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Home My WebLink About1628 CORMORANT DR; ; CB121452; Permit08-01-2012 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Residential Permit Permit No: CB121452 Building Inspection Request Line (760) 602-2725 1628 CORMORANT DR CBAD RESDNTL Sub Type: 2156500408 Lot#: $5,000.00 Constuction Type: Reference #: 0 Structure Type: 0 Bathrooms: Orig PC #: DRAYTON: ADD WALLS & DOORS TO CREATE 3RD BEDROOM RAD 0 NEW Status: ISSUED Applied: 08/01/2012 Entered By: JMA Plan Approved: 08/01/2012 Issued: 08/01/2012 Inspect Area: Plan Check #: Applicant: WORTHING INC, B. A. SUITE #201 690 CARLSBAD VILLAGE DR CARLSBAD, CA 92008 760-729-3965 Owner: N LVTRUST 09-17-97 1628 CORMORANT DR CARLSBAD CA 92011 Building Permit $77.87 Meter Size Add'l Building Permit Fee $0.00 Add'l Red. Water Con. Fee $0.00 Plan Check $54.51 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 (3105540) $0.00 Park in Lieu Fee $0.00 PFF (4305540) $0.00 Park Fee $0.00 License Tax (3104193) $0.00 LFM Fee $0.00 License Tax (4304193) $0.00 Bridge Fee $0.00 Traffic Impact Fee (3105541) $0.00 Other Bridge Fee $0.00 Traffic Impact Fee (4305541) $0.00 BTD #2 Fee $0.00 Sidewalk Fee $0.00 BTD #3 Fee $0.00 PLUMBING TOTAL $0.00 Renewal Fee $0.00 ELECTRICAL TOTAL $0.00 Add'l Renewal Fee $0.00 MECHANICAL TOTAL $0.00 Other Building Fee $0.00 Housing Impact Fee $0.00 HMP Fee $0.00 Housing InLieu Fee $0.00 Pot. Water Con. Fee $0.00 Housing Credit 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 Green BIdg Stands (SB1473) Fee $1.00 Fire Sprinkler Fees $0.00 Green BIdg Stands Plan Chk Fee $0.00 Green BIdg Stands Plan Chk Fee TOTAL PERMIT FEES $134.38 Total Fees: $134.38 Total Payments to Date: $134.38 BalanceDue: $0.00 Inspector: FINAL APPROVAL Date: KIJIIULJ--Clearance: NOTICE: Rease take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reseivations, or other exactions hereafter collectively refeired to as "fees/exactlons.* You have 90 days from the date this peimit was Issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth In Govemment 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/exactlons 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 vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has oreviouslv otheiwise expired. THE FOLLOWINO APPROVALS REQUIRED PRIOR TO PERMITISSUANCE: DPIANNING •ENGINEERING DBUILDING DFIRE DHEALTH •HAZMAT/APCD ^ CITY CARLSBAD O F Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718/2719 Fax: 760-602-8558 www^.ca rlsbadca.gov Plan Check No. I'Z \ ^ S Est. Value Plan Ck. Deposit Date IL SWPP JOB ADDRESS SUITE#/SPACE#/UNIT# CT/PROJECT# PHASE# # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TVPE OCC GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) , I A EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YES • # NOD AIR CONDITIONING YES • NO • FIRESPRINKLERS YES D NOD APPUCANT NAME (Primary Contact) | A APPLICANT NAME (Secondary Contact) ADDRESS ADDRESS CITY STATE Or ZIP CITY STATE ZIP PHONE PHONE EMAIL FAX EMAIL rOTV nwMCD NAME PROPERTY OWNER NAME CONTRACTOR BUS. NAME .. NAME , 1 t L_ / T. . 7^ A STATE zip ADDRESS ADDRESS CITY STATE ZIP CITY PHONE , ^ ^ EMAIL /• 'x \ PHONE lESIGNER NAME & ADOnESS 5' EMAIL Iff) Gtfifti.^ /Vc ARCH/DESIGNER NAME SADDREpS STATE L|C.# CITY BUS. LIC.# (Sec. 7031.5 Business and Professlcms 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 sigJied statement that he is licensed pursuantto the provisions ofthe Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3 ofthe 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 appllcantfor a permit subjects the appiicant to a civil penalty of not more than five hundred doiiars ($500)). W ORKERS- CQMPE N S A T I O W Workers'Compensation DedtrStion: I hereby affinn under penalty d peijury one of the following declarations: O 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. TSI'l have and will maintain workers' coraDensatloiv as required by Section 3700 of the Labor Code, for the perfomiance offte work for which this permit is issued. My workers' compensation ifisurance carrier and policy number are: Insurance Co.. rj9^-W-e.<r:}.