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Home My WebLink About2750 ROOSEVELT ST; B; CB130710; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 03-22-2013 Miscellaneous Permit Permit No: CB130710 Building Inspection Request Line (760) 602-2725 Job Address: 2750 ROOSEVELT ST CBAD St: B Permit Type: MISC Subtype: REPAIR Parcel No: Valuation: 9000000000 .,0~ o::i. ~ Lot#: 0 $0.00 ,,. ' v~e;:, Reference #: PC#: Project Title: DEWHURST: REPAIR EXTERIOR WALL AND REPLACE WINDOW Applicant: R & M CONSTRUCTION STE 1001 7959 SILVERTON AVE SAN DIEGO 92126 858 566-4950 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE Owner: Total Fees: $130.00 Total Payments To Date: $130.00 Inspector: FINAL APPROVAL Date: S:: · '7 · I ,3 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: Balance Due: Clearance: ISSUED 03/22/2013 JMA 03/22/2013 03/22/2013 $130.00 $0.00 $0.00 $130.00 $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. Fanure 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 I i ii h' 1i . n h 1100._ 0 U!,.., .......... , I .... ,.,. .... ,_._"(Uon.,_o, I nJVH OV I ._,_,.,., ..... U"UUO., .__, I ............... .__, ...................... 1....,1uu,-11.u t...-,1 I ... ._ 1....,,,1 .. --.. .. , 1.,.-1 ,.,.._,,.,"'I"' v., •/,1;,, Building Permit Application Plan Check No.C/3 { ?t OJ / Q ✓ (~ '"' / 1635 Faraday Ave., Garlsbad, CA 92008 Est. Value ~ CITY OF Ph: 760-602-2719 Fax: 760-602-8558 CARLSBAD email: buldllng@carlsbadca.gov Plan Ck. Deposit www.~[l,2baQQa,gQv Date 3 ',z..z,/1 "', !swPP JOB ADDRESS :17~o k oo., ,e I/£ /r .s;-SUITE#/SPACE#/UNIT# B APN 5v,--r --- CT/PROJECT# ILOT# P~E/1 # OF UNITS I# BEDROOMS #BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I 01,;C. i..ROUP DESCRIPTION OF WORK: Include Square Feet or Affected Atea(s) {.,.1 Jce ,AND I<,,_, D 12,t f A , i. T.o 6-xTE {l I ~ /µ,::) t l--'b a, .w '°0 .(A/ A//4e,s-,v7'° EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (~F) I FIREPLACE !AIR CONDITIONING I FIRE SPRINKLERS YES O #_ NOD YES O NOD YES D NOD APPLI~r.ME (Prl,.ry Contact) -APPLICANr NAME {Secondary Contact) M • ,v s.n,_,,, <II er' ADDRESS ADDRESS 79::,7 c-/.. I/ E-.e7b_,., Ave ~ /O<~I CITY STATE ZIP CITY STATE ZIP ;i;..; ~~"" C. "J? 1 z,,:;. PHONE • IFAX PHONE l'AX (Fs"JI) ~U,-V?S-0 r~r.P) <"/'/ -~s-1' '7' ... ,.,AIL MAIL -.,..,,.r:r.r -A":, .• IGJS'8c., Ci-/a84C .~ ' PROPERTY OWNER NAME a,~CTpR BUS. NAME -_I 1 I 1 .. -- .,.., £M ADDRESS ;,_ ADDRES3 ?7c1>-. .,, ~ , ST: CITY STATE ZIP CITY STATE ZIP PHONE l'AX PHONE l'AX c.1V1AIL c.1v1AIL ARCH/DESIGNER NAME & ADDRESS ./,,. ,.v~ STATE UC.# ~ "'TATE LIC.# -g-gs ,i <,I .,.p--ICLASB lc1/~"343'-I~- {Sec: 7031.5 Business ~nd P_rol"es~ions Code: Any City or Cqunty which requires a permit to_construct, alter, improve, demolish or r air a structure, _rior ~ its issuance, also requires the apphcant for such permit to file a signed statement that he 1s licensed pursuant to the 1rov1s1ons of the Contractor'_s License Law {~aDte~, commenJng with Section 7000 of Div1s1on 3 of the Business and Professions Code) or ftlat he is exemP.t therefrom, and the basis for the a leged 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 {$500}). WORKERS" COMPENSATION Worbrs' Compensation Declaration: I hereby affmi under penalty of perjury one of the following declarations: □ I have and wlll maintain a certificate of consent to self-lnaure for workers' compensation as provided by Section 3700 of the labor Code, for the performance of the work for which this permit is issued. □ I have and wlll maintain wor1'.ers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation ins ranee carrier and policy number are: Insurance Co. 13($.s _:I: Policy No. ;L-:J-.,</ ,6 Expiration Date _.z;~~~L..::,_ __ _ This section need not be completed if the permit is for one hundred dollars ($100) or less. · □ Certificate of Exemption: I certify that in the pe ance 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: Falkire to secure wo mpensation cover 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, da