The URL can be used to link to this page

Home My WebLink About2728 LOKER AVE W; G; CB051934; Permitjf&~ City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 05-27-2005 Miscellaneous Permit Permit No: CB051934 Building Inspection Request Line (760) 602-2725 Job Address: 2728 LOKER AV WEST CBAD St: G Permit Type: MISC Subtype: Parcel No: 2090812900 Lot#: Valuation: $0.00 Reference #: .--·····--· INl]~RtC>R PAR TIONS/ NO CONST. OTHER 0 Project Title:. S.P··· EC SUJ.T7& G DEMO EXISTIN ,/1\p~~i·::·~-~~·-·~~--~--Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: / DESIGN/BUILD TENANT IMP..:,,/ TEB . / FENTON HG COMPANY 0 CARROLL CE~ RD. S '"B-1~126 619-954-9519 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: $60.00 7588 METROPOLITAN DR SAN DIEGO CA 92108 DEMO-PERMIT FEE Total Payments To Date: $0.00 Balance Due: Clearance: ISSUED 05/27/2005 KG 05/27/2005 05/27/2005 $60.00 $0.00 $0.00 $60.00 $60.00 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/exac ions of which ou h ve reviousl been iven a N Tl E simil r to this or as to which he statute of limitations has r viousl otheiwise ex ired. ,,oo FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NoCJr1:21Cf 31 EST.VAL. __________ _ Plan Ck. Deposit--------- Validated By __________ _ Date ___ ,_0_-~.2~7-i ..... ,S:: __ _ i ~ CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1. PROJECT INFORMATION Phase No. Total # of units # of Bathrooms cs Description of Work SQ. FT. #o Demo (Jp &US f7 de,-/ !'IT. 1?;J.,en /Jti;v S O<PL-/= 2. CONTACT PERSON (If different from applicant) // 0 C..0/l 3 a (I(! T7 (J >J I # of Bedrooms -8,-- Name Address City State/Zip Telephone# Fax# 3. APPLICANT C,t,.i'f.J 'D I+ [J Contractor $,t,-'\,-r 1-1 ~ Agent for Contractor O Owner O Agent for Owner '1,'::{-~ ~u. C."1''-· 12-o ''t:.. '' s .1>. C4 . 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. ~ vjolation of Section 7031.5 by any applica t for a permit subjects the applic nt to a ;ivi) ~ena~ of ~t mo'J t~an fiv hundred dollars [$5001). -, r O O . C. ,-J, .l), l-r4-- ame "" , Address City State/ri'11/ 3 ~e~phone # ~ _ St License # "±ti' V $ j: License Class O City Business License # lo(Q ""L ~ "7 fJ,t-55" 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: 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, for the performance of the work for which this permit is issued. ~ 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 6-r,ere p-u /..) J) Policy No. + 10 r LA!J ~ 1: Expiration Date / -f B, D{o (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 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 ( 00,0001, In addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE ~-,,0 DATE 5-Z.J-t:>S: 7. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 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 salet. 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 L: es not apply to an owner of property who builds or improves thereon, and contracts for sue with contractor(s) licensed pursuant to the Contractor's Licen D I am exempt under Section ------uu~on->.. 4 . ork (include name I address I phone the work, but I have contracted (hired) the following persons to provide the work indicated (include name I address I phone number I type P Y OWNER SIGNATURE _______________________ _ 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? 0 YES ~ 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 )!ir NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES ;(I 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 ruction lending agency for the performance of the work for which this permit is issued (Sec. 3097(il Civil Code). LENDER'S NAME --7"----'---'----------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 Citt 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 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 commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 1 0/26/2005 Permit# CB051934 Title: SPEC SUITES F & G DEMO EXISTIN Description: INTERIOR PARTITIONS/ NO CONST. Type: MISC Sub Type: OTHER Job Address: 2728 LOKER AV WEST Suite: G Lot o Location: APPLICANT DESIGN/BUILD TENANT IMP. Owner: Remarks: GEORGE SAID YOU FINALED THE T.I. PERMIT Total Time: CD Description Act Comment Inspector Assignment: PD Phone: 6199544704 OR 7 lnspecto~ Requested By: GEORGE Entered By: CHRISTINE 19 _F_i_na_i_s_tr_u_c_tu_r_ai _____ f ___________________ _ Associated PCRs/CVs Inspection History Date Description Act lnsp Comments