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Home My WebLink About2158 PALOMAR AIRPORT RD; ; CB044280; PermitCi^rof 11-29-2004 Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No: CB044280 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 2158 PALOMAR AIRPORT RD CBAD MiSC Subtype: OTHER 7602216200 Lot#: 0 $0.00 PALOMAR AIRPORT CAFE-TEMPORARY TENT & TRAILER Applicant: RICHARD AND RICHARD Status: ISSUED Applied: 11/29/2004 Entered By: RMA Plan/Approved: 11/29/2004 Issued: 11/29/2004 Inspect Area: Owner COUNTY OF SAN DIEG0/P4JL0MAR AIRPORT SUITE 100 234 VENTURE ST 92078 PUBLIC AGENCY 00000 Miscelaneous Fee #1 MIscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE $120.00 $0.00 $0.00 $120.00 Total Fees:$120.00 Total Payments To Date:$0.00 Balance Due;$120.00 6307 11/29/04 0002 01 02 CGP 120.00 Inspector: APBROVALFINAL APRRQYAL Date:Clearance: NOTICE Please take NOTICE'tti'at approval of your project Includes ttie 'Imposition' of fees, dedications, reservations, or other exactions hereafter coBecBvety refered to as Tees/exacttons." 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 fie the protest and any other required Infonnatlon with the City Manager for processing in accordance with Carlstrad Municipal Code Section 3.32.030. Failure to timety follow that procedure will Irar 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 orevlQuslv been given a NOTICE similar to this, or as to which the statute of limitations has orevkxislv otherwise expired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faracjay Ave., Carlsbad, CA 92008 r-UH Ol-l-lUt USt UIMLY PLAN CHECK NO., EST. VAL. Plan Ck. Deposit Validated By Date ^ fur L^alDescription T Lot No. Subdivision Name/Numoer Unit No. Phase No. Total # of units Assessor's Parcel # Description of Work 'Bppllcahtj Existing Use / / Propo^ Use ,l-SmP' T K^~hlu "TsqTfT (fof Stories tt of Bedrooms P of Batluaoms A \}(AiAiriuJ CA- ^bLA?-(^'7 AHHroqc ' Citv State/Zip Telephone ff Fax UName Address ' City ,3',_ - APPLICANT □ Contr'actar □ Agent for Contractor . Q Owner , Q Agent for Ownerav - iArKLIUMN I ' I ILJ uonxraciur I ' 'Ur,UUUllMU«.Ul,'i; . VYVMUI , , : /:syuMi ly. V'.'ui. .y 1 y A ' 'WiA/^l'hA'Aiv^ ppA/Anprr]A^^:'':Arir.<^oyo UJAI^ pr IP KiPilAi , , as.,. ,Name ' Address City State/Zip Telephone # §^<§-.^57 / ' fil rjj/>n CA- ^^3-7Name y - Address (W State/Zip Telephone #Name .5../ CONTBACTOB COMPANY NAME ' (Sec. 7031.5 Busine^^ and Professions Code; Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to itsissuance, 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 allegedQxemption.' Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil pen^y of not more than five hundred dollars I«^).^\c)^ilrd K' (U^h6>f. Z34 -Str^ioo Sdr\ C/h ^7-01%—_N^nt^ ^ State/Zip Telep^ 75 ^IT Q >*3^ License Class ^ City Busines^License U [pi > ^2^4- Q{-.^\dd Gdn lApACipd." (Tesioner Narne ' Address City State/Zip Telephone7^^'-76^-2-^(^-0 6 WORKERSf COMPENSATION . -Wckerc' Compensation Declaration; I hereby affirm under penalty of perjury one of the following declarations; □ 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. 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/iSuad. My worker's compensation insurance carrier and policy number are; / / / ZC~/ 1 AT" "7 It nyLInsurance Company '^'/AVT"AJ h Policy Ho. ! (/! ^ ' {t> - A-P OH Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS)I I 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: Foilura to secure workers' compenaotlon coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundredthousand dollars (S^TOO.OOO), in addltlnm^ the cost of compansstlon, damages as provided for In Section 3706 of the Labor codRI..ATMRF PFJj/nMf I ^ —— i7-' - , ,,I hereby affirm that 1 am exempt trom the Contractor's License Law for tne following reason; Q I, as owner of the property or my amployaas 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 doessuch work himself or through his own employees, provided that such improvements are not intended or offered for sale, if, however, the building or improvement issold within one year of completion, the owner-builder will have the burden of proving that ha did not build or improve for the purpose of sale).[~| L 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). □ 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. □ YES [I]N0 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): DATE interest and attorney's fees. 4. I plan to provida 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); PHOHERTY OWNER SIGNATURE DATE iCOMPLETE THIS SECTION fOH NON HBSIDENTIAL BUILDING PERMITS ONLY. _ . Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risx management ano prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? - Q YES EH NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ YES □ NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? [J YES ED 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. ja.. CONSTRUCTION LENDING AGENCY 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 ;9. . APPLICANT CERTIFICATION ' 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 Citl' of Carlsbad to enter upon the above mentioned property for inspection purposes. 1 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. QSHA; An OSHA permit is required for excavatlMS over b'O" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the buili3ira'OfficiaklJnclsr the provisions of this Code shall expire by limitation and become null and void if the building or workauthorized by such permit is not commencpdwilhin 180 day^fom the date of such permit or it the building or work authorized by such permit is suspended or abandonedat any time after the work is commence;i4y a'periodoi IKi days (Section 106.4.4 Uniform Building Code). .> y / .tv DATE f//$-9/{?yAPPLICANT'S SIGNATURE WHITE; File YELLOW; Applicant PINK; Finance City of Carlsbad Building Department UNSCHEDULED INSPECTION REQUEST Date Inspector fv — Building Permit No.Plan Check No. JobAddress Inspection Code (see reverse) Inspection Description Inspection Results Comments V/^i^rv* VoCo- "4^ 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-2700 • FAX (760) 602-8560