HomeMy WebLinkAbout1835 CHESTNUT AVE; ; CB041580; Permitr
05-11-2004 '
City of Carlsbad
s Faraday Av Carlsbad, CA 92008
Miscellaneous Permit Permit No: CB04 1580
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
Project Title:
1835 CHESTNUT AV CBAD
MISC
2052303200
$1,500.00
Subtype: OTHER
Lot#: 0
HERNANDEZ RESIDENCE
CREATE OFFICE & PLAYROOM W/ELEC & MECH.
Applicant:
HERNANDEZ ADOLFINA V
1835 CHESTNUT AVE
CARLSBAD CA 92008
Status: ISSUED
Applied: 05/11/2004
Entered By: MDP
Plan Approved: 05/11/2004
Issued: 05/11/2004
Inspect Area: PD
Owner:
HERNANDEZ ADOLFINA V
1835 CHESTNUT AVE
CARLSBAD CA 92008
Miscelaneous Fee #1
Miscelaneous Fee #2
Additional Fees
MECH ELEC
PERMIT
$44.00
$60.00
$0.00
TOTAL PERMIT FEES $104.00
Total Fees:$104.00 Total Payments To Date:$0.00 Balance Due:$104.00
05/11/04 0002 01 02
104.00
/I I
Inspector: -j
FINAL APPROVAL
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.
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
Addmss (include Bldg/Suite #)
FOR OFFICE USE ONLY
PLAN CHECK NO.,
EST. VAL.
Plan Ck. Deposit.
Validated By
Date
Business Name (at this address)
Legal Description Lot No.Subdivision Name/Number Unit No. Phase No. Total tt of units
Assessor's Parcel #Existing Use proposed Us^e
Description of Work
f
2, . CONTACT PERSON (if different from applicant)
SO. FT.#of Stories tt of Bedrooms tt of Bathrooms
Name Address City
0,' , APPLICANT Q Cantraptai;. D,Agent for Contractor . Q Owner- Q-Agent far Owner
State/Zip Telephone tt Fax tt
Name
OWNER >_
Address
'' s -
5L
City State/Zip Telephone tt
* "Z
A
City State/Zip Telephone #Name " j Address
.B^CCiNtBAQTOBf COMPANY NAME r - ' - -.-.," ~ "- ' , - ' , ' , .- '' -
(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 ($5001).
Name
State License #
Address
License Class
City State/Zip
City Business License tt
Telephone #
Designer Name Address City State/Zip Telephone
State License #
»f', , WORKERS'COMPENSATION . .
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
Q 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.
Q 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 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 [$100] OR LESS)
Q 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 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.
SIGNATURE DATE
WtolER^^ -. -r -. -"-,-'.>• -<•' .- -V,,1 - -
l hereby affirm that I am exempt from the Contractor's License Law for the following reason:
ffl 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).
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).
l~l 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. l~l 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 / contractors license number):
4. (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
number / 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 / type
of work):
V.PROPERTY OWNER SIGNATURE
'COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONK
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? - 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? Q YES 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.
'.9^. CONSTRUCTION LENDING AGENCY-:.. -, .„•„,., :.. c -./_:.v
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,.8l, APPLICANT CERTIFICATIONS '. - -•• ,"* ••-.- .. - - .,.-,., « . t . , - - . .
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 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 PjL LIABILITIES,
JUDGMENTS. COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS/ERMIT.
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 ot abandoned
„ at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). ) / /
^APPLICANT'S SIGNATURE /L^M) ////?^ \J& [tfl_StyP'-fr " ' DATE S" ////
YWHITE: File YELLOW: Applicant PINK: Finance
City of Carlsbad Bldg Inspection Request
For: 07/08/2004
Permit* CB041580
Title: HERNANDEZ RESIDENCE
Description: CREATE OFFICE & PLAYROOM W/ELEC & MECH.
Inspector Assignment: PD
1835 CHESTNUTAV
Lot
Type:MISC Sub Type: OTHER
Job Address:
Suite:
Location:
APPLICANT HERNANDEZ ADOLFINA V
Owner: HERNANDEZ ADOLFINA V
Remarks: wall inspection
Phone: 7607;
Inspector
Total Time:Requested By: ?
Entered By: CHRISTINE
CD Description Act Comment
14 Frame/Steel/Bolting/Welding
Associated PCRs/CVs
Inspection History
Date Description
06/30/2004 14 Frame/Steel/Bolting/Welding
06/30/2004 34 Rough Electric
06/10/2004 14 Frame/Steel/Bolting/Welding
06/10/2004 34 Rough Electric
06/09/2004 14 Frame/Steel/Bolting/Welding
05/19/2004 14 Frame/Steel/Bolting/Welding
Act Insp Comments
AP PD WALUWINDOW
AP PD RECEPS
CO PD SEE ATTACHED NOTICE
CO PD
NS PD
CO PD ON CARD
City of Carlsbad Bldg Inspection Request
For: 06/10/2004
Permit* CB041580
Title: HERNANDEZ RESIDENCE
Description: CREATE OFFICE & PLAYROOM W/ELEC & MECH.
Inspector Assignment: PD
1835 CHESTNUT AV
Lot
Type:MISC Sub Type: OTHER
Job Address:
Suite:
Location:
APPLICANT HERNANDEZ ADOLFINA V
Owner: HERNANDEZ ADOLFINA V
Remarks: PLEASE-INSPECT-AROUND^Piy^
Total Time:
14
5
CD Description
Frame/Steel/Bolting/Welding
Act Comment
Phone: 0000000000
Inspector:
Requested By: LAURA
Entered By: CHRISTINE
Associated PCRs/CVs
Inspection History
Date Description Act Insp Comments
05/19/2004 14 Frame/Steel/Bolting/Welding CO PD ON CARD
NOTICE
CITY OF CARLSBAD (760) 602-2700
BUILDING DEPARTMENT 1635 FARADAY AVENUE
r In-10-DATE Iff IV- "I TIME.
LOCATION
PERMIT NO.V1&
ut
CT'O
/$
t>£
? t_|^YESFOR INSPECTION CALL (760) 602-2725. RE-INSPECTION FEE DUE?
FOR FURTHER INFORMATION, CONTACT .
rf —y/"-" PHONE
£ /£•
BUILDING INSPECTOR CODE ENFORCEMENT OFFICER