COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of 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 the performance
of the work for which this permit is issued.
~ave 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: l ) t::J8
Insurance Company CAu F &M..P Policy No. u.Ylr3 J'5(p ZL33 Expiration Date ~ _ l°r _
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100) OR LESSI
0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as
to become subject to the Workers' Compensation Laws of California.
WARNING: F ' e workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand doll s ($ 0,0001, addition to the cost of compensation, damages as provided for in Section 3706 of the Lab! codze interest and attorney's fees.
SIGNATURE:_~-J=:~.,c.:::;;;~..,_ _ _z:..._~_i:;;;;:::-._.,._.______ DATE 2,_ L/0 __ 9 8
7. OWNER-BUILDER DEC RATION -;:;=--,. ~~t------:;:::=...._..,....._~--,,,----,
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
0 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 ~ one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of salel.
~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(sl licensed
pursuant to the Contractor's License Lawl.
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 ONO
2. I (have/ have notl signed an application for a building permit for the proposed work.
3. I have contracted with the following person (firml to provide the proposed construction (include name / address / phone number / contractors license numberl:
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 I address I phone
number/ contractors license number): ______________________________________________ _
5. I will provide some of the work, but i have contracted (hiredl the following persons to provide the work indicated (include name / address / phone number / type
PROPERTY OWNER SIGNATURE ;=::: 5' ~ DATE z_ / l O / 18
ofworkl: ~
COMPLETE THIS SECTION FOR NON-RESIDEN 14LBUILDING PERMITS ONLY
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? 0 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? 0 YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O 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 CO~STRUCTI0N 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. 30971i1 Civil Codel.
LENDER's NAME SA.JwA B~K.. LENDER's ADDREss'M'oo M.Ac.~~$1.l/f) tlfEit,.Jfdv-Bt.=Ac1-1-CA-'1Zh6
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 Citt 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 permi not commenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended
or abandoned at any time commenced for a period of 180 days (Section 106.4.4 Uniform Building Codel. /
APPLICANT'S SIGNATURE _.:::~~..;;,=~-~.:_~~-=:;;;;;=~=---------DATE -~4i=,,-._/~(J-L_?_8 ____ _
WHITE: File YELLOW: Applicant PINK: Finance
ln~pection List
Permit#: CB980377 Type: RETAIN 405 SF RETAIN WALL-PER ICBO
Date Inspection Item Inspector Act Comments
9/30/98 66 Grout PS AP
9/24/98 11 Fig/Foundation/Piers PS AP
9/23/98 61 Footing PS NS
4/30/98 66 Grout PS AP
Monday, September 13, 1999 Page 1 of 1
EsGil Corporation
2n Parl:rrersliip Witli (jov,mment for 'Buifaing Saf,t9
DATE: March 13, 1998
JURISDICTION: Carlsbad
PLAN CHECK NO.: 980377 SET: II
PROJECT ADDRESS: Poinsettia Heights, C.T. 93-03
PROJECT NAME: LOFFEL RET /WALL FOR POINSETTIA HILL
gjP'.:J5ANT JURIS.
□ PLAN REVIEWER
□ FILE
D The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
~ The plans transmitted herewith will substantially comply with the jurisdiction's building codes
when minor deficiencies identified below are resolved and checked by building department staff.
D The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
D The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
D The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
D The applicant's copy of the check list has been sent to:
■ Esgil Corporation staff did not advise the applicant that the plan check has been completed.
D Esgil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: Telephone#:
Date contacted: (by: ) Fax #: 'f\nJ}
Mail Telephone Fax In Person /\J ~ REMARKS: The city to have the owner change the other set of plans similar to tha/ shown
on sheet 9 of 19 clouded in red.
