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HomeMy WebLinkAbout1630 SANDALWOOD LN; ; CB022318; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 08-13-2002 Residential Permit Permit No: CB022318 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: Applicant: SAM WRIGHT 2911 STATE ST CARLSBAD 92008 720-7631 Building Inspection Request Line (760) 602-2725 1630 SANDALWOOD LN CBAD RESDNTL Sub Type: 2051306000 Lot #: $20,600.00 Construction Type: Reference #: O Structure Type: O Bathrooms: PADILLA RES/200 SF NEW KITCHEN RAD 0 NEW 0 Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: Orig PC#: Plan Check#: PADILLA G RANDEL&LINDA M 1630 SANDALWOOD LN CARLSBAD CA 92008 WITHDRAW 08/08/2002 CB Total Fees: $210.42 Total Payments To Date: $119.85 Balance Due: $90.57 Building Permit Add'I Building Permit Fee Plan Check Add'I Plan Check Fee Plan Check Discount Strong Motion Fee Park in Lieu Fee Park Fee LFM Fee Bridge Fee Other Bridge Fee BTD#2 Fee BTD #3 Fee Renewal Fee Add'I Renewal Fee Other Building Fee Pot. Water Con. Fee Meter Size Add'I Pot. Water Con. Fee Reel. Water Con. Fee Inspector: $184.39 $0.00 $119.85 $0.00 $0.00 $2.06 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Meter Size Add'I Reel. Water Con. Fee Meter Fee SDCWAFee CFD Payoff Fee PFF PFF (CFD Fund) License Tax License Tax (CFD Fund) Traffic Impact Fee Traffic Impact (CFD Fund) Sidewalk Fee PLUMBING TOTAL ELECTRICAL TOTAL MECHANICAL TOTAL Housing Impact Fee Housing lnLieu Fee Master Drainage Fee Sewer Fee Additional Fees TOTAL PERMIT FEES FINAL APPROVAL Date: Clearance: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ($95.88) $210.42 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 Carfsbad 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 . ' . ' ' CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1. PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO.C' Ez,2,:z.,?.;J8 EST. VAL. 20 (/J..aIJ. - Plan Ck. Deposit 1/ c/,PJS Validated?-_ ____.C__.'2~------ Date f2:.. 7-0"'Z- /~3() $A,->OllLcNVc/O Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units LoT S <Jr m1>e No, 57S:7 Assessor's Parcel # Existing Use Proposed Use .2os:. I '30. 4> Q. 0::0 Description of v.:ork J. 2. ~lJr iiRsoN ~~ft.<)~ • ~ s.~. lfferenl from a11plicant) ( II SO. FT. forL. # of Bedrooms 3415 08/081 02 0002 'll I 5/.dc 7-=7'6'631 Name Address State/Zip Telephone# 3. APPLICANT O Contractor O Agent for Contractor ~er O Agent for Owner Name Address City State/Zip Telephone# 6. CONT~CTOR • 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 subjects the applicant to a civil penalty of not more than five hundred dollars [$5001). Name Address City State/Zip Telephone# State License # _________ _ License Class _________ _ City Business License # _______ _ Designer Name Address City State/Zip Telephone State License # _________ _ 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: O 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. 0 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 _____________________ Policy No._____________ Expiration Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS) D 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 ($100,0001, In addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, Interest and attorney's fees. SIGNATURE DATE 7. OWNER-BUILDER DECLARATION --=========-------- 1 hereby af · m that I am exempt from the Contractor's License Law for the following reason: , 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 wi~ne year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). lt)...,-1:" 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(sl licensed pursuant to the Contractor's License Law). D 1 . 2. 3. I am exempt under Section ______ Business and Professions Code for this reason: I person~ provide the major labor and materials for construction of the proposed property improvement. ~NO I (have~ signed an application for a building permit for the proposed work. 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 major work (include name I address I phone number / contractors license number):. ______________________________________________ _ 5. I will provide some of the work, but I have contracted (hired) the fo persons to provide the work indicated (include name / address / phone number/ type of work):. ___________ """",.__-z:i~------~--::::,,"t._-;r--,-------------:ir--:-------------- PROPERTY OWNER SIGNATURE _..(,.a03-~JJ,.....J;,...""""!L..~-.....:\,..J...~::l&~~~------- CQr,,PLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMI S 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 the Presley-Tanner Hazardous Substance Account Act? D YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site 7 0 YES D 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. 6 . CONSTRUCTION LENDING AGENCY 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. APPLIC.l\t,IT CERTIFICATION 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 Cit\! 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 provisions ·s Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within ays from the date o uch per it or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commence rape· d 180 da ( ection 6.4.4 orm B ing Code). ~/e-/,"I-, . APPLICANT'S SIGNATURE __ .(...._p___:----11-J""""'~::::~:::'.~,....ld-~~~!..fl~/-'-.----DATE _ __,_...._,,_ _ __,_~1-.,,-/--"' (U"-=<---;__ __ _ WHITE: File YELLOW: Applicant PINK: Finance /