The URL can be used to link to this page

Home My WebLink About2810 MADISON ST; ; CB000637; PermitCity of Carlsbad /( fY 03/01/2000 Miscellaneous Permit Permit No:CB000637 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2810 MADISON ST CBAD MISC Subtype: OTHER Status: ISSUED 02/25/2000 JM 03/01/2000 03/01/2000 Parcel No: 2031103000 Valuation: $10,000.00 Reference #: Project Tille: ADD 3/4 BATH DOWNSTAIRS Applicant: WORTHING INC, B. A. 690 CARLSBAD VILLAGE DR CARLSBAD, CA 92008 619-729-3965 Lot#: 0 Applied: Entered By: Plan Approved: Issued: Inspect Area: Qwner: 1376 03/01/00 •· .1'ljltlQ!:R FAMILY TRUST 06-04-98 ,, ,, , , i' J28lO:MA01s.oN sr- ~~s1:1Ao CA 920Q8 {, d 0; ',, ' Total Fees: $196.00 , . ,TQ1&:!I Payments To tiMe:. $0.00 Ba1iioce Due: Miscelaneous Fee #1 Miscelaneous Fee #2 TOTAL PERMIT FEES :PERMIT/PCFEE ' 'I ~ ~MEP $fQO.OO • $96.00 $196.00 Clearance: 0001 01 C-PRMT $196.00 NOTICE: Please take NO E that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exacti s.• You have 90 days from the date this permit was issued to protest imposition of these fees/exacticx1s. 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 Cartstad 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 rrJht to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy 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 ou have reviousl been iven a NOTICE similar to this or as to which the statute of limitations has reviousl otherwise ex ired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 02 196~00 . A~~ PERMIT AiPd~t,.,oN CITYOF C/tRLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1,, '.f'~W£CT INFORMATION FOR OFFICE USE ONLY PLAN CHECIS NO. C/3-C:3 7 EST. VAL. /1, /){)() Plan Ck. Deposit=.--,,;--:------ Validated By_......,,_-1--''-'-::::a.-:r-.-,=,--t'-: Date ________ 4',,'f'-,~'IJ,'-b'I Address (include ~~gl~te #) + '2.0\0 rV"lf'o.i'?Ot-1 ~(f 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 #of Stories # of Bedrooms # of Bathrooms City State/Zip Telephone# Fax# City State License # -~--~~~~-- 6. .Wl>llki!ilsl 'COMPENSATlON 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. ~ 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 co ns tion insurancerrrier and policy number are: I . to~ ' I I Insurance Company ~~~~~~::::Il.1,..1.!~----------Policy No. 22. Cf-tt:> UA.11<, ~ I Expiration Dateo o, -t') I !THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) ~ I 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 ($100,00 ddltion to he cost of compensation, damages as provided for in Section 3706 of the L.a r code, terest and attorney's fees. SIGNATURE __ --."'=c='°'.--'£.>.o..,=-,,"',,-------------------DATE L, '2,':7 er:::> ~i" 'OW!llaR•~UllDERD CLARATION I hereby affirm that I am exempt from 0 I, as owner of the property or m',I.Jllw»wf<ees 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. D 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 person (firm) to provide the proposed construction (include name I address I 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 _________ _ Cl>MM!'THiil'BECTION.Fi;iA NON-1/ESIDEfJITIAl ilOltiifNiiPERMttiil>N~Y:: ·· · 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? D YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES D 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. ,9,i Cl>l'iSfRUCTIONUNDING;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,-, ;AP"1-!CANT i:E~TIF!CATION 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 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 of 180 days (Section 106.4.4 Uniform Building Code). DATE 2.... J/7~! .-vi APPLICANT'S SIGNATURE /;!'--~ I YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 5/26/2000 Permit# CB000637 Title: ADD 3/4 BATH DOWNSTAIRS Description: Type:MISC Sub Type: OTHER Job Address: Suite: Location: 2810 MADISON ST Lot APPLICANT WORTHING INC, B. A. 0 Owner: TUCKER FAMILY TRUST 06-04-98 Remarks: Total Time: CD Description 19 Final Structural ~p Comments Associated PC Rs lnsgection HistO!Y Date Description Act lnsp Comments 4/19/2000 17 Interior Lath/Drywall AP PY 4/17/2000 84 Rough Combo AP PY 4/12/2000 14 Frame/Steel/Bolting/Welding co PY SEE LIST 4/12/2000 24 Rough/Topout co PY 4/12/2000 34 Rough Electric co PY Inspector Assignment: PY --- Phone: 7607293965 Inspector: ----- Requested By: TERESA Entered By: CHRISTINE 4/5/2000 29 Final Plumbing co PY SEE LIST ATTACHED