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Home My WebLink About2872 LUCIERNAGA ST; ; CB993446; Permitv'333o City of Carlsbad 09/16/1999 Miscellaneous Permit Permit No:CB993446 Building Inspection Request Line (760) 438-3101 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Tille: 2872 LUCIERNAGA ST CBAD MISC Subtype: 2153302528 Lot #: $0.00 JACOBSSEN RESIDENCE ICBP PATIO ENCLOSURE #5294P OTHER 0 Owner: 40 .,., 09/li. '99 0001 01 t,~ , . ui . Status: ISSUED C-PRMT Applied: 09/16/1999 Entered By: MDP Plan Approved: 09/16/1999 Issued: 09/16/1999 Inspect Area: Applicant: CLASSIC LIFESTYLES JACOBSSEN GEORGE E JR&JOSEPHINE 2872 LUCIERNAGA ST 30663 CHAMPION CANYON LAKE CA 92587 909-244-4086 Total Fees: $45.00 Miscelaneous Fee #1 Miscelaneous Fee #2 TOTAL PERMIT FEES Inspector: CARLSBAD CA 92009 Total Payments To Date: $0.00 PERMIT FINAL APPROVAL Date: '5 ~l-lll) Balance Due: $45.00 $0.00 $45.00 $45.00 Clearance: _____ _ NOTICE: Please take NOTICE that approval o 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 seivice 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 otheiwise ex ired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 02 PERMIT APPLICATION FOR OFFICE USE ONLY PLAN CHECK NO. qc;~ ';:/14 ~ CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. _________ _ Plan Ck. Deposit ________ _ Validated By __________ _ Date _______________ _ 1. PR0,1,ECT INFORMATION 2~72--f._.UC./fflN,1(id S7: Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. T otat # of units Assessor's Parcel # Existing Use Proposed Use #of Stories # of Bedrooms # of Bathrooms Name Address '3~-APPLICANT ~ntractor :g.:Agent'-.tOf'.Co~ctor □·Owner Name Address 4. PROPERTY OWNER Gt'. ,:,)/2.w € IT l't (.Vb s,.., ,,_ Name Address ,s. CONTRACTOR' COMPANYNAM!;, 0)< I 'il /A710 City □ .<\gent tor awner, City City ~ State/Zip Telephone# Fax# State/Zip Telephone# (7ho) L/3 'f, -r 'II I State/Zip Telephone# (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)). Z t.f t( _ ... c_· ?-=14:=S'..-S::i.c'c...='-_ _.L~-L(Lp__,e-_·~57:..,,.._':;f..,,.....t___.,~..,;.5.=·--~.3'-o"'· ,;,:,,,,.J<..' .....,.<'.'."'k"'outtz=-'.(J"-(-"""'-"'"--'-"""a"",1'-"1;...U""vv"'-'c'-;'-rl"-'K..,,._f.....cCc;11,,,_,"<j.-"z""s"'g'-· -'-7__.,(_,'9_.o.,,,f),___Lf {) f-, Name Address City State/Zip Telephone # State License# \7tJeJ-d-9L/ License Class __ _,_""'------City Business License# /:} 0 7'/ z} J Designer Name Address City State/Zip Telephone State License # _________ _ 6. WORKERS' COMP!;NSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: ~ 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: ! J Insurance Company .57AZ"i P~ Policy No. i 4 2 J / 'ft, -99 Expiration Date 2Li. L!2_ Q ) ; (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS·($100J OR LESS! D 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 aecure workers' compensation coverage ie unlawful, and ahaU subject an employer to criminal penaltlee and civil fines up to one hundred thousand dollars ($100,000), In addition to the cost of compensation, demegee es provided for in Section 3706 of the Labor code, Interest and attorney's fees. SIGNATURE,______________________________ DATE _________ _ 7. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D t, 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). D 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/ 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 I address / phone number / type of work): ___________________________________________________________ _ PROPERTY OWNER SIGNATURE ______________________ _ DATE _________ _ COMPLETE THIS SECTION FOR NON./IESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registratio~ or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act7 10 YES ~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 q:x:.'o Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D ~ IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESSITHE 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 per~t is issued (Sec. 3097(i) Civil Code). LENDER'S NAME _____________ _ ,9, -APPLICANT CERTIRCATION 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 tbis Code shall expire by' limitation and become null and void if the building or work authorized by such permit is not commenced within 36 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 wo is commanc fo eriod of 1 days (Se tion 06.4.4 Uniform Building Code). / APPLICANT'S SIGNATURE m . DATE ~~,,114~,,./2~7~1,_ _____ _ PINK: Finance City of Carlsbad Bldg Inspection Request For: 2/29/2000 Perm it# C B993446 Title: JACOBSSEN RESIDENCE Description: ICBP PATIO ENCLOSURE #5294P Type:MISC Sub Type: OTHER Job Address: 2872 LUCIERNAGA ST Suite: Lot 0 Location: APPLICANT CLASSIC LIFESTYLES Owner: JACOBSSEN GEORGE E JR&JOSEPHINE G Remarks: SOLARIUM STRUCT.W/ HOLD CEILING FAN?? Total Time: CD Description Act Comments Inspector Assignment: DM --- Phone: 7604384411 Inspector: x:s)1/\ Requested By: GEORGE JACOBSON Entered By: ROBIN 34 Rough;rtric _M_ ___________________ _ ~ r~,~rat;, =±--------- Associated PCRs Inspection History Date Description 12/7/1999 19 Final Structural Act lnsp Comments CO DM ' ~ I { ' \ . . . --.. . .. ----------.. ------.. ·------r t ' I 0, "'I --t ), r --1:, ~ '-Ji -----1) (i\ {\.> " ~ 4:, --0 ~J ~ -6:..'" c,C\ E ' F ---.J 0 ' .. fJ ,1 z:. -\ < r 1/) j - C rn f r f-.l "'---r<\ -..( ? ( ? 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