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Home My WebLink About1814 MARRON RD; ; CB041237; Permit\..._//7 0 ~ City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 04-1.2.,2004 Miscellaneous Permit Permit No: CB041237 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 1814 MARRON RD CBAD MISC Subtype: REPAIR Parcel No: Lot#: 0 Valuation: $0.00 Reference #: Project Title: SAMBA BRAZILLIAN STEAKHOUSE FIRE REPAIR TRASH AREA Applicant: LL APPLIED RESTORATION 630 NATIONAL CITY BLVD 91950 619-4 77-4080 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: $120.00 Owner: PERMIT FEE Total Payments To Date: $0.00 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 04/12/2004 SB 04/12/2004 04/12/2004 9741 04/12/04 0002 01 02 CGP $120.00 $0.00 $0.00 $120.00 Balance Due: $120.00 120.00 FINAL APPROVAL DATE r~ CLEARANCE __ _ SIGNATURE ~ PERMIT APPLICATION CIT)' OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1. PRo.iECT INFORMATION \ Q:. \Lt, ~A'2,.g0t-,l }2.P · FOR OFFICE USE ONLY PLAN CHECK NO. C,,~t{/Zf:. 7 EST.VAL._~~~~~~~~~ Plan Ck. Dep~---..--------- Validated ,Y----1!7,.,._ _______ _ Date{<i 1_ f 2 /_Q_v} Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Assessor's Parcel # Existing Use tz.~'tblb ~· Description of Work SQ. FT. #of Stories ?-~P~,12-. ~,-.1 ~,-:)0 r,~~t-A~ (2. CONTACT PERSON llf different from appllcentl Unit No. Phase No. Proposed Use ~~' # of Bedrooms cA 9\0..\0 Total # of units # of Bathrooms ~ ~AN Q\1hr!::'.'l!>.Oo \C\\ 6~~ J!.~ c::..\.tU\A',,\!>"lb Name Address City State/Zip Telephone# Fax# 3. APPLICANT O Contractor '-tAgent for Contractor O Owner D Agent for Owner ..i ~~~ <9 \A~'PO \C\ \ ~'I\C'C. P'!'? a\.;~~-v\>lt"h Name Address City State/Zip Telephone# 4. P"'Oe_ERTY OWNER Name Address City State/Zip Telephone# [5. CONTRACTOR • COMPANY NAME (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 ($5001). \..\... Af'\?L\IE°P ecs.~ eA't10N , (p'?>O "-)~~ C..\~ ~-.JO ~An~'-O."ni C-1 C\\C\SO Co 9 ~ "'f1}-"\080 Name State License # _'1_f>_~ __ l_(p ___ _ Address License Class ___ e,"------- City State/Zh Jele11hone # City Business License #f: / , '1 c) ~ Designer Name Address City State/Zip Telephone State License # ---------- 6. WORKERS' COMPENSATION 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. O 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. '"2. q "2. \ q 1"'\ ~ Insurance Company "'>~~ ¥1,AN:O Policy No .. ____________ _ Expiration Oate __ O_\_\~o_<o __ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) O 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 rkera' compensation coverage la unlawful, and shall subject en employer to criminal penalties end civil fines up to one hundred GNA TURE DA TE ct::> ~ VL ,-,~ • ousand do. liars ($100,000), In ddition to the cost of ompensatlon, damages ea provided for in Section 3706 of the Labor code\lnterest and attorney's fees. OWNEfl-BUJLDE!U)ECLARA ION . . --"=-c . ...:;.\-\.1. .... _~t ......... T--:::..,._ ____ ~ I hereby affirm that I am exempt f m the Contractor's L ense Law for the following reason: 0 I, as owner of the property 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). 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. 0 YES ONO 2. I (have I have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firml to provide the proposed construction (include name I address I phone number I 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 I address I phone number I 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 I phone number I type of work): __________________________________________________________ _ PROPERTY OWNER SIGNATURE------------------------ COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY 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? 0 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? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O 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. 18. CO~STRUCTION LENDING AGEN.C'( --_ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 30970) Civil Code). LENDER'S NAME---------------LENDER'S ADDRESS _________________________ _ 9. APPLICANT CERTIFICATION 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 ANO 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 1 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 f 180 days (Sec on 106.4.4 Uniform Building Code). APPLICA 'S SIGNATURE DATE PINK: Finance City of Carlsbad Bldg Inspection Request For: 07/30/2004 Permit# CB041237 Title: SAMBA BRAZILLIAN STEAKHOUSE Description: FIRE REPAIR TRASH AREA Inspector Assignment: TP --- Type: MISC Sub Type: REPAIR Job Address: 1814 MARRON RD Suite: Lot 0 Location: APPLICANT LL APPLIED RESTORATION Owner: Remarks: Total Time: Phone: 6195713240 lnspector:4 Requested By: RAPAHEL Entered By: ROBIN CD Description Act Comment 19 Final Structural A~~~~~~~~~~~ Associated PCRs/CVs lnsi:;1ection History Date Description Act lnsp Comments 06/30/2004 17 Interior Lath/Drywall AP TP 06/30/2004 18 Exterior Lath/Drywall AP TP 06/28/2004 14 Frame/Steel/Bolting/Welding AP TP REPAIR RAFTER 06/28/2004 24 Rough/Topout AP TP SUPPORT ABS 06/24/2004 14 Frame/Steel/Bolting/Welding PA TP SEE BACK OF CARD 06/24/2004 24 Rough/Topout PA TP 06/24/2004 34 Rough Electric AP TP 06/24/2004 44 Rough/Ducts/Dampers WC TP