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Home My WebLink About2738 LA COSTA AVE; ; CB050155; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 01-18-2005 Miscellaneous Permit Permit No: CB050155 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: 2738 LA COSTA AV CBAD MISC 2162801800 $8,990.00 Subtype: REROOF Status: Lot#: 0 Applied: Entered By: Reference #: Plan Approved: Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: $153.00 PERMIT FEE Owner: WERLE BARBARA 2738 LA COSTA AVE CARLSBAD CA 92009 Total Payments To Date: $0.00 Issued: Inspect Area: Balance Due: ISSUED 01/18/2005 LSM 01/18/2005 01/18/2005 $153.00 $0.00 $0.00 $153.00 $153.00 9857 )1/18/0'i 0002 CGF· Inspector: FINAL Date: 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 f e x i nsofwhich h v re i I n iven N Tl E imilart thi r which th ue flimi i nsh s revi u I h iwi e ir PERMIT ~F PUCA Tl ON . FOR OFFICE USE ONLY PLAN CHECK NO. CP:, \)~Of sf; CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL '{ 9 90,0CJ Plan Ck. Depos~..,_...._ ____ _ Validated By_::_.:.:;: _______ _ Date /J /9:' )0 S I ..._, 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 II Proposed Use Existing Use ,le. #of Stories # of Bedrooms # of Bathrooms Name Address li!li'lr~ti;',\il',!lic>,, fllli.11111t~iil!lr(t::'i!mAii@1i1!<1!i~*!ii,o.Qtqr El Own•/ ,;i_ City IJ(Ag:eiit: toi Own.er 3 State/Zip Telephone # Fax I Address i)}.1.k J...4: <!to~ "•i Cit~ O,,,,l!«l "' .,.:,-_"•:·'-. '" Telephone # '1 '3C ;-: 5) I"', Name Address City S.tate/Zip Telephone I ~ffilliim:!&"!i~ill!Miii?,,,: •;,.,c~, ·· (Sec. 7031,6 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 flle 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 emption. _Any viol~on of Section 7031.6 by any applicant fo, a permit subjects the applicant to a civi'[enalty of not more than five.hundred dollars ($6001). ,,~,l,, \ILc,-.,\. W-1s-( J..,,.,6,/~ J ... c:!. , 77 ~-/ ~ 2.. Name Address City · State/Zip Telephone I State License, 70 / O Fi C. License Closs Cc ,3 '1 City Business License, .;/'f Pueo Designer Name Address City State/Zip Telephone State License I _________ _ !lw~{Gi!Jllftl'illiwlii.l!iif!;i i•"t.. . .. • ·•. •• . . 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. 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 worker's com ensption insurance carrier and policy number are: Insurance Company .rk,J. -..., Pol;cyNo. f{.'16'1 )'i-.2.oOY Expirot;onOetoO.fS·b/-.2ooJ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS! 0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work fot which this permit is issued, I shall not employ any person in any manner so 1& to become subject to the Workers' Compensation Laws of California. WARNING: Failure-to ••cure workers' compensadon coverage ll unlawful, and shal subject an employer to criminal penalties and civU fines up to one hundred thouund dollars C$ 00,000), In Ion to the cost of compensation, damagH •• provided for in Section 3706 of the Labor code, Interest and attomay's faes. l~,G~~:~~E ~ • • • • DATE ... P(,I<!;(,~?. ,'1:.if\"r~~-Pr,gJ , '·,: .. , i:'.j, ,: ', ~./ '''-!i:"f! , h? --'"~• r "~ ,. --·· _ ... _ ... ,_. ,. •,,; ... (::,,,,-;,,:· .. ···• ... •.,,_ .. I hei-eby affirm that I am exempt from the Contractor's License Law for the following reason: 0 I, as owner of th~ 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, Buaineu and Profusions 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 hi• 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 ~wner-buildar will have the bwden of proving that ha did not build 01 Improve for the purpou of sale). 0 I, as owner of the property, am exclWllvely contracting with licensed contractors to construct the proj8ct (Sec. 7044, Business and ProfHalona Coda: The Contractor'• License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractorlsl licensed pursuant to the Contractor'• License Law). 0 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 tha proposed property improvement. 0 YES ONO 2. I (have/ have not) signed an application for a building permit for the proposed work. 3. I have contracted _with the following parson lfirml to provide the proposed construction !include name / address / phone number / conttactors 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 I type of work):. ______________________________________________________ _ ;:~::,:::~~~:~-:~-. -.. -.. -.~-.. -fN.-:···•tm-•··-: ·:-te-!i-.li.t!-,-,11-Q-,1!'1!-... -RM-.•• -,t-$i-rQ-.Nll-"'-f:-•. ---:-:-:-:--::--;;: •. • •· • 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 25605, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act7 0 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 district7 D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site1 0 YES O 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 OFF_ICE OF EMERGENCY SERVICES ANO THE AIR POLLUTION CONTROL DISTRICT. tl!!ilwI!®!!l!iffl!il!;!jQN!mWQ!l!)l~Ni:1¥1:S.' •. ,,'.I:i,\\,:J >·· 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), 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 ANO 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 ))ERMIT. OSHA: An OSHA permit Is required for excavations over s•o• deep and demolition or construction of structures over 3 stories in height, EXPIRATION: Every permit Issued by the bui~dlng Official under thEI 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 bullding or work authorized by such permit Is suspended or abandoned at any time after the work is com need for a period o 180 days (Section 106.4.4 Uniform Building Code). YELLOW: Applicant PINK: Finance m. . • . City of Carlsbad Bldg Inspection Request . For: 02/02/2005 Permit# CB050155 Title: WERLE RES-3100 SF LT WT CO NCR Description: Type: MISC Sub Type: REROOF Job Address: 2738 LA COSTA AV Suite: Location: OWNER WERLE BARBARA Owner: WERLE BARBARA Remarks: Total Time: CD Description 19 Final Structural Lot 0 Act Comment f~ Associated PCRs/CVs Inspection History Date Description 01/20/2005 15 Roof/Reroof 01/19/2005 15 Roof/Reroof Act lnsp Comments AP PS NR PS Inspector Assignment: PS --- Phone: 7604977512 Inspector: ---- Requested By: CARLOS Entered By: CHRISTINE