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Home My WebLink About1821 VALENCIA AVE; ; CB160717; Permit02-24-201 6 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB 160717 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 1821 VALENCIA AV CBAD PME Status: ISSUED 02/24/2016 JMA 02/24/2016 02/24/2016 Parcel No: 2072506300 Lot#: 0 Applied: Reference #: PC#: Project Title: Applicant: SMITH: UPGRADE 100A PANEL TO NEW 200A PANEL GOETHALS ELECTRIC 3701 MIRA PACIFIC DR OCEANSIDE CA 92056-3951 760-805-0465 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Entered By: Plan Approved: Issued: Inspect Area: Owner: SMITH CHRISTOPHER S&ASHLEY D 1821 VALENCIA AVE CARLSBAD CA 92008 $0.00 $38.00 $0.00 $0.00 $38.00 Total Fees: $38.00 Total Payments To Date: $38.00 Balance Due: FINAL Inspector: Date: -...-,;'--'-'~'---'.....;-Clearance: ------ $0.00 r--JCrnCE: Rease ta<e <WM d ya.,: ~ed indudes the "lni:n;itioo" ci fees, doocalicns, resavaticns, CY c:ttu exa::ticns haraEtter roledivay referred to as "fees'exaiiO"S." oo rave 00 da>s fl"OOI the date ths pamt v..as iS5U3d to prctest ini:n;itioo d these fees'exaiiO"S. If ,o.i prctest ttun ,o.i m..st fdlON tt-e p-ctest p-oorl.res set forth in G:Na1Yra"t Code Sectioo 68'.l20(a), !rd file the Jn)test !rd any c:ttu req..iroo infCl1T0tioo wth the Oty rva-agar fCY p-a:essirg in 00'.XTdcrce wth Ca1stm Mridpa Code Sectirn 3.32.cro. Faill.f"e to trrely fdlON thi:d ~ wll ta-any~ legal caioo to attrl. relliew, set aside, vc:id, CY a-nJ their ini:n;itioo. Yoo ere hereof FlRTl-ER f'OTIFIED that ,«Jr rig-( to p-ctest the specified fees'exooicns IXl:.S NOT .APPi... Y to IA0ter !rd sewer cxmedia, fees crd ~ ~-rrr plarrirg, zairg. gcrlrg CY ether sinilar wicalia, p-a:essirg CY savire fees in cxmedia1 wth ths ~ed. I'm IXl:.S IT .AFf'L Y to any i vhdl the statute d lini THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING C_cicyof Carlsbad Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov SUITEt/SPACEt/UNITt □BUILDING □FIRE Plan Check No. Est. Value CT/PROJECT# LOT# PHASE# # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME {3 C}{)(){J() t; i/2/ DESCRIPTION OF WORK: Include Square Feet or Affected Area(s) □HEALTH 0HAZMAT/APCD lb·tn(7 SWPPP CONSTR. TYPE OCC. GROUP EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YESC)#_ N<CJ YES □No □ YES□No□ APPLICANT NAME PROPERTY OWNER Primary Contact ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL DESIGN PROFESSIONAL BU N ME ADDRESS ADD CITY STATE ZIP CITY 0, ✓, c ·e?:r"f ' y PHONE FAX PHONE FAX 7tc:, po_r--tJc;-t r -EMAIL EMAIL /'l'C I . CQh-J STATE LIC. # y?' CLASS c·10 (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve. demolish or repair anl structure. prior to its issuan e al 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 7 00 f Division 3 of the Business and Professions Code} or [hat 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 ($500)). Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D 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. ~I have and will maintain worke(S~Ompensation, ~eqyired ~ 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. 76 Iv E cyC_/1 a:::O rt Policy No, d CO I? p Expiration Date I I-/7-;z_ 01, ~section need not be completed if the permit is for one hundred dollars ($100) or less. LJ 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 Calffomia. 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 Sectl 3706 of the Labor code, interest and attorney's fees. ,/iS CONTRACTOR SIGNATURE □AGENT DATE _;z - I hereby affirm that I am exempt from Contractors License 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 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 improvement is sold within one year of completion, the owner-builder will have the burden of proving thal he did not build or Improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply lo an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractors License Law). 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. 0 Yes 0 No 2. I (have I have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide lhe proposed construction (include name address I phone I 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 / address I phone I 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 I type of work): ,/iS PROPERTY OWNER SIGNATURE DATE Inspection List Permit#: CB160717 Type: PME Date Inspection Item 08/08/2016 39 Final Electrical 08/08/2016 39 Final Electrical 03/08/2016 33 Service Change/Upgrade Tuesday,August09,2016 Inspector Act PY PY RI AP AP SMITH: UPGRADE 100A PANEL TO NEW 200A PANEL Comments Page 1 of 1