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Home My WebLink About1069 LIGHTHOUSE RD; ; CB051732; PermitCl o. ~\~!?.:!~ ~.:'!!!~~- 05-23-2005 · U ~5 F~esidential Permit Permit No: CB051732 ., · Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: 1069 LIGHTHOUSE RD CBAD RESDNTL Sub Type: 2145312200 Lot#: $7,750.00 Construction Type: Reference #: O Structure Type: o Bathrooms: ·· KEREKFFY RES 250 SF LOFTS RAD 0 NEW 0 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: Orig PC#: Plan Check#: Applicant: Owner: WORTHING INC, B. A. SUITE #201 690 CARLSBAD VILLAGE DR CARLSBAD, CA 92008 619-729-3965 Building Permit Add'I Building Permit Fee Plan Check Add'I Plan Check Fee Plan Check Die.count Strong Motion Fee Park in Lieu Fee Park Fee LFM Fee Bridge Fee Other Bridge Fee BTD #2 Fee BTD #3 Fee Renewal Fee Add'I Renewal Fee Other BuildinrJ f°=(:e Pot. Water Ccn. r-:-Ge Meter Size Add'I Pot. Wc1t , Con. Fee Reel. Water Cc11. Fee $84,29 $0,00 $54,79 $0,00 $0,00 $1,00 $0,00 $0,00 $0,00 $0,00 $0,00 $0,00 $0,00 $0,00 $0,00 $0,00 $0,00 $0,00 $0,00 KEREKFFY FAMILY TRUST 03-22-04 1069 LIGHTHOUSE RD CARLSBAD CA 92009 Meter Size Add'I Reel. Water Con, Fee Meter Fee SDCWAFee CFO Payoff Fee PFF PFF (CFO Fund) License Tax License Tax (CFO Fund) Traffic Impact Fee Traffic Impact (CFO Fund) Sidewalk Fee PLUMBING TOTAL ELECTRICAL TOTAL MECHANICAL TOTAL Housing Impact Fee Housing lnLieu Fee Housing Credit Fee Master Drainage Fee Sewer Fee Additional Fees TOTAL PERMIT FEES ISSUED 05/16/2005 SB 05/23/2005 05/23/2005 Total Fees: $184,08 Tota .n·• ••·· $0.00 Bala~pue: '--'Q O:>J, I' L lnsr1;ctnr: Date: Clearance: $0,00 $0,00 $0,00 $0,00 $0,00 $0,00 $0,00 $0,00 $0,00 $0,00 $0,00 $0,00 $20,00 $24,00 $0,00 $0,00 $0,00 $0,00 $0,00 $0,00 $184,08 $184.08 NOTICE: P1--~sc 1.,'·e NOTICE that approval of your project includes the ~Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as ":00·-. C'xcictions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the vet• ,:r:dures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing 1n ~:,:i·r·· · nee with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set asid2, v·J j, or annul their imposition. You are hereb'.,1 11~•'.")THER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor pla:'.1'., ·g, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any l slex fr"ms 0 1 ·.+:.-ri h v r PERMIT APPLICATION CITY ..OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1. PROJECT INFORMATION FOR OFFICE USE O~ __ PLAN CHECK No.a~ 1 73L , 7So EST. VAL.-------=----- Plan Ck. Deposit:.--...,,,.------- Valid::fv-~,,..----""""'------- Date.$+/~~ Business Name (at this address) Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use Proposed Use i~n,f Wo;lf_ i N ~,\ I \06 2. CONTACT ~~ON (if different from applicant) SQ. FT. ~ #of Stories # of Bedrooms \ # of Bathrooms Name Address 3. APPLICANT Ncontractor O Agent for Contractor 0 Owner D Agent for Owner 6Cl,,Yne as C.om:v::u!D~ Name Address City State/Zip Telephone# 4. 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 An violation of Section 70 1.l by any applicant for a P.Jl(~i~bj cts the applicant to a civil penalty of no more t n five hundred dollars [$5001). ,(.), UlU l lo State License # --~---..._~-- 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 t')e work for which this permit is issued. ~ 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 c~sation insurance ca? and policy number are: . _ _ _ Insurance Company 2Jl:lJf. f; A,,.h at Pohcy No. 0"2I)8 I J S:: '2l::}t)S" Expiration Date / -Q / -?;G (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100) 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 subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensatio coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in additlo ompensation, damages as provided for in Section 3706 of the apjr de, interest and attorney's fees. SIGNATURE, ________ .....iiµ.-!l....lo!..J[JIL?.~.-,,,.£..------------DATE ~~~L..!: l(<o~~~~--- 7. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's O I, as owner of the property or my employees wi w s 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). O 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). 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 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 I address / phone number I 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 I address / phone number I type of work):. ____________________________________________________________ _ PROPERTY OWNER SIGNATURE _______________________ _ DATE __________ _ COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING 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 D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D 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 ______________ _ LENDER'S ADDRESS ________________________ _ 9.. APPLICANT Cl;RTIFICATION 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 w ith 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 01 this Code shall expire by limitation and become null and void i1 the building or work authorized by such permit is not commenced within 1 BO days from the date of such permit or i1 the building or work authoriz.d:: perm;;Jit is uspended or abandoned at any time after the work is comme e a p 1 l d s (Section 106.4.4 Uniform Building Code). ·--I -L APPLICANT'S SIGNATURE _ __::~~=.c=-=----=--=--=--~::~;::-_____________ DATE I\_ }cg _ o, YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 08/17/2005 Permit# CB051732 Title: KEREKFFY RES 250 SF LOFTS Description: Type: RESDNTL Sub Type: RAD Job Address: 1069 LIGHTHOUSE RD Suite: Lot 0 Location: APPLICANT WORTHING INC, B. A. Owner: KEREKFFY FAMILY TRUST 03-22-04 Remarks: Total Time: CD Description 19 Final Structural 29 Final Plumblng 39 Final Electrical 49 Final Mechanical Associated PCRs/CVs Inspection History Description 17 Interior Lath/Drywall Act lnsp Comments AP JM Inspector Assignment: JM --- Phone: 7607293965 Inspector: ----- Requested By: TERESA Entered By: CHRISTINE Date 07/07/2005 06/28/2005 06/28/2005 31 Underground/Conduit-Wiring 84 Rough Combo PA JM CONDUIT ONLY AP JM