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HomeMy WebLinkAbout245 TAMARACK AVE; ; CB053002; Permit08-19-2005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB053002 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation 'Reference # Pro 245 TAMARACK AV CBAD MISC 2060200300 $000 Subtype OTHER Lot# 0 LUGANO SHORES PROPERTY DEMO 1,300 SF SFD Status Applied Entered By Plan Approved Issued Inspect Area Applicant LUGANO SHQfRES INVESTMENTS L L C VC/O DANIB/ZIMMERMANN 18J&YLINE RD CARLSBAD CA 92008 ISSUED 08/19/2005 MDP 08/19/2005 08/19/2005 Owner LUGANO SHORES INVESTMENTS L L C C/O DANIEL ZIMMERMANN 3818 SKYLINE RD CARLSBAD CA 92008 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT $6000 $000 $000 $6000 Total Fees $60 00 Total Payments To Date $000 Balance Due $6000 5043 08/19/05 0002 01 02 CGF* 60-00 Inspector FINA 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 APPLV 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 you 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 FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date 1 PROJECTJNFORMATION B It I^JS l<3,w\.<xjrcuJ-<. Address (include Bldg/Suite #) Business Name (at this address) ££'>io£ lc*V\o WBWX. X. c£-^*iAlsmJL^ VJo.2, Hffje PQ i&o^ Legal Description Lot No Subdivision Name/Number ~ Unit No Phase No Total # of units Assessor's Parcel tt Existing Use Proposed Use iQv-V Description of Work SQ FT #of Stories # of Bedrooms # of Bathrooms CONTACT PERSON (if different from applicant) Name 3 APPLICANT City Q Contractor Address Q Agent for Contractor ;Sfbwne% Q regent for Owner L,LC_ State/Zip CAr <fecfl S Telephone #Fax # Name /T ' PROPERTY OWNER cej> Address City State/Zip Telephone # Name Address City State/Zip Telephone # CONTRACTOR JCOMPANYi NAME (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 tp a civil penalty of not more than five hundred dollars [$500]} Uc- 2GVQ Name State License tt Address License Class Cij\ O~6 \ City • State/Zip City Business License # Telephone # Designer Name Address City State/Zip Telephone State License # 6, WORKERS; COMPENSATION v , , 'Ji or 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 l~1 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 [$100] OR LESS) 5«£^ CERTIFICATE OF EXEMPTION I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California WARNING Failure to secure workers compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollafS;iL$J-0£),000), in addition to the cost of compensation damages as provided for in Section 3706 of theLabor code interest and attorney s fees SIGNATURE £-L>t3S-^--* " "* • — DATE 6 \\<[ (o£" 7 OWNER-BUILDER DECLARATION ,...: • ' . :.::;.:ifrf':::: '"" :,:: 1i;.. ••*»:• 1 hereby affirm that I am exempt from the Contractor s License Law for the following reason n 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'If as owner of the property, am exclusively contracting with licensed contractors to construct ths 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, dnd contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law) l~l 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 l~l YES fJ]NO 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 8 | jg /Q_ST COMPLETE THIS SECTION FOR NON-RESiDENTIAL BUILDING 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 25505 25533 or 25534 of the Presley Tanner Hazardous Substance Account Act? O 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' O YES l~l NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? d YES [] 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 DIST RICT 8.1 CONSTRUCTION LENDJNG AGENCYr :l:si- '•:'-f;;. . '": -»" __..,.. ' '... I' I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(0 Civil Code) LENDER'S NAME LENDER'S ADDRESS '9 APPLICANT CERTIFICAtlON - '::f'"" .ff" ::-s :: '» ei!, 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 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 c<5fiqmenced for a period of 180 days (Section 106 4 4 Uniform Building Code) APPLICANT'S SIGNATURE t.J^-1 VJ-J-O^i-«—' VtfcWftfeIX DATE-*^, ^- ( «* WHITE File YELLOW Applicant PINK Finance * City of Carlsbad Bldg Inspection Request For 01/09/2006 Permit* CB053002 Title LUGANO SHORES PROPERTY Description DEMO 1,300 SF SFD Inspector Assignment 245 TAMARACK AV Lot 0 Type MISC Sub Type OTHER Job Address Suite Location APPLICANT LUGANO SHORES INVESTMENTS L L C Owner LUGANO SHORES INVESTMENTS L L C Remarks Phone 7607291025 Inspector Total Time CD Description 19 Final Structural Act Comments/Notices/Hold mment Requested By DANIEL Entered By CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments DEMOLITION ASBESTOS CERTIFICATION ADDRESS: ZHS ^Ta>^ou-Cv c U. __ USE OF BUILDING TO BE DEMOLISHED: SQUARE FEET oQ _ X NUMBER OF STORIES PROPERTY OWNER: Lka^vx^ -SUfcrf^ l^VoefS\m*-ejjJt.S ADDRESS: 3&1& SLu\^.^e iL^d ,^M^Ji PHONE 743 APPLICANT: ADDRESS: 3k/& SkjuU^e ^O«g/ £y/cjg»«>c>< _ PHONE Section 19827.5 of California Health and Safety Code states in part: "A demolition permit shall not be issued by any city ...as to any building or other structure except upon receipt from the permit applicant of a copy of each written asbestos notification regarding the building that has been required to be submitted to the United States Environmental Protection Agency or to a designated state agency, or both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations, or the successor to that part. The permit may be issued without the applicant submitting a copy of the written notification if the applicant declares that the notification is not applicable to the scheduled demolition project." As applicant for a demolition permit in the City of Carlsbad, I certify that; I have read the excerpt from Section 19827.5 of the Health and Safety Code provided above; the information I have provided on this form is true and correct; and I further certify the following: ( ) On the attached __ pages are copies of all written asbestos notifications regarding the above referenced building that are required to be submitted to the United States Environmental Protection Agency or to Part 61 of Title 40 of the Code of Federal Regulations, or successor to that part. ( ) I declare that the written asbestos notification is not applicable to the scheduled demolition project. Applicant's Signature Date h \word\front counter handoutsNdemohtion permit requirements doc REV April 19, 2004