HomeMy WebLinkAbout2650 CHESTNUT AVE; ; CB030350; Permit02-04-2003
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Miscellaneous Permit Permit No: CB030350
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
Project Title:
2650 CHESTNUT AV CBAD
MISC
1673931900
$0.00
Subtype: OTHER
Lot #: 0
CURTIS RES-8 FT HIGH PRIVACY
WALL AROUND SPA
Applicant:
CURTIS ROBERT L
2650 CHESTNUT AVE
CARLSBAD CA 92008
Owner:
CURTIS ROBERT L
2650 CHESTNUT; AVE
CARLSBAD CA 92008
Status: ISSUED
Applied: 02/04/2003
Entered By: RMA
Plan Approved: 02/04/2003
Issued: 02/04/2003
Inspect Area:
7355 02/04/03 0002 01
CGP 30-00
Miscelaneous Fee #1 PERMIT FEE
Miscelaneous Fee #2
Additional Fees
$30.00
$0.00
$0.00
TOTAL PERMIT FEES $30.00
Total Fees:$30.00 Total Payments To Date:$0.00 Balance Due:$30.00
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
PROJECT INFORMATION
FOR OFFICE USE QNLV
PLAN CHECK N(
EST. VAL.
Plan Ck. Deposit
Validated By
Date £ (' (./ /"
Address (include Bldg/Suite #)Business Name (at this address)
Legal Description Lot No.
J£
Subdivision Name/Number Unit No.Phase No.Total # of units
Assessor's Parcel #Existing Use Proposed Use
Description of Work
WftWB
2,;/rXONTACrr PERSON (if different from applicant)
SQ. FT.#of Storie
/ Fr
# of Bedrooms
O
# of Bathrooms
O
Name Address City
3. ', APPJLIOANT O Contractor .'O. Agent lor. Contractor O Owner ', Q Agent for Owner
State/Zip Telephone Fax*
Name Address City State/Zip Telephone #
OWNER
to 5O
Address City State/Zip Telephone #Name
6. ,, CONTRACTOR;;- COMPANY NAME ' , ;" -:, .'/>''--, . . , -?,' v,>
(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 dqllars ($5001).
Name
State License #
Address
License Class
City State/Zip
City Business License #
Telephone #
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:
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.
O 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)
l~) 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.
SIGNATURE DATE
/7. OWNER-BUILDER DECLARATION • .7 .••'.' • <"• " .' "1V." ," ," ,..'•' -
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
-0 If 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).
l~l 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).
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. S YES I~|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
U°' work): ; /J. . . f)
[OPERTY OWNER SIGNATURE DATE 2 03
A/AW
COMPLETE THIS, SECTION FOB NON~RKStDEtiTMt BUILDINQ 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? D 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? Q YES O MO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES Q 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 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 conwrenced 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 comrne^cejil \y a p_§fe>dxof/j 80 oftys (Section 106.4.4 Uniform Building Code).
APPLICANT S SIGNATURE DATE
WHITE: File YELLOW: Applicant PINK: Finance
City of Carlsbad Bldg Inspection Request
For: 02/11/2003
Permit* CB030350
Title: CURTIS RES-8 FT HIGH PRIVACY
Description: WALL AROUND SPA
2650 CHESTNUT AV
Lot
Type: MISC
Job Address:
Suite:
Location:
APPLICANT CURTIS ROBERT L
Owner: CURTIS ROBERT L
Remarks: REQUESTED FINAL
Sub Type: OTHER
Inspector Assignment:
Phone: 7607297506
Inspector:
Total Time:
CD Description
19 Final Structural
Act, Comment
Requested By: ROBERT
Entered By: CHRISTINE
Associated PCRs/CVs
Inspection History
Date Description Act Insp Comments
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