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HomeMy WebLinkAbout1277 LAS FLORES DR; ; CB101875; Permit10-12-2010 Job Address: Permit Type: Parcel No: Valuation: Reference #: PC#: Project Title: Applicant: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No: CB101875 Building Inspection Request Line (760) 602-2725 1277 LAS FLORES DR CBAD MISC 1561204300 $0.00 GOLDEN: REPAIR 100 SF OF Subtype: REPAIR Lot#: 0 EXTERIOR WALL DUE TO AUTO ACCIDENT//NO REVISION Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 10/12/2010 JMA 10/12/2010 10/12/2010 GOLDEN EDWARD&JOAN REVOCABLE TRUST 05-08-97 GOLDEN EDWARD&JOAN REVOCABLE TRUST 05-08-97 4189 KIMBERLY LN OCEANSIDE CA 92056 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: $130.00 4189 KIMBERLY LN OCEANSIDE CA 92056 PERMIT FEE Total Payments To Date: $130.00 FINAL APPR9VAL Date: '5 /:z,u I I $130.00 $0.00 $0.00 $130.00 Balance Due: 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 "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 ~gal action to attack, review, set aside, void, or annul thGir imposition. You are hereby FURTHER NOT1;:1cD that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection tees 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 feAs/exactions of which vou have oreviouslv been niven a NOTICF slmilar to this or as to which the statute of limitations has oreviouslv otherwise exoired. ~~~ Building Permit Application Plan Check No. Cl? l O \ 8" 7.) ~ CITY OF CARLSBAD ARCH/DESIGNER NAME & ADDRESS 1635 Faraday Ave., carlsbad, CA 92008 76D-602-2717 / 2718/ 2719 Fax: 760-602-8558 www.carl5badc9.gov SUITE#/SPACE#/UNIT # Est. Value Plan Ck. Deposit Date # BATHR TENAr-rf BUSIN CONTRACTOR BUS, NAME ADDRESS STATE PHONE FAX EMAIL STATE UC.# STATE UC.# CLASS SWPP ZIP CllY BUS. UC.# (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 fChacter 9, commending with Section 7000 of Division 3 of the Business and Professions Code} or that he is exem_g_t therefrom, and the basis for the alleged exemption. Arrt violation of Section 7031.5 by any applicant for a pennlt sub.tects the applicant to a civil penalty of not more than five hundred dollars {:ii500}). WORKERS' COMPENSATION Workers' Compensation Declaratton: I hereby 8lfimJ under psna/ty of perjury Otl6 of the foHowlng declar«ions: □ I have and wil maintain a certificate of consent to 1tlf.in1un1 for WOfkers' compensation as prO'llded by Section 3700 of the Labor Code, for the perlormance of the wort for which lhis permit Is issued. □ I have and will maintain workers' compensation, as required by Seclion 3700 of the Labor Code, for the performance of lhe wOl1<. for which this permit Is issued. My workers' compellSUon Insurance canier arKI poicy number are: Insurance Co. Policy No. _____________ Expiration Dale ________ _ This section need not be completed if the permit is for one hundred dollars ($100) or less. D Certificate of Exemption: I certify that In the performance of lhe work fol' which this permit Is issued, l shall not employ any person In any manner so as to become subted to the Workers' Compensation Laws of catilornia. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an empk>yer to criminal penalUes and clvll fines up to one hundred thousand dollll'8i&100,00G), In addition to the cost of compensation, damagea u provided fOf In SecUon 3706 of the Labor coda, Interest and attorney's fffs. A$ CONTRACTOR SIGNATURE □AGENT DATE OWNER-BUILDER DECLARATION I heiJ',l affinn that I am exempt from Contractor's UceM& Law for the foJ/oNfng reason: _, 1, as owner of the property or my employees with wages as their sole compenselion, wm 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 1:11 owner of property who bu~ds 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 