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HomeMy WebLinkAbout175 PINE AVE; ; CB160169; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Print Date: 06/27/2017 Commercial Permit Permit No: CB160169 www.carlsbadca.gov Job Address:175 Pine Av Permit Type:BLDG-Commercial Work Class:Demo Status:Closed -Finaled Parcel No:Lot U:Applied:01/19/2016 Valuation:$0.00 Reference U:DEV15017 Issued:01/19/2016 Occupancy Group:Construction Type:Finaled: if Dwelling Units:Bathrooms:Inspector: Bedrooms:Orig. Plan Check It: Plan Check U: Project Title:165 PINE AVENUE Description:DEMO -DEMOLISH 2 HOMES ON SAME LOT 165 & 175 PINE AV IN PREPARATION FOR CONDO PROJECT -PC150039 Total Fees:Total Payments To Date:Balance Due: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." 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 you have previously been given a NOTICE similar to this, or as to which the statute of limitation has previously otherwise expired. P t-56 (495 • 566 Q9c CY) el -,__' 1111111111111.1. '7"- THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE:0 PLANNING 0 ENGINEERING 0 BUILDING 0 FIRE 0 HEALTH 0 HAZMATIAPCD rak • gtfna'i'filer%-Building Permit Application Plan Check No.i753(fyq' ,_.City of 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value ' Ph: 760-602-2719 Fax: 760-602-8558 . Carlsbaci email: building@carlsbadca.gov A Plan Ck. Deposit ,16 www.carlsbadca.gov i 4—Datei../6-1 SWPPP I JOB ADDRESS (96 /r..SUITEI/SPACEVUNIT•APN i--Inc-.kit-.9-09 -12-y -01 -00 CT/PROJECT#LOT #PHASE ##OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP g".•3 6.4.5e64-k‘V-g.g 3I U 1 DESCRIPTION OF WORK:Include Square Feetof Affected Area(s)-,..,*, PernoicIViSf%c" -E -c4.0c..61(\51*.;;N6 LAilli on '&4-15V i retnart-t*Isrer,6 ea../te.,s I-t-rv-cs 1 (710.rik...1s•--ct.fv...1.- .5 EXISTING USE PROPOSED USE GARAGE (SF)PATIOS (SF)DECKS (SF)FIREPLACE AIR CONDITIONING FIRE SPRINKLERS asic>usf16:1 c7..,21i-..edr1;41.1 clvi AL4-7 j(_..YESRift No0 YES IA E:1NOElYESNO APPLICANT NAME PROPERTY OWNER NAME Prinatv Contact 5•}40e--1 Fr;f7hrt /ereftl&StimoiliA>1114"The.CRArp..LL-G . ADDRESS ..01.3e ADDRESS6V-lb /AVtit it>e.EaIZArte.t5 1.4,,*_, CITY STATE ZIP CITY 3-7-71 ANk.ntv.......11.0-e... STATE ZIP ...c.r4S6c•-• .....15 •92403 ..0.16...4.0.60...s A.9'-30P PHONE FAX PHONE 'FAX 140 991 -2-14ts slie /13 -'4ssoo EMAIL '4.EMAIL--Ifirix.a.empki-stAvai.rx5:4ne...... cof.-.rio -shccive 0.e31.4.0(r1 DESIGN PROFESSIONAL -•.CONTRACTOR BUS. NAME r=1....c.4 LArauktz.5 13'F'Ate..11A'r.e.,6.I--- refr.c.%. ADDRESS ADDRESS i I te661T eerne.evt.flaw-Gouvi-d4j20 19-1 Avt.nive.ene:A:vms...s'it''Nsirv—s.....eve..4tal.m CITY '.STATE ZIP CITY STATE ZIP PHONE 'SO"971 FAX 1)••••-'2) .9Al2: PHONE .04-1S64.32> FAX GA .9.c0Se fe6ci 6qP--411b st6i<67,9.-Lis -71.4)leri-02.11-11., EMAIL ..t.EMAIL Kra to AGrAi-I ne.... Goin •5tedtelproci-u.150)1Aionsine... 6 2.fet STATE LIC.#STATE LIC.#CLASS CITY BUS. LIC.# 4.15134.9 '916611 APIC4(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 theapplicant 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 theBusiness 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 subjects the applicant to acivil penalty of not more than five hundred dollars ($500)). WORKERS'COMPENSATION Workers' Compensation Declaration:I hereby affirm under penalty of perjury one ofthe following declarations: iI have and will maintaina 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. I have and will maintain workers' cnninonsation an readied by Section :17finnt the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co._pa Atir,itysicRa Ikk1ktislikltE CO .Policy No.Rome.-CAC 5 3 10 4 t Expiration Date to 'O to14 TEIlsection need not be completed if the permit is for one hundred dollars ($100) or less. 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' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (8100,000), in addition to the cost of compensation, damages as provided for'Section 3706 of the Labor code, interest and attorney's fees. ..e5 CONTRACTOR SIGNATURE A.7"0 AGENT DATE 44-i . OWNER -BUILDER DECLARATION I hereby affirm thatlamexempt from Contractor's License Law for the following reason:ElI,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 Code: The Contractors 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 improvementis sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale).pI,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). ElI 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.Dyes EINo .----------....__-__ 2.I (haveI have not) signed an application for a building permit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address I phone/contractors' license number): 4.I plan to provide portions of the work, butI have hired the following person to coordinate, supervise 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): ..ePROPERTY OWNER SIGNATURE DAGENT DATE Inspection History: 01/20/2016: 92-BLDG-Compliance Investigation Approval Completed By PD