^^^yi^tA. TM^. Policy Nn.VM - gC-" 1 - l-Z-6<DirationDate t/ I /if, This section need not be completed ifthe permit is for one hundred dollars ($100) or less. O Certificate of Exemption; I certify that in the perfonnance 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 unlawful, and shall subject an employerto criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages as provided for ifTSiction 370S of the Labor code, interest and attomey's fees. >gf CONTRACTOR SIGNATURE "^^^yl y#^V^yOf(KJ OAGENT DATE OWNER-BUILDER DECLARATI C» N / hereby affirm that I am exempt from Contractor's Ucense Law for the following reasoi itio\will/o , as owner of the property or my employees with wages as their sole compensatio\will/o 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 oflered for sale. If, however, the building or improvement is sold within one year of compietion, the owner-builder will have the burden of proving that he did not buiid or improve for the purpose of sale). I, as owner of the property, am exclusively contrxting with licensed contrxtors 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 contrxtor(s) licensed pursuant to the Contractor's License Law). I am exempt under Section Business and Professions Code for this reason: 1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement. • Yes O No 2.1 (have / have nol) signed an application for a building permit for the proposed wortt. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): 4.1 pian 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 wori<, but I have contracted (hired) the foiiowing persons to provide the work indicated (include name / address / phone / type of work): vfiUfpROPERTY OWNER SIGNATURE •AGENT DATE COMPLETE THiS SECTION rOR NON-RESIDENTiAL BUILDINGf PERMITS ONLY Is the applicant or futuie building occupant required to submit a business plan, acutely hazardous matertals registration form or risk management and prevention program under Sections 25505,25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? CH Yes • No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management distrtct? • Yes DNo Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? • Yes • 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. CONSTRUCTION LENDING! AGENCY I hereby affirm that there is a construction lending agency for the perfomiance of the work this pennit is issued (Sec. 3097 (I) Civil Code). Lender's Name Lender's Address APPLICANT CERTirlCATlON I certily that I have read the application and state that the above information is conect and thatthe infbmiation on the plans is accurate. I agree to comply with all CMy oidlnances and State laws relating to building constiuction. I hereby aulhorize representative of the Qty of Cailsbad to enter upon Ihe above mentbned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST Aa LIABILrriES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA An OSHA pemiit is required for excavations over 5'0' deep and demolifion or constructbn of stnictures over 3 stories in heighL EXPIRATION: Every pennit issued by the Building Offcial under fhe provisbns of this Code shall expire by limitafion and become null and void if the buikJing or writ authorized by such perniit is not commenced within 180 days from ttie date of such pemilt or if ttiebafcling or york aulhorized by such permit is suspended or abandoned at any fime after Ihe vwik is commenced for a period of 180 days (Secfion 106.4.4 Uniform Buifcling Code). ygTAPPLICANT'S SIGNATURE DATE STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. Fax (760) 602-8560, Email www.bulldino(5!carlsbadca.aov or Mail the completed forni to City of Cadsbad, Building Division 1635 Faraday Avenue, Carisbad, California 92008. C0#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING AODRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE FAX OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS • PICK UP: • CONTACT (Listed above) • OCCUPANT (Listed above) • CONTRACTOR (On Pg. 1) a MAIL TO: • CONTACT (Listed above) • OCCUPANT (Listed above) • CONTRACTOR (On Pg. 1) • MAIL / FAX TO OTHER: • ASSOCIATED CB# • NO CHANGE IN USE / NO CONSTRUCTION • CHANGE OF USE / NO CONSTRUCTION ^APPLICANT'S SIGNATURE DATE Inspection List Permit*: CB121452 Date Inspection Item 08/23/2012 89 Final Combo 08/23/2012 89 Final Combo 08/03/2012 84 Rough Combo Type: RESDNTL RAD Inspector PD PD Act Rl AP AP DRAYTON: ADD WALLS & DOORS TO CREATE 3RD BEDROOM Comments GATE CODE 31.07 Friday, August 24, 2012 Page 1 of 1 tt