HomeMy WebLinkAbout1265 LAUREL TREE LN; ; CB120568; Permit04-02-2012
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Miscellaneous Permit Permit No: CBI20568
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
PC#:
Project Title:
1265 LAUREL TREE LN CBAD
MISC
2120407100
$2,000.00
Subtype:
Lot#:
OTHER
0
24 HOUR FITNEES
INSTALL DORR BETWEEN HHRS AND PAYROLL ROOMS
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
04/02/2012
MDP
04/02/2012
04/02/2012
Applicant:
PALOMAR FITNESS PARTNERS L P
Owner
PALOMAR FITNESS PARTNERS L P
501 SANTA MONICA BLVD #312
SANTA MONICA CA 90401
501 SANTA MONICA BLVD #312
SANTA MONICA CA 90401
Miscelaneous Fee #1
Miscelaneous Fee #2
Additional Fees
TOTAL PERMIT FEES
PERMIT $130.00
$0.00
$0.00
$130.00
Total Fees: $130.00 Total Payments To Date: $130.00 Balance Due: $0.00
EXPIRED PERMIT
DATE SI6MATURI
Inspector:
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 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 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
fees^exactions of which vou have oreviouslv been Given a NOTICE similar to this, or as to which the statute of limitations has previously othen»ise expired.
CITY OF
CARLSBAD
Building Permit Application
760-602-2717/2718/2719
Fax 760-602-8558
www.carlsbadca.gov
Plan Check No. (^O'SbV
Est. Value
Plan Ck. Deposit
Date SWPPP
JOB ADDRESS SUITE«/SPACE*/UNrr*
CT/PROJECT # # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME
HOOT fiWss. C^»\sc)
CONSTR. TYPE OCC. GROUP
DESCRIPTION OF WORK: /nciud* Square Faat of Attectad Ana(s) .
EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE
YES|~|*. N0| I
AIR CONDITIONING
YES I INO I I
FIRE SPRINKLERS
YES I |N0| I
APPLICANT NAME (Primary Contact) APPLICANT NAME (Secondary Contact)
ADDRESS
CITY , STATE ZIP
ADDRESS
CITY STATE ZIP
PHONE/' X FAX/" -v
EMAIL T
PHONE FAX
IERNAME^^"^^^"
EMAIL
PROPERTY OWNER NAME CONTRACTOR BUS. NAME
ADDRESS ADDRESS
CITY STATE ZIP CITY STATE CA ZIP
PHONE FAX PHONE,
EMAIL EMAIL
^ I n AQC I pnv Qi ic ARCH/DESIGNER NAME & ADDRESS CrtYBUS. LIC.#
(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 permitto 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 appllcantfor a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)).
WORKERS' COMPENSATION
Workers' Compensation Declaration: / hereby aMrm under penalty of petjuiy one ofthe following dedaratlons:
• I have and will maintain a certificate of consent to seif-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the perfbnnance of the woric for which this permit Is Issued,
.^have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the perfomiance of the work for which this permit Is Issued. My workers' compensation Insurance earner and policy
number are: insurance Co ^MCO^lT'^ A^YtdA/A^ 3?tAh<ft^ll/te#Pollcv No ^UjQ. tOQ^3£^ j Expiration Date
Bsection need not be completed if the perniit Is for one hundred dollars ($100) or less.
Certificate of Exemption: i certify that in the perfomiance of the work for which this pemnit is issued, 1 shall not employ any person in any manner so as to become subgect to the Workers' Compensation Laws of
California. WARNING: Failure to secure workan' compensation coverage is unlawful, and shall subject an employer to criminal penalties and cMi fines up to one hundred thousand dollars (&100,000), in
addition to the cost of compensation, damages aa provided for in Section 3706 of the Labor code, interest and attorney's fees.
JS^ CONTRACTOR SIGNATURE
OWNER-BUILDER DECLARATION
• AGENT DATE
/ heretiy affirm (/ia( / am exempf from Contractor's License Law for the follamlng reason:
I I 1, as owner of the property or my employees with wages as their sole compensatnn, will do the work and the structure Is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's
Lksnse Law does not apply lo an owner of property who bulUs or improves thereon, and who does such work himself or through his own empbyees, provkled that such Impmvements are not intended or offered for
sale, if, however, the buiUIng or Improvement Is sokl within one year of completion, the owner-builder will have the burden of proving that he did not bulM or improve for the purpose of sale).
I I 1, as owner of the property, am exclusively contracting with ikxnsed 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).
I [ I am exempt under Section Business and Professions Code for this reason:
1.1 personally plan to provide the major labor and materials for construdkin of the proposed property Improvement Yes I iNo
2.1 (have / have not) signed an appllcatbn for a building perniit for the proposed work.
