HomeMy WebLinkAbout2617 TOWN GARDEN RD; ; CB054041; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
11-28-2005 Patio/Deck Permit Permit No: CB054041
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
Project Title:
Applicant:
Building Inspection Request Line (760) 602-2725
2617 TOWN GARDEN RD CBAD
PATIO
2131712400
$2,400.00
Lot#: 0
Construction Type: NEW
QOZI RES-160 SF DECK PER CITY
ELEC FOR LIGHTS AND OUTLETS
Owner:
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
Plan Check#:
ISSUED
11/23/2005
LSM
11/23/2005
11/23/2005
QOZI BASILE&SAMIRA J FAMILY TRUST 10-17-02 QOZI BASILE&SAMIRA J FAMILY TRUST 10-17-02
2617 TOWN GARDEN RD
CARLSBAD CA 92009
Building Permit
Add'I Building Permit Fee
Plan Check
Add'I Plan Check Fee
Strong Motion Fee
Renewal Fee
Add'I Renewal Fee
Other Building Fee
Additional Fees
TOTAL PERMIT FEES
Total Fees: $96.55
2617 TOWN GARDEN RD
CARLSBAD CA 92009
$45.79
$0.00
$29.76
$0.00
$1.00
$0.00
$0.00
$20.00
$0.00
$96.55
Total Payments To Date: $96.55 Balance Due:
Inspector: 12 B FINAL APPROVAL
Date 5-"';J.,-3~«{, 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 "lees/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. 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 ttiat 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
f1:u"s1exactiono:. of wtiich vou have nreviouslv been niven a NOTICE similar to this or as to which the stat11te of limitations has nrevio11slv otherwise exnired
FOR OFFICE USE ONLY
PERMIT APPLICATION PLAN CHECK NO. 4fi 059:V'-I-I
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
EST. VAL. _ ____,,,;J.::.,__i;<f_,0,:,.:0:;__ ___ _
Plan Ck. Depositv.._1
Validated By_..,,_~~-~------
Date __ _,i_,l-f(-'2)"'2',._,,_,/µ;)S.,_.-~---
1; P~OJECT INFORMATION v ~ b Irr -J'i,,,., 0
)'.Address {include Bldg/Suite#)
~ ~ • Cv,J?hovi CA:-=&
J Business Name1(at this address)
legal Description lot No. Subdivision Name/Number Unit No. Phase No. Total # of units
Proposed Use
t./ 3
#of Stories # of Bedrooms # of Bathrooms
i, ·u1 lh r
Name Address
3. APPLICANT O Contractor □:Agent for Contractor O Owner
Address
Address
5. CONTRACTOR , COMPANY NAME
City
0 Agent for Owner
City
State/Zip Telephone#
State/Zip Telephone#
City State/Zip Telephone #
Fax#
(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 [$500]).
Name Address City State/Zip Telephone#
State License # _________ _ License Class _________ _ City Business license # _______ _
Designer Name Address City State/Zip Telephone
State License # _________ _
6. WORKERS' COMPENSATION
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.
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. ____________ _ Expiration 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 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 provided for in Section 3706 of the Labor code, interest and attorney's fees.
SIGNATURE /3 ~ &-0~ DATE ________ _
t,l 7. OWNER·BUILDER'DECLARATION , f' I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
Ji3, 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 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 contractor(s) 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.~ YES ONO
2, I (have / ~) 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 I 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)=------------~--------~~-~~-~--------------------------------
F'AOPERTY OWNER SIGNATURE /<? ~ < (5<. eid:::f? DATE _________ _
COMPLEW THIS.SECTION FOR NON-RESIDENTIAL BUILDINQ 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? D YES D NO
Js the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O 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, , . CONSTRUCTION LEND.ING AGENCY
I 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 5'0n 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
any time after the work Is commenced for a period of 180 days (Section 106 4 4 Uniform Bu1ld1ng Code)
PUCANrs sIGNATURE 16 a -:l-,,,..-cS) 6:) I DATE / /. 2-d . "L(Jt? 5-
wHITe: Ftle YELLOW. Apphcant PINK Finance
City of Carlsbad Bldg Inspection Request
For: 08/22/2006
Permit# CB054041
Title: QOZI RES-160 SF DECK PER CITY
Description: ELEC FOR LIGHTS AND OUTLETS
Type: PATIO Sub Type:
Job Address: / 617 TOWN GARDEN R
s 0
calio~-------
Inspector Assignment: BN ---
Phone: 7609189568
Inspector: f!_ P
APPLICANT QOZI BASILE&SAMIRA J FAMILY TRUST 10-17-02
Owner: QOZI BASILE&SAMIRA J FAMILY TRUST 10-17-02
Rema~SE HE~AS ENG REPOR0
--sY
Total Time:
CD Description
19 Final Structural
Act Comment
Requested By: BASIL QOZI
Entered By: KAREN
1l--
-~----
8f ~1. ~ t-tl ~,,./ fo.-r Gkr~e'-&ww;
_ __&_ ___ ~ --------
Comments/Noti~d-
Associated PCRs/CVs Original PC#
lnsQection History
Date Description Act lnsp Comments
07/26/2006 19 Final Structural co RB SEE NOTICE ATTACHED
07/26/2006 29 Final Plumbing AP RB FOR GAS TO B,B_Q. & FIRE PIT
07/26/2006 39 Final Electrical AP RB
12/15/2005 23 GasfTest/Repairs AP BN
12/15/2005 31 Underground/Conduit-Wiring AP BN
11/29/2005 11 Ftg/Foundation/Piers AP BN
11/29/2005 14 Frame/Steel/Bolting/Welding WC BN
11/29/2005 34 Rough Electric WC BN