The URL can be used to link to this page

Home My WebLink About2320 VIA FRANCISCA; ; CB051667; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 05-11-2005 Miscellaneous Permit Permit No: CB051667 Building Inspection Request Line (760) 602-2725 Job Address: 2320 VIA FRANCISCA CBAD Permit Type: MISC Subtype: REPAIR Parcel No: 0000000000 Lot #: 0 Valuation: $0.00 Reference #: Project Title: ~~.d:\l,,LcE FALLS-REPAIR WALKWAYS Applicant: UNIVERSE 9478 OLYMPIC 90202 31 0 420-4238 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES D OR Owner: PERMIT FEE Total Fees: $120.00 Total Payments To Date: $0.00 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 05/11/2005 AMA 05/11/2005 05/1 1/2005 $120.00 $0.00 $0.00 $120.00 Balance Due: $120.00 8051 05/11/05 0002 01 02 CGP 120-00 EXPIRED PERMIT PERMIT HAS EXPIRf D IN ACCORDANCE WITH C.B.C. SECTION 106.4.4 AS AMENDED BY C.M.C.18.04.030 oAreJh,\ow s1GNATURE _dv~~--- Inspector: FINAL APPROVAL 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 Ca~sbad 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 f x i n f whi h h v r vi I iv n N imil r hi r • f limi i n h r vi I h rwi PERMIT APPUCATION . . CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1. &1 Address (Include Bldg/Suite #) Legal Description Lot No. Subdivision Name/Number Name Address 3. APPLICANT 0 Contraptor 0 Agent for Contractor Name Address 0 Owner #of Stories City 81gent for Owner City FOR OFFICE USE ONL V PLAN CHECK NO. ____ _ EST. VAL. _________ _ Plan Ck. Deposit ____ ""7" ___ _ Validated Byil4-=-- Date , 5/ft / o.'r I Proposed Use I of Bedrooms I of Bathrooms State/Zip Telephone I Fax I State/Zip Telephone I ,.,..f,.4. CLJ!...L.t::::!l!::!.~-#~~~b---~~~=----h:.t-.L!._~~-=--4~~~~~ {// Address City State/Zip a ephon ~~ac. ~~~:;;u::::,Ca:::~:=~ode: Any City or County which requires a permit to ca~~!ar, 2~f ;:mot?s/{2]any structure, prloi~-i 12 Issuance, also requires the applicant for such permit to file a signed statement that ha 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 ha is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.6 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (t600)). Name Address City State/Zip Telephone I State License I _________ _ License Class _________ _ City Business License I _______ _ Designer Name Address City State/Zip Telephone State License I _________ _ 8. WQl!lt~s• COMPENSATION Workers· Compensation Dacl111tlon: 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 es provided by Section 3700 of the Labor Code, for the performance of the work for which this permit Is issued. 0 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 _____________________ Policy No._____________ Expiration Data. _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) 0 CERTIFICATE OF EXEMPTION: I certify that In the performance of the work for which this permit is issued, I shall not employ any parson In any manner so as to become aubjact to the Workers' Compensation Laws of California. WARNING: Fllilura to aacura worllara• c:omp«1Htlon coverage la unlawful, and ahaN aubjact en employer to crlmlnal panaltlea and civil fine• up to one hundred _)laouaand dollan ($1 I, In addition to tha coat of companaatlon, damages u provided for In Section 3708 of tha Labor coda, lntaraat and attorney·• faa1. p<-f;IGNATURE DATE . f-/("'-t::,__s: 7. 0 _w I hereby aff' 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 (Sac. 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 improv!! 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 doaa 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). 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 not) signed an application for a building p·ermit 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): ______________________________________________ _ 6. 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): _________ -=-:::::::;;;:::::...:::==:==:::=::::,,,,r----------------------------------- o-4ROPERTY OWNER SIGNAT ~r;;.;~ii~~~~~~~~~~--:------DATE s:::; // _,,_ _s- ,CQMPl.£l'E :THIS SECTIO F !!II 1 ding occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sac · s 25606, 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. 18, CONSTRl:ICTION LENDING AGENC-Y 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., ARPUCAN1 CERTIFlCATIOM I certify that I have reed 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 end demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the building Official under the provisions of lhis Code shall expire by limitation and become null and void If the building or work authorized by such permit Is not commenced within 180 days from the date of such permit or If the building or work authorized by such permit is suspended or abandoned at any lime after the work is comme period (Section 106.4.4 Uniform Building Code). ~ ,/;, / ex APPLICANT'S SIGNATURE .....eATE/"r_ --_t?'_,r _______ _ PINK: Finance