HomeMy WebLinkAbout2758 SOUTHAMPTON RD; ; CB031000; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
04-08-2003 Miscellaneous Permit Permit No: CB031000
Building Inspection Request Line (760) 602-2725
Job Address: 2758 SOUTHAMPTON RD CBAD
Permit Type:
Parcel No:
MISC Subtype: OTHER
2081403000 Lot #: 0
Valuation: $0.00
Reference #:
Project Title: DEATON RES-REPLACE ALL WINDOWS
Owner:
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
04/08/2003
RMA
04/08/2003
04/08/2003
Applicant:
DEATON MICHAEL&BROWN CANDACE DEATON MICHAEL&BROWN CANDACE
2758 SOUTHAMPTON RD
CARLSBAD CA 92008
Miscelaneous Fee #1
Miscelaneous Fee #2
Additional Fees
TOTAL PERMIT FEES
Total Fees: $120.00
Inspector:
2758 SOUTHAMPTON RD
CARLSBAD CA 92008
PERMIT FEE
Total Payments To Date: $0.00
FINAL APPROVAL
Date: f7''f-ri--d,)
$120.00
$0.00
$0.00
$120.00
Balance Due:
Clearance:
$120.00
NOTICE: Please take val of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/ex 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 f 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 s/exacti ns fwhich ouhav r v· Tl E i i r hi r hi h flimi in h I oh rwi e x ir
FOR OFFICE USE ONLY
PERMIT APPLICATION PLAN CHECK NO. {;)J!)J /(Vo
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
EST. VAL. _________ _
Plan Ck. Deposit ________ _
Validated By • / 1/,4--=
Date 'f/jJ4 rt
1. PROJECT INFORMATION
2.7 5 't3 C,(')u,rl AM i? TQ "-I
'{. Address (include Bldg/Suite #)
B,Q) CAR:L';.BAO
Business Name (at this address)
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units
Propos~d Use
rx~~~-.J2..1-1...l,;;l.LD.a...tl1~'-----4',µ.1]~~<..l.-J-<Ll..i:lQ.!.~'-,--'.J=I2....j,,c!.I....--11Ll~~I D.qc-SJ..'.~.__,Q.J,.-J,1-µ..!.:..l'.l..l/\ff
2. CONTACT PERSON (if different frorn applicant)
Name Address
3, AP~LICANT O Contractor O Agent for Contractor D Owner
~ 1 Name
l)( 4. PROPERtv OWNER
Address
City
D Agent for Owner
City
State/Zip
State/Zip
Conda ce; Br::owD '&: IY\, c bo el P:. PeaW/'\ "t 2..0o :R
Name Address <.-:> A Pty State/Zip
2,-, $"" SO ,J'-" """"?='"' f-<Cq_ (0.<7. > bc<.ct
Telephone# Fax#
Telephone#
(71-ol ·:i
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).
Name Address City State/Zip Telephone#
State License # _________ _ License Class _________ _ City Business License # _______ _
Designer Name Address City State/Zip Telephone
State License # _________ _
r,/ 8. WORKERS' COMPENSA TlON
'j' Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
0 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.
D 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:
Insurance Company _____________________ _ Policy No. ____________ _ Exp'1ration Date _______ _
!THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS)
D 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 Cal'lfornia.
WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred ... l thousand do. llar.s ($100,000}, in addition to the cost of compensation, damages as provided for In Section 3706 of the labor code, Interest and attorney's fees.
i;y,.._SIGNATURE______________________________ DATE ________ _
7. OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License law for the following reason:
0 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 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 tor the purpose of sale).
F=J.... I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The
c!ontractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(sl licensed
pursuant to the Contractor's License Law).
D I am exempt under Section ______ Business and Professions Code for this reason:
1.
2.
3.
I personally plan to provide the major labor and materials for construction of the proposed property improvement. D YES -~O
1,i(f,~~/ have not) signed an application for a bu"1lding permit for the proposed work.
J~ contracted with the following person (firm) to provide the proposed constru ti
(' .-0
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 / address / phone
number/ 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/ address/ phone number/ type + ol wmk)o r . ,,// A ~" Al._--,..., \ V .,_, ,C'\c) "2_
PROPERTY OWNER SIGNATURE ~~ C}l'--J Lt (Y\ < ~DATE --__,,;A-A4;._.,r,.__·..,,~l-~o'c-~c:...J.-1 ~
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? 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? D 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.
8. CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097{i) 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 AND 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 180 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 of 180 days (Section 106.4.4 Uniform Building Code).
~APPLICANrss1GNATURE Ca:.-:1--1 -dA--<L_ &o, . ./)(\ , ZD6 3
WHITE: File YELLOW: Applicant PINK: Finance
,i. ~
City of Carlsbad Bldg Inspection Request
For: 04/10/2003
Permit# CB031000
Title: DEATON RES-REPLACE ALL WINDOWS
Description:
Type: MISC Sub Type: OTHER
Job Address: 2758 SOUTHAMPTON RD
Suite: Lot O
Location:
APPLICANT DEATON MICHAEL&BROWN CANDACE
Owner: DEATON MICHAEL&BROWN CANDACE
Remarks: PM PLEASE
Total Time:
Inspector Assignment: .::]"£_
Phone: 7607295245
Inspector: ----
Requested By: CANDACE
Entered By: ROBIN
CD
14
Act Comment • _ ~
Frame/Steel/Bolting/Welding -4.i f:"i /I~
-~--~><_T€~1Z_1t1_/Z. __ L~PJ.~7)1-~~ ~ J
Description
Associated PCRs/CVs
Inspection History
Date Description Act lnsp Comments
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