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Home My WebLink About2525 EL CAMINO REAL; 9030; CB111487; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 07-05-2011 Miscellaneous Permit Permit No: CB111487 Job Address: Permit Type: Parcel No: Valuation: Reference #: PC#: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 2525 EL CAMINO REAL CBAD St: 9030 MISC Subtype: 1563020900 Lot #: $0.00 KALYA BODY JEWELRY-INSPECTION OTHER 0 IN ORDER TO GET CERTIFICATE OF OCCUPANCY Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: PLAZA CAMINO REAL PLAZA CAMINO REAL ISSUED 07/05/2011 KG 07/05/2011 07/05/2011 C/0 WESTFIELD PROPERTY TAX DEPT PO BOX 130940, DEPT WFLD CARLSBAD,CA 92013 C/0 WESTFIELD PROPERTY TAX DEPT PO BOX 130940, DEPT WFLD CARLSBAD, CA 92013 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: Inspector: PERMIT FEE $65.00 Total Payments To Date: $65.00 Balance Due: $65.00 $0.00 $0.00 $65.00 Clearance: ------ $0.00 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 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 fees/exactions of which ou have reviousl been iven a NOTICE similar to this or as to which the statute of limita ions has reviousl otherwise ex ired. CITY OF CARLSBAD JOB ADDRESS CT/PROJECT# LOT# Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 www.carlsbadca.gov I, WI-J... -;. l j ~UITE#/SPACE#/UNIT# j 'i:.51 litA(l f{"b Plan Check NoCB//-/ l/f f Est. Value Plan Ck. Deposit SWPP CONSTR. 1YPE OCC. GROUP EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YESD #_ NOD YES D NOD YES D NOD ~ APPLICANT NAME Plcu.e.. ADDRESS f\Af'C,._, CITY mR'Y ~ ' STATE C'7 ZIP q2c;6.'.?? CITY STATE ZIP {; (;.\_,.. PHONE ttst =fifZ 33 367 FAX PHONE FAX EMAIL ~+cun re C fY'ICvt (, EMAIL TD5 ( Ct'y'v"\ PROPERTY OWNER NAM l,u~· R-eJ& tJ.l CONTRACTOR BUS. NAME ADDRESS J2.S )_ 5 f:;; I tCUrvv1.'r.o f2ec.L ADDRESS CITY Ca1t b&\f.t STATE Cit ZIP CITY STATE ZIP PHONE fbt) -::r-2-q-b /g-3 FAX PHONE FAX EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS STATE UC.# STATE UC.# CLASS Cl1Y BUS. UC.# (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 to a civil penalty of not more than five hundred dollars [$500)). 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, tor the perfOrmance of the work for which this perm it is issued. 0 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 workers' compensation insurance carrier and policy number are: Insurance Co. Policy No. Expiration Date---------- 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: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. ~ CONTRACTOR SIGNATURE 0AGENT DATE I hereby affirm that I am exempt from Contractor's License Law for the following reason: D 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). D 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). D 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 D No 2. I (have I 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 I phone I contractors' license number): 4. I plan to provid rtions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name I address I phone I contractors' license number): 5. I will Rr · ed (hired) the following persons to provide the work indicated (include name I address I phone I type of work): 0AGENT DATE I I 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? D Yes D No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D 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 AND THE AIR POLLUTION CONTROL DISTRICT. I certify that I have read the application and state that the above infonnation is correct and thatthe infonnation on the plans is accurate. I agree to comptywith all City onlinances and State laws relating to building construction. I hereby aulhorize representative of lhe City of Carlsbad to enter upon lhe above mentioned properly for inspection pu,poses. 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 penmit is required for excavations over 5'0' deep and demolfon or construction of structures over 3 stories in height. EXPIRATION: Every pennit issued by lhe Building Official under lhe provisions of lhis Code shall expire by limitation and become null and void if the building or work aulhorized by such pennit is not commenced wilhin 180 days from the date of such pennfor if lhe building work authorized by such pe · · uspended r abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Unifonn Building Code). _a$ APPLICANT'S SIGNATURE DATE ?-. -I