HomeMy WebLinkAbout1065 CARLSBAD VILLAGE DR; D; CB033393; Permit12-08-2003
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Sign Permit Permit No CB033393
Building Inspection Request Line (760) 602-2725
Job Address
Permit Type
Parcel No
Valuation
Reference #
Project Title
1065 CARLSBAD VILLAGE DR CBAD St D
SIGN
Lot# 0
$450 00 Construction Type NEW
RINCON DE NAYARIT-SIGN @ FRONT
Status
Applied
Entered By
Plan Approved
Issued
Inspect Area
ISSUED
12/08/2003
RMA
12/08/2003
12/08/2003
Applicant
E W DAWSON
Owner
302 E MANCHESTER
310G77-2131
Building Permit
Add'l Building Permit Fee
Plan Check
Add'l Plan Check Fee
Electrical Fee
Renewal Fee
Add'l Renewal Fee
Other Building Fee
Additional Fees
TOTAL PERMIT FEES
$1293
$000
$840
$000
$000
$000
$000
$000
$000
$21 33
Total Fees $21 33 Total Payments To Date $000 Balance Due $21 33
0376 12/08/03 0002 01 02
21-33
Inspector
FINAL APPROVAL
/ Q YDate Clearance
NOTICE Please lake NOTICE tflat 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 Ihe date (his permit was issued lo 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/exact 10ns_of which von have previously been given a NOTICEjirnilarlo this, or as to which Ihe statute of limitations has previously otherwise expirej
PERMIT APPLICATION
OrY OF CARLSBAD BUILDING DEPARTMENT
1 635 Faraday Ave , Carlsbad, CA 92008
PROJECT INFORMATION
FOR OFFICE USE ONLY
PLAN CHECK NO £A(J[}>33 <2?
EST VAL
Plan Ck Deposit
Validated By
Date / x
^T
Address (include Bldg/Suite #)Business Name (at this address)
Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units
,PERSON.(if,dlfterent.from,opplicantl
CONTRACTOR,-COMPANYiNAME
Telephone #
\ {.-Lit J ,,~,
(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 l$500])
Klame
State License #
Address
License Class
City State/Zip
City Business License #
Telephone #
Designer Name
State License #
Address City State/Zip Telephone
Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations
Q I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, far the performance
of the work for which this permit is issued
Q 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 Date
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS)
O 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 subyect to tha Workers' Compensation Laws of California ,
WARNING Failure to secure workers' compensation coverage is unlawful and shall subject on employer to criminal penalties and civil fines up to one hundred
thousand dollars ($100 OQjX, in yjrfKlnn tn tto-cost of compensation, damages as provided lor m Section 3706 of the Labor code, interest and attorney's fees
.SIGNATURE ^/^t^^U. ' \^\ J {JJiA*\^ DATE / ?~/ V/fi^
I hereby affirm that I am exempt from the Contractor s License Law for the following reason
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)
Q 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) "i
fj 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 Q YES QNO
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 contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type
,of work)
'ROPERTY OWNER SIGNATURE
[c61^pTEfE~fHTs"SECTrON>dX/VO«r/7fS/O£/V7Mt BUILDlNGiPERMlTS..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? Q YES Q NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES Q NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES Q 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 for which this permit is issued (Sec 3097(0 Civil Code)
LENDER'S NAME __ LENDER S ADDRESS^
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,
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 commenced within 180 days from-the date of such permit or if the building or work authorized by such permit is suspended or abandoned
st any time after the work is compiencefi foi a/period of 1£p/o>ys ({Section 106 4 4 Uniform Building Code)
APPLICANT S SIGNATURE \ \V \S\Cb\\A&*^ DATE
.WHITE File YELLOW Applicant PINK Finance
City of Carlsbad Bldg Inspection Request
For 05/03/2004
Inspector AssignmentPermit^ CB033393
Title RINCON DE NAYARIT-SIGN @ FRONT
Description
Type SIGN
Job Address
Suite
Location
APPLICANT EWDAWSON
Owner
Remarks' FINAL
Total Time
Sub Type
1065 CARLSBAD VILLAGE DR
D Lot 0
CD Description
38 Signs
^ct Comment
(V
Phone 7608229667
Inspector
Requested By YOLANDA
Entered By ROBIN
Associated PCRs/CVs
Inspection History
Date Description Act Insp Comments