HomeMy WebLinkAbout2512 LUCIERNAGA ST; ; CB052741; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Miscellaneous Permit Permit No: CB052741
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
2512 LUCIERNAGA ST CBAD
MISC
2152506100
$0.00
Subtype: OTHER Status:
Lot#: 0 Applied:
Entered By:
Plan Approved:
Issued:
REH RES-ADD WINDOW@OFFICE AREA Inspect Area:
pplicant:
REH GEORGE P&JO PHINA C
Miscelaneous Fee #1
Miscelaneous Fee #2
Additional Fees
TOTAL PERMIT FEES
PERMIT FEE
Owner:
REH GEORGE P&JOSEPHINA C
2512 LUCIERNAGA ST
CARLSBAD CA 92009
ISSUED
07/25/2005
RMA
07/25/2005
07/25/2005
$120.00
$0.00
$0.00
$120.00
Total Fees: $120.00 Total Payments To Date: $0.00 Balance Due: $120.00
3289 07 /25/05 0002 01
CGP
Clearance:
NOTICE: Please take NOTICE that approval of your project includes the "Im osition" fees, dedications, reservations, or other exactions hereafter collectively
referred to as '1ees/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 infom,ation 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 service fees in connection with this project. NOR DOES IT APPLY to any
02
120-00
FOR OFFICE USE ONLY
PERMIT APPLICATION PLAN CHECK NO. ____ _
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
EST. VAL. _________ _
Plan Ck. Deposit ________ _
Validated By __________ _
Date ______________ _
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Cd /tw 8· ,,, ~ r Jt. q 7 """ C)
Addreas (include Bldg/Suite I) Business Name (at this address)
Legal Description lot No. Subdivision Name/Number Unit No. Phase No. Total I of unite
Assessor's Parcel I Existing Use Proposed Use
I of Bathrooms
., f'\
Name Address City
ii t),i':,,~~~ftJ.i.,,,~•:[:lo~lt•,Q,tlJr, ;~gffit'.J9ii:~AAll:Jl.llli!fM<")!lf o:«11J1&.( III ~gAAt (op~9er,,·i! j,! ,,
State/Zip Telephone I
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Fax I
Name Address City State/Zip Telephone I
Name Address
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(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
exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars l$60011.
Name Address City State/Zip Telephone I
State License I _________ _ License Class _________ _ City Business License I _______ _
Designer Name Address City State/Zip Telephone
State License I _________ _
0 I have and will maintain a certificate of consent to self-insure for workers' compensation H provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
0 I have and will maintain workers' compensation, H required by Section 3700 of the Labor Coda, for the performance of the work for which this permit is
issued. My worker'• compenaation inaurance carrier and policy number are:
Insurance Company_____________________ Polley No. Expiration Date. _______ _
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1noo1 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' Compenaation Laws of California.
WARNING: Fallwe to -• worltwa' compenutlon coverage la unlawful, and shall aubject 1111 employer to crlmlnel penaltiN end clvll finN up to one hundred
thouaend dollar• 1'100,0001, In addition to the coat of c:ompenaatlon, dllffllON as provided fOf In Section 3706 of the Labo, code, lntereat end attorney's fHs.
SIGNATURE DATE ________ _
J ·~ 1 I,(· ~-, ~Jt!tt,~r:~··~;~ •. t~·M~~f.t~~jt~1•\~~~•;:~;-~~il)~·~~tt/, L· {~ ~,! '.; ~. •, -:'·i •. 1
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
M I, as owner of the property or my employees with weges II their sole compensation, will do the work and the structure is not Intended or. offered for sale
~c. 7044, Buslnua and Profaaslona Code: The Contractor's LlcanH Law does not apply to an owner of property who builds or improves thereon, and who does
such work himself or through his own employHa, 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 butden 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 llcenaed contractors to construct the project (Sac. 7044, Business and Professions Code: The
Contractor's Llcenae 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 Licenae Law).
0 I am exempt under Section ______ Business and Professions Code for this reaaon:
1. I personally plan to provide the major labor and materials for conatruction of the proposed property Improvement. M,' YES ONO
2. €,} have not) signed an application for • 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/ contractor• llcenae numb«): ______________________________________________ _
ls the applicant or future building occupant required 10 submit • business plan, acutely hazardous materials registration form or risk management and prevention
program under Sections 25606, 26533 or 26634 of the Presley-Tanner Hazardous Substance Account Act? 0 YES O NO
Is the applicant or future building occupant required to obtain• permit from the air pollution control district or air quality management district? O YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES D 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 ANO THE AIR POLLUTION CONTROL DISTRICT.
•I
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued (Sec. 3097111 Civil Code).
LENDER'S NAME______________ LENDER'S ADDRESS
~C1ini.1Am •. ·~n ~Bl,i>J,:11\._.,_l§l.r;F,}.~,M:t.i:~,,t~.:k1~--,;-,.,-~-,,-~ .. -ll~---, .. -1-~---. ,-,.-.-.. -~-;:;,,-·:,-,,.-.½-.~---.\-~-.-,f.(-'.:-;:-,.~--;.1:i_:_~-~-,ii-,,-_;-,.:-'i!-:;.-~-.,,,-!,-.~-.r.)-i-.. -.-,,-.t-: ,-,.-_.-. -1-,-, •! '
I certify that I have read the application and state that the above Information Is correct and that the Information on the plans la accurate: I agree to comply with 111
City ordinances ■nil State laws relating to building construction. I hereby authorize repreaentatives of the Citt of Carlsbad to enter upon the above mentioned
property for Inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES,
JUDGMENTS, COSTS ANO 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 end void ii 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 .J at any time after the work Is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). / /
)APPLICANT'S SIGNATURE 4 t'· ~ ")) DATE 7 1f I et'·
/ WHITE: File YELLOW: Applicant PINK: Finance / /
City of Carlsbad Bldg Inspection Request
For: 12/22/2005
Permit# CB052741
Title: REH RES-ADD WINDOW@OFFICE AREA
Description:
Type: MISC Sub Type: OTHER
Job Address: 2512 LUCIERNAGA ST
Suite: Lot 0
Location:
APPLICANT REH GEORGE P&JOSEPHINA C
Owner: REH GEORGE P&JOSEPHINA C
Remarks:
Total Time:
CD Description
19 Final Structural
Comments/Notices/Hold
Associated PCRs/CVs
lnsgection Histo!Y
Date Description Act lnsp Comments
Inspector Assignment: PS ---
Phone: 7608045788
Inspector£
Requested By: N/A
Entered By: JANEAN
10/20/2005 14 Frame/Steel/Bolting/Welding AP PS WINDOWS ALL CAULKED
10/20/2005 19 Final Structural we PS
10/05/2005 14 Frame/Steel/Bolling/Welding AP BN FRAME ONLY NO WINDOW FLASHING@ THIS TIME
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