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HomeMy WebLinkAbout1251 BASSWOOD AVE; ; CB052864; PermitCity of Carlsbad You are hereby FURTHER NOTIFIED that your right to protest the specified feedexactions 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 08-04-2005 Job Address: Permit Type: Parcel No: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: ORTH GREGORY A 1635 Faraday Av Carlsbad, CA 92008 Building Inspection Request Line (760) 602-2725 1 Demolition Permit Permit No: CB052864 1251 BASSWOOD AVE CARLSBAD CA 92008 1251 BASSWOOD AV CBAD DEMO Full Demo: Y Status: ISSUED 2051 122600 Lot #: 0 Applied: 08/04/2005 Reference #: Plan Approved: 08/04/2005 1 Structure Type: SFD Issued: 08/04/2005 2 Bathrooms: 1 Inspect Area: HOUSE & TEMP POWER POLE Entered By: RMA ORTH RES-DEMO EXIST 850 SF Owner: ORTH GREGORY A 1251 BASSWOOD AVE CARLSBAD CA 92008 Building Permit Plumbing Fee Other Fee Additional Fees TOTAL PERMIT FEES $20.00 $1 0.00 $50.00 $0.00 $80.00 Total Fees: $80.00 Total Payments To Date: $0.00 Balance Due: $80.00 FINALAPP OV L Date: g)t//< Clearance: NOTICE: Please take NdTlCE flat approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as Yeedexactions." You have 90 days from the date this permit was issued to protest imposition of these feedexactions. 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 Cadsbad 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. pr PERMIT APPLICATION c ITY OF 'CARL'S BAD BUILD I NG DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 Addresa (indude BldglSuite #I Business Name FOR OFFICE USE ONL PLAN CHECK NO. Y EST. VAL. _I_ Plan Ck. Deposit Date this address1 (See. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolioh or repeir 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 IChapter 9, commending with Section 7000 of Division 3 of the Business and Professions Codel 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 185001). Statelzip Telephone X Name Address City State License X License Class City Business License X Designer Name Address City Statelzip Telephone State LiCEMe # 0 of the work for which this parmit ie issued. 0 issued. My workw'a compemation insurance carrier and policy number are: Insurance Company Policy No. * Expiration Date 0 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 homo subject to the Workers' Compensation Laws of California. WARNING: F.yW. to wcu. worlruo' wmp.nuOkn wvwclg. la mlnwfd, md rhl rub3.cc n wnpbyu to aimh.l puu)tkc mnd dvU fkur up to OM hundred chouund ddlua ~0100,0001. in addition to tha cost of compmuation, dmmagoa u pr0vid.d for in Section 3706 of the Labor code, Intuut and attomay's fees. SIGNATURE DATE I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason: 0 I. as owner of the property or my employees with wsges as their sole compensation, will do the work and the structure is not intended or offered for sale (Set. 7044, Businrs and Professiom Code: The Contractor's Licenae 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 improvaments are not intended or offered for sale. If, however, the building or improvement is sold d". I ea owner of tho property, am oxdwively contracting with limaed contractors to construct the project (Sac. 7044, Business and Professions Code: The Contractor's License Law does not apply to en owner of property who builds or improver thereon, and contracts foc such projects with contractor(s) licensed pursuant to the Contrsctor'a License Law). 0 1. 2. 3. I have and will maintain a certificate of consent to self-insure for workers' cornpensstion as provided by Section 3700 of the Labor Code, for the performance I have and will maintain workers' compensation, aa required by Section 3700 of the Labof Coda, for the performance of the work for which this pecmit is (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS IO1001 OR USSI ithin OM 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 am enempt under Section I personally plan to provida thm ma@ 1- and materials for construction of the proposed property improvement. 0 YES UNO I (have I hrva not) signed an application for e buildno permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction (include name I address I phone number I contractors license number): Businwa ad Professions Code for this reaaon: 4. number I contractors licenae numbed: 6. 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 I address / Phone I will provide some of the work, but I have contrected (hired) the following persons to provide the work Indicated (include name I address I phone number / type 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 Sactima 26606, 26633 or 26534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES 0 NO Is the applicant or future building occupant required to obtain a permit from the eir pollution control district or air quality management district? 0 YES 0 NO la the facility to be COMtrUcted within 1,OOO feet of the outer boundary of a school site? 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 0 YES 0 NO I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097ti) Civil Code). LENDERS ADDRESS I certify that I have read the application and atate that the above information is correct and that the information on the plam b accurate. I agree to comply with 111 CW ordinancea and State laws relsting to building construction. I hareby authorize representativer, of the Cie of Carlsbad to enter upon the above mentioned property for inapectlon 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 6'0' 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 the date of such permit or if the building or work authorized by such permit is suspendsd or abandoned at any time after the work is co ys (section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE 7/25/06 WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 08/11 /2005 Permit## CB052864 Inspector Assignment: Title: ORTH RES-DEMO EXIST 850 SF Description: HOUSE Type: DEMO Sub Type: Job Address: 1251 BASSWOOD AV Suite: Lot 0 Location: APPLICANT ORTH GREGORY A Owner: ORTH GREGORY A Remarks: CARD ON THE POLE BY SEWER CAP Total Time: Phone: 7606855028 Inspector: Requested By: NA Entered By: CHRISTINE CD Description Act Comment 19 Final Structural Associated PCRs/CVs Date Inspection Historv Description Act lnsp Comments 8- 4-05; 8:POAM;SEMPRA ENERGY ;760 438 6280 # 1/ 1 W .. ec b Id c n 4% .. . .. . 0 3 DEMOLITION ASBESTOS CERTIFICATION ADDRESS: t25l &sdood &re SQUARE FEET x NUMBER& STORIES I PROPERTY OWNER: G<eq ow A. Q r% USE OF BUILDING TO BE DEMOLISHED: dWdi;fi,q ADDRESS: 125\ 6A5586Cnth /k APPLICANT: &ey&W A s ADDRESS: Iz5\ !!!&A 55o~A kw PHONd7- Section 19827.5 of California Health and Safety Code states in part: .--------------------------------------------------------------------------------- “A demolition permit shall not be issued by any city ... as to any building or other structure except upon receipt from the permit applicant of a copy of each written asbestos notification regarding the building that has been required to be submitted to the United States Environmental Protection Agency or to a designated state agency, or both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations, or the successor to that part. The permit may be issued without the applicant submitting a copy of the written notification if the applicant declares that the notification is not applicable to the scheduled demolition project” As applicant for a demolition permit in the City of Carlsbad, I certify that; I have read the excerpt from Section 19827.5 of the Health and Safety Code provided above; the information I have provided on this form is true and correct; and I further certify the following: I i .____----------------------------------------------------------------------------- ( ) Ontheattached pages are copies of all written asbestos notifications regarding the above referenced building that are required to be submitted to the United States Environmental Protection Agency or to Part 61 of Title 40 of the Code of Federal Regulations, or successor to that part. I declare that the written asbestos notification is not applicable to the scheduled demolition project. ( Applicw Signature h:\word\front counter handoutsWemoliion permit requiremenkdoc REV April 19,2004