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Home My WebLink About2326 KEATS PL; ; CB030452; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 ()2-14.-2003 Residential Permit Permit No: CB030452 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: 2326 KEATS PL CBAD RESDNTL 2121502500 Sub Type: Lot#: $600.00 Construction Type: Reference#: O Structure Type: 0 Bathrooms: SIMPSON RES CLOSE OFF MSTR BD RETREAT TO CREATE 5 TH BEDROOM RAD 0 NEW 0 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: Orig PC#: Plan Check#: Applicant: Owner: SIMPSON JAMES S&STACY L SIMPSON JAMES S&STACY L 5112 CIARDI CT 5112 CIARDI CT CARLSBAD CA 92008 CARLSBAD CA 92008 Building Permit $14.61 Meter Size Add'! Building Permit Fee $0.00 Add'! Reel. Water Con. Fee Plan Check $9.50 Meter Fee Add'! Plan Check Fee $0.00 SDCWAFee Plan Check Discount $0.00 CFD Payoff Fee Strong Motion Fee $1.00 PFF Park in Lieu Fee $0.00 PFF (CFD Fund) Park Fee $0.00 License Tax LFM Fee $0.00 License Tax (CFD Fund) Bridge Fee $0.00 Traffic Impact Fee Other Bridge Fee $0.00 Traffic Impact (CFD Fund) BTD #2 Fee $0.00 Sidewalk Fee BTD #3 Fee $0.00 PLUMBING TOTAL Renewal Fee $0.00 ELECTRICAL TOTAL Add'! Renewal Fee $0.00 MECHANICAL TOTAL Other Building Fee $0.00 Housing Impact Fee Pot. Water Con. Fee $0.00 Housing lnLieu Fee Meter Size Master Drainage Fee Add'! Pot. Water Con. Fee $0.00 Sewer Fee Reel. Water Con. Fee $0.00 Additional Fees TOTAL PERMIT FEES ISSUED 02/14/2003 SB 02/14/2003 02/14/2003 ~ '.,'-. -, $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $20.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $45.11 Total Fees: $45.11 Total Payments To Date: $0.00 Balance Due: $45.11 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. C po :>O t..f..:::,-Z... CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. _________ _ Plan Ck. Deposit ~ Validated By_,C::..-";:-,.fZ.::::.... ______ _ Date 2 -'f-03 Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use Proposed Use # of Bedrooms # of Bathrooms Name Address City State/Zip Telephone# Fax# 36: ,:J:!!:IAcenHo,i!b,;iiia~ior . ,Q ~,,.,::: ,;'G]'A;iim"!oi'O-wnor Name Address City State/Zip Telephone# •k > •l>l!Ql'liiin' 0:WNl;I! " " Name Address City State/Zip Telephone# "$/"'.: ""'Cl"ilffl!AC:i"Oi!:•'llOl\lifiN',:'iii"A111&:: . (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 dollars l$5001). Name Address City State/Zip Telephone# State License # _________ _ License Class _________ _ City Business License # _______ _ Designer Name Address City State/Zip Telephone State License # _________ _ a;;,:.:,w,o.11~~rw.:eo1,1as11m1,1,:1. 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. 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) 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 to secure workers' compensation coverage la 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, damages as provided for In Section 3706 of the Labor code, interest and attomey's fees. ,;~.~~:::a:::,;::illl:::i;;:tlijji!:;;.;;: __ .;;,;;:'.~;;:CliAIIA;;" ;;_ ;;. ;;:li;;O:;:N;;:, -==============--=== DATE ---------- 1 hereby affirm that I am exempt from the 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). 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). 0 I am exempt under Section ______ Business and Professions Code for this reason: 1. 2. 3, I personally plan to provide the major labor and materials for construction of the proposed property improvement.bi::::v'Es ONO ~ have not) signed an application for a building permit for the proposed work. { ~e 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).:_------------------------------------------------ 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 Act1 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 D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D 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. :$;; •cONIITRUCTiONlEl'IDINGAGENCY· 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 _____________ _ 9, A,PIJCANT ceRTJFICAftON 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 Citt" 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 com ,..e,1-..rmnnea days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned _ /t any time after the work is c 180 days (Section 106.4.4 Uniform Building Code). [)(APPLICANT'S SIGNAT DATE ____________ _ WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 04/01/2003 Permit# CB030452 Title: SIMPSON RES CLOSE OFF MSTR BD Description: RETREAT TO CREATE 5 TH BEDROOM Type: RESDNTL Sub Type: RAD Job Address: 2326 KEATS PL Suite: Lot 0 Location: APPLICANT SIMPSON JAMES $&STACY L Owner: SIMPSON JAMES S&STACY L Remarks: Total Time: CD Description Act Comment 19 Final Structural 29 Final Plumbing 39 Final Electrical 49 Final Mechanical Associated PCRs/CVs Inspection History Date Description Act lnsp Comments 02/18/2003 14 Frame/Steel/Bolting/Welding AP PY 02/18/2003 34 Rough Electric AP PY Inspector Assignment: PY --- Phone: 7604317714 Inspector: ---- Requested By: JIM Entered By: CHRISTINE