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Home My WebLink About1287 BUENA VISTA WAY; ; CB012910; Permit; 09-07-2OO 1 ' 'Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: Amlicant: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Building Inspection Request Line (760) 602-2725 Miscellaneous Permit Permit No:CB012910 1287 BUENA VISTA WY CBAD MlSC Subtype: OTHER Status: ISSUED 1562300100 Lot #: 0 Applied: 09/07/2001 $1,500.00 Entered By: CB Plan Approved: 09/07/2001 Issued: 09/07/2001 GIOVANNETTI RES/ REPLACING Inspect Area: Owner: GIOVANNETTI ROBERT A~IJANET s GIOVANNETTI ROBERT A&JANET S 1287 BUENA VISTA WAY ,CARLSBAD CA 92008 1287 BUENA VISTA WAY 9352 09/*7/01 Ooo2 02 CARLSBAD CA 92008 CGF' 60 900 f Total Fees: $60.00 Total Payments To Date: $0.00 Balance Due: $60.00 i Miscelaneous Fee #I PERMIT FEE $60.00 Miscelaneous Fee #2 $0.00 Additional Fees $0.00 TOTAL PERMIT FEES $60.00 @ :-'L SfGlM~~ FINAL APPROVAL Clearance: Inspector: Date: 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 feeslexactiions. 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 Carisbad 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 feeslexactions DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any feeslexactions of which you have previously been qiven a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. PERMIT APPLICATION CITY OF*CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 -_ 1. PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO&'?/2q/O EST. VAL. Plan Ck. Deposit Validated By && Date I7537 Buf5+6zb W\S.b (Y-Lh-I cjwG=s*p\p Business Name lat this address) Address (include BldgISuite #I Legal Description Lot No. Subdivision NamelNumber Phase No. Total X of units Unit No. Assessor's Parcel X . Existing Use Part* Proposed Use =5\;L€Z-. - GbGBA LfiWPd p LP-=%i% \- Deschtion of Work sa. FT. #of Stories 1, 0) Bedrooms 1, of Bathrooms \.-to 5.-y4zwP.vL~- 6*7---cFJ 2. Name Address City StateIZip Telephone 1, Fax X 3. APPLICANT a Cornramor [3 Agent for Contractor @Owner 0 Agent for Owner Name Address City Statelzip Telephone 1, 4. PROPERTY OWNER Name .CONTACT PERSON (If different from appEcnnt) L-lF-i-7 SW.-l LAb\M+ [ ZS7 kc,et+t3, V~TP \AM. 6Prlkc-&PU> CA .9 2ocp- 1-7 [ <*- 1 \.. l$k 7~30--Zi35\\4-(pO Address City StateIZip Telephone X SAt+ 6, 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 Codel 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 155001). Name Address City Statelzip Telephone X State License X License Class City Business License # Designer Name Address City StateIZip Telephone State License # 6. WORKERS' COMPENSATtON Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 of the work for which this permit is issued. 0 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) 0 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 unkwful. and 8h.U subject an employer to criminal ponaltku and civil fines up to one hundrmd thousand dollan ($100,000). in addition to the coat of compensation, damages aa provided for in Section 3706 of the Labor code, interest and ettomy's fees. SIGNATURE DATE I hereby affirm that I em exempt from the Contractor's License Law for the following reason: 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 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 7. OWNER-BUILDER DECLARATION 1, 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 x ( c. 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). 0 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(s1 licensed pursuant to the Contractor's License Law). 0 1. I am exempt under Section I personally plan to provide the major labor and materials for construction of the proposed property improvement. Business and Professions Code for this reason: YES ON0 2. eve not) signed an application for a building permit for the proposed work. x 3. 4. number I contractors license number): 5. I have contracted with the following person (firm) to provide the proposed construction (include name I address I phone number I contractors license number): I plan to provide portions of the work, but I have hire following person to coordinate, supervise and provide the major work (include name I address I phone I will providesome of the work. but Ihave contradhhiredl thebollowing persons to provide the work indicated (include name I address I phone number I type of work): PROPERTY OWNER SIGNATURE DATE 7 COMPLETE THIS SECTION FOR~N-~DBV~~AL BUII!QING PEmip ONLY Is the applicant or future build&g occupant required to skiTftTdiness plan, acutely hazardous materials registration form or risk management and prevention program under Sbctions 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES 0 NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 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 ISec. 3097li) Civil Code). LENDER'S NAME LENDER'S ADDRESS 9. APPLICANT CERTIFICATION 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 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 OSHA: An OSHA permit is EXPIRATION: Every permit authorized by such permit is 0 YES 0 NO at any time alter the work is commence APPLICANT'S SIGNATURE DATE niform Building Code). -. WHITke- YELLOW: Applicant PINK: Finance /'