HomeMy WebLinkAbout2320 HOSP WAY; ; CB012039; Permitv ( '1 0/
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
07/03/2001 Miscellaneous Permit Permit No:CB012039
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
2320 HOSP WY CBAD
MISC
$18,000.00
Subtype: OTHER Status:
Lot#: 0 Applied:
Entered By:
Reference #: Plan Approved:
ISSUED
06/12/2001
JM
07/03/2001
07/03/2001 Issued:
Project Tille: THE GROVE Inspect Area:
REPLACE EXIST CONCRETE STAIRS PROJECT WIDE
Applicant:
DAHLBERG STEVE
14661 MYFORD ROAD
TUSTIN CA 92780
714-734-0466
Total Fees: $266.00
Miscelaneous Fee #1
Miscelaneous Fee #2
Additional Fees
TOTAL PERMIT FEES
Owner:
Total Payments To Date:
PLAN CHECK
PERMIT
$105.00
lnspector:k-4./l.W,
FINAL APPROVAL
Date: y-z<;/4--z.-
Balance Due: $161.00
$105.00
$161.00
$0.00
$266.00
3668 07/03/01 0002 01 02
CGP 161,00
Clearance: _____ _
NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reseivations, or other exactions hereafter collectively
referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with ca~sbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED that your I\Jht to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy
changes, nor planning, zoning, grading or other similar application processing or service fees in connection INith this project NOR DOES IT APPLY to any
fees/exactions of which vou have nreviouslv been nlven a NOTICE similar to this or as to which the statute of limitations has nreviouslv otherwise exnired.
°1L-
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
1. PROJECT IN&ON lj 1-?lia · I( A Address (include dg/Suite #) 1 ¥ Business Name (at this address)
Legal Description Lot No. Subdivision Name/Number u1e1~ 06/ L.f'l)llfil NW 02 o.r 1 # ~nits
Assessor's Parcel # Existing Use Proposed Use GOP 05 00
Description of Work SO. FT. #of Stories # of Bedrooms
2. CONTACT PERSON (If different from applicant)
fSn1$ D.A»LBP~ 1¼"21 (t;'1{bRo Re Sn-e, Lt~rf/11
Name Ad ress City State/Zip Telephone#
5. CONTRACTOR • COMPANY NAME
(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
tion. Any vi tion of Section 7031.5 by an pplican or a permit subl_cts the a licant to a civil penalty of t ore than five hundred dollars 1$500)).
~ D--;-'lb
State License # _________ _ License Class _________ _ City Business License # _______ _
Designer Name Address City State/Zip Telephone
State License # _________ _
6. WORKERS' COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
0 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
issued. My worker's compensation insurance carrier and policy number are:
Insurance Company ~ l-<J),J) v".'5 C Lo . Policy No. 6 4-~ r:8 ~ '51r° Expiration Date 0 1. ! l r I \PU V
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS)
0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as
to become subject to the Workers' Compensation Laws of California.
WARNING: Failure s ure workers' compensation coverage is unlawful, and shall subject en employer to criminal penalties and civil fines up to one hundred
thousand dollars($ 00,0 addition to the cost of compensation. damages as provided for in Section 3706 of the La r code, Interest and attorney's fees.
SIGNATURE ___ .....,_--+,r-.,..-:_1-_-C_~----------------------DATE l ?i O /
7. OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
0 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).
0 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).
0 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. 0 YES ONO
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 I phone number / type of work): ________________________________________________________ _
PROPERTY OWNER SIGNATURE ______________________ _ DATE _________ _
COMPLETE THIS SECTION FOR NON-RESIDENTIAL 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 Act7 0 YES O NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site 7 0 YES O 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.
8. 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 Citt of Carlsbad to enter upon the above mentioned
property tor 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 comme ed 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 commenc 18 (Section 106.4.4 Uniform Building Code). ✓-'/. /,-?, ~/
APPLICANT'S SIGNATURE _.,.;a.::::::;,t..:'.'.!~~~H~L(~to,~.,._____________ DATE __ cp~/~ ~~,t,1_,.'1f_ (,v__,~------~~ •
YELLOW: Applicant PINK: Finance
Inspection List
Permit#: CB012039 Type: MISC OTHER THE GROVE
REPLACE EXIST CONCRETE STAIRS PR
Date Inspection Item Inspector Act Comments
02/22/2002 19 Final Structural RCB AP FINAL FOR PERMIT
02/22/2002 29 Final Plumbing RCB WC
02/22/2002 39 Final Electrical RCB WC
02/22/2002 49 Final Mechanical RCB WC
02/22/2002 89 Final Combo RI
02/11/2002 11 Fig/Foundation/Piers RCB PA OK TO POUR STAIR #2
01/16/2002 11 Fig/Foundation/Piers JC AP STAIR #1 OK TO POUR
01/16/2002 14 Frame/Steel/Bolting/Weldin JC WC
01/15/2002 18 Exterior Lath/Drywall JC NR
01/14/2002 14 Frame/Steel/Bolting/Weldin JC NR
12/12/2001 11 Fig/Foundation/Piers RCB AP STAIR #3 (FOOTINGS AND STEEL) OK
TO POUR
11/28/2001 14 Frame/Steel/Bolting/Weldin RCB WC
11/28/2001 62 Steel/Bond Beam RCB PA OK TO POUR STAIR #4
11/20/2001 11 Fig/Foundation/Piers RCB AP OK TO GROUT WALLS AT STAIRS
11/19/2001 11 Fig/Foundation/Piers RCB CA
11/15/2001 61 Footing RCB NR
11/15/2001 62 Steel/Bond Beam RCB NR
09/19/2001 11 Fig/Foundation/Piers RCB AP OK TO POUR
08/09/2001 11 Fig/Foundation/Piers RCB PA FTGS FOR STAIRWAY #4
Monday, February 25, 2002 Page 1 of 1
>E 6
ADE 6
'MAP NO SCALE
SHEET TITLE
COVER SHEET
REVISIONS
~ SET REVISED
~JANUARY 2':t 2001 SPD
~ SET REVISED
~FEBRUARY 5 2001 SPD
A FIELD REVISION SPD
~NOVEMBER 1 2001
6 -----1
6-----1
JOB NO. 2000401.002
DRAWN BY DAHLBER~
CHECKED BY
SCALE AS NOTED
DATE DEC. 11 , 2000
SHEET NO.
OF
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