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HomeMy WebLinkAbout2352 JEFFERS PL; ; CB032354; Permit~ City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 08-22-2003 Miscellaneous Permit Permit No: CB032354 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2352 JEFFERS PL CBAD MISC Subtype: REPAIR Status: Parcel No: 2081620300 Lot#: 0 Applied: Valuation: $0.00 Reference #: Project Title: BACHER RES HOT MOP AND RETILE AT MASTER BATH Applicant: HAMMOND & MAS/NG CONTRACTORS STE E 9770 CARROLL CENTER RD 92126 858 536-2440 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE Entered By: Plan Approved: Issued: Inspect Area: Owner: BACHER GERALD D&MARIANNA E 2352 JEFFERS PL CARLSBAD CA 92008 ISSUED 08/22/2003 SB 08/22/2003 08/22/2003 $89.00 $0.00 $0.00 $89.00 Total Fees: $89.00 Total Payments To Date: $0.00 Balance Due: $89.00 2587 08/22/03 0002 OJ.. CGP Inspector: 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 pennit was issued to protest imposition of these fees/exactions. lf 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 sel'\lice fees in connection with this project. NOR DOES IT APPLY to any xinfi vii imil whih · 02 39 -00 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK No.CfoSZ3sz' EST. VAL. _________ _ Plan Ck. Deposit 7"'~7.a~----- Validated,~~-,-~:::,..i='-------r,· Address (include Bldg/Suite #I Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total I of unrts Proposed Use #of Stories # of Bedrooms # of Bathrooms Name Address City State/Zip Telephone# Fax I l:f,l;j;l!~~l;,11,i\ii'·, ,□ .. CiWi•A'tor.· :iClt,!<il!im:f!o\i!PolffiiiM~i'/0Q'i:i,;;i6er{i.'i'□141i•nt'l~f'<iwner'I••: .. Name Address City State/Zip Telephone# State License # Address /'J License Class _,F""..>'-' ,'./.~;hc,1/.c:C:::.='---- Designer Name Address City State/Zip Telephone State License # _________ _ ~lti~~agt'Jif'itiarf~0S01,0:t10:~r010_~: ,,·:: ::..,:;::n::·, Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: ---a--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 policy number are: Insurance Company ~{.;.~;:ii".:"-1!~:,+LZ_L,,AQZ!Jl""i---Policy No .. _ _c/c....16z...cO,:_/.L_.'8,._.tJ.,_'"1+--- 0NE HUNDRED DOLLARS [$1001 OR LESS) Expiration Date J.2./¥ 7 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 to the Workers' Compensation Laws of California. WARNING: Fallu thousand dollars $ SIGNATURE lliiiii!lm"!liR I hereby affirm 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 woving 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. D 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 I 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).,_----------------------------------------------------------- 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? D YES D 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. 0(;;,1:l~ON1ITjjUCT10N'tEl\(D1NGi.i\<lENCY•}''' 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 _____________ _ 'i1':§.Cl(li~Lii1Aliil"tmr11!J114f10N":'.,,, · 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 commenced 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 co d for a iod o~ays (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATU C ---- WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 09/12/2003 Permit# CB032354 Title: BACHER RES HOT MOP AND RETILE Description: AT MASTER BATH Type: MISC Sub Type: REPAIR Job Address: 2352 JEFFERS PL Suite: Lot 0 Location: APPLICANT HAMMOND & MASING CONTRACTORS Owner: BACHER GERALD D&MARIANNA E Remarks: Total Time: CD Description Act Comment Inspector Assignment: JM --- Phone: 6192477769 Inspector: ---- Requested By: RUDY Entered By: CHRISTINE 19 Final Structural _f{._ ______ _ 29 Final Plumbing +---------------- Associated PCRs/CVs Inspection History Date Description 09/08/2003 27 Shower Pan/Roman Tubs Act lnsp Comments AP JM