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Home My WebLink About1790 Cottonwood Ave; ; CBR2018-0072; PermitPrint Date: 07/03/2019 Job Address: 1790 Cottonwood Ave Permit Type: BLDG-Residential Parcel No: 2155033717 Valuation: $0.00 Occupancy Group: # Dwelling Units: Bedrooms: Project Title: Description: NORVELL: GAS LINE REPAIR Residential Permit Work Class: P/M/E Lot#: Reference#: Construction Type: Bathrooms: Orig. Plan Check#: Plan Check#: Owner: Status: Applied: Issued: Permit Finaled: Inspector: Final Inspection: Co-Applicant: NCP INC (city of Carlsbad Permit No: CBR2018·0072 Closed -Withdrawn 01/10/2018 01/10/2018 01/18/2018 KATHERINE NORVELL 1790 Cottonwood Ave CARLSBAD, CA 92011 760-505-5975 2613 Temple Heights Dr, Ste B Oceanside, CA 92056-3583 760-735-4900 FEE PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT Total Fees: $170.00 Total Payments To Date: $170.00 Balance Due: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." 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 limitation has previously otherwise expired. Building Division 1635 Faraday Avenue, Carlsbad CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov AMOUNT $170.00 $0.00 ' , ( Cicyof Carlsbad JOB ADDRESS Building Permit Application 1635 Faraday Ave., Garlsbad, CA 92008 Ph: 78CMI02-271.9 Fax: 760-602-8558 email: bulldlng@carlsbadca.gov www.carlsbadca.gov SUITE#/SPACE#/UNIT# DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) Geo~ I 1 .r\<2-, ·· Plan Check No. Cll,E:__ dO I Est. Value Plan Ck. Deposit Date APN EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES □# __ NOD YES □ NO □ YES □ NO □ APPLICANT NAME (Primary Contact) Vel l ADDRESS CITY STATE ZIP ZIP q 2,o I I ~---0 PHONE FAX EMAIL CuWJ CITY STATE ZIP ZIP PHONE FAA EMAIL STATE LIC. # (Sec: 7031.5 Business and P_rofessions 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 per_m1t to file a s1~ned statement that he 1s licensed pursuant to the provisions of the Contractor's License Law /Chapter 9, commend mg with Section 7000 of Division 3 of the B_usmess and Professions Code} or [hat he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 1031.5 by any applicant for a permit subjects the applicant to a c1v1I penalty of not more than five hundred dollars {$500}). t WORKERS' COMPENSATION ~,~7f' ,, ,,, % /2~:,, /2---/2 Workers' Compensalion Declaralion: / hereby affirm under penalty of petjury one of the following declarations: D 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 D 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 number are: Insurance Co ______________________ Policy No _______________ Expiration Date _________ _ This section need not be completed if the permit is for one hundred dollars ($100) or less D Certificale of Exemplion: 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 unlawful, and shall subject an employer to criminal penalties and civil fines up lo 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. fl5 CONTRACTOR SIGNATURE □AGENT DATE I hereby affirm that I am exempt from Contractor's License Law for the following reason: □ 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). D 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 D Yes D No 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 I phone I 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 I phone I contractors' license number) provide some of the work but I have contracted (hired} the following persons to provide the work indicated (include name/ address I phone I type of work)· □AGENT 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? □ Yes □ No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ Yes □ No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ 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 ANO THE AIR POLLUTION CONTROL DISTRICT. I certify that I have read the application and state that the above information ls 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 au1horize representative of 1he City of Carlsbad to enter upon 1he 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 strucllJres over 3 stories in hek;Jht EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by txnitation and become nun and void W the building or wor1( authorized by such permit is not commenced within 180 days from the date of such permit or W e 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). DATE \O I~