Loading...
HomeMy WebLinkAbout2801 CARRILLO WAY; ; CB031257; Permit04-30-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No: CB031257 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: Applicant: SUMMIT SERVICES P O BOX 270392 SDCA 92198 944-9615 2801 CARRILLO WY CBAD MISC 2226621400 $3,125.00 Subtype: OTHER Lot #: 0 WOOLF RES-GAS&ELECT TO BBQ & FIREPLACE-10.5FTHIGH Status: ISSUED Applied: 04/30/2003 Entered By: RMA Plan Approved: 04/30/2003 Issued: 04/30/2003 Inspect Area: Owner: WOOLF PETER&BROOKE 2801 CARRILLO WAY CARLSBAD CA 92009 3923 04/30/03 0002 01 02 CGP 136.00 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE $136.00 $0.00 $0.00 $136.00 Total Fees: $136.00 Total Payments To Date:$0.00 Balance Due:$136.00 Inspector:UA 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 fees/exactions of which you have Dreviouslv been aiven 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 FOR OFFICE USE ONLY PLAN CHECK EST. VAL. Plan Ck. Deposit. Validated, Date Business Name (at this address) Legal Description ~rleT 22^7 Name Address City State/Zip Telephone # Fax» /<f?o Name Address City State/Zip Telephone . / BKoowr Name Address City State/Zip Telephone tt (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 [$500])." Name State License # Address City ' State/Zip Telephone # License Class . City Business License tt 12O 5" 0 €) Designer Name State License # Address City State/Zip Telephone - j* >,v - •'.. - ':••;- . : ~- <«r.?.- - Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: O 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 ed. My worker's compensation insurance carrier and policy number are: '771 Insurance Company fe^ &v< E?T A/ #T<- . * A/ $ V RA*/C* Policy ^WeCMXJO <W ?-O*» Expjration Date /Q-?J-63 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) n 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 secur* workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollar* ($100/*Q<fK injddltlon/^the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE £J*~^£i>~/^>1&24*isL*~^ DATE ^ I hereby affirm that I am exempt from the Contractor's License Law for the following reason: Q 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). O 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).. Q 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. Q 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 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 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 Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q 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. «i;:< CONSTRUCTION LENDING AGENCY •'l' 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 I certify that I have read the applioation 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 commej»ecUtffhin 180 d^s 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 comm^Kf^Bjl^rajieriodjyfsp days (Section 106.4.4 Uniform Building Code). ^/APPLICANT'S SIGNATURE WHITE: File YELLOW: Applicant PINK: Finance DATE City of Carlsbad Bldg Inspection Request For: 07/09/2003 Permit* CB031257 Inspector Assignment: JM Title: WOOLF RES-GAS&ELECT TO BBQ & Description: FIREPLACE-10.5 FT HIGH Type:MISC Sub Type: OTHER Phone: Job Address: 2801 CARRILLOWY Suite: Lot 0 "rr Location: Inspector: x| *W>. APPLICANT SUMMIT SERVICES Owner: WOOLF PETER&BROOKE Remarks: FINAL FIREPLACE Total Time: Requested By: ENRIQUE Entered By: CHRISTINE CD Description Act Comment 68 Fireplace/Tie Straps r^ Associated PCRs/CVs Inspection History Date Description Act Insp Comments 05/30/2003 47 Fireplace/Chimney WC JM 05/30/2003 66 Grout AP JM 05/09/2003 11 Ftg/Foundation/Piers AP JM 5/8/2003 05/09/2003 12 Steel/Bond Beam AP JM 05/08/2003 51 Excav/SteeVBonding/Fence AP JM OK TO POUR 05/02/2003 23 Gas^est/Repairs AP JM FIREPLACE & BBQ 05/02/2003 31 Underground/Conduit-Wiring PA JM ACORD CERTIFICATE OF LIABILITY INSURANCE PRODUCER (559)650-3555 FAX (559)650-3558 Landscape Contractors (Lic#0755906) Insurance Services, Inc. 1835 N. Fine Avenue Fresno, , CA 93727 INSURED PCA Summit Services, Inc. P. 0. Box 270392 San Diego, CA 92198 i DATE (MM/DD/YY) 11/11/2002 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A. Everest National Insurance INSURER B: INSURER C: INSURER 0: INSURER E: COVERAGES ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <• '|NTR A TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY J CLAIMS MADE | | OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: ~~| POLICY f~~l 51$' FlLOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY ANY AUTO POLICY NUMBER EXCESS LIABILITY 1 -^. 1 1 1 L^a^HHHMH^^^b.| OCCUR | | CLAIMS MA°|«HPHM«HflH^^^^^ DEDUCTIBLE J^ RETENTION $ f WORKERS COMPENSATIOBND EMPLOYERS' LIABILITY BL OTHER 1 ^ t 3800000937-021 M-»/ MHhBra^tfP^•!••!** POLICY EFFECTIVEDATEIMM/DD/YY) ,10/31/2002 POLICY EXPIRATIONDATE<MM/DDfYY» 10/31/2003 LIMITS EACH OCCURRENCE FIRE DAMAGE (Any one fire) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT(Ea accident) BODILY INJURY (Per person) BODILY INJURY(Per accident) PROPERTY DAMAGE(Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN EAACC AUTO ONLY: ^Q EACH OCCURRENCE AGGREGATE X I WC 5TATU- 1 IOTH1 TORY LIMITS! 1 ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE E.L. DISEASE - POLICY LIMIT $ S $ S S S $ S $ $ $ $ $ 1,000,000 $ 1,000,000 $ l.OOO.OOC DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONSIE: License #631676 CERTIFICATE HOLDER |ADDITIONAL INSURED; INSURER LETTER: CANCELLATION Contractors State License Board Workers Comp Unit P.O. Box 26000 Sacramento, CA 95826 ACORD 25-S (7/97) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN' NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE /— "V ^ Irene Torres/CASEY \£l*lsd™wJ ©ACORD CORPORATION 1988