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HomeMy WebLinkAbout1014 LAGUNA DR; 07; CB054338; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 ( 12-29-2005 Miscellaneous Permit Permit No: CB054338 Building Inspection Request Line (760) 602-2725 Job Address: 1014 LAGUNA DR CBAD St: 07 Permit Type: MISC Subtype: REPAIR Parcel No: 155272200T Lot#: 0 Valuation: $0.00 Reference #: Project Title: HALLIDAY RES REPAIR WATER DAMAGE, DRYWALL.INSULATION-NO STRUCTURAL Applicant: SERVICE MASTER ALL PHASE SUITE 6 1466 PIONEER WAY 92020 619-442-1234 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: $120.00 Inspector: PERMIT FEE Total Payments To Date: $120.00 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 12/29/2005 KG 12/29/2005 12/29/2005 $120.00 $0.00 $0.00 $120.00 Balance Due: Clearance: $0.00 NOTICE: Please take NOTIC 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 pennit 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 lega! 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 hi h I Tl hir ihh liinh hi I t .. FOR OFFICE USE ONLY ,..,/ PLAN CHECK Nc/2f!lJ5L/3 36"" PERMIT APPLICATION EST. VAL. __________ _ CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Plan Ck. Deposit (j Validated 1~ _,c:_ Date U 'l-q-~ 1. PROJECT INFORMATION Address (include Bldg/Suite #) 1a11 ~A D~. # 1 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 Description of Work # of Bedrooms rt 1fff fc,tf p >}< ,e_ -UK It t J.,J 2. co Name Address City State/Zip Telephone# Fax# AP.PLICANT Contractot: C l C er 'Se'Rv1<LMA~.,..V< Au. Praue R~nc /-+-e,,& Name Address City C (l!nt for Owne 86NElf8 l,.,l1w· 0-0l:ftl' CA ~o 20 State/Zip Telephone # Name A8dress City State/Zip Telephone# 5 co E (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). 5<t<1 /treuowr AfJaV< Name Address City State License# 7 J2;t $" 1 License Class __,13~-------- State/Zip l Z Te.Jeptpi_,p __ City Business License# 4_].v,:;"'=--'l-'Z.""""::..:~=--" iP:c.... __ """ft. Designer Name Address City State/Zip Telephone# State License# _______ _ I . WORKER'S COMPEN,.....,A""Tl""ON..--.--------------------~------------------- Workers' 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 workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. iii{ I have and will maintain worker's 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 _________________ Polley No. ____________ Expiration Date ___________ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) 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' 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 are provided for in Section 3706 of the Labor Code, Interest and attorney's fees. SIGNATURE ~4'l'E~ DATE OWNER-BUILDER DEClARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D I, as owner of the property or my employees with wages as their sole compensation, will d 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). D 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). 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. D YES D NO 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 / /ontractors 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 I address/ phone number I type of work): PROPERTY OWNER SIGNATURE ____________________________ DATE ___________ _ WHITE: File YELLOW: Applicant PINK: Finance ' ► PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Page 2 of 2 COMPLETE THIS SECTION FOR NON-RESIDENnAL BUILDING PERMITS ONL Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration for or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? □ YES □ NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ YES □ NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ 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 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Code). LENDER'S NAME __________________ _ LENDER'S ADDRESS ___________________ _ 9. N --------------------------------. 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 City 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, JUDGEMENTS, 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 of 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 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 time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE ___ ~.g.' -L"'""""--""'"""-'=µ"--...=----------------DATE_..:../_Z..---'-(-'-z..:..:$:.,/4c.."°...:~_-_______ _ WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 05/11/2006 Permit# CB054338 Inspector Assignment: PY --- Title: HALLIDAY RES REPAIR WATER Description: DAMAGE, DRYWALL,INSULATION-NO STRUCTURAL Type: MISC Sub Type: REPAIR Phone: 6194421234 Job Address: 1014 LAGUNA DR Suite: 07 Lot 0 Location: Inspector: OWNER KORNHER CLARA S LIVING TRUST 05-24-02 Owner: Remarks: Total Time: CD Description Act Comment ----- Requested By: LESLIE Entered By: CHRISTINE 19 Final Structural ----~-- Comments/Notices/Hold Associated PCRs/CVs Original PC# lns12ection Histo!Y Date Description Act lnsp Comments 02/13/2006 17 Interior Lath/Drywall AP PY 01/12/2006 14 Frame/Steel/Bolting/Welding AP PY 01/12/2006 16 Insulation AP PY