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Home My WebLink About2756 GALICIA WAY; ; CB053338; PermitCitv of Carlsbad Residential Permit Job Address: 2756 GALICIA WY Permit Type: RESDNTL Status: Applied: Permit No: CB053338 ABANDOND 09/22/2005 Parcel No: 2162200300 Lot#: 0 Approved: Reference No: Issued: PC#: Inspect Area: Project Title: VAN WEY RES 242 SF ADDITION Applicant: Owner: SAM WRIGHT VANWEY LARRY V&GWEN A 2911 STATE ST 760-213-1460 00136104885 BLDG PLAN CHECK Fees: $447.88 Additional Fees: 2756 GALICIA WY CARLSBAD CA $157.94 $0.00 Total Fees: $447.88 Balance: $289.94 0526501-3 0039 09/22/2005 001 15 FOR OFFICE USE ONLY ,,,,/' PLAN CHECK NO.CJ3.Zf3 3 jlS EST. VAL. .t~¥, PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1. PROJECT INFORMATION .:2. 7 > <.e c,., A+--• C. I A w ~ '1 Address (include Bldg/Suite #) L-.o...,.. '2., C,.. $ OF-\'-1.......-"-IO C::, 54-CS. Plan Ck. Deposit ~t'/ 9 Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units 2..( I..R· "2. "\. c:>. C>?,. 0 ~ Assessor's Parcel # Existing Use Proposed Use 2 4='-5. E· ~o, -r, c," Description of Work SQ. FT. #of Stories # of Bedrooms # of Bathrooms 2. CONTACT PERSON (If different from applicant) ~H 1-J fl:-\ 1....arH'.T Z. 9 \ l <=:.,e::r,t. ST. Su, 'Ti:--N Name Address City State/Zip Telephone# Fax# 3. APPLICANT O Contractor O Agent for Contractor O Owner O Agent for Owner "?AM L e, 5, ~v £ Name Address City State/Zip Telephone # 4. PROPERTY OWNER \cA12-e,._. .. Name ' N, e-c:;.., 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 [$500U. Name Address City State/Zip Telephone# State License # ----------License Class----------City Business License # -------- 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: 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 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) 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 ($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·-----------------------------.,- 7. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: DATE ---:=:::::::==== 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 sale). 0 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). 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 the proposed property improvement. 0 YES ONO 2. I (have I 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 I address I phone number I 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 I 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 I address / phone number / type of work):·----------------------------------------------------------- PROPERTY OWNER SIGNATURE----------------------- COMPLETE THIS SECTION FOR NON-RESIDENT/AL 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 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 O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 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 OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 8. CONSTRUCTIO~ 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--------------- 9. APPLICANT CERTIFICATION LENDER'S ADDRESS·------------------------- 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 AV ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. EXPIRATION: Every permit issued by th authorized by such permil is not comm at any time after the work is comme DA~"Z-~]. O~ PINK: Finance City of Carlsbad i=l'IIGllll·M•l4·Elii,,14,il June 20, 2006 SAM WRIGHT 2911 STATE ST #N CARLSBAD CA 92008 RE: APPLICATION DATE: PLAN CHECK#: ADDRESS: EXPIRATION DATE: PERMIT TYPE: DESCRIPTION: 09/22/2005 CB053338 2756 GALICIA WY 09/22/2006 RESDNTL VAN WEY ES 242 SF ADDITION You applied to have your plans checked on the date noted above. To date, the related building permit has not been obtained. The original plan review application will expire as no building permit has been issued. Plans submitted and not retrieved from the building department prior to the plan check expiration date noted above will be destroyed. The provisions of sections 304 ( d) of the Uniform Building Code state: "Section 304 9d) Expiration of Plan Review Applications for which no permit is issued within one year following the date of application shall expire by limitation, and plans and other data submitted for review may thereafter be returned to the applicant or destroyed by the Building Official. In order to renew action on an application after expiration, the applicant shall resubmit plans and pay a new plan review fee." In order to provide better service, please indicate your handling choice for the plans originally submitted and return this letter to the Building Department. L Project Abandoned-I will pick up the plans within 10 days __ Project Abandoned -Plans may be destroyed If you have any questions, please contact the Building Department at (760) 602-2719. Building Department 1635 Faraday Avenue• Carlsbad, CA 92008-7314 • (760) 602-2700 Building Counter • (760) 602-2719 • FAX (760) 602-8558