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HomeMy WebLinkAbout1905 CALLE BARCELONA; 120; CB110012; Permit01-04-2011 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Commercial/Industrial Permit Permit No: CB110012 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: Project Title: Applicant: SIMACCONSTRUCTION INC 15938 BERMUDA CENTER DR SD 92127-1828 858-674-9880 1905 CALLE BARCELONA CBAD St: 120 Tl - Sub Type: COMM 2550120400 Lot#: 0 Status: ISSUED $0.00 Construction Type: NEW Applied: 01/04/20.11 Reference*: Entered By: RMA THE FORUM- LANDLORD DEMOLITION Plan Approved: 01/04/2011 (SUITES 115 & 120) OF NON LOAD-BEARING WALLS & DROP Issued: 01/04/2011 Inspect Area: Plan Check#: Owner: FOURTH QUARTER PROPERTIES XXX L L C C/O THOMAS TROPEA 45 ANSLEY DR NEWNAN GA 30263 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Plan Check Discount Strong Motion Fee Park Fee LFM Fee Bridge Fee BTD #2 Fee BTD #3 Fee Renewal Fee Add'l Renewal Fee Other Building Fee Pot. Water Con. Fee Meter Size Add'l Pot. Water Con, Fee Reel. Water Con, Fee Green Bldg Stands (SB1473) Fee Fire Expedited Plan Review $0.00 Meter Size $0.00 Add'l Reel. Water Con. Fee $0.00 Meter Fee $0.00 SDCWA Fee $0.00 CFD Payoff Fee $1,00 PFF (3105540) $0.00 PFF (4305540) $0.00 License Tax (3104193) $0.00 License Tax (4304193) $0.00 Traffic Impact Fee (3105541) $0.00 Traffic Impact Fee (4305541) $0.00 PLUMBING TOTAL $0.00 ELECTRICAL TOTAL $65.00 MECHANICAL TOTAL $0.00 Master Drainage Fee Sewer Fee $0.00 Redev Parking Fee $0.00 Additional Fees $1.00 HMPFee $0.00 TOTAL PERMIT FEES $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $67.00 Total Fees:$67,00 Total Payments To Date:$67.00 Balance Due:$0.00 Inspector: FINAL APPROVAL Date: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. CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717/2718/2719 Fax: 760-602-8558 www.carlsbadca.gov Plan Check No. Est. Value Plan Ck. Deposit Date / I L{/ U SWPPP SUITE#/SPACE#/UNIT# PHASE # # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Areafs) p/R CONDITIONING YES D NOD CONTACT NAME (If Different Fom Applicant PROPERTY OWNER NAME CONTRACTOR BUS. NAME ARCH/DESIGNER NAME & ADDRESS (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 theapplicant 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 theBusiness 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 acivil penalty of not more than five hundred dollars ($500)). Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: G 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 perm it is issued. ffi I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for whicyhis permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. <gr*.a-6<N-» >TtT e^Tf^ff^_ \l*3&> , ffo . Policy No. ^£ ^>^j£3 |[ Expiration Date fa /£*"* / 11 I I, ' f This section need not be completed if the permit is for one hundred dollars ($100) or less. ' O 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 ttajLabor code, interest and attorney's fees. / ) JB!> CONTRACTOR SIGNATURE (^PlsttA J?' \^20MM2j&li4&A-~ \~\ OAGENT DATE / J_f*/J] I hereby affirm that I am exempt from Contractor's License Law for the following reason: O 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). D 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 contractors) 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. O Yes O No 2.1 (have / have not) signed an application for a building permit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): 4.1 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 / contractors' license number): 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): PROPERTY OWNER SIGNATURE l~l DAGENT 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? CJYes gWo Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? a Yes Is the facility to be constructed within 1,000 feet of the outer boundary of a 'school site? OYes IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPAK EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address 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 otthis Code shall expire by limitation and become null and void if the building or work authorized by such permit is notcommenced within 180 days from the date of such permit or if the building or wojjs authorized by suffinenmit is suspended or abandoned at any time after the work is commenced fqr a period of 180 days (Section 106.4.4 Uniform Building Code). >€f APPLICANT'S SIGNATURE DATE City of Carlsbad Bldg Inspection Request For: 04/05/2011 Permit* CB110012^ Inspector Assignment: Title: THE FORUM- LANDLORD DEMOLITION Description: (SUITES 115 & 120 ) OF NON LOAD-BEARING WALLS & DROP CEILING - IN PREPARATION FOR FUTURE Type:TI Sub Type: COMM Phone: 7603170981 Job Address: 1905 CALLE BARCELONA Suite: 120 Lot: 0 Location: Inspector: APPLICANT SIMACCONSTRUCTION INC Owner: Remarks: Total Time: Requested By: JASON Entered By: CHRISTINE CD Description Act Comments \14 Frame/Steel/Bolting/Welding ' 24 Rough/Topout 34\ Rough Electric 44 i Rough/Ducts/Dampers Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# PCR03133 ISSUED BORDERS REV WALL CONST. TYPE; NON BEARING PCR03183 ISSUED ULTA/BORDERS-EXTEND EXISTING; DUCTS FROM BORDERS TO ULTA SW100556 ISSUED URBAN OUTFITTERS-RETAIL TI; Inspection History Date Description Act Insp Comments Check a License - Contractors State License Board Page 1 of 1 of Affairs *"""* Contractors State Li e eoard Contractor's License Detail - License # 486058 DISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this information, you should be aware of the following limitations. ••» CSLB complaint disclosure is restricted by law (B&P7124.6) If this entity Is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action information. -» Per B&P.7071,1.7 , only construction related civil judgments reported to the CSLB are disclosed. -•» Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. -» Due to workload, there may be relevant information that has not yet been entered onto the Board's license database. License Number Business Information 486058 siMAC CONSTRUCTION INCORPORATED 2067 WINERIDGE PLACE STE A ESCONDIDO, CA 92029 Extract Date: 1/4/2011 __Corporaton " 01/27/1986 J|ntity_:_ JssueJDate Jxpire Date _ £1/31/2012 License Status This license is Additional Status: reviewed Classifications: Certifications: Bonding: Workers' Compensation: CLASS B DESCRIPTION CERT ASB DESCRIPTION ASBESTOS t CONTRACTOR'S BOND This license filed Contractor's Bond number 1220259 in the amount of $12,500 with the bonding company Ol:D.EEPUBUC.GENERAUNSUMNCE.CQRP_QRATiQN, Effective Date: 01/01/2007 CQnlractQr's.BondiD3..H]story BOND OF QUALIFYING INDIVIDUAL 1. The Responsible Managing Officer (RMO) SIMIS RICHARD SCOTT certified that he/she owns 10 percent or more of the voting stock/equity of the corporation. A bond of qualifying individual is not required. Effective Date: 01/27/1986 This license has workers compensation insurance with the Policy Number:WC001918696 Effective Date: 06/08/2010 Expire Date: 06/08/201 1 Workers' Compensation History Personnel listed on this license (current or disassociated) are listed on other licenses. Coodffions of.Use | Privacy. Policy Copyright © 2010 State of California https://www2.cslb.ca.gov/OnlineServices/CheckLicenseII/LicenseDetail.aspx?LicNum=4... 01/04/2011