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HomeMy WebLinkAbout1490 PINE AVE; ; CB013666; Permit11-28-2001 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: City of Carlsbad 1635 Faraday Av Carlsbad, OA 92008 Residential Permit Permit No:CB013666 Building Inspection Request Line (760) 602-2725 1490 PINEAVCBAD RESDNTL 2050202300 $1,800.00 0 0 Sub Type: RAD Lot #: 0 Construction Type: VN Reference #: Structure Type: Bathrooms: 0 NELSON • ADD INTERIOR BATHRM Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: Orig PC#: Plan Check#: ISSUED 11/28/2001 JM 11/28/2001 11/28/2001 Applicant: WORTHING INC. B. A. 690 CARLSBAD VILLAGE DR CARLSBAD. CA 92008 619-729-3965 Owner: NELSON ALBERT A TR 3218MCKINLEY ST CARLSBAD CA 92008 5449 11/28/01 0002 01 02 CGP 152.37 Total Fees: $152.37 Total Payments To Date:$0.00 Balance Due: $152.37 Building Permit $34.77 Meter Size Add'] Building Permit Fee $0.00 Add'l Red. Water Con. Fee $0.00 Plan Check $22.60 Meter Fee $0.00 Add'l Plan Check Fee $0.00 SDCWA Fee $0.00 Plan Check Discount $0.00 CFD Payoff Fee $0.00 Strong Motion Fee $1.00 PFF $0.00 Park in Lieu Fee $0.00 PFF {CFD Fund)$0.00 Park Fee $0.00 License Tax $0.00 LFM Fee $0.00 License Tax (CFD Fund)$0.00 Bridge Fee $0.00 Traffic Impact Fee $0.00 Other Bridge Fee $0.00 Traffic Impact (CFD Fund)$0.00 BTD #2 Fee $0.00 Sidewalk Fee $0.00 BTD #3 Fee $0.00 PLUMBING TOTAL $48.00 Renewal Fee $0.00 ELECTRICAL TOTAL $20.00 Add1 Renewal Fee $0.00 MECHANICAL TOTAL $26.00 Other Building Fee $0.00 Housing Impact Fee $0.00 Pot. Water Con. Fee $0.00 Housing InLieu Fee $0.00 Meter Size Master Drainage Fee $0.00 Add'l Pot. Water Con. Fee $0.00 Sewer Fee $0.00 Reel. Water Con. Fee $0.00 Additional Fees $0.00 TOTAL PERMIT FEES $152.37 Inspector: FINAL APPROVAL Date:Clearance: NOTICE; Please lake NOTICE that approval of your project Includes the Impositjon" of fees, dedications, reservations, or other exactions hereafter collectively referred to as lees/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 ttiat 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 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 fees/exactions of which vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. PEllMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1. PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO fEST. VAL. Plan Ck. Deposit Validated Bv TljW Date zzz Address (includeBldg/Suite/) W^O 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 # of Bedrooms # of Bathrooms 2. CONTACT PERSONiltf ififfmnt froni appaeant} Fax # 7 (ho Name Address 3, APPLICANT Q Goittwctor Q AgentforContraOt^'^^OibVwiibr' City Agent; for Owner"^' State/Zip Telephone # BA WORTHING, INC, PC BOX 1041, CARLSABD,CA 92018 7fin-77Q-^Qfit^ Name A. PROPERTY OWNERA Address City State/Zip Teiephon^F 1 14^ IWe. a-7jDd?-, Name Address City ( State/Zip Telephone # B. CONTRACTOR • COMPANY NAME i (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 |$500]). BA WORTHING, INC. PO BOX 1041, CARLSABD.CA 92018 760-729-3965 Name State License # 39874 BROOKS WORTHING Address License Class POROX 1041■ City Stata/Zip Telephone #City Business License # 549200 CARLSBAD, CA 92018 760-729-3965 B-1 Address 392894 City State/Zip TelephoneDesigner Name State License # B— 1 6. WORKERS'COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: n I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Coda, 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 led. My worker's compensation insurance carrier and policy number are: Insurance Company STATE FUND Policy NO.046--01 Ullit 8775 Expiration Datel-1—02 {THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [»1001 OR LESS) n 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 workm' compensation coverage is unlawful, and ^all subject an ampioyaf to criminal penaHiea and civil fines up to one hundredthousand dollars in add-on to the cost of compensation, damages as provided for in Section 3706 of tha Labor code, interest and attomey's fees.Labor code, interi DATE )ECLARATION1 hereby affirm that I am exempt from thd Contractor's License Law for the following reason: Q I, as owner of the property or my/emuoyees 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 The Contractor's License Lew does not apply to an owner of property who builds or improves thereon, and who doessuch 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 ha 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 am exempt under Section Business and Professions Co^e 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 t 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 / phonenumber / 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 I type of work): PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOR W/Vr/IE5/OfiV7Z4Z 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 26505, 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? O TES O 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. APPUCANT 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 CitV 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 S'O" 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 workauthorized by such permit is not comnjBjiced wi^n 180 days from the date of such permit or it the building or work authorized by such permit is suspended or aliandoned at any time after ttie work is co: APPLICANT'S SIGNATUR Section 106.4,4 Uniform Building Code). DATE WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad BIdg Inspection Request For: 03/12/2002 Inspector Assignment: PYPermit# CB013666 Title: NELSON-ADD INTERIOR BATHRM Description: Type: RESDNTL Sub Type: RAD Job Address: 1490 PINEAV Suite: Lot 0 Location: APPLICANT WORTHING INC, B. A. Owner: NELSON ALBERT A TR Remarks: Phone: 7607293965 Inspector: Total Time: CD Description 19 Final Structural 29 Final Plumbing 39 Final Electrical 49 Final Mechanical Requested By: GAIL Entered By: CHRISTINE Act Comments Associated PCRs Inspection History Date Description Act Insp 01/30/2002 17 Interior Lath/Drywall AP GG 01/28/2002 16 Insulation AP GG 01/24/2002 84 Rough Combo AP GG 12/06/2001 21 Underground/Under Floor AP GG PLANNING/ENGINEERING APPROVALS PERMIT NUMBER CB 0 L id-C ADDRESS IHQO DiA<i DATE If aw/ RESIDENTIAL TENANT IMPROVEMENT RESIDENTIAL ADDITION MINOR (<$10,000.00) PLAZA CAMINO REAL CARLSBAD COMPANY STORES VILLAGE FAIRE COMPLETE OFFICE BUILDING OTHER PLANNER DATE lilM ENGINEER DATE Docs/Mlsforms/Planning Engineering Approvals