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Home My WebLink About2728 CHESTNUT AVE; ; CB041731; Permit05-13-200 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 M)f> Residential Permit Permit No: CB041731 Brjilding Inspection Request Line (760) 602-2725 2728 CHESTNUT AV CBAD RESDNTL 1673921000 $0.00 0 0 Sub Type: . Lot#: Construction Type: Reference #: Structure Type: Bathrooms: RAD 0 NEW GONZALES RES- BATHROOM REMDL AND INSTALL SKYLIGHT (150 SF) Status: -Applied: Entered By: Plan Approved: Issued: Inspect Area: Orig PC#: Plan Check#: ISSUED 05/13/2004 KMT 05/13/2004 05/13/2004 Applicant: WORTHING INC, B. A. SUITE #201 690 CARLSBAD VILLAGE DR CARLSBAD, CA 92008 619-729-3965 Owner: GONZALES BELYNN R 2728CHESTNUTAVE CARLSBAD CA 92008 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Plan Check Discount Strong Motion Fee Park in Lieu Fee Park Fee LFM Fee Bridge Fee Other Bridge Fee BTD #2 Fee BTD #3 Fee Renewal Fee Add'l Renewal Fee Other Building Fee Pot. Water Con. Fee Meter Size Add'l Pot. Water Con. Fee Reel. Water Con. Fee $0.00 Meter Size $60.00 Add'l Reel. Water Con. Fee $0.00 Meter Fee $0.00 SDCWA Fee $0.00 CFD Payoff Fee $1.00 PFF $0.00 PFF (CFD Fund) $0.00 License Tax $0.00 License Tax (CFD Fund) $0.00 Traffic Impact Fee $0.00 Traffic Impact (CFD Fund) $0.00 Sidewalk Fee $0.00 PLUMBING TOTAL $0.00 ELECTRICAL TOTAL $0.00 MECHANICAL TOTAL $0.00 Housing Impact Fee $0.00 Housing InLieu Fee Housing Credit Fee $0.00 Master Drainage Fee $0.00 Sewer Fee Additional Fees TOTAL PERMIT FEES $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $41.00 $20.00 $21.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $143.50 Total Fees:$143.50 Total Payments To Date:$0.00 Balance Due:$143.50 2058 05/13/04 0002 01 02 CGP 143.50 Inspector: FINAL APPROVAL ^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 "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 Jees/exaetions 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 INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. Deposi Validated Date? Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total # of units Assessor's Parcel #Existing Use Proposed Use Descrip.tion of Work SO. FT.#of Stories # of Bedrooms # of Bathrooms 2. CONTACT PERSON (if different from applicant) -0104 Name 3. APPLICANT Address City. mjuiBSv) v^uy Qcontractor Q Agent for Contractor Q Owner Q Agent for Owner v\r* &O- QOX. ICsAN CCirV. State/Zip Telephone # (-HoCO-iaO- Name 4. PROPERTY OWNER Address City State/Zip Telephone # 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 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 [$5001). Ihc • Po> Bo* \ AddressName .'••;. State License # oH 8 ~) L^License Class p> ~~ City State/Zip Telephone City Business License # 5*4*^1 £-GC> Designer Name "~" . Address City State/Zip Telephone State License # S\^tt<~1 *Q- 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: [~l 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. LH 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 <C^fUf^ F"tX-^T_£?* Policy No. OCf~^^)~)~l^J "T:s'^-%.J^Expiration Date / '— | — Q o (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) l~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 ($100JpBO*J/in additio/f'tcj/tbe cost of cojnpensation, damages as provided for in Section 3706 of thej-aljor code, jnteres^t and attorney's fees. SIGNATURE *sffc£jjy\foj\^/^ DATE '. 7. OWNER-BUILDER DECLARATION /\ I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D I, as owner of the property or my emfitoyees 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). 