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Home My WebLink About2320 HOSP WAY; ; CB132493; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 10-10-2013 Miscellaneous Permit Permit No: CB132493 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: PC#: 2320 HOSP WY CBAD MISC 0000000000 $0.00 Subtype: REROOF Lot#: 0 THE GROVE CLUBHOUSE -RE-ROOF Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: Project Title: RE-FELT ONLY -REPLACE EXISTING TILE ROOF W/ SAME Applicant: ACI ATTERHOLT CONSTRUCTION 175 W ORANGETHORPE AVE PLACENTIA CA 92870-6922 714-996-3200 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: Inspector: $65.00 Owner: BUILDING INSPECTION Total Payments To Date: $65.00 FINAL APPROVAL Date: 11-5 -;J Balance Due: Clearance: ISSUED 10/10/2013 SKS 10/10/2013 10/10/2013 $65.00 $0.00 $0.00 $65.00 $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 pennit 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 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 f hi ti h v imil r hi whi f imi h ~ . «~t. ~ CITY OF CARLSBAD JOB ADDRESS 23'2..o --t+osf t.Ja_ CT/PROJECT# LOT# Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: bulldlng@carlsbadca.gov www.carlsbadca.gov PHASE# # OF UNITS # BEDROOMS # BATHROOMS Plan Check No. Est. Value Plan Ck. Deposit SWPP CONSTR, TYPE CCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) +-(!rr"'\ Ci'-<-b { Z,OD EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS (!)...,h~ YES □#_ NO □ YES □ NOD YES □ NOD APPLICANT NAME (Seconda,y Contact) ADDRESS CITY STATE ZIP PHONE FAX EMAIL CONTRACTOR BUS. NA1: ADDRESS ltS"' iJ O,r CITY ZIP CITY -r• d, cC---r> l '<'\. c:2:TE ZIP q z~S- PHONE 7(,, 0 FAX PHONE 7r<+ Cjqb ?,2.00 FAX EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LIC. # (Sec: 7031.5 Business and Professions Code: Any City or Coun_ty which requires a permit to construct. alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such per_mit 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 [hat he is exem_12t therefrom, and the basis for the alleged exemption. Any violation of Section 1031.5 by any applicant for a permit subJects the applicant to a c1v1I penalty of not more than five hundred dollars [:ii500}). WORKERS' COMPENSATION --- 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 ~ I have and will maintain work rs' compensatl9.11 ¥ r ired by S8jtion).7_00 of the L r Code, for the performanc for which !~is wet is issued. My workers' compensati~ insur~ce car . rand policy number are: Insurance Co. 'IV/ e".I'"' {._Q Policy No -'""--'=..L----'=~~=--=l---~ Expiration Date --''-~l~S~.L_,, ____ _ This section need not be completed if the permit is for one hundred dollars ($100) or less D 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 lo the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to crlmlnal penalties and civll fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages rovided for In Section 3706 of the Labor code, interest and attorney's fees. NS CONTRACTOR SIGNATURE .a-- I hereby affirm that I am exempt from Contractor's License Law for the following reason: □ 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). □ 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), □ 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 □ No 2. I {have/ have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (flrm) to provide the proposed construction (include name address/ phone I 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 m.,.·or work (include name I address/ phone/ 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 I type of work)· R) PROPERTY OWNER SIGNATURE □AGENT DATE COMfi'i.t"n!i THIS SECTION F':)R NON•RISIDENTIAI," BUILDING PERMITS ONLY Is the applicant or fuluJe buildinp occupant required to submit a business plan, acute~ hazardous materials registration form or risk management and prevention program under SecUons 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 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? □ 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. I certify that I have read the application and state that the above Information ls correct and that the Information on the plans is accurate. I agree to comply with all City ordinances and State laws relatlngto bulldlngconstruction. I hereby au1hOlize representative of 1he Ci~ of Carlsbad to enter upon 1he above menooned property for inspection purposes. I ALSO AGREE TO SAVE, INOEMNIFY ANO 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 he~ht. EXPIRATION: Every permit issued by the Building Official under the pl'OVISions of this Code shall expire by r1mitation and become null and void if the building or work authorized by such pemiit is notcooimenced wilhW'I 180 days from the date of such permit or if the building or work authorized by such perm~ is suspended or abandoned atw:iy time after the work is commenced for a period of 180 days (Section 106.4.4 Unif0m1 Building Code). .§:I' APPLICANT'S SIGNATURE 'l_,i-----DATE Inspection List Permit#: CB132493 Date lnsp.,clionJtem 10/31/2013 15 Roof/Reroof 10/31/2013 19 Final Structural 10/31/2013 19 Final Structural 10/16/2013 15 Roof/Reroof Friday, November 01, 2013 Type: MISC REROOF Inspector Act RI RI PB AP PB AP THE GROVE CLUBHOUSE -RE-ROOF RE-FELT ONLY -REPLACE EXISTING TIL Comments GATE CODE *5037 AM PLS Page 1 of 1