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Home My WebLink About2180 RUTHERFORD RD; ; CB130430; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 02-21-2013 Miscellaneous Permit Permit No: CB130430 Building Inspection Request Line (760) 602-2725 Job Address: 2180 RUTHERFORD RD CBAD Permit Type: MISC Subtype: OTHER Status: Parcel No: 2120102500 Lot#: 0 Applied: Valuation: $0.00 Entered By: Reference #: Plan Approved: PC#: Issued: Inspect Area: Project Title: CALLAWAY GOLF WORK IN PREPERATION OF CB 12-2634 Applicant: Owner: PACIFIC BUILDING GROUP STE 150 CALLAWAY GOLF CO 9752 ASPEN CREEK CT SAN DIEGO, CA 92126 858-552-0600 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: $130.00 Inspector: PERMIT 2180 RUTHERFORD RD CARLSBAD CA 92008 Total Payments To Date: $130.00 Balance Due: FINAL APPROVAL <Date: 2 f-lo/' Clearance: ISSUED 02/21/2013 MOP 02/21/2013 02/21/2013 $130.00 $0.00 $0.00 $130.00 $0.00 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 setforth 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. ~/ THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: 0PLANNING D ENGINEERING OBUILDING OFIRE 0HEALTH D HAZMAT/APCD . ~ «.<~ " ·,. CITY OF CARLSBAD JOB ADDRESS Building Permit Application 1635 Faraday Ave., Garlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: buldllng@carlsbadca.gov www.carlsbadca.gov SUITE#/SPACE#/UNIT# .DESCRIPTION OF WORJ(: Include Square Feet of Affected Area(s) . . · -\JJ()rl l IN f M(.l~/lMtl0{\J er-f ellM rr cf); f?, ~IJ,b ~. EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (Sf) DECKS (SF) Plan Check No . Est. Value Plan Ck. Deposit Date SWPP APN . i-mo -1E -/)() FIREPLACE YESD #_ NOD CONSTR. TYPE OCC. GROUP AIR CONDITIO.NING YES D NOD FIRE SPRINKLERS YES D. NOD APPLICANT NAt,'IE (Secondary Contact) ADDRESS CITY STATE ZIP PHONE FAX EMAIL CITY CLASS (Sec. 7031.5 Business and.Professions·Code: Any City or County which requires a permit to construct alter, improve, demolish or repair an~ structure, prior to its issuance, also requires the applicant for such permit toJ1le 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 pen~lty of not more than five hundred dollar9 ($500}). . · =~~--.,...._=.,......,.,......,.,......,.,......,,_.,......,=,,......,......,-.,.,,,.,......,.,......,.......,.......,.,......,...,,.,=c-,-:===....,...,......,,.,-~ Workers' Compensation Declaration: / hereby affirm under penalty of pe,juiy one of the following declarations: 0 I have and wlll 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' co\UP.ensation, i}S required by Section ~700 .]I the abor Code, f 1rJhe performan&f the work for which this permilis is_,s,ued. My workers' compensation insurance carrier and policy numberare:lnsuranceCo. Loe TON /V~t.l 'a ~olicyNo. IC W3/p8l/ IJ..b ff · Expiration Date a-1-1~ . - '"' This section need not be completed if the,permitis for one hundred dollars ($100) or less. · · 0 Certificate of Exemption: I certify that in the performance of the work for which this permilis 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 verage 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, dama es as proviiled fo ection 3706 of the Labor code,.lnterest and attorney's fees. _N5 COt:ITRACTOR-SIGNATURE I he~by affirm that I am exempt from Contractor's Ucense Law for the following reason: Cl I, as owner of the property or.my employees with wages as their sole compensation, will do the work and the structure is not int~nded 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, ang who dqes such wqrk 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). c:i· I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions C.ode: 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 l:aw). CJ' I am ex~mpt under Section ____ Business and Professions Code 'for t~is·reason: 1. I personally plan lo provide the major labor and materials for construction of the proposed property improvement. Cl Yes Cl No 2. I (have/ have not)'signed an application for, a building permit for the proposed work. 3.1 have contract~ with the·following person (firm) to provide the proposed cortslruction (include name address/ phone/ contractors' license number): 4. I plan to provide portions of the work, but l·have hired the following person to coordinate, supervise and provide the.major work {include name/ address/ phone I contractors' license number): 5. I will provide some of the mrk, but I have contracted (hired) the following persons to provide the work indicated (Include name / address / phone/ type of work): _,g PROPERTY OWNER SIGNATURE r:IAGENT DATE Is the applicant or future builstfng occupant required to submit a business plan, acutely hazardous matertals registration form.or rtsk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Cl Yes Cl No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management distrtct? Cl Yes Cl No Is the facility to be const,ructed within 1,000 feet of the outer boundary of a school site? Cl Yes . Cl 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 certifythatl have read the application and state that the above infonnation is cormctand that the lnfonnation on the plans is accurate. I agree to complywith all City ordinances and State laws relating to building construction. I hereby authorize representative of ity of Carlsbad to enterupon the aoove menfioned property for ins _ . purposes, I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST All. LIABILITIES, JU MEN , COSTS AND EXPENSES WHICH MAY IN ANYWAY AC EAGAINST SAID CITY IN CONSEQUENCE OFTHE GRANTING OF THIS PERMIT. OSHA, P..[l OSHA permtt is req for ex vations over 5'0' deep and demolition or construction ctures over 3 stories in he~ht. EXPIRATION: Every permit' ued by the ilding Official under the 'sions of this Code . I expire by.limitation and become null and void if the building or mrk authorized by such permitis not commenced within 180 days from the date of s pe · or' the 'kf g orv.ork au · eel b · uch perm· : suspended or abandoned at any time afferthe mrk is commenced for peiiod of 180 days (Section 106.4.4 Uniform Building Code). DATE STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the-following ONLY if a Certificate of Occupancy will be requested at final inspection. CEflTlflCATF OF OCCUPANCY [Commerc1ai Projects On I y I Fax (760) 602'8560, Email www.buitding@carlsbadca.gov.or M~il the completed form.to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. I CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY . STATE ZIP CITY STATE ZIP Carlsbad CA PHONE I FAX :EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS C1 PICK UP: o CONTACT (Listed above) o OCCUPANT (Listed above) o CONTRACT9R (On P~. :1.) Cl MAIL TO: o CONTACT (Listed above) o OCCUPANT (Listed above) o ASSOC!ATED CB# o CONTRACTOR (On.Pg. :I.) o NO CHANGE IN USE/ NO CONSTRUCTION Cl MAIL/ FAX TO OTHER: · o CHANGE-OF USE/ NO CONSTRUCTION ~--- '' ~ APPLICA.NT'S SIGNATURE DATE