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Home My WebLink About2887 CAMINO SERBAL; ; CB011185; Permit03/28/2001 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Patio/Deck Permit Permit No:CB011185 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 2887 CAMINO SERBAL CBAD PATIO 2552832300 Lot #: 0 $2,232.00 Construction Type: NEW PRYOR - COV PATIO 288 SF Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 03/28/2001 JM 03/28/2001 03/28/2001 Applicant: PARKER, DAVID 4911 REFUGIOAV CARLSBAD, CA Owner: PRYOR JILL A 2887 CAMINO SERBAL CARLSBAD CA 92009 5258 03/28/01 0002 01 02 CGP 76-55 Total Fees: $76.55 Total Payments To Date:$0.00 Balance Due: $76.55 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 $45.79 $0.00 $29.76 $0.00 $1.00 $0.00 $0.00 $0.00 $76.55 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(3), 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 previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. PERMIT APPLICATION CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 t;-> MUM FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated Bv Date Address (include Bldg/Suite *)Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total tt of units Assessoi Existing Use Proposed Use Description of Work SO. FT.#of Stories # of Bedrooms # of Bathrooms Name / Address City State/Zip Telephone # ••MMBiNMMrti^^ •*" -V- '»• - -> -, ' "V , -, (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 19 exempt therefrom, and the basis for the alleged Any violation of-Section 7021,5by any applicant for a perrmt su Name -n ±A r ^ i Address ^ State License f / 6--Y ^J tX ( License Class C- ~* Designer Name Address State License # <->, i^-j City State/Zip / ^ Telephone It > *" ' City Business License * /C> O Q / ,£-> "2- City State/Zip Telephone Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: J0 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. D 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 comperjsjtiojvinsurance.carrier arjdjioJicy numbgrare: »\ .-—\CJ ,_-. -i -j Insurance Company ^7 /Q ~] r^> 1 '& hJ Q Policy No. C>C/- / 0 (Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) n CERTIFICATE OF EXEMPTION: Ipettify 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 iMcure wqflcersVcornpflnsation coverage Is unlawful, and dial subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100(000). In^ftdttjfo toMe cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE /jf J yy^ DATE 3 ~ 2^ <5 " 0 I I hereby affirm that I am exempt from the Contractor's License Law for the following reason: CD 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). n 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 NO 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 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? D YES D Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? D 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. • "-^' " •- ', ' - .'.-r :j:- ;-*.'-- 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 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 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 r^quiredjfor excavatjpfts over 5'0" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permi/issued by the burning 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 corilmencaj} wjjriin 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 iMpr/ffrtfncedjgjx£eri°d of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATUflE>X^ V 6£^L~—~' DATE WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 05/08/2001 Permit# CB011185 Title: PRYOR - COV PATIO 288 SF Description: Inspector Assignment: PD Type: PATIO Sub Type: Job Address: 2887 CAMINO SERBAL Suite: Lot 0 Location: APPLICANT PARKER, DAVID Owner: PRYOR JILL A Remarks: Phone: 7605187944 Inspector; Total Time: CD Description 11 Ftg/Fpundation/Piers Act Comments Requested By: DAVID Entered By: ROBIN Associated PCRs Inspection History Date Description Act Insp Comments 03/29/2001 11Ftg/Foundation/Piers AP PD PLANNING DEPARTMENT APPROVAL so COMPttNSAttON INSURANCE P.O. BOX 807, SAN FRANCISCO,CA 94101-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 01-01-01 POLICY ISIUMBER: £2*-01 UNIT 0017449 CERTIFICATE EXPIRES: 01*01 -02 CONTRACTORS SjATE LICENSE BOARD ATTN: WORKERS' COMP. UNIT BOX 26000 SACRAMENTO CA 95826 JOB: # 709501 INCEPTION DATE: O1-O1-O1 0.0.: SAN DIEGO This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 1O days' advance written notice to the employer. We will also give you 10 days' advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate of insurance 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. PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,OOO,OOO.OO PER OCCURRENCE. STANDARD EXCLUSION: INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY. EMPLOYER LEGAL NAME DAVID L. PARKER LANDSCAPE 1*911 REFUGIO AVE CARLSBAD CA 92008 PARKER, DAVID L PRINTED: 12-16-00 P0409 THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND SCIF 10265 (REV 2-