HomeMy WebLinkAbout2335 CAMINO VIDA ROBLE; ; CB971136; Permitr „ r D P R M I TBUILDING PERMIT
05/05/97 i6:06
Permit Type: DEMOLITION PERMIT
Parcel No: 213-050-27-00
°
or
Permit No: CB971136
Project No : A9701454
Development No:
*Referenced
Construction Type: NEW
Status: PENDING
: VENTI CONSTRUCTION
1095 MEMORY LANE
ESCONDIDO, CA 92026
** Fees Required ***
Fees :
Adjustments:
Total Fees:
Fee description
30.
Other
Total
Entered By:
760 747-9590
Collected & Credits
C-PRMT. 00
.00
30. 00
Ext fee Data
* * *
;o-oo
30,00 PERMIT FEE
30.00
FINAL
INSP.
CITY OF CARLSBAD
2075 L» Pataw Dr.. QtfW»d, CA 92009 (619) 438-1161
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(760)438-1161
M'ffiife
FOR OFFICE USE ONLY
PLAN CHECK NO.T f // 1) W
EST. VAL.
Plan Ck. Deposit
Validated uy>•— /*Date
Address (include Bldg/Suite #) ,r*AjLAiMD lytOA-.ivi
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
Name Address City
Q Agent for Contractor Q Owner Q Agent for Owner
(C#<T fAlgUQf^fU) -£*£.
Address | City
State/Zip Telephone #Fax*
State/Zip Telephone #
Name Address City 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
exemption. Any violation of Section 7031.5 try any applicant for a permit subjects the applicant to a civil penalty of not more than-fivg hundred dollars
City State/Zip
City Business License #
Designer Name
State License #
Address City State/Zip'elephone
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.
T3T 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
4ssu0ti. My worker's compensation insurance carrier and policy number are:
Insurance Company '^'ffijTrl ^flAjvO _ Policy No. _ Expiration Date _
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [9100] 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 subjectjathe Workers' Compensation Laws of California.
WARNING: Failure tp secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars (feOTO,000), iaaddntorto ttiMOttof compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees.
DATE
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 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 contractors) 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. Q YES C]NO
2. 1 (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 fallowing 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 / phone number / type
of work): _ _ __ __ _ _ _ _ __ „ __ . _ _ _
PROPERTY OWNER SIGNATURE DATE
NO
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? C3 YES Q 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
Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? Q YES Q 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 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 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 CitV 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 fo^-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 jrfrovisions 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 3B6 daysJrom thfl date of such permit or if the building or work authorized by such permit is suspended
or abandoned at any time after the worMs/cpmmenced for/pjJnod'ofISffdays {Section 106.4.4 Uniform Building Code),
APPLICANT'S SIGNATURE
WHITE: File YELLOW: Applicant PINK: Finance
NO INSPECTIONS RECORDS FOUND FOR PERMIT*
~~ iJOtfOl.^tx-^^ - /VV-
City of Carlsbad
Building Department
DATE: 04/01/98
TO: VENTI CONSTRUCTION
1095 MEMORY LANE
ESCONDIDO, CA 92026
PLAN CHECK EXPIRATION
PC# CB971136 DATE: 05/05/98
ADDRESS: 2335 CAMINO VIDA ROBLE
You have applied to have your plans checked on the date shown
above, and you have not obtained your building permit.
The provisions of Section 304(d) of the Uniform Building Code
state:
"Section 304(d) Expiration of Plan Review
Applications for which no permit is issued
within one year following the date of
application shall expire by limitation, and
plans and other data submitted for review
may thereafter be returned to the applicant
or destroyed by the Building Official.
In order to renew action on an application
after expiration, the applicant shall resubmit
plans and pay a new plan review fee."
Please check the appropriate box indicating your choice
and return this letter to the BUILDING DEPARTMENT.
PROJECT ABANDONED. I WILL PICK UP PLANS WITHIN 10 DAYS.
PROJECT ABANDONED. PLANS MAY BE DESTROYED.
If you have any questions, please contact the Building
Department at (619) 438-1161 extension 4331.
RAENETTE ABBEY
Building Department
2O75 Las Palmas Drive • Carlsbad, California 92OO9-1576 • (619) 438-1161
SD
COMPENSATION
N SUnANCE
P.O. BOX 807, SAN FRANCISCO,CA 94101-0807
FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 05-01-97
POLICY NUMBER: 1076222 - 97
CERTIFICATE EXPIRES: OS-O1-98
CONTRACTORS STATE LICENSE BOARD
ATTN: WORKERS' COMP. UNIT
BOX 26000
SACRAMENTO CA 95826
JOB: LIC #326755
INCEPTION DATE: 05-01-97
D.O.: SAN DIEGO
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 30 days' advance written notice to the employer.
We will also give you 30 days' advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other documentwith respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the
policies described herein is subject to alt the terms, exclusions and conditions of such policies.
• ^PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,OOO,OOO.OO PER OCCURRENCE.
STANDARD EXCLUSION: INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE
FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY.
ENDORSEMENT #2085 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE O5/01/97 IS ATTACHED TO AND
FORMS A PART OF THIS POLICY.
EMPLOYER LEGAL NAME
VENT I CONSTRUCTION
1095 MEMORY LN
ESCONDIDO CA 92026
VENTI, ARNOLD L.
- 04-18-97
CUMENT HAS A BLUE PATTERNED BACKGROUND SCIF 10265 (REV. 2-95)