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Home My WebLink About2270 CAMINO VIDA ROBLE; A; CB022449; Permit03-03-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Commercial/Industrial Permit Permit No: CB022449 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: Project Title: 2270 CAMINO VIDA ROBLE CBAD St: A Tl Sub Type: 2130504700 Lot#: $0.00 Construction Type: Reference #: SPEC TI-CAP OFF 9 FLOOR SINKS, REMOVE/RE-POUR 853 SF CONCRETE SLAB INDUST 0 NEW Applicant: BOB JAFFE CONSTRUCTION 2865 LEHIGHCT 92056 760 739-5686 Status: ISSUED Applied: 08/22/2002 Entered By: RMA Plan Approved: 08/22/2002 Issued: 08/22/2002 Inspect Area: PY Owner: CARLSBAD INDUSTRIAL ASSOCIATES LTD C/O JOHN W RUSSELL 116 MAIN ST#A TIBURONCA 94920 9334 03/03/03 Of Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Plan Check Discount Strong Motion Fee Park Fee LFM Fee Bridge Fee BTD #2 Fee BTD #3 Fee Renewal Fee Add'l Renewal Fee Other Building Fee Pot. Water Con. Fee Meter Size Add'l Pot. Water Con. Fee Reel. Water Con. Fee $0.00 Meter Size $0.00 Add'l Reel. Water Con. Fee $0.00 Meter Fee $0.00 SDCWAFee $0.00 CFD Payoff Fee $0.00 PFF $0.00 PFF (CFD Fund) $0.00 License Tax $0.00 License Tax (CFD Fund) $0.00 Traffic Impact Fee $0.00 Traffic Impact (CFD Fund) $0.00 PLUMBING TOTAL $60.00 ELECTRICAL TOTAL $120.00 MECHANICAL TOTAL $0.00 Master Drainage Fee Sewer Fee $0.00 Redev Parking Fee $0.00 Additional Fees TOTAL PERMIT FEES $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $180.00 Total Fees:$180.00 Total Payments To Date:$120.00 Balance Due:$60.00 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 •V ^S««»^rKSK!BJ*l&lRilMI«MWVIiIwlWiv »r,ft V\ £7^10 CAtYN'mo FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. ** Plan Ck. Deposit Validated B Date Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total # of units Assessor's Parcel #Existing Use Proposed Use ^Description of Work SO. FT.#of Stories # of Bedrooms ft of Bathrooms Name Address City State/Zip Telephone # • (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 dollarsj$500}). •hName State License # ") 2,6 V*f f) Address License Class Q City State/Zip City Business License # € Telephone # Designer Name Address City State/Zip Telephone State License # X /^C^^-^ft-4; V«XU-&&W1X<£&£'~~- B^iaMl^WJt^J^aLS "" -£- -,°;'^ •••>•<: --&-;* -*"* •""•- -^•'--*'™*a V ' -i-cr" *•:*" ,*"*>•• '••- •.-.*'"*-:*^'*:::> -• -.'"'-r." '.,"•<. • • • •-- •• - •-•- " ,,..-..., , . ...- ,.,, -.- *.-.,•; Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D 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. D 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 Policy No. Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS} ^QT 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 tooecome 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^addhkirijo the cost of compensation, damages as provided for in Section 3706 of the Labor code. Interest and attorney's fees. SIGNATURE f^gA C.A^S MDATE ^-^-1- O? /as 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). 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. Q YES f~)NO 2. 1 (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): DATEPROPERTY OWNER SIGNATURE II 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? Q YES Q 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 Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q 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. MlIilfMu^ &&£f &!• ^$::^.«mmrt,iSW X:-:,,:; =.:.;;.... ^ * a l •,;> <;<^u,-;-,;, :.?•--. ;-* •; .'- y,>'; •;'.- f:. -.. < • i ^ => ? -• ? • 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 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 wo k authorized by such permit is suspended or abandoned ?t any time after the work is cojjiinejice^for a pejnga of 180 days {Section 106.4.4 Uniform Building Code). 'APPLICANT'S SIGNATURED WHITE: File YELLOW: Applicant PINK: Finance •/ DATE ~ City of Carlsbad Bldg Inspection Request For: 03/05/2003 Permit* CB022449 Title: SPEC TI-CAP OFF 9 FLOOR SINKS, Description: REMOVE/RE-POUR 853 SF CONCRETE SLAB Inspector Assignment: PY 2270 CAMINO VIDA ROBLE A Lot 0 Type:TI Sub Type: INDUS! Job Address: Suite: Location: APPLICANT BOB JAFFE CONSTRUCTION Owner: CARLSBAD INDUSTRIAL ASSOCIATES LTD Remarks: CONCRETE AND FLOOR SINKS INSPECTION Phone: 7608228354 Inspector: Total Time: CD Description 24 Rough/Topout Comment Requested By: BOB JAFFE CONSTR Entered By: CHRISTINE Associated PCRs/CVs CV020695 CLOSED H-CONSTRUCTION W/O PERMITS; CV030143 OPEN H-EXPBLDG PERMIT; Inspection History Date Description Act Insp Comments 08/23/2002 11 Ftg/Foundation/Piers CO PY WORK COMPLETED WITHOUT INSPECTION 08/23/2002 22 Sewer/Water Service CO PY buite A 6,594 Square Feet Not to Scale (I.