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Home My WebLink About2711 VIA ROBERTO; ; CB160351; Permit02-03-2016 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB 160351 Building Inspection Request Line (760) 602-2725 2711 VIA ROBERTO CBAD PME 1673501600 Lot#: 0 HUL T:REPAIR SEWER IN FRONT OF GARAGE AND PATCH ASPHALT WITH R.O.W. PERMIT Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 01/28/2016 SLE 02/03/2016 02/03/2016 INDEPENDENT PLUMBING HULT KENNETH T&MARY A 2513 VIA ESPARTO CARLSBAD CA 92010 619 920-8858 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES 271 1 VIA ROBERTO CARLSBAD CA 92010 $163.00 $0.00 $0.00 $0.00 $163.00 Total Fees: $163.00 Total Payments To Date: $163.00 Balance Due: FINAL APPROVAL Inspector: Date: Z -(I~/~ Clearance: $0.00 NOTlCE: Rease ta<e NOTlCE that~ cl yOJ ptject irduci3s the "lrrµ::sition" cl fees, deda:tioos, resavaticns, or cths' exactia,s l"a'eelter CXJlledively referred to as "fees'exactioos." Yoo rave 00 days fran the date ths pemit was issw:J to pretest irT'JX)Sitiai cl these fees'exactiais. If you pretest then'\ you rrust fdlON the pretest poo3(i.res set forth in GNerrrrait c.ode Sediai fro20(a), and file the J:)'Otest and cJnf dh8' req..ired infcnretiai wth the Oty MJ"lagel' for ~rg in ro::ada-x:e wth Ca1sboo M.rid~ c.ode Sediai 3.32.030. Fali.re to tirrely fdlON that i::roorl.re wll ta-cJnf subs8:µ:rt legal adia, to attoo<, re,,;ew, set aside, \cid, or cfTU treir irT'JX)Sitim Yoo a-e hereof FlRlrER NOTl RED that y0..r rigi to p-ctest the ~fioo fees'exactia,s IXES I\OT J\PPL Y to v..ater and seNer oainediai fees and ~ty d-a1g95, nor pla-nrg, :zcrirg, gmrg or cths' sirrila-~icatiai ~rg or savioe fees in oornection wth ths ptject. ~ IXES IT J\PPL Y to cJnf fees' widi ·oos1 ·ven a NOTlCE sirrila-to tlis or as to widi the statute cl lirritatia,s has 'a.isl ctha-v.1 . fr::c FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH □HAZMAT/APCD 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 Plan Check No. C6IC.O D3~ / Est. Value I\ Plan Ck. Dep sit SWPPP ----.-----------, Date -Z6-KP JOB ADDRESS 2. SUITE#/SPACE#/UNITI CT/PROJECT # # OF UNITS # BEDROOMS #BATHROOMS TENANT BUSINESS NAME I .3 3 EXISTING USE PRO OSED USE PATIOS (SF) DECKS (SF) PROPERTY OWNER K. DESIGN PROFESSIONAL CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY STATE ZIP CITY PHONE FAX PHONE EMAIL EMAIL STATE LIC. # STATE LIC.# FAX STATE FAX CLASS CON TR. lYPE OCC. GROUP FIRE SPRINKLERS YES□No□ ZIP q"l....Ol 0 ZIP CllY BUS. LIC.# (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 Chat he Is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 1031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)). Workers' Compensation Declaration: / hereby affirm under penalty of perju,y one of the following declarations: I:;! 1, and will maintain a certificate of consent to self-insure for workers' oompensation as provided by Section 3700 of the Labor Code, lor the perfonmance of the work for which this penmit is issued. 1..1:::t'rhave and will maintain workers' compensation, as required Section 3700 of the Labor Code, for the perfonmance of the work for which this penmit is issued. My workers' oompensation insurance arrier and policy number are: Insurance Co. ,Jo{Z._ , Policy No U\I lAJ C.h z.o 3 b-::;--Expiration Date __,_.,_I .,_...___,~._«L..-"5,;>. ~section need not be oompleted if the permit is for one hundred dollars ($100) or less. LJ Certificate of Exemption: I certify that In the perfonmance of the work for which this penmit is issued, I shall not employ any person in any manner so as to beoome 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, da rovided for in Section 3706 of the Labor code, into ttomey's fees. £5 CONTRACTOR SIGNATURE "")E---1----DATE t hereby affirm that t am exempt from Contractor's Ucense Law for the following reason: □ □ □ I, as owner of the property or my employees with wages as !heir sole oompensation, will do lhe 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 oompletion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). I, as owner of the property, am exclusively oontracting with licensed oontractors to oonstruct the project (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and oontracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). I am exempt under Section ____ Business and Professions Code for this reason: 1. I personally plan to provkle the major labor and materials for oonstruction of the proposed property improvement. O Yes O No 2. I (have/ have not) signed an application for a building penmit for the proposed work. 3. I have oontracled with the following person (finm) to provkle the proposed oonstruction (include name address I phone I oontractors' license number): 4. I plan to provide portions of the work, but I have hired the following person to ooondinate, supervise and provide the major work (include name /address / phone / oontractors' license number): 5. I will provide some of the work, but I have oontracted (hired) the following persons to provkle the work indicated (include name I address/ phone / type of work): fi5 PROPERTY OWNER SIGNATURE □AGENT DATE 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? Yes No Is the applicant or future 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. is issued (Sec. 3097 (i) Civil Code}. Lender's Address I certify that I have read the application and state that the above infonnation is conectand that the Information on the plans is accurate. I agree to comply with all City ordinances and State law.; relating to bulldlngconstruction. I hereby aulhorize represenlalive of lhe City of Carlsbad lo enler u~ lhe alx>ve menooned property br inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CllY OF C.ARLSEW) AG!IINST ALL LIABILITIES, JU[X;MENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA perm~ 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 Bwld1ng Offcial under the provisons of this Code shall expire by Imitation and bealme null and void ~ the bu1ld1ng or l',()rl( authorized by sucl1 permit IS not rommenced v.11h1n 180 days from lhe date of sucl1 permit or~·f I g orl',()rl( authorized by such perm~IS suspe a ndioned al any time after the l',()r1( IS oommenoed for a period of 180 days (Seeton 1064 4 Uniform Bu1ld1ng Code). ' -I I ./IS APPLICANT'S SIGNATURE ~ DATE , STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. j c ~"! ( ....:: U P /\ "3 \ f C C !,1 •~J .,_• • c r . ' i-') J '' ' ~ 'l I y I 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. I CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Ca rlsbad CA PHONE I FAX EMAIL OCCUPANT'S BUS. llC. No. DELIVERY OPTIONS PICK UP: CONTACT (listed above) OCCUPANT (listed above) CONTRACTOR (On Pg. 1) MAIL TO: CONTACT (listed above) OCCUPANT (listed above) ASSOCIATED CB# CONTRACTOR (On Pg. 1) NO CHANGE IN USE/ NO CONSTRUCTION MAIL/ FAX TO OTHER: CHANGE OF USE/ NO CONSTRUCTION .kf APPLICANT'S SIGNATURE DATE Inspection List Permit#: CB160351 Type: PME Date Ins ection Item ----- 02/11/2016 22 Sewer/Water Service 02/11/2016 22 Sewer/Water Service 02/11/2016 29 Final Plumbing Friday, February 12, 2016 Inspector Act RI PB AP PB AP HULT:REPAIR SEWER IN FRONT OF GARAGE AND PATCH ASPHALT WITH R. Comments LATE PM PLEASE Page 1 of 1