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HomeMy WebLinkAbout1265 LAUREL TREE LN; ; CB071414; Permit05-22-2007 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Sign Permit Permit No: CB071414 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: Applicant: FORD SIGNS STEE 1304N. MELROSE VISTA CA 92073 760-631-1976 1265 LAUREL TREE LN CBAD SIGN 2120402500 Lot#: 0 $2,400.00 Construction Type: NEW 24 HOUR FITNESS 3 ILLUMINATED CHANNEL LETTER WALL SIGNS Status: ISSUED Applied: 05/22/2007 Entered By: KG Plan Approved: 05/22/2007 Issued: 05/22/2007 Inspect Area: Owner: ASCENT BILTMORE CARLSBAD L L C 111 W MONROE ST#1111 PHOENIX AZ 85003 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 $45.79 $0.00 $29.76 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $75.55 Total Fees:$75.55 Total Payments To Date:$75.55 Balance Due:$0.00 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 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 limitations has previously otherwise expired. City of Carlsbad /^ 1635 Fa radayAve,,Carlsbad, CA 92008 ra^Nf/^ 7,60-602-2717/2718/2719 %|^fJ^ Fax: 760-602-8558 ^a^r*-^ XjJjJ^ Building Permit Application JOB ADDRESS /Wit 1 /) A_ l?(^5'L0'Ui T/^d. [tyJL L6i Y' lt?V?6t£{ .C/P " S. PianChecKNoMPO'/^y H Est. Value^4^^7 f Plan Ck. Deposit y Date ^Ls-Tmf] J^fJ/ -^ ' '^ // SUITE#/SPACE#/UNIT# APN - . If CT/PROJECT # LOT # PHASE * # OF UNITS # BEDROOMS * BATHROOMS TENANT BUSINESS NAME TYPE OF CONST. . OCCBGROUP • DESCRIPTION OF WORK: (Please describe present use and proposed use) . . f 1 f ' "• ^3?><?jv^ i y\ s-fecULCcATv OVA-^ "171 <~ j5 j | lotni r\& rtrc[ t\$(l SV^/rO - • . . • : '. • - . ! - .-. .- . . •' . " BUILDING AREA (SF) ADDITION AREA (SF) GARAGE (SF) PATIOS (SF) CONTACT NAME (If Different Fdm Applicant) ^FOYYA — => i^fi r\«=^ I ^C, . ADDRESS . lS»\o KJL -, LA tA \TK>S*£- X^r CITY STATE ZIP PHONE FAX EMAIL • PROPERTY OWNER NAME ADDRESS ... CITY . , ' STATE ZIP PHONE FAX EMAIL ARCH/DESIGNER NAME & ADDRESS . STATE LIC. # DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES D # : NO D YES O NO D YES D NO D APPLICANT NAME ADDRESS ' . •' . . , . • . . CITY • STATE .ZIP ' PHONE . FAX • - . . ' . EMAIL • CONTRACTOR BUS. NAME ADDRESS s^> C'y t STATE ZlPx-7 -^* PHONE - . . FAX ^_- . . EMAIL . . ' • STATE LIC.# ' .. ' ' CLASS ' CITY BUS. LIC.S [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 a1 permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500}). ' , . ' Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: 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. 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 workers' compensation insurance carrier and policy numberare: . ' , . s~ , i n — I r I f) Insurance Co. '(^o.O-Ct-fr-0^ N)fxV% tWOX. \y\-e^.. ; : Policy No. l-^rhP V O I'^ci toHExpiralion Date U-> O°! /QX 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 (his 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. J&£ CONTRACTOR SIGNATURE DATE . / hereby affirm that I am exempt from Contractor's License Law for the following reason: O 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). a 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). a 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. QYes O No 2.1 (have / have not) signed an application for a building permit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): 4.1 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 / contractors' license number): 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): .^PROPERTY OWNER SIGNATURE DATE 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? O Yes d No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D Yes Q No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? DYes O No . . IF ANY OF THE ANSWERS ARE YES, t EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) 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 representative 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 at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). '. .s-\ > APPLICANT'S SIGNATURE DATE Q LU LU O LU DC Q <H cvj ££ «~J 00 < O« 02 ^ U- 2 T\W OSOT ,WE 8E N § f JS^ 0 ffi 02: 1 &a, r^a.W3 — £= **" P C5 fe. <C IT 1 (0 "^i^* f]oCS c "• 0 M , — ) -J i; [ r [ i 0 0 5^ Fy . & ^ 1 S :5f T 1*£., M»J -j^ffl £"i 12 g |; til M Sil-o O ^ 3 II o co ^2 as CD O UJ I ceo O 4COflir-€ERTIFICATE OF LIABILITY INSURANCE F0^0-^ ^sT™/^' PRODUCER Der Manouel Ins & Fin Svcs Inc Der Manouei Insurance Group 7405 N. First Street ; Fresno CA 93720-2823 Phone:559-447-4600 INSURED Ford Signs, Inc. 1310-A N. Melrose Drive Vista CA 92083 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A: Golden Eagle Insurance Corp. INSURER B: clarendon National Insurance INSURER C: INSURER D: INSURER E: NAIC# COVERAGES ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR fi.DO'L LTR NSRD A A A A B A A X TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY | CLAIMS MADE [xj OCCUR X Mobile Equipment GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [X~] JECT P~l LOC AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS X SCHEDULED AUTOS X HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS/UMBRELLA LIABILITY | OCCUR | | CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER Installation Float Equipment Floate POLICY NUMBER CBP8023964 CBP8023964 CBP8023964 CBP8023964 02KR0030977 CBP8023964 CBP8023964 POLICY EFFECTIVE DATE (MM/DD/YY) 05/09/07 05/09/07 05/09/07 05/09/07 05/09/07 05/09/07 05/09/07 POLICY EXPIRATION DATE (MM/DD/YY) 05/09/08 05/09/08 05/09/08 05/09/08 05/09/08 05/09/08 05/09/08 LIMITS EACH OCCURRENCE UAMAtit 1 U KbN 1 hL> PREMISES (Ea occurence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT OTr AU1 IFR THAN EA ACC OONLY: AGQ EACH OCCURRENCE AGGREGATE X E.L. E.L E.L. WC STATU- OTH- TORY LIMITS ER EACH ACCIDENT DISEASE.- EA EMPLOYEE DISEASE - POLICY LIMIT $1000000 $100000 $5000 $1000000 $2000000 $2000000 $1000000 $ $ $ $ $ $ $ $ $ $ $ $1000000 $1000000 $1000000 Ded:$1000 $20000 Ded:$500 $96692 **10 day notice of cancellation will be issued for non-payment of premium.** Winners Circle Resort Management, Inc. , Carlsbad, Inn LTD is named as additional insured per attached form GECG 602(09/04) with respects to the general liability. CERTIFICATE HOLDER CANCELLATION WINNI 1 0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOr. WINNERS CIRCLE RESORT DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN MANAGEMENT , INC . NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO so SHALL CARLSBAD INN, LTD. a omc t-f.-DTd-of.-r-. T^TITT^ IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR.3U/D WvvLiOtSAU oLtyU CARLSBAD CA 92008 REPRESENTATIVES. ' AUTHORI|EJJJ3eH5ESH^TIVE^..--p?*S" — </ ^ ACORD 25 (2001/08)©ACORD CORPORATION 1988