By: Bert Domingo
Esgil Corporation
□ GA □ CM □ EJ □ PC
Enclosures:
3/11/98 trnsmtl.dot
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (619) 560-1468 ♦ Fax (619) 560-1576
DATE: February 23, 1998
JURISDICTION: Carlsbad
PLAN CHECK NO.: 980377
EsGil Corporation
Prof.ssional Pfan !11.,_eview 'Engi~,rs
SET:I
PROJECT ADDRESS: Poinsettia Heights, C.T. 93-03
□ APPLICANT
-/=YJURIS.
D PLAN REVIEWER
□ FILE
PROJECT NAME: LOFFEL RETAINING WALL FOR POINSETTIA HILL
D The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
D The plans transmitted herewith will substantially comply with the jurisdiction's building codes
when minor deficiencies identified below are resolved and checked by building department
staff.
D The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
■ The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
D The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
■ The applicant's copy of the check list has been sent to:
Western Pacific Housing
2385 Camino Vida Roble, Ste. 107, Carlsbad, CA 92009
■ Esgil Corporation staff did not advise the applicant (except by mail) that the plan check has
been completed.
D Esgil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: Telephone#:
Date contacted: {by: ) Fax#:
Mail Telephone Fax In Person
□ REMARKS:
By: Bert Domingo Enclosures:
Esgil Corporation
D GA DCM D EJ D PC 2/12/98 trnsmtl.dot
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (619) 560-1468 ♦ Fax (619) 560-1576
Carlsbad 980377
F~bruary 23, 1998
PLAN REVIEW CORRECTION LIST
SINGLE FAMILY DWELLINGS AND DUPLEXES
PLAN CHECK NO.: 980377 JURISDICTION: Carlsbad
PROJECT ADDRESS: Poinsettia Heights, C.T. 93-03
FLOOR AREA:
REMARKS:
DATE PLANS RECEIVED BY
JURISDICTION:
DATE INITIAL PLAN REVIEW
COMPLETED: February 23, 1998
FOREWORD (PLEASE READ):
STORIES:
HEIGHT:
DATE PLANS RECEIVED BY
ESGIL CORPORATION: 2/12/98
PLAN REVIEWER: Bert Domingo
This plan review is limited to the technical requirements contained in the Uniform Building
Code, Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state
laws regulating energy conservation, noise attenuation and access for the disabled. This plan
review is based on regulations enforced by the Building Department. You may have other
corrections based on laws and ordinance by the Planning Department, Engineering
Department, Fire Department or other departments. Clearance from those departments may be
required prior to the issuance of a building permit.
Present California law mandates that residential construction comply with Title 24 and the
following model codes: 1994 UBC (effective 12/28/95), 1994 UPC (effective 12/28/95), 1994
UMC (effective 2/23/96) and 1993 NEC (effective 12/28/95).
The above regulations apply to residential construction, regardless of the code editions
adopted by ordinance.
The following items listed need clarification, modification or change. All items must be satisfied
before the plans will be in conformance with the cited codes and regulations. Per Sec. 106.4.3,
1994 Uniform Building Code, the approval of the plans does not permit the violation of any
state, county or city law.
To speed up the recheck process, please note on this list (or a copy) where each
correction item has been addressed, i.e., plan sheet number, specification section. etc.
Be sure to enclose the marked up list when you submit the revised plans.
LIST N0.1, GENERAL SINGLE FAMILY DWELLINGS AND DUPLEXES WITHOUT SUPPLEMENTS (1994 UBC) r3forw.dot
Carlsbad 980377
February 23, 1998
• PLANS
1. Please make all corrections on the original tracings, as requested in the
correction list. Submit three sets of plans for commercial/industrial projects (two
sets of plans for residential projects). For expeditious processing, corrected sets
can be submitted in one of two ways:
1. Deliver all corrected sets of plans and calculations/reports directly to the City
of Carlsbad Building Department, 2075 Las Palmas Drive, Carlsbad, CA 92009,
(619) 438-1161. The City will route the plans to EsGil Corporation and the
Carlsbad Planning, Engineering and Fire Departments.
