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Home My WebLink About2765 SOUTHAMPTON RD; ; CB111737; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 08-10-2011 Miscellaneous Permit Permit No: CB111737 Job Address: Permit Type: Parcel No: Valuation: Reference #: PC#: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 2765 SOUTHAMPTON RD CBAD MISC Subtype: REPAIR Status: 2081402600 Lot#: 0 Applied: $0.00 Entered By: Plan Approved: Issued: Inspect Area: GUNDREY RES-FIRE DAMAGE REPAIR-MISC ELECT, INSULATION, DRYWALL Owner: ISSUED 08/10/2011 LSM 08/10/2011 08/10/2011 PD WORTHING INC, B. A. SUITE #201 GUNDREY ROY W 1998 TRUST 01-22-98 690 CARLSBAD VILLAGE DR CARLSBAD, CA 92008 760-729-3965 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: $150.00 Inspector: 2765 SOUTHAMPTON RD CARLSBAD CA 92010 PERMIT FEE ELECT Total Payments To Date: $150.00 FINAL APPROVAL, Date: /0 · I J· ( I Balance Due: Clearance: $130.00 $20.00 $0.00 $150.00 $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 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 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. NOA DOES IT APPLY to any f exaction of which ou have revious been iven N TICE similar o this or as to which th statute of limi ions has revious otherwi x ired. ~ « .._(fj> ~ CITY OF CARLSBAD JOB ADDRESS CT/PROJECT# EXISTING USE EMAIL ARCH/DESIGNER NAME & ADDRESS Building Permit Application 1635 Faraday Ave .• Garlsbad, CA 92008 760-602-2717 / 2718/ 2719 Fax: 760-602-8558 www.carlsbadca.gov SUITE#/SPACE#/UNIT# Plan Check No. Est. Value Plan Ck. Deposit Dateg # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YES □#_ NOD NAME (Secondary Contact) CITY STATE FAX CONTRACTOR BUS. NAME ADDRESS ZIP CITY ctzo o STATE LIC. # $WPP CONSTR. TYPE CCC. GROUP AIR CONDITIONING FIRE SPRINKLERS YES O NOD YES □ NO □ ZIP (Sec: 7031.5 Business and Professions Code: Any City or Coun_ty which requires a perm rt. 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 B_usiness and Professions Code) or fhat he Is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subiects the applicant to a civil penalty of not more than five hundred dollars {$500)). -~ --1 WORKIIIU' COMl"illlfAT'ION _ Wonters' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: □ 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 pern1it is issued. □ I have and will maintain wor1u,n' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this pern1it is issued. My workers' compensation insurance carrier and policy number are: lnsurar\CE! Co ______________________ Policy No. ______________ Expiration Date _________ _ This section need not be completed if the permit is for one hundred dollars ($100) or less. D Certificate of Exemption: I certify that in the performance of the work for whk:h this pern1il is issued, I shall r\Ot employ any person in any manner so as to become'subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages as pr vlded for I action 3706 of the Labor code, interest and attorney's fees. _.,1$ CONTRACTOR SIGNATURE I hereby affirm that I am exempt from Contractor's Ucense Law for the following r □ I, as owner of the property or my employees with wages as their sole com , will do the work and the strllClure is not intended or offered for sale (Sec. 7044, Business and Profess kins Code: The Contractor's license Law does not apply to an owner of property who builds or improves thereon, and who does su:;h 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). □ 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 this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. □ Yes □ No 2. I (have/ have not) signed an applicabon for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed constrllClion (include name address I phone 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/ phone/ contractors' license number): 5. I will provide some of the work, but I have contra:ted (hired) the following persons to provide the wall( indicated (include name/ address I phone I type of mrk): ,65 PROPERTY OWNER SIGNATURE □AGENT DATE '"',0~ ~ ~ eTh ,' -~ ~ '\. j C -' -,-5'~ C -j \ :;COMl'tlifli THU $1iJ:UOIII l'OR IIION•RE'SIDU\ITJAL IIUliDINli JlliltMUS 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 ~o Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air_qu~ management district? Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ Yes Wo □Yes 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 ce,tifythat I have read the application and state that the aboYe lnfonnatlon Is correct and that the lnfonnation on the plans is accurate. I agiee ID comply'Mlh all City ordinances and S1ate laws relatlng ID building construction. I hereby authorize rei:resentative of lhe Qty of Carlsbad to enter upon the aOOve men!Oned property tir inspection pulJX)ses. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF C.ARLSB.AJ) AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERM~. OSHA: M OSHA permit is required tir excavations over S'O' deep and demolition oro::mstruction of structures over 3 stories in heght. EXPIRATION: Every ~nnit issued by the Building Offcial under !he provisions of this Cede sha! expire by imitati:m and become nu! and vokl if the buik:1ing or Y.Olk authorized by such pennit is notW11menood 'MIilin 180 days from the date of such permit or if lhe buiding or 'Mlrk aulho · by such permit is suspended or abandoned at any lime after the oork is commenood for a period of 180 days (Secfun 100.4 .4 Uniform Buik:1ing Code}. AS APPLICANT'S SIGNATURE ,,..\;rYIJl,,j,-1W DATE t>/10 / ll City of Carlsbad Bldg Inspection Request For: 10/12/2011 Permit# CB111737 Inspector Assignment: PD Title: GUNDREY RES-FIRE DAMAGE Description: REPAIR-MISC ELECT, INSULATION, DRYWALL Type:MISC Sub Type: REPAIR Job Address: 2765 SOUTHAMPTON RD Suite: Lot: 0 Location: APPLICANT WORTHING INC, B. A. Owner: GUNDREY ROY W 1998 TRUST 01-22-98 Remarks: --- Total Time: Requested By: JOHN Entered By: JANEAN CD Description Act Comments 19 Final Structural ~ -------+A-,,,c...-/J+-+/~pr-t..:..=~-------__g_j_ ____ - Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# lnsQection Histo[Y Date Description Act lnsp Comments 08/31/2011 17 Interior Lath/Drywall AP PD 08/29/2011 16 Insulation AP PD 08/26/2011 16 Insulation NR TP INSUL. NOT IN PLACE 08/19/2011 34 Rough Electric AP PD @KITCHEN 08/18/2011 34 Rough Electric NR PD NOACCESS@11 OR 11:30 08/15/2011 14 Frame/Steel/Bolting/Welding PA PD 08/12/2011 14 Frame/Steel/Bolting/Welding CA PD WANTS MONDAY