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Home My WebLink About1923 CALLE BARCELONA; 142; CB140261; Permit02-03-2014 City of Carlsbad 1635 Faraday Av Carlsbad.CA 92008 Miscellaneous Permit Permit No: CB140261 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: PC#: Project Title: Applicant: J.D. BUILDERS P.O. BOX 2458 92624 949-240-1340 1923 CALLE BARCELONA CBAD St: 142 MISC Subtype: 2550120400 Lot#: $0,00 OTHER 0 MADEWELL- DEMO NON-LOAD BEARI WALLS, DROP CEILING & STORE FRONT- NO NEW Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: Owner: T-C FORUM AT CARLSBAD LLC C/O TIAA-CREF 4675 MACARTHUR CT #1100 NEWPORT BEACH CA 92660 ISSUED 02/03/2014 RMA 02/03/2014 02/03/2014 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE $65,00 $0,00 $0,00 $65.00 Total Fees: $65.00 Total Payments To Date: $65.00 Balance Due: $0.00 Inspector FINAL APPROVAL Date: Clearance: NOTICE: Please tal<e NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively refen-ed to as "fees/exactions," You have 90 days from the date this pemiit 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 IVIunicipal Code Section 3.32,030, Failure to timely follow that procedure wiil 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 vou have previously been oiven a NOTICE similar to this, or as to which the statute of limitations has previously othenwise expired, THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: OPLANNING nENGINEERlNG nBUlLDING OFIRE IZlHEALTH • HAZMAT/APCD Plan Check No. f^/(4t^/^CJ ^ CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax:760-602-8558 email: building(gcarlsbadca,gov www.carlsbadca.gov 1^ Est. Value Plan Ck. Deposit Date SWPPP JOBADDRESS . f. SUITE«/SPACE«/UNIT* APN - CT/PHOJECT # LOT # PHASE # # OF UNITS 1 # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR, TYPE OCC GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Areafs) ' >' EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YEs|~|# No| 1 YESQNOQ YES| | NO| 1 APPLICANTNAME (Primary Contact) APPLICANTNAME (Secondary Contact; ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL PROPERTY OWNER NAME CONTRACjmBUS. NAME , A ADDRESS AOORESS - • -• J CITY STATE ZIP CITY « STATE ZIP , / PHONE FAX ^0 Mo EMAIL EMAIL • ~ ARCH/DESIGNER NAME & ADDRESS STATE LIC, # STATE LIC,# 1 , CLASS* CITY BUS, LIC,# 1^ (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 applicantfor such permitto file a signed statement that he is licensed pursuant to the provisions ofthe Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3 ofthe 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 applicantfor a permit subjects the applicantlo a civil penalty of not more than five hundred dollars ($500)). Workers' Compensation Declaration: / hereby affinn under penalty of perjury one ofthe following declarations: ^9 I have and will maintain a certificate cf consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the perfomiance of the work for which this pennit is issued, UZN have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the perfomiance of the work fpr which this permit is issued. My workers' compensatiOD insurancjLCamer and policy number are: Insurance Cxs.^yft- Cc^-^fi^T'^'^l^^^"^ P°'i'=y ' 0^1*14 f^'^'^O) 2) Expiration Date"7 ( / / ^ ^ Thjs section need not be completed if the permit is for one hundred dollars ($100) or less, (^^Certificate of Exemption: I certify that in the perfonnance of the work for which this pemiit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Califolnia, WARNING: Failure to secure workers' compensation coverage is unlawful, and shali subject an employer to criminal penaKles and civil fines up to one hundred thousand dollars (&100,000), In addition lo the cost of compensalion, damages as provided for in Seclion 3706 of the Labor code, Interest and attomey's fees. . ^eS" CONTRACTOR SIGNATURE QAGENT DATE 2^ f JI ^\ ^ O WNER-BUitOER DECL A I? ATION / hereby affm that I am exempt from Contractor's Ucense Law for the following reason: I I I, as owner of the property or my employees with wages as their sole compensation, will do the work and the stmcture 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 impravements 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 praving that he did not build or improve for the purpose of sale), I I I, as owner of the praperty, am exclusively contracting with licensed contractors to constmct the project (Sec, 7044, Business and Prafessions 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), • 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 praperty improvement, QYes I iNo 2.1 (have / have not) signed an application for a building pennit for the proposed work, 3,1 have contracted with the following person (firni) to provide the praposed constmction (include name address / phone / contractors' license number): 4.1 plan to provide portions of the wori<, but I have hired the following person to coordinate, supen/ise 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 wori< indicated (include name / address / phone / type of wortt): ^PROPERTY OWNER SIGNATURE QAGENT DATE COMPLETE THIS SECTION FOR N O N - R E $ I D E N T I A I. BUILDING PERMITS OMLY Is the applicant or future building oxupant 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? Yes No Is the applicant or future building occupant required to obtain a permit fram the air pollution control district or air quality management district? Yes No Is the facility to be constmcted within 1,000 feet of the outer boundary of a school site? Yes 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. NSTRUCTI ON LENDING AGENCY I hereby affinn that there is a constmction lending agency for the perfonnance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address A P P L I C ANT C E R TIFjCATION I cetiiy that 1 have lead the application and state that the above information is conectand thatthe infoimation on tie plans is accurate. I agree to comply with all City oidinances and State iaws relating to buiicBng constmction. I hereby authorize representative ofthe City of Cailsbad 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 UABILmES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CfTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMfF, OSHA: An OSHA pemiit is nequired for excavations over 5'0' deep and demolition or constmction of structures over 3 stories in height, EXPIFWTION: Every pennit issued by the Building Oflicial under the provisions of this Code shall expire by limitation and become null and void if the building or wori< authorized by such permit is not commenoed wilhin 180 days from the date ofsuch pennit or if the building or worit authorized by such pemiit is suspended or abandoned at any time after the vwrit is commenced for a period of 180 days (Sectbn 106,4,4 Unifbmi Building Code), APPLICANT'S SIGNATUI DATE 73 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 buildlnq(S)carlsbadca.gov or Mail the completed fom to City of Carlsbad, Building Division 1635 Faraday Avenue, Carisbad, Califomia 92008, C0#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE EMAIL OCCUPANT'S BUS. UC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAILTO: CONTACT (Lisied above) OCCUPANT (Usted above) CONTRACTOR (On Pg, 1) MAIL / FAX TO OTHER: ASSOCIATED CB#- NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION .ef APPLICANT'S SIGNATURE DATE Inspection List Permit*: CB140261 Type: MISC OTHER MADEWELL-DEMO NON-LOAD BEARI WALLS, DROP CEILING & STORE FRONT- Date Inspection Item Inspector Act Comments 04/15/2014 19 Final Structural PD AP Wednesday, April 16, 2014 Page 1 of 1