2. Bring one corrected set of plans and calculations/reports to EsGil
Corporation, 9320 Chesapeake Drive, Suite 208, San Diego, CA 92123, (619)
560-1468. Deliver all remaining sets of plans and calculations/reports directly to
the City of Carlsbad Building Department for routing to their Planning,
Engineering and Fire Departments.
NOTE: Plans that are submitted directly to EsGil Corporation only will not be
reviewed by the City Planning, Engineering and Fire Departments until review by
EsGil Corporation is complete.
• MISCELLANEOUS
2. Please submit ICBO approval number or submit complete calculation and
technical specifications for the loffel retaining wall.
3. Please show complete details of the wall.
To speed up the review process, note on this list (or a copy) where each
correction item has been addressed, i.e., plan sheet, note or detail number,
calculation page, etc.
Please indicate here if any changes have been made to the plans that are not a
result of corrections from this list. If there are other changes, please briefly
describe them and where they are located in the plans.
Have changes been made to the plans not resulting from this correction
list? Please indicate:
Yes □ No □
The jurisdiction has contracted with Esgil Corporation located at 9320
Chesapeake Drive, Suite 208, San Diego, California 92123; telephone number
of 619/560-1468, to perform the plan review for your project. If you have any
questions regarding these plan review items, please contact Bert Domingo at
Esgil Corporation. Thank you.
Carlsbad 980377
F_ebruary 23, 1998
VALUATION AND PLAN CHECK FEE
JURISDICTION: Carlsbad PLAN CHECK NO.: 980377
PREPARED BY: Bert Domingo DATE: February 23, 1998
BUILDING ADDRESS: Poinsettia Heights, C.T. 93-03
BUILDING OCCUPANCY: TYPE OF CONSTRUCTION:
BUILDING PORTION BUILDING AREA VALUATION VALUE
(ft. 2) MULTIPLIER ($)
Loffel Ret/wall 405 13.50 5,467.50
Air Conditionina
Fire Sorinklers
TOTAL VALUE $ 5,467.50
■ 1991 UBC Building Permit Fee D Bldg. Permit Fee by ordinance: $ 81 .00
■ 1991 UBC Plan Check Fee D Plan Check Fee by ordinance: $ 52.65
Type of Review: D Complete Review D Structural Only D Hourly
D Repetitive Fee Applicable D Other:
Esgil Plan Review Fee: $ 42.12
Comments:
Sheet 1 of 1
macvalue.doc 5196
'
City of Carlsbad M ¥1, ,. I I I 144 I I ■,. I •JA .;; 4 I, I IA'' I
BUILDING PLANCHECK CHECKLIST
RETAINING WALL
BUILDING PLANCHECK NUMBER: CB cz:? () '-3 7 7
BUILDING ADDRESS: Ptu,Jt,<l.f,tift& . ~L ;
PROJECT DESCRIPTION: _R,._,.e:c:t=ai::..:n::..:in~g..:.W:..:a::::11 _____ _
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. ~-ma~~ Date:14-!rr
ATTACHMENTS
D Right-of-Way Permit Application
DENIAL
Please see the attached report of deficiencies
marked with D. Make necessary corrections to
plans or specifications for compliance ~h
applicable codes and standards. Submit corrected
plans and/or specifications to this office for review.
By:
By:
By:
________ Date:
________ Date:
________ Date:
ENGINEERING DEPT. CONTACT PERSON
NAME: MICHELE MASTERSON
City of Carlsbad
ADDRESS: 2075 Las Palmas Drive
Carlsbad,CA 92009
PHONE: (619) 438-1161, ext. 4315
2075 Las Palmas Dr.• Carlsbad, CA 92009-1576 • (619) 438-1161 • FAX (619) 438-0894
✓□
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4.
