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Home My WebLink About2851 CAMINO SERBAL; ; CB001953; PermitI/ 05-23-2000 City of Carlsbad Patio/Deck Permit Permit No:CB001953 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 2851 CAMINO SERBAL CBAD PATIO 2552811900 Lot#: 0 $1,856.00 Construction Type: NEW SHELBOURNE MODEL 256 SF FREE STANDING PATIO PER PLAN Status: ISSUED Applied: 05/23/2000 Entered By: MDP Plan Approved: 05/23/2000 Issued: 05/23/2000 Inspect Area: Applicant: HILLCREST CONSTRUCTION 4842 SCHOOL STREET YORBA LINDA CA 92886 Total Fees: $69.84 i •*..«*• -,•#: -CARLSBAD L P #1400 8090 05/23/00 0001 01 02 C-PRMT yments To Datffi $0.00 Balance Due:$69.84 69.84 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Strong Motion Fee Renewal Fee Add'l Renewal Fee Other Building Fee TOTAL PERMIT FEES "$0.00 $1.00 $0.00 $0.00 $0.00 $69.84 Inspector: FINAL APPROVAL 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 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 you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 l-ROiECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO.. EST. VAL. Plan Ck. Deposit Validated By Date Address (include Bldg/Suite tt)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 Name Address "V^^CL. City Q"Agent for Contractor O Owner O ftgerklbr Owner State/Zip^Telephone,*. __ -F«r Name 4;OWNER Address c tate/Zip Telephone # 6. CONTRACTOR - COMPANY I (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 subj^ctf the Applicant to a civil penalty of not more than five^hundred d9llars [$500]). Name State License * fc?O S» ? fl Designer Name State License tt COMPENSATION Address ^-~. License Class L2 Address - -, - , ,-^ _ _ - City City City * & ' State/Zip Business License * Q G J State/Zip 1 i * .„,' --, " -' * > • Telephone tt 'p* T"tt ^l. 'Telephone Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Q 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. G 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: / / ~ 2.7F *-(&Q( Expiration Date 6 /2.7/^JQInsurance Company Policy No. (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 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 additionlo the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE <£SL-^ ^^^ *&%&!? '" DATE S/2-3/<*O 7. •' OWNEfl-BUILfjfRTJECLARATIo'N ~ - -'ji - - - ' . ~ ' '' I hereby affirm that I am exempt from the Contractor's License Law for the following reason: O 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). l~l 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). CD 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? D 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 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. 8,. CONSTRUCTION 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. 30971!) Civil Code). LENDER'S NAME 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 CitV 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: 6/23/2000 Permit* CB001953 Title: SHELBOURNE MODEL Description: 256 SF FREE STANDING PATIO PER PLAN Inspector Assignment: PD 2851 CAMINO SERBAL Lot 0 Type: PATIO Sub Type: Job Address: Suite: Location: APPLICANT HILLCREST CONSTRUCTION Owner: Remarks: AM PLEASE - PATIO INSPECTION Phone: 7609424358 Inspector: Total Time: CD Description Act Comments 14 Frame/Steel/Bolting/Welding |Q C/S . Requested By: JOE Entered By: CHRISTINE Associated PCRs Inspection History Date Description Act Insp Comments 5/24/2000 11 Ftg/Foundation/Piers AP PD ACORD, CERTIFICATE OF LIABIL PRODUCER Goodman Insurance Agency 28202 Cabot Road, Suite #110 iguna Niguel CA 92677-1248 phmNo. 949-365-8700 F«NO. INSURED • James R. McDaniel, Inc. dba: Hillcrest Construction Company 4842 School Street Yorba Linda CA 92886 ITY INSUF NCEcsRTs o^e(MMIOOr^.1 1 1 IINO^H .INWI_ HILLC22 07/29/99 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. COMPANIES AFFORDING COVERAGE COMPANY A United Pacific Insurance Co. COMPANY B COMPANYc COMPANY D COVERAGES INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIRCATE 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COLTR A A A * TYPE OF INSURANCE GET _x_ ~x~ X X AU1 "x~ X X 4ERAL LIABILITY COMMERCIAL GENERAL LIABILITY | CLAIMS MADE [x | OCCUR OWNER'S t CONTRACTOR'S PROT Contractual Broad Form P.O. ^MOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS OARAOE LIABILITY ANY AUTO EXCESS LIABILITY 1 UMBRELLA FORM 1 OTHER THAN UMBRELLA FORM WORKERS COMPENSATION EMPLOYERS1 LIABILITY THE PROPRIETOR/ PARTNERS/EXECUTIVE OFFICERS ARE: AND INCL X EXCL OTHER SUBJECT TO 10 DAYS NON PAYMENT OR NON POLICY NUMBER NSA 278 4601 *AGGREGAT PER PROJECT NSA 278 4601 NWA 1178145 01 KOTICT XH THE BVCHT Of SUBMISSION OF PAYROLL POLICY EFFECTIVE DATE (MM/DOflrY) 06/27/99 06/27/99 08/01/99 POLCY EXPIRATION DATE (MM/OD/YY) 06/27/00 06/27/00 08/01/00 LIMITS GENERAL AGGREGATE PRODUCTS - COMP/OP AGO PERSONAL & ADV INJURY EACH OCCURRENCE FIRE DAMAGE (Any on* fir*) MED EXP (Any on* parson) COMBINED SINGLE LIMIT BODILY INJURY(P«rp«non) BODILY INJURY (Per •ccMirit) PROPERTY DAMAGE AUTO ONLY . EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE EACH OCCURRENCE AGGREGATE X WC STATU- OTH-TORY LIMITS ER EL EACH ACCIDENT EL DISEASE • POLICY LIMIT EL DISEASE • EA EMPLOYEE $2,000,000 $2,000,000 l 1,000,000 si, 000, 000 t 50,000 J 10,000 $ 1,000,000 I t t t t t t t t t 1000000 s 1000000 I 1000000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS LICENSE #: 655178 CERTIFICATE HOLDER CONTRAC Contractor's State License Board ATTN: BONNIE PHILLIPS P 0 Box 26000 Sacramento CA 95826 ACORD25-S(1/95) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL * 3 0 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%v Ow 4 /-- • .- ' •' ACORD CORPORATION 1980