The URL can be used to link to this page

Home My WebLink About2003 COSTA DEL MAR RD; 690; CB050274; Permit01-28-2005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB050274 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title' 2003 COSTA DEL MAR RD CBAD MISC 2162100301 $20,000 00 Subtype OTHER Lot# 0 ROSTEN REMODEL CREATE 2 ROOMS^FROM 1 & KIT REMODEL Status Applied Entered By Plan Approved Issued Inspect Area Applicant \ GREGORY BARKHUIZEN c6j\ISTRUCTION 26562 AVE DESEO 4ISSION VIEJO 92691 Owner ROSTEN ALBERT NANCY 2003 COSTA DEL MAR RD CARLSBAD 92009 ISSUED 01/28/2005 MDP 01/28/2005 01/28/2005 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees PLUM, MECH, ELEC PERMIT $71 00 $6000 $000 TOTAL PERMIT FEES $131 00 Total Fees $131 00 Total Payments To Date $000 Balance Due $131 00 BUILDING PL,-i, IN STORAGP ATTACHE!-05<0 01/28/05 0002 01 02 CGR Inspector FINAL APPROVAL Date 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 "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 vou have oreviouslv been aiven a NOTICE similar to this or as to which the statute of limitations has_previouslv otherwise expired 131.00 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date _ £i Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor's Parcel #Existing Use Proposed Use Description of Work SQ FT #of Stories # of Bedrooms of Bathrooms w£it*«*i^*»Mt;?«*s«w««|*ir»«»«™»*j " •::-::-- ••£KHuizsy_2&il2_as^i Name Address City r (~J Agent for Contractor |~3 Owner Q Agent for Owner Name Address City State/Zip Telephone tt Name Address City State/Zip ^ 'Telephone # ercONlRftCTOR - COMPANY NAME '" • • :;;., : - ... : •'>! , ' • V-. • .* -.- • (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 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 ($5001) Name State License # MM Address License Class H'£- City State/Zi City Business License # Telephone # Designer1 Name State License # *, Address City State/Zip Telephone Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations 03" 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 Q 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 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 [$100] OR LESS) V3 CERTIFICATC-QEiEXEMPTION 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 subjecWBTTreTWorkers' Compensation Laws of California WARNING FailureJj&Mcure worker*! compensation coverage it unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollaraJJMf&QOp), in addition to th/cVst of compensation,jJaAiages as provided for in Section 3706 of the Labor code, interest and attorney » fees SIGNATURE^^ yV-">--~-'\_X ^*\ —-~ DATE Q/ — 0\.%> ^LOOS 1. OWNER«UiDE>i*llctARAT10N ~' ... : ^ ~ " ~ • •• Jir •• I hereby affirm that I am exempt from the Contractor's License Law for the following reason Q 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) Q 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) D 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 Q YES QNO 2 I (have / 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 / phone number / 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 / address / phone number / 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 / address / phone number / type of work) PROPERTY OWNER SIGNATURE DATE COMPLETEMS sieiioMFo*^ 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? Q YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES Q 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 *^l£01N^ =: <-':;•'•->-• ••:. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 30970) Civil Code) LENDER'S NAME _ LENDER'S ADDRESS _ -"^-.f-f :: -r^: ' • " ' ' "* ° 9= " *< """ - . " ' ' ''' <=""^' ' ' 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 CitV 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 is commenced for a period of 180 days (Section 106 4 4 Uniform Building Code) APPLICANT'S SIGNATURE _ DATE WHITE File YELLOW Applicant PINK Finance 'City of Carlsbad Bldg Inspection Request For 03/18/2005 Permit# CB050274 Title ROSTEN REMODEL Description CREATE 2 ROOMS FROM 1 & KIT REMODEL Inspector Assignment PD 2003 COSTA DEL MAR RD Lot 0 Type MISC Sub Type OTHER Job Address Suite Location APPLICANT GREGORY BARKHUIZEN CONSTRUCTION Owner Remarks AM PLEASE Total Time CD Description 13 „ Final Structural COM Act/\ Comment Phone 7143288521 Inspect Requested By GREG Entered By CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 02/17/2005 17 Interior Lath/Drywall AP PD 02/15/2005 84 Rough Combo AP PD #690 0 4k fr 5 vi oL I ! 5 T Of ft ' J * — 1 $ 3 r 5 3 0 {£. h i^ -i — -t i * V- » ^H3 f ! /7 / ^ C^APPRCD L*"> b ^f} X £ V NT f 3 J :... *,^A-: ..*. .^--.. $ ^Jt .(30 ?09 1. 9 \J 01 02 y a h § 2 V WhUr / ' ' *\^ Vi -V- <t tf> ^ T^ '3 5,c£ i- S-: v 9 H tu 1 fcVsj —i *• r i i™S| (.+. . 5 i- ** --> 2 A <-»* r \J v* \ •o o * b. -3 2T /3 y. VJ « =3 to ** ^\y> K. t.Jy» £ . f g Ku» 1 I •*iti (^ 5 /a* Nrt ^- ex /o -=*• U ^»«» 01/27/2005 11:20 7023686723 GORDON GROUP PAGE 01 60" JIBS" £$2- 36" •ufcpc* to vwifimioa on jofc *fot ««i «4fu»«in«rt to fit job eonditioa*. Thi» ifrdcued or «opi*d aal«w upplicwMB fba tu* bom t»ld or job onter ptoe«l IPpl 1/22A3S 1/22/D5 . 1 FROM 7023606723 TO Preferred Customer 1/27/2005 11 17 AM Paqe 1