BUILDING PLANCHECK CHECKLIST
RETAINING WALLS
-~ 5J.-£1;4
O'~cc!~" Y"' ~ ,';-~1d 1
Provide a fully dimensioned site plan drawn to scale. Show: · {'-"' 'ii/ g / q
A. North Arrow D. Easements
8. Existing & Proposed Structures E. Retaining Wall
(dimensioned from street) (location and height)
C. Property Lines
Show on site plan:
A. Drainage Patterns
8. Existing & Proposed Slopes
C. Existing Topography
Include on title sheet:
A. Site Address
8. Assessor's Parcel Number
C. Legal Description
D. Grading Quantities Cut___ Fill___ lmporVExport __ _
(Grading Permit and Haul Route Permit may be required)
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 tot he 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.
Page 1
Rw.ll22.IIMS
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PLANNING DEPARTMENT
BUILDING PLAN CHECK REVIEW CHECKLIST
Plan Check ~J· ~~ qe-',377
Planner l!f::. ( '11il\
APN: /£'~0
Address/6M ~
Phone (619) 438-1161, extension ___ _
Type of P_r:,oir<:t & Use:~~•'--!e:=.o'-'----Net Project Density: A DU AC
Zoning: P-{ft'G.. General Plan: Jf!./lll Facilities Management Zone: _'2...--'-(~_
CFO lin/outl #~Date of participation: ~ Remaining net dev acres:+
Circle One
(For non-residential development: Type of land used created by
this permit: _____________________ )
Legend: ~ Item Complete (0) Item Incomplete -Needs your action
Environmental Review Required: YES NO TYPE ___ _
DATE OF COMPLETION: ______ _
Compliance with conditions of approval? If not, state conditions which require action.
Conditions of Approval:
Discretionary Action Required: YES NO TYPE ___ _
APPROVAL/RESO. NO. _____ DATE ___ _
PROJECT NO. _______ _
OTHER RELATED CASES: ___________________ _
Compliance with conditions or approval? If not, state conditions which require action.
Conditions of Approval: ________________________ _
Coastal Zone Assessment/Compliance
Project site located in Coastal Zone? YES NO
CA Coastal Commission Authority? YES NO
If California Coastal Commission Authority: Contact them at -3111 Camino Del Rio North, Suite
200, San Diego CA 92108-1725; (619) 521-8036
Determine ·status (Coastal Permit Required or Exempt):
Coastal Permit Determination Form already completed? YES NO
If NO, complete Coastal Permit Determination Form now.
Coastal Permit Determination Log #:
Follow-Up Actions:
1) Stamp Building Plans as "Exempt" or "Coastal Permit Required" (at minimum
Floor Plans).
2) Complete Coastal Permit Determination Log as needed.
~□□
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~□□
~□□
~ □ □
~ □ □
~ □ □
~ □ □
~□ □
lnclusionary Housing Fee required: YES __ NO
(Effective date of lnclusionary Housing Ordinance -May 21, 1993.J
Data Entry Completed? YES __ NO __
(Enter CB#; UACT; NEXT12; Construct housing Y/N; Enter Fee Amount (See fee schedule for amount); Return)
Site Plan:
1. Provide a fully dimensional site plan drawn to scale. Show: North arrow,
property lines, easements, existing and proposed structures, streets, existing
street improvements, right-of-way width, dimensional setbacks and existing
topograp~ical fines.
2. Provide legal description of property and assessor's parcel number.
Zoning:
1 . Setbacks:
Front:
Interior Side:
Street Side:
Rear:
Required ______ _
Required ______ _
Required ______ _
Required ______ _
Shown -------Shown -------Shown -------Shown -------
2. Accessory structure setbacks:
Front: Required Shown
Interior Side: Required Shown
Street Side: Required Shown
Rear: Required Shown
Structure separation: Required Shown
3. Lot Coverage: Required Shown
4. Height: Required Shown
5. Parking: Spaces Required Shown
Guest Spaces Required Shown
Additional Comments
OK TO ISSUE AND ENTERED APPROVAL INTO COMPUTE
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APPROVALS
Date
~::'.:! "iM1ii=. Engtneerfn1
--Fire
-Coastal
----Health
Assoc.
