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Home My WebLink About1701 TAMARACK AVE; ; CB051221; PermitI City bf Carlsbad ,1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No: CB051221 Building Inspection Request Line (760) 602-2725 ·,, Job Address: Permit Type: Parcel No: Valuation: Reference #: 1701 TAMARACK AV CBAD MISC 2072606700 $0.00 Subtype: OTHER Status: Lot#: 0 Applied: Entered By: Plan Approved: Issued: Project Title: HALLOCK RES-STAIRS TO DECK Inspect Area: Applicant WORTHING INC, SUITE #201 690 CARLSBAD V AGE DR CARLSBAD, C 2008 619-729-3 Owner: HALLOCK ANN H C/0 RPM MANAGEMENT PO BOX 1111 CARLSBAD CA 92018 ISSUED 04/04/2005 LSM 04/04/2005 04/04/2005 "----~::::-"".::...._ ________________________________ _ Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: Inspector: $60.00 PERMIT FEE Total Payments To Date: $0.00 Balance Due: $60.00 $0.00 $0.00 $60.00 $60.00 5193 04/04/05 0002 01 02 CGF" 50.00 Clearance: _____ _ NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of lees, dedications, reseivations, or other exactions hereafter collectively referred to as '1ees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. 11 you protest them, you must 1ollow 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 seivice fees in connection with this project. NOR DOES IT APPLY to any FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. {J,l!f) ;--J ~ CITY Of CAR'LSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. __________ _ Plan Ck. Deposit ~ Validated By ~ Date -</-.....,.)--4~/r-Q-,-~---- 1 t 1. • PRQJi:Ct INFORMATION Address (include Bldg/Suite #) It; l '70 t 1"'~4-e · Business Name (at this address} Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # 2o1-2(.,0-{pf Exist'1ng Use Proposed Use SQ. FT. #of Stories It of Bedrooms # of Bathrooms City State/Zip Btu! foc1-\er City State/Zip Telephone# .!h ' CONtF!ACTOR ~ 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 State License# --=::.._!w!'--"~....::..--'L.._ __ 6. WORl(ERS\COMPENsAilON '' .. Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D 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. 'i;/ 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 com e sation insur e carrier nd policy number are: Insurance Company -~~::;.c'~~.;'_,""_:-,...__"'-"=---..e.:.._________ Policy No. o:ro e·17 S::-d Q~~piration Date I -o t -o S:: ITHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT JS 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 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 1$100,0001, in a o the cost of compensation, damages as provided for in Section 3706 of the~!Acodj interest and attorney's fees. SIGNATURE _____ ___:~::X'l,L..ll..~~_,J.~=----------------DATE ~Et-1-'°2 7, : OWNEFi•BUILPEFi DEctARATIPN . ... .. . .. . .... . .. . . ... . . . .. ... . . I hereby affirm that I am exempt from the Co D I, as owner of the property or my empl yees ith 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: T C tractor'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, ovided that such improvements are not intended or offered for sate. 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). D 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 contractorlsl licensed pursuant to the Contractor's License Law). D 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. D YES ONO 2. I (have / have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person {firm) to provide the proposed construction (include name / address / phone number / 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 / 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 of work): __________________________________________________________ _ PROPERTY OWNER SIGNATURE ______________________ _ DATE _________ _ 'COMPLETE THIS'SEClJON FOR·.NON.JlESIDENTiAL BUILDililGiPERMJTSONi:.Y 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? D 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 D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D 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; ; CPNSTRUCi'iONLENti1NG ~GENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097Iil Civil Code). LENDER'S NAME ______________ _ LENDER'S ADDRESS _________________________ _ &> , APPUCA.NTCERTIFlCATIOtL · 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 su'J' permit is suspended or abandoned al any time after the work is commenced for riod of 180 days (Section 106.4.4 Uniform Building Code). 4-/+ 0 .c; APPLICANT'S SIGNATURE -----"---.=-.-="--,,~----------------DATE IC,./ YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 05/12/2005 Permit# CB051221 Title: HALLOCK RES-ST AIRS TO DECK Description: Type: MISC Sub Type: OTHER Job Address: Suite: Location: 1701 TAMARACK AV Lot APPLICANT WORTHING INC, B. A. Owner: HALLOCK ANN H Remarks: Total Time: CD Description 0 Act Comment Inspector Assignment: PC --- Phone: 7607293965 Inspector: L_ Requested By: TERESA Entered By: CHRISTINE 19 Final Structural AfJ------ ------•-· --- ------------- Associated PCRs/CVs Inspection History Date Description 04/21/2005 11 Ftg/Foundation/Piers Act lnsp Comments AP PC