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HomeMy WebLinkAbout1250 CARLSBAD VILLAGE DR; ; CB010478; Permit02/05/2001 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB010478 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 1250 CARLSBAD VILLAGE DR CBAD MISC Subtype OTHER Lot# 0 $000 COLE LIBRARY MECH ENCLOSURE/ ELECTRIC WORK Applicant HAFNER/BERGMAN CORP, 13745 SEMINOLEDR CHINOCA Owner Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 02/05/2001 MDP 02/05/2001 02/05/2001 Total Fees $000 ,_v t Total Payments To Date $000 \ Miscelaneous Fee #1 'l..'^"- f V ~ ~" ~ - " - „ -~~V ~V~*F*/X Miscelaneous Fee(#2 , " " J > v^ "-/-"""" / '" Balance" Due \ \ \ / i ^ * ' \ / $0 00 \ - , 40 oo , * $000 TOTAL PERMIT FEES - $0 00 Inspector *s7sfa&t*&u^ FINAL APPROVAL Date Clearance __ NOTICE Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions" You have 90 days from the date this permit was issued to protest imposition of these fees/exactions If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3 32 030 Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any Jees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 1. PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total * of units Assessor's Parcel It Existing Use Proposed Use Description of Work 2 CONTACT PERSON (if different from applicant} SQ FT #of Stones of Bedrooms # of Bathrooms iContractor Address City Agent for Contractor(,! GU Owner IQ Agent for Owner State/Zip Telephone # Fax # -7&0 *f$?'/-S/6 Name 4 PROPERTY, OWNER Address City State/Zip Telephone ft Name Address City State/Zip Telephone # B . CONTRACTOR - COMPANY-NAME * "* .' <*' ^ .\ '7 t ( I ' \r "' *( ;,' '.', " ' \ "" -„' ^ » (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 piovisions 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 basts lor the alleged exemption Any violation of Section 7031 5 by any applicant tor a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]) 9/7/O Name State # Address License Class City State/Zip Telephone # City Business License # __J2.//l7£) Designer Name Address City State/Zip Telephone State License # 6 "WORKERS' COMPENSATION -,,_'*., •' ' • J . •"«','. Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations O 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 J0 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 earner and policy number are Insurance Company Policy No Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) 0 CERTIFICATE OF EXEMPTION I certify that in the performance of the work for which this permit is issued, I shall rot 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 DATE 7. OWNER-BUILDER DECLARATION. ^ , - T' ,J, \ !*_ , , , _ ] " T . ' " 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason O 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) 0 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 comractor(s) licensed pursuant to the Contractor's License Lawl 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 f~lNO 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 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 Act7 Q YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES D WO Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? Q YES Cl 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 , *'»,*'" «">»*'< 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 „'"" a ' u« V' -_ !" ', " -' ' ' • * " , I certify that I have read the application and state that the above information is correct and that the information on the plcins is accurate I agree to comply with all City ordinances and State laws relating to building construction I hereby authorize representatives of the CitV 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 stones in height EXPIRATION Every permit issued by the building Official under the provisions of this Code shall expire by limitation and become nulf and void i( 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 clays^Section 106 4 4 Uniform Building Code) APPLICANT S SIGNATURE DATE WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 03/29/2001 Permit# CB010478 Title COLE LIBRARY Description MECH ENCLOSURE/ELECTRIC WORK Inspector Assignment GG 1250 CARLSBAD VILLAGE DR Lot 0 Type MISC Sub Type OTHER Job Address Suite Location APPLICANT HAFNER/BERGMAN CORP, Owner Remarks AM PLEASE Phone 9092087051 Inspector Total Time CD Description 18 Exterior Lath/Drywall Requested By KIRK WILLIAMS Entered By CHRISTINE Act Comments /4P Associated PCRs Inspection History Date Description Act Insp Comments 03/27/2001 18 Exterior Lath/Drywall 03/22/2001 11 Ftg/Foundation/Piers 03/16/2001 31 Underground/Conduit-Wiring 02/22/2001 31 Underground/Conduit-Wiring' 02/21/2001 31 Underground/Conduit-Wiring NR GG NO CONTRACTOR - NO PLANS AP GG AP GG AP GG CIRCLE &J BOX AREA AP GG N OF HANDICAP PARKING ONLY 10/10 'd 606 'ON XW TOOH39 3H1 M 91:60 NOW 1003-50-83^ JftH-30-2001 TUS 01:22 FM THE WOW COMPftNIES , m HO. 809 627 54S JAH-28-2001 FRI 10' 41 Ml FAX HO, P. Ul P. 02/02 dCOfffl. CERTIFICATE OF LIABILITY iNSURANCftu^ ^WODUCW! Strachota Inaiirwaee Agsncy California Llcaaae ftOJ45fi73 435GO Ktdgpa j?ax-fc fc^ivs sea 203OA IJtEUWO COVERAGES BiB Caba Kir nsri2?4sChino Inc. 1713 THIS CERTVlCAfE B t£flUED~A$ A MATTER Of INFORMATION ONLV AND COKPIf I* HO RIGHTS UPON THE CftKTlHCATEHOCOER TM» CERTiTtCATlS DOES NOTAMGNp, EXTEND OR ALTSR TWS COVERAGE AFPORDED 8Y THE POLICIES Bf LOW. INSURERS AFFOKOING COVERAGE Wftfttolioabfcr^giro Insurance C<»,_ liia, Co.1NSJRERB, jusuKflC' jwricaa abates SbafcQ Coapftna.ateion run<i[ iHte fcuaw, or i^aitfKMLC t'STco R€-J&W HAVC QCEN usuto TQ r,ta (MSJRU »*AIJSO wiove FOR THE fOUCY ?6xiuD itioffivw - ' - - ^r,TCTMO«0«NOirfONOFA^«NTn«TCR57>i^ewiJ«^ J. 1HE W£UW|NC€ WJfpTOEB BY T IE PGUt'CB SS5C»Sefi HEM*! ft SUBJECT 70 AU-THE TEfWS, fctCLWS]»ffi WO COM3TT1CWB O? 5-CHAccncijATF UWT9 «HOWN UAY HAVC DCBM (Vioucao Br PAIP ClAMaffic;LflflTS U- i'IV OMT^iCftCtAJ, fiENTVi LWrLFTY xflCOffi,,J 08/31/00 I OB/:il/Ol . j"~l fouayi "1 |jgSfc 1 "]J^QC ! AUTaMDBILtMACtlW C [itl AMY AUTO 11/30/00 11/30/01 «1000000 ¥ p »ll"] X JKWMllW (10600 oirS 09/31/00 08/31/01 O'fiWR 1ST6194-00 05/01/01 2396146 04/OZ/OO •JOflj.CjO J 50000CO•w~* »— ^1 •— .J __L£<^tut41'fs e u ow- VIOOCOQO n.oop,ooo_ MQ-flAPA 04/0hl/01 D*d. $iOO 123735 Cod, iSOO IQOooo *exaapt foe lo dayu CERTIFICATE HOLDER OWLm8^^,MSJRCRLgr7eil. Contractors State £J.e«ipa Dr. ACOftbiS's f7/07) SHWli.6 UW ftp -Hi iBCPrt 6WSPBMD POVJCiES et CAWCtl L£o ftWORETHa fiXMUTiQM OAltTHEWW" TWISSllWKtIMStJaeRVdLLfHSCAVOAtO VUL ^P.J^OW^WRHmH NOTICE TO ThCCUTiriCATU MOk-OiR M4MEB tOTHE LEFT. OUT MlLUM TO DO 30 SfWU, iMf>oac HO OiuruTiam on luemrvsp AHV KurowJUEJsauRER, ITS WEND on t ACofiD CORPORATION I98fl