HomeMy WebLinkAbout2047 CORTE QUINTA MAR; ; CB043936; Permit10-19-2004
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Demolition Permit Permit No CB043936
Building Inspection Request Line (760) 602-2725
Job Address
Permit Type
Parcel No
Occupancy Group
# Dwelling Units
Bedrooms
Project Title
2047 CORTE QUINTA MAR CBAD
DEMO Full Demo
2151601300 Lot#0
Reference #
1 Structure Type SFD
3 Bathrooms 2
LA COSTA RESORT DEMO SFD
Status ISSUED
Applied 10/19/2004
Entered By SB
Plan Approved 10/19/2004
Issued 10/19/2004
Inspect Area
Applicant
KSL LA COSTA I L L C
C/O KSL RECREASTION CORP
50-905 AVENIDA BERMUDA
LAQUINTACA 92253
Owner
KSL LA COSTA I L L C
C/O KSL RECREASTION CORP
50-905 AVENIDA BERMUDA
LAQUINTACA 92253
Building Permit
Plumbing Fee
Other Fee
Additional Fees
TOTAL PERMIT FEES
$2000
$1000
$3000
$000
$6000
Total Fees $60 00 Total Payments To Date $0 00 Balance Due $6000
3576 10/19/04 0002 01 02
CGP 60 ..'50
Inspector
FINAL APPROVAL
Date ?~1-'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 finely 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
PERMIT APPLICATION j
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave , Carlsbad, CA 92008
. PROJECT INFPRMA'TION;
"
Address (include Bldg/Suite tt)
FOR OFFICE USE ONLY
PLAN CHECK NO £
EST VAL
Plan Ck Deposit
Validated By
Date
Business Name (at this address)
Legal Description
I/5"—/fcO-
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 tt of Bedrooms # of Bathrooms
,Z L 1C6NTACTF.PERSJ3NJ|f .different from applicantL J;j-VH^'^ii .* '!.« !
Name • Address
3..,, 'APPjliCANT' ; Q^mractqr/.vQ^AgentJfbfjfontradtpr; iV E1.0wnerlJ:,
/»/H< I**L
City
gent:for'Ovvnari.
State/Zip Telephone #Fax
Name
4
k^i
:Address
"""'W' • " '
City
'-!' ViF •••"•-'<.!•LA
State/Zip Telephone i
Name 'Address City State/Zip Telephone #
(Sec 7031 5 Business and Professions Code jAny 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 [$500)1
Name
State License #
Address
License Class
City State/Zip
City Business License tt
Telephone tt
Designer Name
State License tt
6 WORKERS'COMPENSATION •
Address City State/Zip Telephone
Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations
l~l 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 '
fl 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)
l~| 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,QOO), in addition to theicost of compensation, damages as provided for in Section 3706 of the Labor code^nterest and attorney s fees
SIGNATURE //~\ ^S\ //, C ^\ DATE /ft /f 9
I hereby affirm that I am exempt from the Contractor's License Law for the following reason
G 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-withm 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)
uH 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)
G 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, butjl 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) i
PROPERTY OWNER SIGNATURE DATE
COMPLETE THIS 'SECTION FQH,NON-ft£SIDBVnAL BUILDING PERMliS^LXj^ s£ "'t ";; ^n^ , _;.
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? fJ YES fj 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 Q NO
Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? l~1 YES l~) 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
"' . ... , •- •••
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(0 Civil Code)
LENDER'S NAME
>9~".
LENDER S ADDRESS
^« .;.--- ' ' v,- «,- a..,, s^i .•**»<- -^ J ...:•-; ..,„,'•, "<• L ;,.. - ..... ,.. , , ..'i
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
DEMOLITION ASBESTOS CERTIFICATION
ADDRESS:
USE OF BUILDING TO BE DEMOLISHED:
SQUARE FEET ^0^-1 ' £v£r { *iW X NUMBER OF STORIES T-^
PROPERTY OWNER: fel_ Lfr CJ>f>TlQ~ d.
ADDRESS: T-lOO £o$Tit- &&- /WWL &><H)PHONE -
APPLICANT:
ADDRESS: ^IDD G»ST9r Q&-WL fc)/ht> PHONE
Section 19827.5 of California Health and Safety Code states in part:
"A demolition permit shall not be issued by any city ...as to any building or other
structure except upon receipt from the permit applicant of a copy of each written
asbestos notification regarding the building that has been required to be submitted to the
United States Environmental Protection Agency or to a designated state agency, or both,
pursuant to Part 61 of Title 40 of the Code of Federal Regulations, or the successor to
that part. The permit may be issued without the applicant submitting a copy of the
written notification if the applicant declares that the notification is not applicable to the
scheduled demolition project."
As applicant for a demolition permit in the City of Carlsbad, I certify that; I have read
the excerpt from Section 19827.5 of the Health and Safety Code provided above; the
information I have provided on this form is true and correct; and I further certify the
following:
>n the attached pages are copies of all written asbestos notifications
regarding the above referenced building that are required to be submitted to the
United States Environmental Protection Agency or to Part 61 of Title 40 of the
Code of Federal Regulations, or successor to that part.
( ) I declare that the written asbestos notification is not applicable to the scheduled
demolition project.
Applicant's Signature
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REV July 10,2003
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2434 SOUTHPORT WAY, SUITE L
NATIONAL CITY, CA 91950
PHONE(619)-474-8548
FAX(619)-474-6128
E-MAIL lpitt@hmpittlabs com
H. M. Pitt Labs, Inc.
March 11, 2004
Mr Mike Cusik
La Costa Resort & Spa
2100 Costa Del Mar Road
Carlsbad, Ca 92009
V \<, V
Re Lab #52154 -C^*T2024 A, 2036 C, 2048 D, 2047 E & 2025 F Corta Quinta Mar, Lead-
Based Paint and Afflestos results summary
Dear Mr Cusik,
State and Federal Standards identify Lead-Based paint (LBP) as paint of other surface
coatings that contain an mount of lead equal to or in excess of one milligram per square centimeter
• (Img/cm2) or more than half of one percent (0 5%) by weight Weight measures are also identified
as LBP in excess of 5000 parts per million (ppm), 5000 mg/kg or 5000ug/g
Building materials are identified by the EPA as Asbestos-containing materials (ACM) when
the fiber concentration of the material is identified as containing Asbestos fibers in excess of one
percent (>1%)
Below, I have summarized the Lead-based paint, lead containing materials and asbestos
containing materials identified at the above locations Attached are the XRF readings, XRF identified
positives, field calibration forms, building material sample analysis for asbestos and sample location
maps
Lead results
The lead-based paint and lead containing materials identified by XRF at the above locations
are as follows
2021 A Corte Quinta Mar
XRF reading numbers 19, 29, 51, 69, 78, 79, 81, 89, 97 and 109 identify wall paint in the
bathroom on wall D, door casing paint and ceramic tiles to be lead based
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