The URL can be used to link to this page

Home My WebLink About2804 ROOSEVELT ST; ; CB133228; Permit, City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 12-30-2013 Sign Permit Permit No: CB133228 Job Address: Permit Type: Parcel No: Valuation: Reference#: PC#: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 2804 ROOSEVELT ST CBAD SIGN Lot#: 2031820400 $1,000.00 Construction Type: 0 NEW URGENT CARE-1 BLADE SIGN NOT ILLUMINATED Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 12/30/2013 RMA 12/30/2013 12/30/2013 WESTERN SIGN & AWNING ROOSEVELT TAMARACK INVESTMENTS LP DBA STANFORD SIGN & AWNING 261 S PACIFIC ST SAN MARCOS CA 92078 760 736 6070 Building Permit Add'I Building Permit Fee Plan Check Add'I Plan Check Fee Electrical Fee Renewal Fee Add'I Renewal Fee Other Building Fee Additional Fees TOTAL PERMIT FEES 6 VENTURE #215 IRVINE CA 92618 $27.10 $18.93 $18.97 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $65.00 Total Fees: $65.00 Total Payments To Date: $65.00 Balance Due: lnspecto FINA Date: Clearance: $0.00 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 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 f I x i n h r vi I Tl E imil r hi whi h h I i n h I fHE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE «~ Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov Plan Check No. ~ CITY OF CARLSBAD JOB ADDR,,,,g °" CT/PROJECT# PHASE# # OF UNITS # BEDROOMS SUITEI/SPACEI/UNITI # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) ~J 1~1/(J ~A~ CJ!1,U<f7 WC...- EXISTING USE GARAGE (SF) PATIOS (SF) DECKS {SF) AIR CONDITIONING FIREPLACE YESQI No[] YES □No □ FIRE SPRINKLERS YES0ND□ APPLICANT NAM~a,y Co APPLICANT NAME (Secondary Contact) ADDRESS ADDRESS CITY CITY STATE ZIP PHONE FAX EMAIL EMAIL PROPERTY OWNER NAME f; ADDRESS CITY STATE ZIP CITY a-4 sc'A-, '?Zl/9 I/ PHONE FAX PHONEJ/Y,-,f FAX 1;;1'J-4).?-'!slt EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS STATE UC.# STATE UC.# 9(/J{70 '6 (Sec. 7031.5 Business and Professions Code: Any City or Coun_ty which requires a permit to.construct, alter, improve, demolish or repair any structure, prior to its Issuance, also requires the applicant for such per_mIt to file a signed statement that he is licensed pursuant to the provIsIons of the Contractor's License Law JChapter "9, commending with Section 7000 of D1v1s1on 3 of the B_usmess and Professions Code) or that he Is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 031.5 by any applicant for a permit subjects the applicant to a cIvII penalty of not more than five hundred dollars [$500}). WORKERS' COMPENSATION Workers' Compensation Declaration: / hereby affirm under penalfy of perjury one of the following declarations: 0 I have and will maintain a certificate of consent to self-Insure for "MJrkers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued ~ I have and will maintain workers' compensation a~ Quired ection 3700 of the Labor Code, for the performance ;ij t~f'f).,C) th~Jitf' issued. My workers' compens;}fn)ns7.npeprrier and policy number are: Insurance Co.~ -,-W' Y1 Policy No. ] t, // f.P Expiration Date _c.,./~,l_,__,/~4-cc_ ____ _ ~section need not be completed if the permit is for one hu tired dollars ($100) or less. LJ Certificate of Exemption: I certify that in the pertormance 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 penaltles and clvH fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, dama a provided for i 06 of the Labor code, interest and attomey"s fees . .JiS CONTRACTOR SIGNATURE I hereby affirm that I am exempt from Contractor's Ucense Law for the following reeson: □ □ □ 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 worl< 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). 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). I am exempt under Section _____ Business and Professions Code for lhis reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0Yes 0No 2. I (have/ have not) signed an application for a building permit for the proposed worlt 3. I have contracted wilh the following person (ftrm) to provide the proposed construction (include name address I phone/ contractors' license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide lhe major work {include name I address I phone I contractors' license number): 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the worl< indicated (include name I address I phone I type of work): ~ PROPERTY OWNER SIGNATURE □AGENT DATE ...... \ COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY 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.? Yes No Is the applicant or future building occupant required to obtain a pem1it from the air pollution control district or air quality management district? Yes No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Yes 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. I certify that I have read the application and state that the above infonnatlon is correct and that the Information 011 the plans Is accurate. I agree ID 0Jfl1plyv.ith all City ordinances and State lav.s relating to bulldlng construction. I hereby authorize representabve of the City of Carlsbad to enter upon !he alxJve mentioned pro~rty for inspecoon pul'JX)ses. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CrTY 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: M OSHA pennt is required for excavations over 5'0' deep and demolnKln or construction of structures over 3 stories in height. EXPIRATION: Every pem,t issued by the Buik:Jing Oflk:ial under the ptMs:Ons of !his Code shall expire by limitation and oooome nul and "'i:1 Wthe buik:ling or 'MXk authorized by such pennit is not commenced .....;thin 100days from the date of sud1 pennij or if the bri:g or'Mlrk authorized by su ~rmn is sus~nded or abandoned at anytime after the w:irk is oommeoced bf a perkld of _180 days (Sectkln 100.4.4 Uniform Building Code) . ..€S' APPLICANT'S SIGNATURE ~ DATE / /JO/; STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. Fax {760) 602-8560, Email building@carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAIL TO: CONTACT (Listed above) CONTRACTOR (On Pg. 1) OCCUPANT (Listed above) MAIL/ FAX TO OTHER: _______________ _ ,AS APPLICANT'S SIGNATURE ASSOCIATED CB#------------- NO CHANGE IN USE/ NO CONSTRUCTION CHANGE OF USE/ NO CONSTRUCTION DATE ZIP Inspection List Permit#: CB133228 Date Inspection Item 06/23/2014 19 Final Structural 06/23/2014 38 Signs 06/19/2014 38 Signs Wednesday, January 28, 2015 Type: SIGN Inspector Act PD AP PD AP PD co URGENT CARE-1 BLADE SIGN NOT ILLUMINATED Comments Page 1 of 1