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Home My WebLink About2450 LA COSTA AVE; ; CB972572; PermitJob Address: 2450 LA COSTA AV Permit Type: RAD Citv of Carlsbad RESIDENTAL ADD/ALT Status: Applied: Permit No: CB972572 WITHDRAW 9/11/1997 Parcel No: 2161601300 Lot#: Approved: Reference No: Issued: PC#: Inspect Area: Project Title: 665 SF-FINISH BASEMENT AREA Applicant: HENEGAR HOMES 1615 JERRILYNN PL ENCINITAS CA 760 633-1421 00136104885 Plan Check Fees: $105.00 Additional Fees: Owner: MATHEWS DENIS E&ROSE J $105.00 $0.00 Total Fees: $105.00 Balance: $0.00 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. 17 ;1_5 79- CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. v AL. / ~ I ~ ] c2 Plan Ck. Deposit --~.-----,H---+-_..,.....__ 1. Address include Bldg/Suite #) Business Name (at this address) ).,oy ,::; tPE M eosrt1 SouT/f uh lf/4/4).l Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units WJ t:1.;5e o Existing Use 2. CONTACT PERSON (If different from applicant) Name 3. 5. Address CONTRACTOR • COMPANY NAME #of Stories City 0 Agent for Owner ~ B'< ep,~1<RMJ..~ 01 Proposed Use C-PRH 02 105-00 # of Bedrooms # of Bathrooms State/Zip (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 exem tion. Any violation of Sec ·on 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)). -I -JL , -~o .o .. / 2 Name Address City State/Zip Telephone # License Class 8 City Business License # /£.O </-'-/-IC} / State License# J '871(ie0 ~me., Designer Name Address City State/Zip Telephone State License # _________ _ 6. WORKERS' COMPENSATION 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. 0""1 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 .572tTe FCl ~ p Policy No. ll, ;i_ 9 -B> / :?,3 0 0 Expiration Date /..,. Cf :ff (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) O 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 worker~· co ensatlon coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars $100,000), in addition t the cost of compensation, damages as provided for In Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE:_j_~~:::1::::~~L.,.~~~~~~~::..__________ DATE 9-/ / -'22 7. OWNER-BUI DER DECLARATION 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 tor the purpose of sale). O 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. 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 I 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 I address / phone number / type of work): ________________________________________________________ _ PROPERTY OWNER SIGNATURE ______________________ _ DATE _________ _ 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? 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? 0 YES O NO ls 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. 8. CONSTRUCTION LENDING 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(i) Civil Code). LENDER'S NAME ______________ _ LENDER'S ADDRESS. ________________________ _ 9. APPLICANT CERTIFICATION 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 6'0" 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 365 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 ork is com mensed for a eriod of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE _jLl..f=:'~.U:.U::JC4~"'-P-..,,.~~~~~~~~------DATE 9-1 1 -9: 7 PINK: Finance City of Carlsbad ■ ~1111 &I I ,1·1 •JA •Glli,,14 ,; I DATE: 08/07/98 TO: HENEGAR HOMES 1615 JERRILYNN PL ENCINITAS CA 92024 PLAN CHECK EXPIRATION PC# CB972572 DATE: 09/11/98 ADDRESS: 2450 LA COSTA AV You have applied to have your plans checked on the date shown above, and you have not obtained your buildinq 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. ~OJECT AI!AHDON'ED. PIJ\.N3 i-!AY DE DESTROYED. If you have any questions, please contact the Building Department at (619) 438-1161 extension 4331. RAENETTE ABBEY Building Department 2075 Las Palmas Dr.• Carlsbad, CA 92009-1576 • (760) 438-1161 • FAX (760) 438-0894