3.1 have contracted with the folkiwing person (flrni) to provide the proposed construction (Include name address / phone / contractors' Iteense number):
4.1 plan to provkle portions of the work, but 1 have hired the following person to coordinate, supen/lse and provide the major work (Include name / address / phone / contractors' license number):
5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (Include name / address / phone / type of work):
>erPROPERTY OWNER SIGNATURE •AGENT 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 Ibrm or risk management and prevention program under Sectons 25505,25533 or 25534 of the
Presley-Tanner Hazardous Substance Account 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 constnicted 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 SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
CONSTRUCTION LENDING AGENCY
I hereby affiim that there Is a construction lending agency for the perfomiance of the work this pennit is issued (Sec. 3097 (i) Civil Code).
Lender's Name Lender's Address
APPLICANT CERTIFICATION
I cettiiy that I have read the appllcatkm and Slate that the above Infbrnratlon Is collect and that the inlbmiatim
I hereby authorize repiBsentatlve of the City of Carlsbad to enter upon Ihe above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEIMNIFY AND KEEP HARMLESS THE CRY OF CARLSBAD
AGAINST ALL LIABILmES, JUDGI«ENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT
GSHA An OSHA peimit is required Ibr excavations over S'O' deep and demolition or construction of stmctures over 3 stories In height.
EXPIRATION: Every permit issued by the Building Officjajitfhder (he provisions of Ihls Code shall expire by limitation and become null and void if the building or mk authorized by such perniit is not oommenoed vtilhin
180 days fiom the date of such pennit or If Ihe bdldiiMrwoik authorized by such perniit is suspended or abandoned at any time after the w»k is commenced Ibr a period of 180 days (Section 106.4.4 Unilbmi Building Code).
>eS'APPLICANT'S SIGNATURE DATE ^^Jt-^O/^
STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE.
Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection.
Fax (760) 602-8560, Email www.buildinofllcaijsbadca.oQV or Mall the completed fbmi to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, Califbmia 92008.
C0#: (Office Use Only)
CONTACT NAME OCCUPANT NAME
ADDRESS BUILblNdAbDi^^
CWf StATt Zlt-CitY STATE ZIP
Carlsbad CA
PHONE I^AX
EMAIL OCCUPANT'S BUS. LIC. No.
DEUVERY OPTIONS
PICK UP: CONTACT (Listed above) OCCUPANT (Listed above)
CONTRACTOR (On Pg. 1)
MAIL TO: CONTACT (Listed above) OCCUPANT (Listed above)
CONTRACTOR (On Pg. 1)
MAIL/FAX TO OTHER:
ASSOCIATED CB#
NO CHANGE IN USE / NO CONSTRUCTION
CHANGE OF USE / NO CONSTRUCTION
ASSOCIATED CB#
NO CHANGE IN USE / NO CONSTRUCTION
CHANGE OF USE / NO CONSTRUCTION
^APPLICANT'S SIGNATURE DATE
RECORD COPY nooefM
August 1, 2012 Permit Number: CB120568
Issue Date: 04/02/2012
CHARLES JOHNSON
15354 BONANZA RD STE B
VICTORVILLE CA 92392
RE: BUILDING PERMIT EXPIRATION ADDRESS: 1265 LAUREL TREE LN
PERMIT TYPE: INSTALL DOOR PLEASE CALL FOR AN INSPECTION IF WORK IS
COMPLETE
Our records indicate that your building permit will expire by limitation of time on 09/29/2012.
The provisions of CBC, Section 105.5 as amended by the Carlsbad [\/Iunicipal Code state:
"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 worl< authorized by such permit is
not commenced within one hundred eighty calendar days from the date of such permit, or If the
building or work authorized by such permit is stopped at any time after the work Is commenced for
a period of one hundred eighty calendar days, or if the building or work authorized by such permit
exceeds three calendar years from the issuance date of the permit. Work shall be presumed to
have commenced if the permittee has obtained a required inspection approval of work authorized
by the permit by the Building Official within one hundred eighty calendar days of the date of permit
issuance. Work shall be presumed to be stopped if the permittee has not obtained a required
inspection approval of work by the Building Official within each one hundred eighty day period upon
the initial commencement of work authorized by such permit.
Before such work can be recommenced, a new permit shall be obtained to do so, and the fee
therefore shall be one half the amount required for a new permit for such work, and provided that
no changes have been made or will be made in the original plans and specifications for such work,
and provided further that such suspension or abandonment has not exceeded one year. In order to
renew action on a permit after expiration, the permittee shall pay a new permit fee.
Any permittee holding an unexpired permit may apply for an extension of time within which work
may commence under that permit when the permittee is unable to commence work within the time
period required by this section for good and satisfactory reasons.
Please check below indicating your intentions and return this letter to us.
Project abandoned. A new permit will be obtained prior to commencing work.
No fee extension requested for 180 days, (must attach a letter of explanation)
Renewal permit requested.
If the project has been completed and only a final Inspection is needed, please call the inspection
request line at 760-602-2725.
If you have any questions, please contact the Building Inspection Department at 760-602-2700.
Janean Hawney
Office Specialist
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