HomeMy WebLinkAbout1019 WHIMBREL CT; ; CB160626; PermitPrint Date: 04/27/2017
Job Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Group:
# Dwelling Units:
Bedrooms:
Project Title:
1019 Whimbrel Ct
BLDG-Residential
2157202700
$2,502.00
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Residential Permit
www.carlsbadca.gov
Work Class: Addition Status:
Lot#: Applied:
Reference II: Issued:
Construction Type: Finaled:
Bathrooms: Inspector:
Orig. Plan Check #:
Plan ~heck #:
Description: RESDNTL -RAD ANHOOHI RES-REPLACE 2 WINDOWS WITH NEW Bl-FOLD CANTINA DOORS-IN FAMILY ROOM
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 ofthese
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 previously been given a NOTICE similar to this, or as to which the
statute of limitation has previously otherwise expired.
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p~ 4~.
Permit No: CB160626
Closed -Expired
02/17/2016
,,,, THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH 0 HAZMAT/APCD
C_cicyof
Carlsbad
Building Permit Application
1635 Faraday Ave., Carlsbad, CA 92008
Ph: 760-602-2719 Fax: 760-602-8558
email: building@carlsbadca.gov
www.carlsbadca.gov
Plan Check No.
JOB ADDRESS
CT/PROJECT# L T #
DESCRIPTION OF WORK: Include Square Feet of Affected A
~ v c.. j_p
APPLICANT NAME
Primary Co ntact
ADDRESS
CITY
PHONE
EMAIL
DESIGN PROFESSIONAL
ADDRESS
CITY
PHONE
EMAIL
STATE
FAX
ZIP
STATE UC.#
Est. Value
SWPPP
SUITEf/SPACEt/UNITf
# BATHR MS
, 7o be re, /oc#
a "I ZIP -, <1--0 I {
CONTRACTOR BUS. NAME
ADDRESS
CITY STATE ZIP
PHONE FAX
EMAIL
STATE UC.# CLASS CITY BUS. UC.#
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, Improve, demolish or repair ant 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 !hat 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 ($500)).
Worl(ers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations·
D I have and will maintain a certificate of consent to self•insure for oorkers' compensation as provided by Section 3700 of the Labor Code, for the perfoonance of the oork for which this permit is issued. D I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the oork for which this permit is Issued. My oorkers' compensation insurance carrier and policy
number are: Insurance Co. _____________________ Poicy No. ______________ Expiration Date _________ _
~ section need not be ccmpleted ~ the permit is for one hundred dollars ($100) or less. LJ Certificate of Exemption: I certify !hat in the performance of the oork for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of
California. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In
addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, interest and attorney's fees.
Ji:S CONTRACTOR SIGNATURE □AGENT DATE
I hereby affirm that I am exempt from Contractor's License Law for the lo/Jowing reason: D I, as owner of the property or my employees with wages as their sole ccmpensat.ion, will do the oork 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 ol property who bllilds or Improves thereon, and who does such work himse~ or through his own employees, provided that such improvements are not Intended or offered for
sale. II, however, the building or improvement is sold within one year of ccmpletion, the owner•builder will have the burden of proving that he did not build or improve for the purpose ol sale).
~ I. as owner of the property, am exclusively ccntracting with licensed ccntractors to ccnstruct the project (Sec. 7044, Business and Professions Code: The Contracto(s License Law does not apply to an owner of
property who builds or Improves thereon, and ccntracts 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 ccnstruction of the proposed property improvement. 0Yes 18'.JNo
2.1 (have/have not) signed an application fora building permit for the proposed 1\1'.lrk. <~ ~ 'P(lrl-fo~ '-It).,.() ,r (p('f) 7 OS-3 :)_(p I
3. I have ccntracted with the following person (firm) to provide the proposed ccnstruction (iricl'uc/e ~e aod!(J / phone / ~ntractors•'li;';nse number): /
4. I plan to provide portions of the oork, but I have hired the following person to ccordinate, supervise and provide the major oork (include name /address/ phone / ccntractors' license number):
5. 1 will provide some of the oork, but I have ccntracted (hired) the following persons to provide the work indicated (include name I oodress / phone I type of oork):
_£5 PROPERTY OWNER StGNATUR~ AGENT DATE
Is the applicant or future building occupant required to submit a business ptan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the
Presley-Tanner Hazardous Substance Account Acri □ Yes □ No
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management districrl D Yes D No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D 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 ANO THE AIR POLLUTION CONTROL DISTRICT.
I certify thatl have read the application and state that the above lnlonnatlon Is correct and that the information on the plans Is accurate. I agree to comply with all City ordinances and State la\\S relating to building construction.
I hereby authorize represeotaliYeof the Cityof Cartsbad toenteruix,n the above menooned ~rty br inspedioo puJJX)SeS. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CAALSBA.D
AGA.INST ALL UABIUTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CITY IN CONSEOOENCE OF THE GRANTING OF THIS PERMIT.
OSHA AA OSHA pennit is requied br excavations CNfJf SO' deep and demoiti:ln oc 001strudi:ln of structures CNfJf 3 sbies in height
EXPIRATKlN: Every peon~ issued b't the 0.Jt!ing Offcial under the ~i:Jnsof tnis Code shallexpre b't .n~ and berome nua andvoi:J if the buik:1ing ocoork authorized b't sudl pemit is notcxmnenred v.,thin
100days rom the dateof sudl penn~ oc if the buikf ocoork authorized tl'j sudl peon~ is susperded oc abandcoed at any line ali!r the \\Ork is cxmnenred bra peood of 100days (Sectbn 100.4.4 Unimn ~ikling Code).
_#5 APPLICANT'S SIGNATURE ~ DATE 7 i
STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE.
Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection.
Fax (760) 602-8560, Email building@carlsbadca.gov or Mail the completed form to City of Car1sbad, Building Division 1635 Faraday Avenue, Car1sbad, California 92008.
CO#: (Office Use Only)
CONTACT NAME OCCUPANT NAME
ADDRESS BUILDING ADDRESS
CITY STATE ZIP CITY STATE ZIP
Carlsbad CA
PHONE FAX
EMAIL OCCUPANT'S BUS. UC. No.
DELIVERY OPTIONS
PICK UP: o CONTACT (Listed above) o OCCUPANT (Listed above)
o CONTRACTOR (On Pg. 1)
o ASSOCIATED CB#-------------MAIL TO: o CONTACT (Listed above) o OCCUPANT (Listed above)
o CONTRACTOR (On Pg. 1) o NO CHANGE IN USE / NO CONSTRUCTION
MAIL/ FAX TO OTHER: ________________ _
o CHANGE OF USE/ NO CONSTRUCTION
,.IS APPLICANT'S SIGNATURE DATE