provided n 06 of the Labor code, interest and attorney's feet. NS CONTRACTOR SIGNATURE ~ I hereby affirm that I am exempt lrom Contractor's Ucense Law for the following reason: □ 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 Sllch work himself or through his own employees, provided that such improvements are not intended or offered for sale. \f, however, the building or improvement is sold within one year of completion, the owner-builder will have the bllrden of proving that he did not build or improve for the purpose of sale). □ l, as owner of the property, am exclusively contracting with licensed contractors to constr1,1c\ 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 _____ B,usiness and Professions Code for this reason: 1. I personally plan lo provide the major labor and materials for constructbn of the proposed property improvement □ Yes □ No 2. l (have I have not) signed an application for a building permit for the proposed work. 3. \ have contracted with the following person (firm) to provide the proposed construction (include name address I phone/ contractors' license number): 4. I plan to provide portions of the work, D.Jt l have hired the following person to coordinate, supervise and provide the major work (include name/ 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 work indicated (include name I address I phone I type of work): NS PROPERTY OWNER SIGNATURE □AGENT DATE I ,. f.OMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY , __ ls 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 ls the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ Yes □ t-«J Is the facility to be constru:;ted within 1,000 feet of the outer boundary of a school site? □ Yes □ No If AIIY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUEO UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. CONSTRUCTION I.ENDING AGENCY I hereby affirm that there 1s a construction lencbng agency for the perfonnance of the work this permit is issued (Sec 3097 (1) Civil Code). Lender's Name Lender's Address APPLICANT CERTIFICATION I certtrythat I haw! read the appllcatfon and state that the above Information Is correct and that the Information on the plans Is accurate. I agree to comply with an City ordinances and Stats laws relating to building construction. I hereby aulholize ,epresenla1ive af lhe City of Galsbad IDenlBr upoo !he above mentioned property for ,spedion purposes. I ALSO AGREE TO SAVE, INDEM'IIFY AND KEEP HARM.ESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH W.Y IN Alf'f WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: /.Ji OSHA pemit is reqused for exca,,ations over 5'0' d demolition or c:onslru'1ion of s1Ncrures over3 smries in height EXPIRATION: Every permit issued by lhe Bui~ing Official provisions of lhis Code shall expire by limilatioo and become nul and void ff lhe build'1Q or work aulhotized by such pemit is not conmenced v.lhi, 180 days from lhe date of such pemit or ff !he build· by su ended or abandoned at any time allef lhe work is corM1enCed for a period al 180 days (Section 106.4.4 Uniform Buk>ng Gode). ~ APPLICANT'S SIGNATURE • 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 www.buflding@cansbadca.gov or Mall lhe 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. UC. No. DELIVERY OPTIONS □ PICK UP: o CONTACT (Listed above) o OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1.) Cl MAIL TO: o CONTACT (Usted above) o OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) □MAIL/FAX TO OTHER: _______________ _ ,El' APPLICANT'S SIGNATURE o ASSOCIATED CB#------------ □ NO CHANGE IN USE/ NO CONSTRUCTION o CHANGE OF USE/ NO CONSTRUCTION DATE ZIP ' , Inspection List Permit#: CB130710 Type: MISC Date lnspection_ltem 05/07/2013 19 Final Structural 05/07/2013 89 Final Combo 04/16/2013 14 Frame/Steel/Bolting/Weldin 04/16/2013 34 Rough Electric Wednesday, May 08, 2013 REPAIR Inspector Act RI PD AP PD AP PD AP DEWHURST: REPAIR EXTERIOR WALL AND REPLACE WINDOW Comments Page 1 of 1