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Home My WebLink About2335 CAMINO VIDA ROBLE; ; CB033079; Permit11-f2-20()3 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No: CB033079 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 2335 CAMINO VIDA ROBLE CBAD MISC Subtype: 2130502700 Lot#: $0.00 OTHER 0 CAMINO CORP PLAZA DEMO NON BEARING PARTIONS NO NEW CONSTRUCTION Applicant: RICHARD AND RICHARD CONSTRUCTION 4751 OCEANSIDE BLVD #D OCEANSIDE, CA 92056 760-630-1540 Status: ISSUED Applied: 11/12/2003 Entered By: SB Plan Approved: 11/12/2003 Issued: 11/12/2003 Inspect Area: Owner: WELLS FARGO BANK TR Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE Total Fees:$60.00 Total Payments To Date:$0.00 Balance Due:$60.00 8504 11/12/03 0002 01 02 CGP 60-00 Inspector: FINAL APPROVAL Date: _Clearance: 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 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 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 previously otherwise expired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 £-?>=>£_l«XAJV Q /Q Vl t-A- FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL Plan Ck. Deposit Validated By 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 SQ.FT.#of Stories # of Bedrooms # of Bathrooms !, V" r*- *-" «. "tal1 * ' *j>f "_*• 'I** <T <fte tod A <faxTR 766 7g? Name ^-Cantractor. _A£L Address City &J^ttti!M#Mln* lOOAmc - 0 A&MMP Own! State/Zip Telephone #Fax It Name Address City State/Zip Telephone If Name Address City1 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 emption. Any violatiorujf Section 7031.5 by any applicant for a permit subjects trm applicant to a^pivil perjalty of not more than five hundred dollars [$500]^ Name State License # C&-\.*C) Address License Class City State/Zip City Business License # Designer Name State License # Address City State/Zip Telephone Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Q 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. h4IXL 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 ^TpcyT"^- rT»**JP Policy No. l^l ^? 1 V O ^ Expiration Data j / \ /£ *~( (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) ~^ ' Q 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: FaJjyKftUo.secjjwnorkers' cAmerwatlon coverage la unlawful, and shall lubject an employer to criminal penalties and civil fines up to one hundred tirauaand dattB^M^><[p<ODO),ir^ddn?oiJo|tri_Ncost of compensation, damage* as provided for in Section 3706 of the. Labor code, ifltBrait^nd attorney's fee*. DATE- I hereby affirm that I am exempt from the Contractor's License Law for the following reason: Q 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 intendedjir_otfereo 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"notbuild or improve for the purpose of sale). Q I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Coda: The Contractor's License Law does not apply to an owner of property whojwifos 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 QNO 2. I (have / have not) signed an application for a buifding permit for the proposed work. 3. I have contracted with the following persgfrffirm) to provide the proposed construction (include name / address / phone number / contractors license number): ./ . .... ... ...... w 4. I plan to provide portions of the wof^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 wDfk, but 1 have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work): PROPERTY OWNER SIGNATURE DATE 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 (fif 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 £} NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES 0- 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. SilEi!S§"$$RW^ 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 1 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, t 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 urfter 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 day:/ Mom 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 coj»menrej^terfpejj]fe oi^Bpdpys (Section 106.4.4 Uniform Building Code), APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance W'ACORD.. fcca <S3ffi»:*¥W-¥:WSSiB$v: "* * ~" "• sgflfi'CATE 6F tlABIL PRODUCER 619-699-0539 Driver Alliant Insurance 1B20 Fifth Avenue San Diego, CA 92101 Jim Castle INSURED Richard & Richard Construction, Inc. 4751 Oceanside Blvd. Oceanside CA 92056 I st^iKr|t|RAN,ci -; .-• £,/- •"•assfni THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION" ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOwT COMPANIES AFFORDING COVERAGE COMPANY M^ HAWLEY |NSURANcE co COMPANY HARTFORD CASUALTY INSURANCE CO COMPANY STATE COMPENSATION FUND COMPANY D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR A C B TYPE OF INSURANCE GENERAL UABIUTY X COMMERCIAL GENERAL UABIUTY i. I CLAIMS MADE [_Xj OCCUR X OWNER'S ft CONTRACTOR'S PROT AUTOMOBILE UABIUTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS OARAGE UABIUTY ANY AUTO EXCESS UABIUTY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION EMPLOYERS' UABIUTY THE PROPRIETOR/ PARTNERS/EXECUTIVE OFFICERS ARE: OTHER LEASED/RENTED EQUIPMENT UNO INCL EXCL POUCY NUMBBt MGL0 135539 PER PROJECT AGGREGATE 181511503 72S8AAA571&, POLICY EFFECTIVE DATE WM/DD/YYI 3/26/03 01/01/03 03/26/03 POUCY EXPIRATION DATE (MM/DO/YY) 3/26/04 i 01/01/04 03/26/04 UMTT* GENERAL AGGREGATE PRODUCTS - COMPVOP AGO PERSONAL & ADV INJURY EACH OCCURRENCE FIRE DAMAGE (Any arm flral MED EXP (Any on* (Mroonl COMBINED SINGLE UMCT BODILY INJURY IP«r p«rton) BODILY INJURY PROPERTY DAMAGE AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE EACH OCCURRENCE AGGREGATE v j WC STATU- | lOTH-*• iTORYUMITSl I tR EL EACH ACCIDENT EL DISEASE - POLICY LIMIT EL DISEASE • EA EMPLOYEE « 2000000 4 1000000 « 1000000 1 1000000 * 50000 » 5000 . 1 * t * * *$ 1 *... "" . _.', •'-_ "-- - - -_ ; * 1000000 t 1000000 * 1000000 $50,000 LIMIT $500 DEDUCTIBLE SPECIAL FORM PERILS DESCRIPTION OF OPERATIONS/LOCATIONS/VEHCLES/SPECIAL ITEMS •10 DAYS NOTICE FOR NON-PAYMENT OF PREMIUM. INFORMATION PURPOSES ONLY SHOULD ANY EXPIRATION 30 DAYS ' V OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL WRITTEN NOTICE TO THE CERTIFICATE HOLDOt NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. J , ,#CORD 25-S (1/95) '- ...— V-.- -:^w. AUTH6rtZEMWBR£4ENTATIUt ^y S w '' ^"tts'U ° ''(' CACQRP CORPORATION 1988