HomeMy WebLinkAbout2421 LA COSTA AVE; B; CB062840; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
10-03-2ob6 Miscellaneous Permit Permit No: CB062840
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
Project Title:
Applicant:
2421 LA COSTA AV CBAD St: B
MISC Subtype: REPAIR
216240552tf-Lot#: 0
$0.00
MARSELLA HOA-REPLACE GUARD
RAIL@DECK
Owner:
JON WAYNE CONSTRUCTION JUREWITZ LEE I
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
2580 FORTUNE WY
VISTA CA 92083
2421 LACOSTAAVE#C
CARLSBAD CA 92009
760 727-2494
Miscelaneous Fee #1
Miscelaneous Fee #2
Additional Fees
TOTAL PERMIT FEES
Total Fees:
Inspector:
$60.00
PERMIT FEE
Total Payments To Date: $60.00 Balance Due:
VAL
Date: Clearance:
ISSUED
10/02/2006
RMA
10/03/2006
10/03/2006
$60.00
$0.00
$0.00
$60.00
$0.00
NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collecUvely
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 (egal 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 X in fwhi h h v r i I n iv n N T imil flimi in h I h rwi
FOR OFFICE USE ONLY
PERMIT APPLICATION PLAN CHECK NO. CJptJ.l'-1 {)
CffY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
EST. VAL _________ _
Plan Ck. Deposit -------,~----
Validate<}~t'2 • /lj-.
Date tO/A(LJb
6-ddresJ linclude Bldgj uite #) l ,.. /"" _. tA , Business Name (at this address)
------ll\ '-{ · u-,. \J>~M ""I!·
Legal Description ~ Lot No. ubdivision Name/Number Unit No. Phase No. Total I of units
Wl~C\.,\..A-~
Assessor's Parcel # Existing Use Proposed Use
· SQ. FT. #of Stories I of Bedrooms I of Bathrooms
Name
3.
Name
4 PROPEJITY OWr,IER
Name
~,,2>~
11
.a:t~,n..~ t S1')'(.o fA-~~ 4 ~\ltS
(fl+q 6#•~\
Address State/Zip
q Sint1_ai:1or □.owner
~l.nl-lb
City
0 Agent -tor' Owner "° c0lCl'Uw(: Wit~
Address City State/Zip
Address City S.tate/Zip
Telephone# Fax#
Telephone#
Telephone#
6. CQ~Cl'Oft.-: f;0,..8ANY NAt.11: ...,
(Sec. 7031 .6 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
exemp i~ Cy c~~f Section 7031.5 by ane~Uor ~c'.;it sub~e applicant to a civil p ;~y of \~ mort\~iir hun,~o; ($5001).
Name ddress City State/Zip Telephone #
State License # 4, :).. \ S C\ License Class ~ City Business License I \ Z 'Z.o -Z.Z 0
Designer Name Address City State/Zip Telephone
State License # _________ _
6, WORKERS' COMPffiSATLOl't ~ ,
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
1lf' 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
';J the work for which this permit is issued. ,e._ I h~ve 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 t'l'\-J\ c.w~c: • M~ OC-jfiO;S, Policy No. we '"' '1-"' '\ Expiration Date \ h l 01
(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: Fal o secure worker•' compensation coverege la unlawful, and ahaU aubject an employer to criminal penaltiH and civil flnH up to one hundred
,0001, in addition e.?i• coat of compensation, damagH u provided for In Section 3706 of the Lfbor f ode, Interest and attorney'• fees.
SIGNATURE L......, ......... :a.-::,!.44.l, r-w DATE \(') _ z.. l O {o
7. OWNER,l!UILP~ DEC~tlQ~ f ' -.
I hereby affirm that I am exempt from the Contractor's 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 proving 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 contractorls) 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. 0 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/ 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 _________ _
C0!',1Pl-liTE THI$ SECTION FQR fl(lf/~!;IOElfTl~L llVILDINO PERMITS'ONLY _ -~
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 25605, 25533 or 25534 of the Presley-Tanner Hazardous Subst ance Account Act? 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 7 O YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 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.
18._-C.P_NSTflUCTIQ.N Ll;NDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(11 Civil Code).
LENDER'S NAME ______________ _ LENDER'S ADDRESS _________________________ _
,$.,. APPl,.IC~t Cl:li.TIFLCATIOI\I , • _,. r.:, ,-~ ... ,_, ••· •. t_.;: • ,, , , ~-..
I certify that I have read the application end 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 Cit\' 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 c enced within 180 d s fr m 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 c m ced for a p ri d of 1 (Section 106.4.4 Uniform Building Code).
' APPLICANT'S SIGNATURE -J~:.._:~~:'.:=~5-.....JL_~.,,l_--======------DATE __ l_o__._]2_]1-o_Cp.:a;;_ __ _
WHITE: File YELLOW: Applicant PINK: Finance
City of Carlsbad Bldg Inspection Request
For 04/30/2007
Permit# CB062840
Title MARSELLA HOA-REPLACE GUARD
Description RAIL @ DECK
Type MISC Sub Type: REPAIR
Job Address: 2421 LA COSTA AV
Suite: B Lot: 0
Location·
APPLICANT JON WAYNE CONSTRUCTION
Owner:
Remarks:
Total Time:
CD Description Act Comments
---'
Inspector Assignment: __)y\/\
Phone: 9492444553
Inspector: -----
Requested By: DAVE
Entered By: JANEAN
19 Final Structural ~-------
Comments/Notices/Holds
Associated PCRs/CVs Original PC#
Inspection History
Date Description Act lnsp Comments