HomeMy WebLinkAbout2052 CORTE DEL NOGAL; ; CB032684; Permit09-29-2003
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Miscellaneous Permit Permit No CB032684
Building Inspection Request Line (760) 602-2725
Job Address
Permit Type
Parcel No
Valuation
Reference #
Project Title
2052 CORTE DEL NOGAL CBAD
MISC
2130610600
$000
Subtype
Lot#
REDDOTNET
DEMO WALLS FOR FUTURE Tl
Applicant
GOOD & ROBERTS INC
1090 JOSHUA WAY
VISTA, CA 92083
619-598-7614
OTHER Status
0 Applied
Entered By
Plan Approved
Issued
Inspect Area
Owner
DEI LLC
C/0 LAW OFFICES OF JON LADD
11440 WEST BERNARDO CT #214
SANDIEGOCA92127
ISSUED
09/29/2003
MDP
09/29/2003
09/29/2003
Miscelaneous Fee #1
Miscelaneous Fee #2
Additional Fees
TOTAL PERMIT FEES
PERMIT $6000
$000
$000
$6000
Total Fees $6000 Total Payments To Date $000 Balance Due $6000
5259 09/29/03 0002 01
CGP 60 = 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
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave , Carlsbad, CA 92008
K
FOR OFFICE USE ONLY
PLAN CHECK NO
EST VAL
Plan Ck Deposit
Validated By
Date
Address (include Bldg/Suite #1
Legal Description
Assessor's Parcel #
Description of Work
Business Name (at this address)
Lot No Subdivision Name/Number
Existing Use
SO. FT #of Stories
Unit No Phase No
Proposed Use
# of Bedrooms
Total # of units
# of Bathrooms
Name Address City State/Zip Telephone # Fax #
Name Address City State/Zip Telephone tt
Name Address City State/Zip Telephone #
iirssofira^^ ':.i,;: ..":..-,"...:.:- ;^vi; L:-,:-'.!-«.. ;."•„.-.....^;-;,'-._.-iJ
(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 [$500])
r>A
Name
State License # (i3??'>'<*/
Address
License Class /£j
City State/Zip
City Business License #
"Telephone #
"
Designer Name
State License #
Address City State/Zip Telephone
Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations
Q I have and will maintain a certificate of consent to self insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued
,{9 I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued My worker's compensation insurance carrier and policy number are
Insurance Company _fypfT& Gcnfl . ^LlT. /TfrJlO _ Policy No Jffi!?$£5Ocl _ Expiration Date Ai
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS)
Q 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
l~l 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)
n 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)
l~1 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 C] YES C]NO
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_
" .", . i -[CpJlJjTg^^ ' ;,
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? O YES [U NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? O YES d NO
Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? fj YES fj] 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(i) Civil Code)
LENDER'S NAME _ LENDER'S ADDRESS
T>c!^
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 City 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 (^llj^?^&^~ DATE
WHITE File YELLOW Applicant PINK Finance
City of Carlsbad Bldg Inspection Request
For 11/03/2003
Permit* CB032684
Title REDDOTNET
Description DEMO WALLS FOR FUTURE Tl
Inspector Assignment
2052 CORTE DEL NOGAL
B Lot 0
Type MISC
Job Address
Suite
Location
APPLICANT GOOD & ROBERTS INC
Owner DEI LLC
Remarks DEMO PERMIT FINAL
Sub Type OTHER
Phone 6195205777
Inspector
Total Time
CD Description
19 Final Structural
Act Comment
Requested By NICK
Entered By ROBIN
Associated PCRs/CVs
Inspection History
Date Description Act Insp Comments
Date 10/15/02 0937AM Sender's Fax ID Vanorsdale Insurance Page 2 of 2
ECI GOOD&RO-01
ACORDTJ HFRTIFICATF OF 1 IARILI
PRODUCER License #0623506 (858) 541-2900
' orsdale Insurance Services
j S Galloway
4=>u9 Murphy Canyon Road, Suite 510
San Diego CA 92123
INSURED
Good & Roberts , Inc
2320 Cousteau Court
I Vista CA 92083-8346
TY INSURANCE 10/D15/2M0DoT
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
INSURERS AFFORDING COVERAGE
INSURER A State Compensation Insurance Fund
INSI IRER 6
INSI IRER C
INSURER D
INrilRER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING
ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
1NSRLTR
A
TYPE OF INSURANCE
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
1 CLAIMS MADE | | OCCUR
GENL AGGREGATE LIMIT APPLIES PER
~~1 POLICY |~~| SE& 1 1 LOG
AUTOMOBILE LIABILITY
ANY Ai ITO
ALLO'ANEOAUT.V-,
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AI ITOJ
GARAGE LIABILITY
ANY AI ITO
EXCESS LIABILITY
1 OCCUR 1 [CLAIMS MADE
DEDUCTIFLE
RETENTION I
WORKERS COMPENSATION AND
EMPLOYERS LIABILITY
OTHER
POLICY NUMBER
33334502
POLICY EFFECTIVEDATE (MM/DD/YY)
10/1/2002
POLICY EXPIRATIONDATE (MM/DDfYY)
10/1/2003
LIMITS
EACH OCCURRENCE
FIRE DAMAGE (An\ onp fire)
MED EXP (Any nnfi person)
F'ERbONAL «, ADV IN 11 JRY
GENERAL AGGREGATE
PRODI ICTS COMP/OP AGG
COMBINED SINGLE LIMITIE* arridTit)
FODILYINIURY(Por [icrori)
BODILY IN II IRY
(Perarnrtfint)
PROPERTY DAMAGE(Por arc irtpr.t)
AlltOONLY EA ACCIDENT
OTHFR TH'iN ^A ^ ^AUTO ONLY Af-G
EACH OCCI IRRENCE
AGGREGATE
V WC STATI 1- I | OTH-TORY LIMITS 1 1 ER
EL EACH ACCIDENT
E L DISEASE EA EMPLOYEE
E L DISEASE POLICY LIMIT
$
$
$
$
S
S
$
$
$
$
I
I
I
1
I
J
I
$
j 1,000,000
$ 1,000,000
t 1,000,000
*10 days Notice of Cancellation given if for non-payment of premium
All operations of the named insured as certificate holders interest may appear
**REPLACES CERTIFICATE ISSUED 9/30/02** (certholder ' s address revised)
CERTIFICATE HOLDER ADDITIONAL INSURED INSURER LETTER CANCELLATION
City of Carlsbad
Purchasing D
1635 Faraday
Carlsbad CA 92008-
1
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30jAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
REPRESENTATIVES
AUTHORIZED REPRESENTATIVE ~ J«^ ^- --.— _j^ p=^, «-I?_i->JLJ
<^L ^
ACORD 25-5(7/97)0 ACORD CORPORATION 1988