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Home My WebLink About2777 ROOSEVELT ST; ; CB140655; Permit03-21-2014 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB140655 Building Inspection Request Line (760) 602-2725 rJ;> ~ ~ 2777 ROOSEVELT ST CBAD f\e::,~iJC'J9 \ c,/~V Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: PME Status: ISSUED 2031810900 Lot#: 0 Applied: 03121/2014 HENNESSEY'S-REPAIR WATER MAIN TO BUILDING Owner: Entered By: LSM Plan Approved: 0312112014 Issued: 0312112014 Inspect Area: DUANE (SKIP) GREENHOE HOWARD-JONES MARITAL TRUST 03-31-81 C/O CAROLYN WOERPEL 760-889-9056 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES 2785 ROOSEVELT ST CARLSBAD CA 92008 $158.00 $0.00 $0.00 $0.00 $158.00 Total Fees: $158.00 Total Payments To Date: $158.00 Balance Due: Inspector: FINAL APPROVAL 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 pennit 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 infonnation 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 h' vi I T i ii I THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH 0HAZMAT/APCO ~· Building Permit Application Plan Check No. Cit, I lfO (o ~ «~,, 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value ~ CITY OF Ph: 760-602-2719 Fax: 760-602-8558 CARLSBAD email: building@carlsbadca.gov Plan Ck. Deposit www.carlsbadca.gov Date .!3/ ~i,/ / Y, ISWPPP ~ JOBAOORESS Yr' -'-1--;L SUITEf/SPACEf/UNITf APN . -Z..\--1+ ---- ,..., CT/PROJE1.,;1 # LOT# I PHASE# I# OF UNITS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I occ GROUP ~v:;i=~"' ····;:,e;;;y·~ 1::--}o -1-hE bo1ld1:31 f{en~-se; Jtl Veth EXISTING USE FIREPLACE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) YES[]# 1 IAIR CONDITIONING I FIRE SPRINKLERS Nc0 vesO•oO vesO•oD APPLICANT NAME Primary Contact PROPE?liJ~~ I o ,,11e LI,_, -~A1U) -JO/(J~ ~ ADDRESS ADDRES"S CITY STATE ZIP CITY STATE ZIP PHONE IFAX PHONE IFAX EMAIL EMAIL !J1 11A 1,4,n DESIGN PROFESSIONAL -,:_ONTRACTOR au~ N..,..E (1, V ... /, -· • ,1 I., Mhf-'/ ADDRESS AO~S(J 'i?,J'}( '3-3¥ CITY STATE ZIP CITY l'ld, J,., ·rA-~Z0-57 ~-' PHONE IFAX PHONE IFAX EMAIL EMAIL I STATE UC.# SJf,';J~· ---IC~ I CITY BUS. UC.# > 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, pnorto its issuance, also requires the applicant for such permit to file a signed statement tliat 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 exemr;>t therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit sub;ects the applicant to a clvil penalty of not more than five hundred dollars ($500)). WORKERS' COMPENSATION Worilen' Compensation Declaration: / hereby affirm under penalty of perjury one of the fol/owing declarations: El I have and will maintain a certificate of consent to 1elf.in1ure for workers' compensation as provided tiy Section 3700 of lhe Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation, as reQUired tiv Section 3700 of the Labor Code, for tile performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy numtier are: Insurance Co. ____________________ Policy No. _____________ Expiration Date ________ _ ~section need not be completed if the permit is for one hundred dollars ($100) or less. LJ Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person ln any manner so as to become sutlject to the Wor11ers' Compensaijon Laws of California. WARNING: Failure to secure workers' compensation coverage 11 unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In addition to the cost of compensation, damages II provided fOf" In Section 3706 of the Labor code, Interest and attorney's fees. ~ CONTRACTOR SIGNATURE □AGENT DATE OWNER-BUILDER DECLARATION ~by affirm that I am exempt from Contractor's License Law for the following reason: w-+ 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 Yitlo 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. 1f, 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 exdusively 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 tiuilds 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 this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0Yes []No 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 (firm) to · e the proposed construcijon (include name address I phone I contractors' license number): 4. I plan to provide portions of the work, but I ha d t Hawing person to coordinate, ise and provide the major work (include name I address I phone f contractors' license number): 5. I will provide some ol the work, but I ha ntracted red) the fo ·ng PE! fovide the work indicated (include name I address I phone I type of work): DATE COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or Mure l)uilding oc:c'upant required to submit a business plan, cnrtely 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 permit 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 certtt,1hatl have read the appllcallon and state that the above Information Is Olfl8Ct and that the lnbnnatlon on the plans Is accurate. I agreetD comply'Mth all Cily on:llnances and State laws relating 1D buUdng construction. I hereby au~orize representative of~e Cly of Garlsbad lo en~r upon~ alxM! mentioned property !Jr inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HAAMLESS lliE CITY OF CAALSBAD AGAINST fil LIABILITIES, JUDGMENTS, ooiiJ:8,ffl'iXf'ENSES WHICH M IN WAY ACCRUE AGAINST SAJD CITY IN CCNSEQUENCE OF lliE GRANTING OF THIS PERMIT. OSHA: kl OSHA permit is requi'ed t>rexca s over 5' 'deep or truction of strucb.Jres ewer 3 stories fl heght. EXPIRATION: Every permit issued by the 11ding Offici nder · ons o IS Code shall expire by lknitation and beoome null and vokl W the building or'o\OIX aulhorized by such permit is not commenced within 180days from the dale of such permit the tllik1ing v.oo<. by permit is suspended or abandoned at any time after the 'Mlrk is commenced lbr a J);lrkxi of 180 (Section 100.4.4 Uniform 0.Jik:ling Code). ,1$ APPLICANT'S SIGNATU DATE 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. Ema II building@carlsbadca.gov or Mall !he completed form to City of ca~sbed, Building Di,~on 1635 Faraday Avonue, Ca~sbad, 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/FAXTOOTHER: _______________ _ A$ APPLICANT'S SIGNATURE ASSOCIATEDCB#'------------ NO CHANGE IN USE/ NO CONSTRUCTION CHANGE OF USE/ NO CONSTRUCTtON DATE ZIP I Request for Refund City of C;irlsbad Account #: _,oc.=o..:c13=-=s:...:.1-=-04.:.=2=23=-----------Vendor #: Amount of Refund: $158.00 Fee Paid For: ~='-=-=-----Building Permit# CB140655 Date Fee Paid: 0312112014 Fee Paid By: Skip Greenhoe -(credit card) Facts Supporting Request: This permit was applied for in error. The leak at the Hennessey's ' Tavern was due to a sprinkler leak, not a water main break. No inspections were performed. NAME OF APPLICANT: Skip Duane Greenhoe Telephone 760 889-9056 STREET ADDRESS: 2777 Roosevelt St CITY, STATE & ZIP: Carlsbad CA 92008 PREPARED BY: -'R-"a=e=ne=tt=e-'-A=bc:c.be"-'y'----------DATE: 3/27/2014 APPROVING DIVISION OFFICIAL: _____________ _ DATE: ____ _ APPROVING DEPARTMENT OFFICIAL: _____________ _ DATE: ____ _