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HomeMy WebLinkAbout1075 MAGNOLIA AVE; ; CB090754; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 05-06-2009 Miscellaneous Permit Permit No: CB090754 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: 1075 MAGNOLIA AV CBAD MISC 2052702400 $0.00 Subtype: OTHER Status: Lot#: 0 Applied: Entered By: Reference #: Plan Approved: PC#: Project Title: MAASHOFF RES REPLACE/ENLARGE BATHROOM WINDOW-EXISTING HEADER Applicant: Owner: MAASHOFF JOHN E MAASHOFF JOHN E 1075 MAGNOLIA AVE CARLSBAD CA 92008 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: Inspector: $65.00 PERMIT FEE 1075 MAGNOLIA AVE CARLSBAD CA 92008 Total Payments To Date: $65.00 Issued: Inspect Area: Balance Due: Clearance: ISSUED 05/06/2009 KG 05/06/2009 05/06/2009 $65.00 $0.00 $0.00 $65.00 $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. 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 xa in fwhich hv vi I b n ivn N TICE imilr hi r whihth s fli in h I h i C'ity of Carlsbad 1635 Faraday Ave., Carlsbad, CA 92008 71.l0-602-,2717 / 2718/ 2719 Fax: 760-602-8558 www.car1sbadca.gov Building Permit Application JOB ADDRESS CT/PROJECT# LOT# PHASE# DESCRIPTION OF WORK: Include Square eet of Affected Area(s) e #fil:bROOMS Plan Check No(; Est. Value Plan Ck. Deposit Date SUITE# /SPACE# /UNIT# # BATHROOMS TENANT BUSINESS NAME CONSTFf TYPE. DCC.GROUP ow EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES □# __ NOD YES O NO □ YES □ NO □ CONTACT NAME (If Different Fom Applicant) APPLICANT NAME ADDRESS ADDRESS CITY STATE ZIP CITY ZIP 2-"0 f> PHONE FAX EMAIL PROPERTY OWNER NAME CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY ZIP CITY STATE ZIP 'Z-'05 PHONE FAX PHONE FAX EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS STATE UC.# STATE UC.# CLASS CITY BUS. UC.# fSM. 7031.5 Businm and Prof~ui<lns (ode: Any City or Count): which requires a permit to conmucl, _alter/ improve, demolish or reP.air any 1tructure1 prior to its i11uanct, also requires the ap_ptic.,nt for mh permit 10 file a sigi,ed statement that he i1 r.censtd Jl:D!luant to the provisions of tht Contractor's License Law {Chapter 9, commending with Semon 000 or Division J of the Busint11 ;md Pr01mion1 Code} or 1ha1 he is exempt there from, and tht basis for tllt alleged mmp1ion. Any violation or Section 7011.5 by any applicant for a permit subjects the applicant to a civil penalty of not mart than five hundred dolla!l {$500}). WORKERS' COMl'ENSATfON , Workers' Compensation Dectaratlon: 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 wor!(ers' compensation as provided by Section 3700 of the Labor Code, for the performance ol the work for which this permit is issued. D 1 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 worl(ers' compensation insurance carrier and policy number are: Insurance 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 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 en,ployerto crlmlnal penalties and civil fines up to one hundred thousand dollars {&100,000), in addition to !he cos! ot compensation, damages as provided for in Section 3706 of the Labor code, Interest and attorney's tees. ~ CONTRACTOR SIGNATURE DATE I hereby affirm that I am exempt from Contractor's License 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 such work himself or through his own employees, provided that such improvements are not intended or offered for sale. !I, 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 construe! 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 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 I phone/ 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/ contractors' license number): 5. I will provide some of the work, but I h ve contracted (hired) the following persons to provide the work indicated (include name/ address/ phone/ type o/ work)· ls the applicant or lulu re 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 SubstanM Acccunt Act? □ Yes □ No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ Yes □ No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ Yes □ 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 SERVICE;S ANO THE AIR POLLUTION CONTROL DISTRICT. I certify that I have read the application and state that the above infonnation is correct and that the infonnation on the plans is accurate. I agree tocomplywtth all City ordinances and State laws relating to building construction. I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE Cl"TY 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 perm~ is required for excavations over 5'0' deep and demol~ion 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 W the building or work authorized by such permit is not commenced within 180 days from the date of such permit or the building or work auth ·zed by uch rmit is suspended or abandoned at any time after the worl( is commenced for a pe:riod of 180 days (Section 106.4.4 Undonn Building Code). DATE . •.··~ 4_. '4 -~ CITY OF CARLSBAD DATE: 7-/t0 t} o/ ' PERMIT#: L-/50o/()J5'c( Unscheduled Building Inspection Building Department 1635 Faraday Avenue Carlsbad CA . 92008 760-602-2700 INSPECTOR:~~- CONTACT: _____ _ PHONE#: ------- JOB ADDRESS: ____./_O_Z'--"-'-C---'fvl'-,i_VJ-'-"-/'1_0-=-l--'-f.:....:.f1' ______ _ DESCRIPTION: -------------------- CODE I{ 11 ' Bldg Inspection Form DESCRIPTION rflfttf{C ACT COMMENTS A#/- Page 1 of 1 Rev. 06/09 . ' .... D t "'1r bvJ 11.,t 0 )(_ 'c ~ q S'(L \ 5