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Home My WebLink About1480 CHESTNUT AVE; ; CB004649; PermitV , 12/11/2000 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Spa Permit Permit No:CB004649 Building Inspection Request Line (760) 602-2725 ''a •'''- !; \' Job Address: Permit Type: Parcel No: Reference #: Project Title: 1480 CHESTNUT AV CBAD SPA 2051307800 Lot#: 0 Construction Type: UN DAVARI RESIDENCE IN GROUND FIBERGLASS SPA Applicant: RUBACKY, CHARLES J PO BOX 500233 SAN DIEGO, CA 92150 Status: ISSUED Applied: 12/11/2000 Entered By: MDP Plan Approved: 12/11/2000 Issued: 12/11/2000 Inspect Area: Owner: WIEGAND NEGLIA CORP 1060WIEGAND RD#1601 ENCINITAS CA 92024 Total Fees:$80.00 Total Payments To Date:$0.00 Balance Due: $80.00 Building Permit Other Building Fee TOTAL PERMIT FEES $80.00 $0.00 $80.00 FINAL APPROVAL Date: 2 '/_f'• Of 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 fees/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•4 CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK EST. VAL. Plan Ck. Deposit Validated By Date Acldrfes (include Bldg/Suite #)ddress) Subdivision Name/Number Unit No. Proposed Use Description of Work 2. CONTACT PERSON (if different from applicant) Stories # of Bedrooms # of Bathrooms Name 3. >APPU Address City State/Zip Telephone tt Fax # Name 4. PRQPERT Address "City "Statefop'Telephone # dress City State/Zip Telephone #Name 5._ CONTRACTOR - COMPANY NAME "-,.,„,„,,_ . '". . . » (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 [Chapter 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. £ijyj/iglajipn oiSectiop 7031.5 by any applicant for a permit subjects the applicant to a civil penalty gf/iot rrjgre than fjue_hundreg.dql|aj:£,[$£ Name State License # Address License Class City ' StateTZip City Business License # ^telephone # lyN Designer Name Address City State/Zip Telephone State License # 67 " WORKERS'COMPENSATION "" , . .H .1, Vi 17 Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: [~1 | 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. VS^n have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the-iwork for which this parmifr is• \ • j f/jt/j£j9issued. My worker's compensjjyy insurance c^rrfBr and pplicv number are: *f/// ///•/ji/^xi r\IU/S\/r Insurance Company ,~^^^^^f^r f^r^^r/^r Policy No. Lfff-'f^jl/li/ff (Jfjl I •^expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) / '/ |~l 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'xorniraisation coverage is unlawjfif, and shall subject an employer to criminal penalties and civjKfines up to one hundred thousand dollars ($100,000^/1^ddU^>^^^osto^omjDpnsatiop^^fnages as provided for in Section 3706 of the Labor c<ufe, interest and attorney's fees. SIGNATURE /J£'^^r&&£^£s'&'&(.-*&^'*'J^'' DATE /f^Y f(//tf & 7. OWNER-BUILDER rjECLAR^TION ^ _. „ / ' I he\jby affirm that I am exempt from the Contractor's License Law for the following reason: D l/Ss 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. 7042W 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 hiVqself 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>gar of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). l~l I, as owner oV^he property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Dsw 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 ContractoK^License Law). |~1 | am exempt under SectioX^ Business and Professions Code for this reason: 1. I personally plan to provide the">Hajpr labor and materials for construction of the proposed property improvement. O YES 2. I (have / have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following pers>»n (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 haveS^red 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 IpMPLEtE THIS SECTION FOR /tfdJil^SrMiti|uTii^||EiSMlf S ONLY .,^ ' • Is the applicant or ntture building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections^505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? C] YES Q NO Is the applicant or future bulVjing occupant required to obtain a permit from the air pollution control district or air quality management district? L~] YES Q NO Is the facility to be constructed wjthin 1,000 feet of the outer boundary of a school site? l~l YES CD NO IF ANY OF THE ANSWERS ARE YEsS^FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMBRgENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 8. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending T^ncy for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME \ >. LENDER'S ADDRESS 3;.. APllC^iNiiJERTIFICAflON,, , 77^ ^ "••„. ~" "„.. ,"L. " ~~. " „-,-" I certify that I have read the application and state that the above information is correct and that the information on the plans 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 stories in height. EXPIRATION: Every permit issued by the building Official under the provisionsof this Code shall expire by limitation and become null and void if the. building or work authorized by such permit is not commenced wijhin100 days fcpm the date ofsd^fi permit or if the building or work authorized by such permij/i§ suspe/fded or abandoned at any time after the work is commen/s^^^gg^of 1§o^jaysJSection/f9g?4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE WHITE: File LLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 02/14/2001 Permit# CB004649 Title: DAVARI RESIDENCE Description: IN GROUND FIBERGLASS SPA Inspector Assignment: PD 1480 CHESTNUT AV Lot 0 Type: SPA Sub Type: Job Address: Suite: Location: APPLICANT RUBACKY, CHARLES J Owner: WIEGAND NEGLIACORP Remarks: Phone: 8584862797 Inspectoj^ Total Time: CD Description 59 Final Pool Requested By: CHUCK Entered By: CHRISTINE Act Comments Associated PCRs Inspection History Date Description Act Insp Comments 02/13/2001 59 Final Pool CA PD RESET FOR 2/14 12/21/2000 53 Electric/Conduit/Wiring 12/15/2000 21 Underground/Under Floor 12/15/2000 31 Underground/Conduit-Wiring CO PD ON CARD AP PD AP PD P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE POLICY NUMBER; CERTIFICATE EXPIRES: CITY OF CflRLSPrtD ATTiM; BUILDING S&7-J LAS PALMflC L^lMf. CH <3/W:J -^e.:- -£0 UNIT i'iB; fh.l .'Jl-'e KH f ", This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissionertoittte emplover^narned betow for the policy period indicated. .-,j' . •/.";• k,.... ..'--:• •^.i,^,.;./.;,—-..".., .v,..^^,.-..„,, -. ..',,.-.4^., Vv1!^.: .-• .. ,, .. ft. . . . ^ ^ ^-;.»--. >'-: ; '..-..' .*f*.;-v .'•;.' '-• i •-'--;.^ , . ' this policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer. We will also give you TEN days' advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies. AUTHORIZED REPRESENTATIVE EMPLOYER'S LIABILITY LIMIT .INCLUDING DEfENSC COST";: f; PRESIDENT PER OCCURRENCE. EMPLOYER r CHURL ES RUBPCKY PO BOX speess S8N DIEGO C«.9 MR SCIP10262 (REV. 3-95)'