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Home My WebLink About1917 ALGA RD; A; CB050533; Permit*- I 02-22-2005 Job Address: Permit Type: Parcel No: Valuation: Reference #: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Building Inspection Request Line (760) 602-2725 Miscellaneous Permit Permit No: CB050533 191 7 ALGA RD CBAD St: A MlSC Subtype: REPAIR Status: ISSUED 21 51 700347 Lot #: 0 Applied: 02/22/2005 $0.00 Entered By: MDP Plan Approved: 02/22/2005 Issued: 02/22/2005 Proje&TitKE-I\BAKER RESIDENCE Inspect Area: IRE DAMAGE REPAIR /COMPLETE REBUILD ”... -1” Mplicant: I Owner: STE 1001 858 566-4950 BAKER LORIS M TR 225 WAKE AVE #94B EL CENTRO CA 92243 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT $1 20.00 $0.00 $0.00 $1 20.00 $1 20.00 Total Fees: $1 20.00 Total Payments To Date: $0.00 Balance Due: 2d44 FINAL APPROVAL Inspector: Date: g)zT/b f 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 ‘Yeesiexactions.” You have 90 days from the date this permit was issued to protest imposition of these feesiexactions. 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 feesiexactions 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 feesiexactions of which vou have oreviouslv been aiven a NOTICE similar to this, or as to which the statute of limitations has Dreviouslv otherwise exoired. FOR OFFICE USE ONLY PERMIT APPLlCATlON PLAN CHECK NO. CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 Plan Ck. Deposit Legal Description Lot No. Subdivision NameINumber Unit No. Phase No. Total # of units Descriptdn of Work sa. FT. #of Stories # of Bedrooms # of Bathrooms iL isting Use L ERSON'm diff cant) +- Name Address City Statelzip Telephone # Fax # Owner 0 Agent for Name Address City Statelzip Telephone # ity or County which requires a permit to con 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 Professions Code1 or that he is exempt therefrom, end the basis for the alleged penalty of not more than five hundred dollars 1$5001). /,# 9Z/zs -6 KC 83Ef-866 -$?%Z) Name Address City Statelzip T lephone # State License # 8 33 Z 9 S License Class 6 City Business License # Designer Name Address City Statenip Telephone 0 of the work for which this permit is issued. 0 issued. My worker's Compensation insurance carrier and policy number are: Insurance Company c 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 ~$100.000~. in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 1. as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If. however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). 0 I, as owner of the property. am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s1 licensed pursuant to the Contractor's License Law). 0 1. 2. 3. I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is e UR 5s. s?f J,iO ?'Policy NO.ZSL 006 46 2 -04- * 0 Expiration Date TQA - dc %THIS SECTION NEED ::BE :fLTED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS I$lOOI OR LESS) 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 I contractors license number): Business and Professions Code for this reason: 4. number I contractors license number): 5. 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 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 number / type of work): PROPERTY OWNER SIGNATURE DATE E,THIS SECTION FOR NON-R€S/DFNTIAL BUILDING PERMITS ONLY licant or future building occupant required to submit a business plan, acute1 istration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 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? Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 NO 0 YES 0 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. NDlN LENDER'S NAME LENDER'S AD 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 k authorized by such permit is suspended or abandoned at any time after the work is \TNT'S SIGNATURE DATE 2 - 2 2 05' WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 08/18/2005 Permit# CB050533 Title: BAKER RESIDENCE Description: FIRE DAMAGE REPAIR / COMPLETE REBUILD Type: MlSC Sub Type: REPAIR Job Address: 1917 ALGA RD Suite: A Lot 0 Location: APPLICANT R & M CONSTRUCTION Owner: Remarks: Inspector Assignment: TP Phone: 8582047 m Inspector: -Y Total Time: Requested By: LONNIE CD Description Entered By: CHRISTINE 20mment 19 Final Structural Associated PCRs/CVs Date 06/09/2005 06/07/2005 06/07/2005 06/03/2005 06/02/2005 05/26/2005 05/26/2005 InsDection Histow Description 18 Exterior LatWDrywall 17 Interior LatWDrywall 18 Exterior LatWDrywall 16 Insulation 16 Insulation 14 FramelSteel/Bolting/Welding 34 Rough Electric Act lnsp Comments AP TP AP TP AP TP AP TP NR TP AP TP EMTCMTWWALL AP TP REWIREUNIT I. L POLICYHOLDER COPY STATE P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807 COM Pa NSATI ON INSURANCE FUN 13) CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 12-06-2004 CONTRACTORS STATE LICENSING BOARD WORKERS COMPENSATION UNIT P.O. BOX 26000 SACRAMENTO CA 95826 GROUP: 000496 POLICY NUMBER: 2085-2004 CERTIFICATE ID: 10 CERTIFICATE EXPIRES 11 - 01-20 05 JOB: LICENSE NUMBER: 833248 INCEPTION DATE: 11-01-04 This is to certify that we have issued a valid Worker's Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of Insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. &ORlno REPRESENTATIVE PRESIOENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - RANDY MC CANN, PRESiSECiTRES - EXCLUDED. ENDORSEMENT #1600 - RANDY MCCA", P,SgT - EXCLUDED. ENDORSEMENT #1600 - ROB JACKSON, VP - EXCLUDED. ENDORSEMENT #1600 - KATHY RODRIGUEZ, VP - EXCLUDED. ENDORSEMENT #1600 - ROBERT FORSBERG, VP - EXCLUDED. ENDORSEMENT 11600 - PETER DEPUY, VP - EXCLUDED. ENDORSEMENT P2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 11-15-2004 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER R br M CONSTRUCTION, INC AND/OR ENVIRONMENTAL AND DECONTAMINATION S AND/OR MC CANN, RANDY (AN INDIVIDUAL) 7959 SILVERTON AVE STE 1001 SAN DIEGO CA 92126 SClF 10262E Aaept this certiiicate only if you reo a faint wabnnark lhat reads 'OFFICIAL STATE FUND DOCUMEM" !%#ED: 12a-2004 PAGE 1 OF1