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AS'.'ESSOR PLI.NS
• r-f)
' ,_, City of Carlsbad
92008
08-29-2014
1635 Faraday Av Carlsbad, CA
Building Permit Permit No:PCR98086
Building Inspection Request Line (760) 602-2725
Job Address: 1750 KALMIA CR CBAD
Permit Type: PCR Sub Type:
Parcel No: Lot #:
Valuation: $0.00 Const Type: NEW
OccGroup: Reference #: CB971088
Project Title: REVISIONS TO POST TENSION SLAB
FROM PHASE 4 & ON-POINSETTIA HEIGHTS
Applicant:
WESTERN PACIFIC HOUSING
2385 CAMINO VIDA ROBLE
CARLSBAD CA 92011
760 929-1600
Owner:
CARLSBAD I
STE 1
Total Fees:
$0.00
$109.00 Payments To Date:
Status
Applied:
Entered By:
Appr/Issued:
Inspect Area:
$109.00
WITHDRAW
05/21/1998
RMA
Balance Due:
Description Fee
-------------------------------------------------------------------------------
Plan Check Revision Fee 109.00
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 capactiy
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 meviouslv been aiven a NOTICE similar to this or as to which the statute of limitations has oreviouslv otherwise exoired.
'I -.
PERMIT A_Pf:lblCATION
FOR OFFICE USE O~ Y
PLAN CHECK No.U. qJ0 J1
Va"5¥£
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(760) 438-1161
Date_---.:.,,,_+-++-+=-*+"'-------
1. PROJECT INFORMATION
Business Name (at this address)
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units
Assessor's Parcel # Existing Use Proposed Use
SO. FT. #of Stories # of Bedroom
Name Address City State/Zip Telephone # Fax #
3. D Agent f r Contractor D Agent for Owner {.... "s ~ t:.-o J-.1:~ T
Name City State/Zip Telephone#
4. PROPERTY OWNER
S~"i..
Name Address City State/Zip Telephone#
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 Se tion 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more han five hundred dollars [$5001). L ~e-1"111 ~ It CA 9:lc::::t:> ·1(;,::, -I
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6. WORKERS' COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of 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 the performance
of the work for which this permit is issued.
)1/( 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: • '::> '3/ L
Insurance Company (Au f. L/?Mf Policy No. ,a9B 313b4-0..:::> Expiration Date ~1°t 19,
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS)
D 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' c atlon coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars [$100,000), in a · cost of compensation, damages as provided for in Section 3706 of the Labo code, terest and attorney's fees.
SIGNATURE ____ --,,;;c...__.,,.~{~-:_~':_-:_~-:_-:_-:_-:_-:_-:_-:_-:_-=._____________ DATE __ S:=-,~c:i.+-1-'""'---
1. OWNER-BUILDER 0
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
0 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).
M I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The
~ntractor'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).
D 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 ONO
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 contra the following persons to provide the work indicated (include name / address / phone number / type
of work): ______________ ----,f7',:;._fr-.6£...----------------------+---1I------------
PROPERTY OWNER SIGNATURE----~....:...:;;....,"'------------------
COMPLETE THIS SECTION FOR NON-RESID
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? 0 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? 0 YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O 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 5A:}JwA: ~,-o? LENDER'S ADDRESS "1,tc.d:R,~ Ru!P M2w?~T~ cA. '1,;/1.,o
9. APPLICANT CERTIFICATION I )
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 Citt 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 commence · n 365 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 · for a period of 180 days (Section 106.4.4 Uniform Building Code). / /
PLICANT'SSIGNATURE --~-=:........o:~-----------------DATE s--;., IC/'8 l WHITE: File YELLOW: Applicant PINK: Finance
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