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Home My WebLink About2690 ROOSEVELT ST; ; CB132677; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 10-29-2013 Sign Permit Permit No: CB132677 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 2690 ROOSEVELT ST CBAD SIGN Status: Lot#: 0 Applied: Valuation: 2031021500 $0.00 Construction Type: NEW Entered By: Reference #: Plan Approved: PC#: Issued: Project Title: MISSION URGENT CARE-6 SIGNS ALL WALL SIGNS -NOT ILLUMINATED Inspect Area: Applicant: DUFF ROBERT A 2003 TRUST 2803 5TH ST NE WASHINGTON DC 20017 760 632-1900 XT 13 Building Permit Add'I Building Permit Fee Plan Check Add'I Plan Check Fee Electrical Fee Renewal Fee Add'I Renewal Fee Other Building Fee Additional Fees TOTAL PERMIT FEES Owner: DUFF ROBERT A 2003 TRUST 2803 5TH ST NE WASHINGTON DC 20017 ISSUED 10/29/2013 RMA 10/29/2013 10/29/2013 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $65.00 $0.00 $65.00 Total Fees: $65.00 Total Payments To Date: $65.00 Balance Due: Inspector: fV\· ~ FINAL Date: Clearance: $0.00 NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservatio11s, 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 connectio11 fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in con11ection with this project NOR DOES IT APPLY to any f x i n f h' h h I iv n N Tl E imil r hi r whi h h t f limi i n h I ... THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING .~. <,((#Ji, ~ CITY OF CARLSBAD aA•••=~(,C( 0 ,Roosev e. Ii Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov Sf-. SUITEf/SPACE#/UNITf □BUILDING □FIRE Plan Check No. t. Value 'f /00 Plan Ck. Deposit Date ID ( b 13 SWPPP LOT# PHASE# # OF UNITS # BEDROOMS # BATHROOMS CONSTR. TYPE OCC. GROUP CRIPTION OF WORK: Include Square Feet of Al'l'ected Area(s) £i5t'id' ~'3"'-" f-o be ~r..._;~ 6 JI ~ /1/ 5 -}'J tJ /lJ I L '-V rf/4_ I h ,1-;-f...-/J EXlSTING USE GARAGE (SF) PPLICANT NAME (Primary Contact) '5~t\.h. ~ 0-.lf"'WI.O-I ADDR~b Cf O J--Oos .w,z, It STAcA-ZIP 1 ::ioo-i FAX ~ o-,w-0.\"'11 PATIOS (SF) DECKS {SF) FIREPLACE YES[), AIR CONDITIONING No[] YES □No□ APPLICANT NAME (Secondary Contact) ADDRESS CITY STATE ZIP PHONE FAX EMAIL CONTRACTOR BUS. NAME J\DDRESS CITY STATE ZIP PHONE FAX EMAIL STATE LIC.# CLASS CITY BUS. LIC.# FIRE SPRINKLERS YES0N00 (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 B_uslness and Professions Code} orfhat he 1s exemP.t therefrom, and the basis for the alleged exemption. Any violation of Section 1031.5 by any applicant for a permitsubiects the applicant to a civil penalty of not more than five hundred dollars {$500)). WORKERS' COMPENSATION Worker,' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 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. D I have and wlll maintain worker,' compensation, as reciuired by Section 3700 of 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, ______________________ Policy No _____________ _ Expiration Date _________ _ ~n need not be completed if the pem1it is for one hundred dollars ($100) or less. ~artffls h f Excmptio.1: 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 (&100,000), in addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, Interest and attorney's fees. \g CONTRACTOR SIGNATURE □AGENT DATE OWNl!R-BUILPER DECLARATION I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: ~ 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 Code: The 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 the burden of proving that he did not build or improve for the purpose of sale) 0 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). ~ I apu!!empt under Section . Business and Professions Code for this reason: \.J...!)>ersonally plan to provkle the major labor and materials for construction of the proposed property improvement. ~Yes ONo 2. I (have/ have not) signed an application for a buikling permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (include name address/ phone/ contractors' license number): 4. I p!an to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name/ address/ phone / 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 I phone/ type of work): g PROPERTY OWNER SIGNATURE ~ AGENT DATE /0 COMPLETE ,THIS SECTION FOR NON-Rl!$1DENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of lhe Presley~Tanner Hazardous Substance Account Acr? Yes No Is the applicant or Mure 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 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. CON ST RU C Tt ON LI! NO ING• AGENCY I hereby affirm that there Is a construction lending agency for the performance of the work this permit Is issued (Sec 3097 (1) Civil Code) Lender's Name Lender's Address APPLICANT C:ERTIFICATION I certify that I have read the appllcatlon and state that the above infoimallon Is correct and that the lnfonnatioo on the plans Is accurate. I agree to mnpt,'Mth all Cily ordinances and State laws relating to building cons1rUcllon. I hereby authorize representative of the City of Cansbad lo enlerupon the al:xlve mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY .AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN AN'/ WAY ACCRUE AGAINST S/<D CITY IN Ca-JSEQUENCE Cf THE GRANTING Cf THIS PERMIT. OSHA: /vi OSHA pennit is requred for excavations over 5'0' deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every peimil issued by the BJilding Official under the provisbns of this Qxle shall expre by IITlitation and beo:lme null and ..,,,kl if the building orv.ork authorized by such permit is not oommenced withll 180 days from the date of such pennit or if the buldhg or ulhorized by such permit is suspended or abanctmed at anytime after the v.ork is commenced for a perbd of 100days (Sec!On 100.4.4 Unitinn BJilding Qxle), ,6 APPLICANT'S SIGNATURE DATE /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 building@carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. DELM:RY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAIL TO: CONTACT (Listed above) CONTRACTOR (On Pg. 1) OCCUPANT (Listed above) MAIL/ FAX TO OTHER: _______________ _ A$ APPLICANT'S SIGNATURE ASSOCIATED CB#------------ NO CHANGE IN USE/ NO CONSTRUCTION CHANGE OF USE/ NO CONSTRUCTION DATE ZIP Inspection List Permit#: CB132677 Date Inspection Item 11/06/2013 38 Signs 11/06/2013 38 Signs Thursday, November 07, 2013 Type: SIGN Inspector Act RI MC Fl MISSION URGENT CARE-6 SIGNS ALL WALL SIGNS -NOT ILLUMINATED Comments AFTER 9AM Page 1 of 1