HomeMy WebLinkAbout2101 COSTA DEL MAR RD; ; CB023610; Permit12-02-2002
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Miscellaneous Permit Permit No CB023610
Building Inspection Request Line (760) 602-2725
Job Address
Permit Type
Parcel No
Valuation
Reference #
Project Title
Applicant
TOM MCCABE
619233-8740
2101 COSTA DEL MAR RD CBAD
MISC Subtype
2152101800 Lot#
$000
LA COSTA RESORT-GARDEN CAFE
REMOVE & NEW PARTITION WALLS
OTHER Status
0 Applied
Entered By
Plan Approved
Issued
Inspect Area
Owner 235B
K S L LA COSTA RESORT CORP
50 905 AVENIDA BERMUDA
LA QUINTA CA 92253
ISSUED
12/02/2002
RMA
12/02/2002
12/02/2002
0002 01
CGP
02
120.00
Total Fees $12000 Total Payments To Date $000 Balance Due $12000
Miscelaneous Fee #1
Miscelaneous Fee #2
Additional Fees
TOTAL PERMIT FEES
PERMIT FEE $12000
$000
$000
$12000
Inspector^
FINAL VA
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
'lB"h;. PROJECT INFORMATION
•2 1 ot icst*. t)ec MAR. go
FOR OFFICE USE ONLY
PLAN CHECK NO
EST VAL
Plan Ck Deposit
Validated By
Date n
Address (include Bldg/Suite #)Business Name (at this address)
Legal Description
o5"
Lot No Unit No Phase No Total # of units
Assessor s Parcel ft Existing Use
37&Q so FT SPACE, BE/H.VEL.
Proposed Use
Description of Work
2y CONTACT PERSON (if different frornapplJcantjjBti
SQ FT #of Stories ft of Bedrooms ff of Bathrooms
Name
,3S iiAPPLICANT Contractor-'
Address
Agent'fdr'"i:"ontra6tor [0 Owner'
City
?Agent for Owner
State/Zip Telephone #Fax #
/7V/
Name Address City State/Zip Telephone #
- 1 < n
Name Address City State/Zip Telephone tt
(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 [S'sOOD
Name
State License #
Address
License Class
City State/Zip
Citv Business License tt
Telephone #
Designer Name
State License tt
Address City State/Zip Telephone
16' 'i»s^RKERS-CPENSA)Nr
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
|~1 | 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 [$1001 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 m 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
O 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 contractoi(s) licensed
pursuant to the Contractor s License Law)
[~] | 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
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 OATE
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 £j NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES £jj NO
Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? O YES £j 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 _____ _ LENDER S ADDRESS
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
Citv 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 commqpee^or^ period of 18£rJa^JSectioij*406 4 4 Uniform Building Code)
APPLICANT S SIGNATURE DATE
WHITE File YELLOW Applicant PINK Finance
Inspection List
Permit* CB023610 Type MISC OTHER LA COSTA RESORT-GARDEN CAFE
REMOVE & NEW PARTITION WALLS
Date Inspection Item Inspector Act Comments
07/18/200319 Final Structural PD AP
Friday, July 18 2003 Page 1 of 1
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