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. CD 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 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? Q 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? O YES [3 NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? l~1 YES f~) 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. _ .CONSTRUCtliHliliplNliiilPY 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 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 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 tap 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 commejTjperfor a perid&*f»180 days (Section 106.4.4 Uniform Building Code). J[ sSSSM. ^iAAl\ A ^^^ APPLICANT'S SIGNATURE DATE SWrllTE: File YELLOW: Applicant PINK: Finance ;City of Carlsbad Bldg Inspection Request For: 11/02/2004 Permit* CB041731 Title: GONZALES RES- BATHROOM REMDL Description: AND INSTALL SKYLIGHT (150 SF) Inspector Assignment: PY 2728 CHESTNUT AV Lot Type: RESDNTL Job Address: Suite: Location: OWNER GONZALES BELYNN R Owner: GONZALES BELYNN R Remarks: Sub Type: RAD Phone: 7607293965 Inspector: Total Time: CD Description 19 Final Structural 29 Final Plumbing 39 Final Electrical 49 Final Mechanical Requested By: TERESA Entered By: CHRISTINE mment Associated PCRs/CVs CV030256 CLOSED Z-CATERING BUS FROM RES; CV990407 CLOSED ILLEGAL CONSTRUCTION; Inspection History Act Insp Comments CO RB AP PY AP PY Date Description 10/29/2004 89 Final Combo 06/24/2004 17 Interior Lath/Drywall 06/24/2004 18 Exterior Lath/Drywall 06/18/2004 84 Rough Combo 06/08/2004 84 Rough Combo 05/27/2004 24 Rough/Topout 05/25/2004 24 Rough/Topout SEE NOTICE ATTACHED AP NR AP NR PY PY TP PY NEED TOP OUT TEST City of Carlsbad Bldg Inspection Request For: 10/29/2004 Permit* CB041731 Title: GONZALES RES- BATHROOM REMDL Description: AND INSTALL SKYLIGHT (150 SF) Inspector Assignment: PY 2728 CHESTNUT AV Lot Type:RESDNTL Sub Type: RAD Job Address: Suite: Location: OWNER GONZALES BELYNN R Owner: GONZALES BELYNN R Remarks: Phone: 7607293965 Inspector: Total Time: CD Description 19 Final Structural 29 Final Plumbing 39 Final Electrical 49 Final Mechanical Requested By: THERESA Entered By: JH Act Comment Associated PCRs/CVs CV030256 CLOSED Z-CATERING BUS FROM RES; CV990407 CLOSED ILLEGAL CONSTRUCTION; Inspection History Date Description Act Insp Comments 06/24/2004 17 Interior Lath/Drywall AP PY 06/24/2004 18 Exterior Lath/Drywall AP PY 06/18/2004 84 Rough Combo AP PY 06/08/2004 84 Rough Combo NR PY 05/27/2004 24 Rough/Topout AP TP 05/25/2004 24 Rough/Topout NR PY NEED TOP OUT TEST CITY OF CARLSBAD BUILDING DEPARTMENT DATE NOTICE (760) 602-2700 1635 FARADAY AVENUE TIME LOCATION •=^L PERMIT NO. J^»^2«C FOR INSPECTION CALL (760) 602-2725. RE-INSPECTION FEE DUE? FOR FURTHER INFORMATION, CONTACT YES PHONE CODE ENFORCEMENT OFFICER ® SD UCYHGLDER COPY COMPENSATION I N S U R A N C E p:q, SOX; 007, SAN FRANCISCO,CA 94142^0107 FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 01-01-2004 i; CITY OF OCEANS)DE, BUILDING DEPT. SD 300 N. COAST HWY OCEANS IDE CA, 9205*» i GROUP: ..';.-. 000046 POLICY NUMBER: -/ 0008775-2O04 CERTIFICATEi ?)D: r 3 • CERTIFICATE EXPIRES: 01-0,1-2005 Oil-di-2004/01-01-2005 JOB: AtL OPERATIONS This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. " This policy is not subject to cancellation by the Fund except upon 30 days' advance written notice to the employer. We will also give you 30 days' advance notice should'this policy be cancelled prior to its normal expiration. This certificate of: insurance is not ah insurance policy and does not amend, extend or alter the coverage afforded by the pplicies listed herein.Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies. t ; AUTHORIZED REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED^CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01-01-2O04 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER LEGAL NAME B.A. WORTHING INC. PO BOX 101*1 I CARLSBAD CA 92018 B.A. WORTHING, INC. (REV.3-03)PRINTED: THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND pn/nn