0Ylfl8f-builder WIii have the burden of proving that he did not build or improve fol' the purpose of sale). □ I, as owner of the property, am exdusively contracting with licensed contractors to construct the pn)t&CI (Sec. 7044, Business llld Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such prq&Cts with conlractor(s) licensed pursuant to the Contractor's License Law). □ I am exempt under Seclion ____ ~,usiness and Professions Code for this reason: 1. I personally plan to provide Vie major labor and material, for construction of the proposed property improvement. □ Yes □ No 2. I (have I have not) signed an application for a buikling psi-mil for the proposed work. 3.1 have contracted with the folklwlng 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 Vie major work Qnclude name/ addre&S /phone/ contractors' lic:ense number): 5.1 wi~ providi some of the work, but I (hired) the lowing persons to provKle t18 work lndlcated (Include name I address I phone I type of woril;): □AGENT DATE /< COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY Is tf'ie clpplicanl'OI' future builcfng occupant required to submit a business plan, acutely haz&l'dous materials registration form or risk management and prevention program under Sections 25505, 25533 CN' 25534 dthe Pf9Sle't-T anl'IEli' Hazardous Substance Account Ad.? □ Yes □ No Is the applicant or future building occupant required to obtain a permit &om the air pollution control district or air quality management dlswlct? □ 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 SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work lh1s perrmt 1s issued (Sec 3097 (i) Civil Code). Lender's Name lender's AdO"ess APPLICANT CERTIFICATION I certtfythat I have read the appllcatlon and state that the atxwe lnfonnation is correct and that the lnfoonatlon on the plans Is accurate. I agree to complywllh all City oldlnances and State laws relating to bulkllng construcUon. I hel8by aulhorize Jepresenlalile of lhe City of Carisbad t,-upoo lhe above menooned property la nspec1iJn purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS TIE c~ Of CARlSBAll AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN /WY WAY ACCRUE AGPJNST SAID C~ IN CONSEQUENCE Of lHE GRANTING Of lHIS PERMIT. OSHA: M OSHA pem,il o n,qlftd ilr oxcavation, "'" 5U' deep and demollion or oonstrucloo of slruduras CNf/r 3 stJries i1 "'9'- EXPIRATION: Every peimlt issued by lhe Building Offcial oodef the provisbns of this C.ode shall expi'e by lrrlilalion and become nu1 and void if tie buidllQ Of WOik aul'lorlzed by suctt pemit is not conmenced Ydhl 180 days tom lhe dale of sud1 pem,l or ff Ile · """1< aullorizsd by sud1 penni • suspended oraba at any lire after Ile """1< is commenced ilr a period of 180days (Sacllln 106AA lklilJnn BultG Code). _15 APPLICANT'S SIGNATURE DAT£ ---···-----· City of Carlsbad Bldg Inspection Request For: 03/21/2011 Permit# CB101875 Inspector Assignment: TP Title GOLDEN: REPAIR 100 SF OF Description: EXTERIOR WALL DUE TO AUTO ACCIDENT//NO REVISION TO EXISTING STRUCTURE Sub Type: REPAIR --- Type:MISC Phone: 6192797100 Job Address: 1277 LAS FLORES DR Suite: Lot: 0 Location: '""""''? APPLICANT GOLDEN EDWARD&JOAN REVOCABLE TRUST 05-08-97 Owner: GOLDEN EDWARD&JOAN REVOCABLE TRUST 05-08-97 Remarks: A M PLEASE (Called in Thursday) Total Time: CD Description 19 Final Structural Act Comments Requested By: ERIC SMITH Entered By: CHRISTINE -Al!_ _______ _ Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# lns12ection Histo!:)! Date Description Act lnsp Comments 10/25/2010 14 Frame/Steel/Bolting/Welding AP TP 10/25/2010 17 Interior Lath/Drywall AP TP 10/25/2010 34 Rough Electric AP TP 10/19/2010 14 Frame/Steel/Bolting/Welding PA TP NEED EGRESS WINDOW FOR BEDROOM