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Home My WebLink About2610 COLIBRI LN; ; CB052001; Permit06-01-2005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB052001 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 2610COLIBRILNCBAD MISC 2155340900 $000 Subtype OTHER Lot* 0 Status ISSUED Applied 06/01/2005 SB 06/01/2005 CHURCHILL RES REPLACE WINDOW AT FRONT LIVING ROOM Entered By Plan Approved Issued Inspect Area .pplicant CHURCHILL JAMES E&MONIQUE 2610COLIBRILN CARLSBAD CA 92009 Owner CHURCHILL JAMES E&MONIQUE 2610COLIBRILN CARLSBAD CA 92009 06/01/2005 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE $6000 $000 $000 $6000 Total Fees $60 00 Total Payments To Date $0 00 Balance Due $6000 9516 06/01/05 0002 01 COP 60-00 Inspector FINAL/APPROVAL,, Date /^"I^'O 5 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 lees/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 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 1., PROJECT INFORMATIpN 3-C/o ''PN /Loli FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date_ Address (include Bldg/Suite #) Legal Description Assessor's Parcel ft Description of Work 2 CONTACT PERSON (if different from am Wl <rn f C\> <>•€_ C M <J <~CJU Name 1 Business Name (at this address) Lot No Subdivision Name/Number Existing Use SQ FT #of Stories lllCaitt) : > ,' ' .: , . :(( 2&i° Coftbs: I^L £ Address City Unit No Phase No Proposed Use tt of Bedrooms '6shG*J Cf <72-04 State/Zip Telephi Total tt of units tt of Bathrooms 7 rtD^V-tfjT? ine # Fax # 3- APPLICANT Q Contractor Q Agent for Contractor \wner Q Agent for Owner Name 4 PROPERTYsOWNER Address City State/Zip Telephone tt Name Address City State/Zip Telephone 5 ^CONTRACTOR - COMPANY 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 Codel 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 I $5001) Name State License tt Address License Class City State/Zip City Business License # Telephone tt Designer Name State License tt Address City State/Zip Telephone . Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations Q 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 |~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 earner 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) Q 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 \s 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 SIGNATURE _ __ DATE _ 7 OWNER-BUILDER DECLARATION i - "•>.";."•",' «-. '• •""•;<* •."• .*'=. ~ L • -• ' •• ,, '•'.... ., • ?"..:-. h.r - -, , - I hereby affirm that I am exempt from the Contractor's License Law for the following reason Q 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) Q 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) Q 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 Q YES QNO 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 PATE (o f / '«PROPERTY OWNER SIGNATURE COMPLETE THI&SECTION FOR NON-RfSIDE Is the applicant or future building occupant/squired to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or Z5534 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 8. CONSTRUCTION LENDING AGENCY f , 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; iK ;• •..-.<..,.. ^.x .,,; .... : , ,, ..: . - - .. ••, '•• 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 City 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 stones in height EXPIRATION Every permit issued by the building Official under theprovisions oj 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 ttr§ date of su/!H neronif or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced forAa period of 180 days (Section lO^/ft/VnifpVrn Building Code) ; ^WHITE File YELLOW Applicant PINK Finance APPLICANT'S SIGNATURE DATE City of Carlsbad Bldg Inspection Request For 06/06/2005 Permit* CB052001 Title CHURCHILL RES REPLACE WINDOW Description AT FRONT LIVING ROOM Inspector Assignment 2610 COLIBRI LN Lot Type MISC Sub Type OTHER Job Address Suite Location OWNER CHURCHILL JAMES E&MONIQUE Owner CHURCHILL JAMES E&MONIQUE Remarks WINDOW INSPECTION Phone 7608451063 Inspect Total Time CD Description Act Comment 14 Framje/Steel/Boltmg/Weldmg Requested By MONIQUE Entered By CHRISTINE Date Associated PCRs/CVs Inspection History Description Act Insp Comments BY JUN 01 2005 City of CARLSBAD BUILDING DEPT. 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