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Home My WebLink About2283 COSMOS CT; ; CB140886; Permit04-21-2014 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Demolition Permit Permit No: CB140886 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Occupancy Group: PC #: # Dwelling Units: Bedrooms: Project Title: 2283 COSMOS CT CBAD DEMO 2130504300 Full Demo: Lot#: Reference #: 0 Structure Type: 0 Bathrooms: SKATEOPLEX: INTERIOR DEMO NON SRUCTURAL ITEMS ONLY Status: Applied: Entered By: Pian Approved: Issued: Inspect Area: ISSUED 04/21/2014 JMA 04/21/2014 04/21/2014 Applicant: JRG CONSTRUCTION INC A-410 231 E. ALESSANDRO BL RIVERSIDE CA 92508 951-660-5856 Owner: WESTERN STATES TECHNOLOGIES HOLDINGS INC C/O TODD P MILLER 18101 VON KARMAN AVE #330 IRVINE CA 92612 Building Permit Plumbing Fee Other Fee Additional Fees TOTAL PERMIT FEES $0.00 $0.00 $65.00 $0.00 $65.00 Total Fees: $65.00 Total Payments To Date: $65.00 Balance Due: $0.00 Inspector: FINAL APR Date: - ^ 'PROVAL / Clearance: NOTICE: Please take NOTICE that approval of your project includes the Imposition" of fees, dedications, reservations, or other exactions hereafter collectively refen-ed 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 Govemment 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 vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has oreviouslv othenvise expired. THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: nPLANNING nENGINEERING • BUILDING •FIRE nHEALTH nHAZMAT/APCD CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax:760-602-8558 email: building@carlsbadca.gov www.carisbadca.gov Plan Check No. - QQ^ Est. Value Plan Ck. Deposit Date SWPPP JOB ADDRESS ^ ^ 2 2.^3 ^ip£noS ^7- SUITE«/SPACE*/UNIT* CT/PROJECT # # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Areafs) EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YESPV N0| I AIR CONDITIONING YES QNO I I FIRE SPRINKLERS YES I |NO| I APPLICANT NAIVIE (Primary Contact) APPLICANT NAME (Secondary Contact; ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL PROPERTY OWNER NAME CgmRACTOR BUS. NAME . ADDRESS ^^ESS^^^^^^^^ ^^^^ ^ ^.y^^ r-) , STATE _ ^ ZIP _ ^ CITY STATE ZIP PHONE FAX PHONE ^ ^ FAX _ EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS TATEi.lC.# _ _ CLASS CITY BUS. LIC.# Y (Sec. 7031.5 Business and Professions Code: Any City or County v<hich requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuancejeiso requires the applicantfor such permitto file a signed statement that he is licensed pursuantto the provisions ofthe Contractor's License Law (Chapter 9, commending v»ith Section YuDO of Division 3 ofthe 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)). WOi?KERS' COMPENSATION Workers' Compensation Declaration: / hereby affinn under penalty ol peijury one ofthe 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 perfomiance of the wori< for which this pennit is issued. I have and will maintain woiitere' compensation, as PMuired by Section 3700 of the Labor Code, for the perfonnance of the work lorjMchMs pvmit is issued. My workers' compensaSLon insuranca.camer and [ number are: Insurance Co.. Policy No. Expiration Date^ )ensalon insurancacamer and Qoiicy 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 ttier^Smiance of the work for which this petmins^ssued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Califomia. WARNING: Failure to securu^prKe^' compen5atian^overagririrnlawnil.,an(^^ subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, djiniages as providjiMSfmSection 3706 of the LatowMpde, interest and attomey's fees. >eS'CONTRACTOR SIGNATURE 0*9—'='*=-^ QAGENT DATE t/^-<^-/—/Y OWNER-BUILO'sit DECLARATION / /lereby affirm fhaf / am exempf froml (ip/i(racfor's License Law for the following reason: I I I, as owner of the property or mV^nployees with wages as their sole compensation, will do the work and the stmcture is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to anbwner of properly who builds or impraves 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). I I I, as owner of the property, am exclusively contracting with licensed contractors to constmct 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 I I am exempt under Section Business and Professions Code for this reason: 1.1 personally plan to provide the major labor and materials for construction of the proposed property improvemenL QYes I iNo 2.1 (have / have not) signed an application for a building pemiit for the proposed work. 3.1 have contracted with the following person (fimi) to provide the proposed constmction (include name address / phone / contractors' license number): 4,1 plan to provide portions of the work, but I have hired the following person to cooniinate, supen/ise and provide the major work (include name / address / phone / contractors' license number): 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indkated (indude name / address / phone / type of work): >e!5'pR0PERTY OWNER SIGNATURE QAGENT DATE CO MPLETE T«fS SECTION FOR NON-RESiDSMTIAL BUILDING PERMITS ONLY 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? Yes No Is the applicant or future building occupant required to obtain a permit fram the air pollution control district or air quality management district? Yes No Is the facility to be constmcted within 1,000 feet of the outer boundary of a school site? Yes 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address APPLICANT CERTIFICATION I certi^ that I have read the applicatfcin and state that the above infonnation is conect and that the infonnation on the plans is accurate. I agiee to comply wHh all Oty oidinances and State lave relating to building constniction. I hereby authorize nspiBsentative of the City of Caristad to enter upon the above mentwned property (br inspection puiposes. I ALSO AGI^E TO SAVE, INDBUNIFY AND KEEP HAIRLESS 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 pernilt is required tor excavations over 5'0' deep and demolition or consttuction of stmctures over 3 stories in height. EXPIRATION; Every pemiit issued by the Building Official under the provisions of this (Dode shall expire by limitatton and become null and void If the building or vMk authorized by such pemiit is not commenced within 180 days from the date of such pennit or if the building or work authorized by such pemiit is suspended or abandoned at any time after the wort< is commenced fbr a period of 180 days (Sectton 106.4.4 Unifonn Building Code). APPLICANT'S SIGNATURE 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. Fax (760) 602-8560, Email buildina(S)cai1sbadca.aov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, Califomia 92008. C0#: (Offlce Use Only) CONTACT NAME OCCUPANT NAIVIE ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICKUP: CO NTACT (Usted above) OCCU PANT (Listed a bove) CONTRACTOR (On Pg. 1) MAIL TO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAIL/FAX TO OTHER: ASSOCIATED CB# NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION ASSOCIATED CB# NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION >eS'APPLICANT'S SIGNATURE DATE Inspection List Permit*: CB140886 Type: DEMO SKATEOPLEX: INTERIOR DEMO NON SRUCTURAL ITEMS ONLY Date Inspection Item Inspector Act Comments 07/08/2014 19 Final Structural - Rl DEMO FINAL 07/08/2014 19 Final Structural PY AP Wednesday, July 09, 2014 Page 1 of 1