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Home My WebLink About1890 RUTHERFORD RD; 100; CB120431; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 03-12-2012 Miscellaneous Permit Permit No: CB120431 Building Inspection Request Line (760) 602-2725 Job Address: 1890 RUTHERFORD RD CBAD St: 100 Permit Type: MISC Subtype: OTHER 0 Status: Parcel No: 2121203500 Lot#: Applied: Valuation: $0.00 Entered By: Reference #: Plan Approved: PC#: Issued: Inspect Area: Project Title: GENOPTIX DEMO NON BEARING PARTIONS, CEILING, MECH DUCTING Applicant: GOOD & ROBERTS INC. 1090 JOSHUA WAY VISTA, CA 92083 619-598-7614 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: $130.00 DEMO PLUMBING Owner: PDG CARLSBAD 47&48 L P 1826GILLESPIE WAY #102 EL CAJON CA 92020 Total Payments To Date: $130.00 Balance Due: Clearance: ISSUED 03/12/2012 MOP 03/12/2012 03/12/2012 PY $65.00 $65.00 $0.00 $130.00 $0.00 NOTICE: Please take NOTICE at approval of your project includes the "lmposit1 n" o 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 ou have revious been iven a NOTICE similar to this or as to which the statute of limitations has revious otherwise ex ired. CITY OF CAR BAD JOB ADDRESS CT/PROJECT# DESCRIPTION OF WORK: EXISTING USE CITY PHONE EMAIL PROPERTY OWNER NAME. ADDRESS CITY PHONE EMAIL ARCH/DESIGNER NAME & ADDRESS Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 I 2718 / 2719 Fax: 760-602-8558 www.carlsbadca.gov SUITE#/SPACE#/UNIT# # BEDROOMS # BATHROOMS PATIOS (SF) DECKS (SF) Plan Check No. Est. Value Plan Ck. Deposit Date APN FIREPLACE YESD # __ NOD APPLICANT NAME (Secondary Contact) C ADDRESS CITY STATE PHONE FAX EMAIL CONTRACTOR BUS. NAME ADDRESS STATE ZIP CITY FAX PHONE EMAIL STATE UC.# STATE UC.# CLASS SWPP CONSTR. TYPE OCC. GROUP AIR CONDITIONING YES D NOD ZIP FIRE SPRINKLERS YES D NOD (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 exemQt 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]). Workers' Compensation Declaration: I hereby affirm under penalty of petjury one of the following declaraffons: 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 . .tJt"1 have and will maintain workers' com ensation, as requ'.'ed by Section 3700 of the Labor Code, for the performance of,th\ work for which this permit is iss_ued. My workers' compensation insur nee c rrier and policy number are: Insurance Co. ,-, Policy No. ;JuJC. (0 0 $231 Expiration Date , This section need not be completed if the permit is for one hundred dollars ($100) or less. D 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 bec_ome 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. ,/E5 CONTRACTOR SIGNATURE I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: LI 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). LI 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). LI 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. LI Yes LI No 2. I (have I 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 I address I phone I 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 I address I phone I type of work): ,/E5 PROPERTY OWNER SIGNATURE CJ 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? Cl Yes Cl No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Cl Yes Cl No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Cl Yes Cl No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR rs MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 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 Cily ordinances and State laws relating to building construction. I hereby authorize representative 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 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 ormrk authorized by such permit is not commenced within 180 days from the date of such permit or if the building ormrk authorized by such permit is suspended or abandoned at any time after the mrk is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). A$ APPLICANT'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.buildinq@carlsbadca.gov or Mail the completed fonm to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS Cl PICK UP: o CONTACT (Listed above) o OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) Cl MAIL TO: o CONTACT (Listed above) o OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) Cl MAIL/ FAX TO OTHER: ________________ _ A$ APPLICANT'S SIGNATURE o ASSOCIATED CB# .... o NO CHANGE IN USE/ NO CONSTRUCTION o CHANGE OF USE/ NO CONSTRUCTION DATE ZIP Inspection List Permit#: CB120431 Type: MISC Date Inspection Item 09/06/2012 19 Final Structural 04/05/2012 21 Underground/Under Floor Thursday, September 06, 2012 OTHER GENOPTIX DEMO NON BEARING PARTIONS, CEILIN Inspector Act Comments PD AP PY AP Page 1 of 1