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Home My WebLink About1870 BIENVENIDA CIR; ; CB041414; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 NOTICE: Please take NOTICE tbt approval of your project includes the 'Imposition" of fees, dedications, reselvations, 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 feeslexactions. 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 feeslexactions 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 ~ I 04-28-2004 Miscellaneous Permit Permit No: CB041414 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: MlSC Subtype: OTHER Status: ISSUED Parcel No: 2072504700 Lot#: 0 Applied: 04/28/2004 Valuation: $2,500.00 Entered By: MDP Reference #: Plan Approved: 04/28/2004 Issued: 04/28/2004 Project Title: FORMANEK RESIDENCE Inspect Area: 1870 BIENVENIDA CR CBAD WINDOW POP OUTS @ LEFT SIDE W/ ELEC Applicant: Owner: FORMANEK SHEILA TR 1870 BIENVENIDA CIR CARLSBAD CA 92008 CARLSBAD CA 92008 Miscelaneous Fee #I Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES ELEC WINDOWS $20.00 $120.00 $0.00 $140.00 Total Fees: $140.00 Total Payments To Date: $0.00 Balance Due: $1 40.00 InsPector: Date: Clearance: PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 Date FOR OFFICE USE ONLY PLAN CHECK NO. & !'!(q EST. VAL. Plan Ck. Deposit Validated By f Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units ! Assessor's Parcel # Existing Use Proposed Use t \ mescriotion of Work 1 Sa FT. - r ~ #of Stories # of Bedrooms # of Bathrooms (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 Code1 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]). Name Address City Statelzip Telephone # State License # License Class City Business License # Designer Name Address City State/Zip Telephone State License # 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 unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,00OL in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. 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 SIGNATURE DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 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 sr 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(sl licensed pursuant to the Contractor's License Law). 0 1. 2. 3. 4. number I contractors license number): 5. in 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). I am exempt under Section I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ON0 I (have / have not) signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction (include name I address I phone number / contractors license number): 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 I address 1 phone I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name I address / phone number / type Business and Professions Code for this reason: 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? 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 [7 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. 0 YES 0 NO 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 CER 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 Cit) 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 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 or abandoned at any time after the work APPLICANT'S SIGNATUR Lg-gIJd - DATE 3/26 /n d of 1 ys (Section 106.4.4 Un' rm Building Code). WHITE: File YELLOW Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 09/08/2004 Permit# CB041414 Title: FORMANEK RESIDENCE Description: WINDOW POP OUTS 0 LEFT SIDE W/ ELEC Type: MlSC Sub Type: OTHER Job Address: 1870 BIENVENIDA CR Suite: Lot 0 Location: OWNER FORMANEK SHEILATR Owner: FORMANEK SHEILA TR Remarks: Total Time: Inspector Assignment: Phone: 7609087706 Inspector: Requested By: CARL LEROY Entered By: CHRISTINE CD Description Act Comment 14 Frame/SteeUBoltingMlelding 19 Final Structural Associated PCRs/CVs Inspection History Date Description Act lnsp Comments t: 2 N -- d ‘I 1 1 U t c--. I /’ ! I ! I .. r. Y’ . ,- ,