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HomeMy WebLinkAbout2075 CORTE DEL NOGAL; J; CB012257; Permit07/92/2001 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB012257 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 2075 CORTE DEL NOGAL CBAD St J MISC Subtype OTHER 2130610700 Lot# 0 $1,00000 QUOREX ADD WALL & MOVE OUTLET Applicant GOOD & ROBERTS INC 1090 JOSHUA WAY VISTA, CA 92083 619-598-7614 Status ISSUED Applied 07/02/2001 Entered By MDP Plan Approved 07/02/2001 Issued 07/02/2001 Inspect Area Owner SAN-GAL TRUST 550 WCST #1820 SAN DIEGO CA 92101 3562 07/02/01 0002 01 02 CGP 60.00 Total Fees $6000 Total Payments To Date $000 Balance Due $6000 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES ELECTRIC PERMIT $2000 $4000 $000 $6000 Inspector FINAL APPROVAL Date Clearance NOTICE Please take NOTICE that approval of your project includes the Imposition' of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions" You have 90 days from the date this permit was issued to protest imposition of these fees/exactions If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3 32 030 Failure to tmely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 1 PROJECT INFORMATION 2.Q7S FOR OFFICE USE ONLY PLAN CHECK NO <*> EST VAL Plan Ck Deposit Validated By Date Address (include Bldg/Suite tt)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total tt of units Assessor's Parcel #Existing Use Proposed Use Description of Work SQ FT 2; ;vGONTACT PERSON (itdiffaifenMrom.applicant) f, ,, #of Stories c-r tt of Bedrooms tt of Bathrooms Name 3'.'"" APPLICANT , : ,JJ3 Contractor IT- Address Agent for Contractor Q Owner CCt/r. 2TZ.d City Agent : for, Owner State/Zip Telephone tt Fax tt Name 4 ' r .PROPERTY OWNER Address City State/Zip Telephone tt Address City State/Zip Telephone ttName •$>-. :•-•- CONTRACTOR - COMPANY NAME , : '. , „. ;.: ; ,:V-.:. .^ "".'., ' '' 'SV:: i '•.. • • '"'' ,„: " • .,:''•*'•• "::"-'--- " >' ... ,° (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]) Name State License #_j Address License Class City State/Zip City Business License tt Telephone tt Designer Name Address City State/Zip Telephone State License tt 6 WORKERS'"COMPENSATION : • ' ''"' ' .,'.. ••,,., ,.'. -! :! ..: ; . V'-v ./: ' '••' •• •" - - ,' • Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations 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 /Kl 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 5 TT^g /X/o^Q Policy No .J3 3 ~3 YS ~ OCt Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FORGONE HUNDRED DOLLARS I$100J OR LESS) [3 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 C*tf-/*&• DATE ?" Z^O/ 7 OWNER-BUILDER DECLARA^N ' ' : ••• ' rf.;. ' •:. "'"V. ^7., t L '' - • :"" :>•• : . '/..-' '; .-. ,•' '•• ; • 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) D 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 O YES DN0 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 NO COMPLETE THJS SECTION FOR \ NON-RESIDENTIAL BUILDING PERMITS ONLY, : Vis ;'• :.. '. '. J ; 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? D 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 Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? fj 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 8 CONSTRUCTiONlENDING AGENCY > .", " ; ,, , 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 9.;f APPLICANT CERTIFICATION ' •> ' -'• .>;,.' ." ;• •.%.:•., ' ,"" :' " :• - -. -. -^V, ' •, 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 penodrftBO days (Section 106 4 4 Uniform Building Code) APPLICANT'S SIGNATURE &£*£.^^~ DATE ?~ "c WHITE File YELLOW Applicant FINK Finance City of Carlsbad Bldg Inspection Request For 07/10/2001 Permit# CB012257 Title QUOREX Description ADD WALL & MOVE OUTLET Inspector Assignment GG 2075 CORTE DEL NOGAL J Lot 0 Type MISC Job Address Suite Location APPLICANT GOOD & ROBERTS INC Owner PLETA TRUST Remarks Sub Type OTHER Phone 6197193630 Inspector Total Time CD Description 17 Interior Lath/Drywall Act Comments Requested By J P JONES Entered By CHRISTINE Associated PCRs Inspection History Date Description Act Insp Comments KDB ACORDm CERTIFICATE OF LIABILITY INSURANCE PRODUCER (858) 541-2900 Vanorsdale North County Insurance Services Ooug S . Galloway 1 Murphy Canyon Road, #200 San Diego CA 92123- INSURED Good & Roberts, Inc 2320 Cousteau Court Vista CA 92083-8346 DATE (MM/DDfifY) 10/3/2000 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 INSURER B INSURER C INSURER D INSURER 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 INSRLTR s A TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY I CLAIMS MADE | | OCCUR GEN L AGGREGATE LIMIT APPLIES PER~~i POLICY r~i 5?& riLoc AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS LIABILITY | OCCUR | I CLAIMS MADE DEDUCTIBLE RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OTHER POLICY NUMBER i \ 333-345-00 POLICY EFFECTIVEDATE (MM/DD/YY) - 10/1/2000 POLICY EXPIRATION DATE (MM/DD^YY) 10/1/2001 LIMITS EACH OCCURRENCE FIRE DAMAGE (Anyone fire) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS COMP/OPAGG COMBINED SINGLE LIMIT ~ (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY EA ACCIDENT OTHER THAN ^ ACC AUTO ONLY AGQ EACH OCCURRENCE AGGREGATE V I WCSTATU OTH •"• 1 TORY LIMITS ER EL EACH ACCIDENT E L DISEASE EA EMPLOYEE EL DISEASE - POLICY LIMIT S S $ S $ $ S S S S S S S S S S S S s 1,000,000 s 1,000,000 s 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS *10 days notice of cancellation given if for nonpayment of premium* All operations of the named insured as certificate holders interest may appear CERTIFICATE HOLDER ' ADDITIONAL INSURED INSURER LETTER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN City of Carlsbad Purchasing Department 2075 Las Palmas Drive Carlsbad CA 92009 i ACORD 25-S (7/97) 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 ©^eORDtQRPORATION 1988 ••; -.; -. >'- nPT 1 "t Vflllfi V- -J£. 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