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Home My WebLink About1740 CATALPA RD; ; CB033535; Permit12-17-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB033535 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 1740 CATALPA RD CBAD MISC 2155160200 $000 Subtype OTHER Lot# 0 GREENE RES REMOVE CEDAR SHAKE Status Applied Entered By Plan Approved Issued Inspect Area ADD STUCCO, MISC ELEC AND CHANGE OUT BAY WINDOW Applicant WORTHING INC, B A SUITE #201 690 CARLSBAD VILLAGE DR CARLSBAD, CA 92008 619-729-3965 Owner GREENE STEPHEN&KAREN K 1740 CATALPA RD CARLSBAD CA 92009 ISSUED 12/17/2003 SB 12/17/2003 12/17/2003 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE ELEC FEE $60 00 $2000 $000 $3000 Total Fees $8000 Total Payments To Date $000 Balance Due $8000 1212 .12/17/03 000? 0^ 02 Inspector FINAL APR 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 imposilion 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 ;onnection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NORCOES IT APPLY to any fees/exactions of which vou have previously been qiven a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired PERMIT APPLICATIONj» CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 'I"?' PROJECT INFORMATION "T"'Ll > ™ , "" ^ ~ ™ ~ "s s FOR OFFICE USE ONLY PLAN CHECK 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 #Existing Use Proposed Use Description of Work £eJUv- ^ i o<v CONTACT PERSON (if different from applicant}Som-e FT <~*&\,/ Stones of Bedrooms of Bathrooms Name Address City *3 "'l> APPLICANT QjCantractar "Q'Agent fortontractor Q Owner ,Q Agent,for Owner', PQ So* }f^4t DxHSbcid State/lip Telephone # CA Address City State/Zip Telephone ft it ( State/ZipNameAddressty Telephone # , 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 Code] 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 sublets the applicant to a civil penalty of not more than five hundred dollars IS500]) &A WoK-M^ m A. Xrvr PQ aox io-Hl Cjourtetaxrj Co. /gjaoifc C-7CgO")-7p^ - Name State License #1 (-£> *\ Address License Class City State/Zip Telephone City Business License # .1 Po 04 C-iuo^ Designer Name State License # 3 ^j 3, % °[ -^ Address City State/Zip Telephone Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations n 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 ^T 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 carrier and policy number are Insurance Company 5'T'A^A--£^ PLAVV-fA. Policy No COOQ~l"1 ^? ^^OQ^J Expiration Date j [ — Q *4 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS) O CERTIFICATE OF EXEMPTION I certify that in the performance of the work for which this permit is issued, I shall not omploy 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 [SIOJMrtJpi, in addtjioo to the castgf-eSmpensation damages as provided for in Section 3706 of the Labor code, interest and attorney's fees SIGNATURE /^^S,^JrfA/M A cost ot-cfimp SEC1ARATION I hereby affirm that I am exempt from the ebntfector s License Law for the following reason C] 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 Cbde Tne 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 trie burden of proving that he did not build or improve for the purpose of sale) Q 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 contractor(s) licensed pursuant to the Contractor's License Law) Q 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 Q YES QNO 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 mEi)or 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 .COMRLETE.THISSECTION^FOR/VO/V-flfS/OflVrMt BUILDING PERMITS ONLY . „„ ' _ ' ,„, ," \ , ,sl,\ ~ .»',">, > , .U/> ,VrS „* 1 !j Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration foim or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 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 Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site' Q YES (3 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 ' ,' ' ' „ .' '\ ',_''„ , ' ' ," "' ' l' ' , i J, " ,',',' "" ' ' ", " ' 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 jl . ._ "" ' ,' ""_ _' '."_"'' "'L " " '* „" '" ." ' " 1 "!'~ ' VT"". , f^, ,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 stones 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 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 ts comrngpeeS^for a period of 180days (Section 106 4 4 Uniform Building Code) APPLICANT'S SIGNATURE DATE WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 02/11/2004 Permit* CB033535 Inspector Assignment JM Title GREENE RES REMOVE CEDAR SHAKE Description ADD STUCCO, MISC ELEC AND CHANGE OUT BAY WINDOW Type MISC Sub Type OTHER Phone 7607293965 Job Address 1740 CATALPARD Suite Lot 0 —r\ Location Inspector ^UA APPLICANT WORTHING INC, B. A. Owner GREENE STEPHEN&KAREN K Remarks Total Time Requested By TERESA Entered By CHRISTINE CD Description Act Comment 19 Final Structural Associated PCRs/CVs Inspection History Date Description Act Insp Comments 01/15/2004 18 Exterior Lath/Drywall AP JM 01/15/2004 84 Rough Combo WC JM lCYHOLDER COFV, PO BOX 307, SAN FRANCISCO.CA 94142-QB07 S UR ANC6 FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE O1-O1-2002 COUNTY OF SAN 01 EGO ATTNi BUILDING DEPARTMENT 5201 RUFF IN ROAD, SAN DIEGO CA 92123 SD GROUP 000048 POLICY NUMBER- OOO877S-20O3 CERTIFICATE IO 5 CERTIFICATE EXPIRES Q1-O1-20O4 Ol-Q*-2003/01-01-2004 JOBI ALL OPERATIONS This is to certify that wg have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated This policy is not subject to cancellation by the Fund except upon 30 days' advance written notice to the employer We will also give ypu 3O 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 lisfed 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 fnsurjihce afforded by the policies described herein is subject to all the terms exclusions and conditions of such policies ^ AUTHORIZED REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS- $ 1,OOO,OOO.OO PER OCCURRENCE ENDORSEMENT ¥2063 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE O1-01-2OO& IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER B A. WORTHING, INC. PO BOX 10M CARLSBAD CA 92018 PRINTED 12-13-2002 P0409