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Home My WebLink About2222 VISTA LA NISA; ; CB151636; Permitt • City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 05-28-201 5 Permit No: CB1 51636 Bu ildi ng Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: 2222 VISTA LA NISA CBAD PME 2552623000 LAVALLEE: AC CHANGOUT ACTION AIR COND & HEATING-SD 2750 S SANTA FE AV SAN MARCOS CA 92069 760 727 4152 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Lot#: 0 Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 05/28/2015 JMA 05/28/2015 05/28/2015 LAVALLEE MADELEINE L TRUST 03-25-11 2222 VISTA LA NISA CARLSBAD CA 92009 $0.00 $0.00 $160.00 $0.00 $160.00 Total Fees: $160.00 Total Payments To Date: $160.00 Balance Due: Inspector: FINAL APPROVAL Date: ob{':?-:$ {l-5 Clearance: $0.00 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 perrrit 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 nf which vou hav<> nreviouslv been aiven a NOTICE similar tn thi• nr a• to which the statute of limitations has orevinuslv otherwise exniren. THE FOLLOWING AFPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH □HAZMAT/APCD C cityof 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. cal s. l CT/PROJECT# LOT# PHASE# DESCRIPTION OF WORK: Include Square Feet of Atrected Area(s) EXISTING USE APPLICANT NAME Primary Contact ADDRESS C,Oh CITY PH0NE(o EMAIL DESIGN PROFESSIONAL ADDRESS CITY PHONE EMAIL FAX STATE FAX # OF UNITS # BEDROOMS GARAGE (SF) s- ZIP ZIP STATE UC.# Est. Value SUITE•/SPACE•/UNITI # BATHROOMS CONSTR. TYPE OCC. GROUP PATIOS (SF) DECKS (SF) FIRE SPRINKLERS YESO NO□ PROPERTY OWNER e. CITY ZIP PHO FAX EMAIL CONTRACTOR BUS. NAME ADDRESS STATE UC.# 509805 CLASS C..Z.-0 C}·\ (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 {$500)). Wor1<ers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: D,lt;ave 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 w~rl<ers' compensatjqn, as reouired bv Section 3700 of the Labor Code, for the performance of the work for which this opr"!!J. is issued. My workers' compensation in urance rrier and policy numberarelnsuranceCo.\'l\S. D:>~ Ck-~ V\le.'£\--PolicyNo.WSGS02-"\s4'o'::> 0~ ExpirationDale l2-\ (S ~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 California. WARNING: Failure to secure wor1<ers' compensation coverage Is unlawful, and shall subject an employerto criminal penalties and civil fines up to one hundred thousand dollars {&100,000), in addition to the cost of compensation, dama e ed for In Section 3706 of the Labor code, interest and attorney's fees. / ,,g CONTRACTOR SIGNATURE IQ"AGENT I hereby affirm that I am exempt from Contractor's 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 Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himsett 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). 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 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. O Yes ONo 2. I (have/ have not) signed an application for a building permit for the proposed work. 3. I 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, but I have hired the following person to coordinate, supervise and provide the major work (include name I 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/ phone / type of work): JiS PROPERTY OWNER SIGNATURE DATE Is the applicant or future building occupant required to submit a business plan).!(utely 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 ev Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air Quality management district? Yes Gil 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. I hereby affirm that there is a construction lending agency for the performance of the worl< this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address I certify that I have read the application and state that the above infonnation is correct and that the infonnation on the plans is aa:urate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representative of the City of Carlsbad to enler upon the atxJve mentioned property br inspection pulJXlS8S. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CAALSBAD 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 permrt is requi:ed for excavations over 5'0' deep and demoliton or construction of structures over 3 stories n height. EXPIRATION: Every permit issued by the Building Offcial u r the provisons of this Code shall expire by Imitation and become null and 1/Qij ff the building or Y,Orl< authorized by such permit is not commenced wthin 180 days from the dale of such permrt or if the buildng or uthorized by such perm rt is suspended or abandoned at any time after the work-is commenced for a period of 180 days (Seeton 100.4.4 Uniform Building Code). ~APPLICANT'S SIGNATUR Y6./'f-~...a=-...:::= DATE 'c)/ D5 It s STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. CERTIFICATE OF OCCUPANCY /Commcrc,al Proicct, On I y I Fax (760) 602-8560, Email buildinq@carlsbadca.gov or Mail the completed form to City of Cartsbad, Building Division 1635 Faraday Avenue, Cartsbad, California 92008. I CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE I FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) ASSOCIATED CB# MAIL TO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) NO CHANGE IN USE/ NO CONSTRUCTION MAIL/ FAX TO OTHER: CHANGE OF USE / NO CONSTRUCTION ,,t6 APPLICANT'S SIGNATURE DATE Inspection List Permit#: CB151636 Type: PME Date Inspection Item 06/23/2015 43 AirCond/Furnace Set 06/23/2015 43 AirCond/Furnace Set 06/23/2015 49 Final Mechanical 06/23/2015 49 Final Mechanical Thursday, June 25, 2015 Inspector Act RI MC AP RI MC AP LAVALLEE: AC CHANGOUT Comments 8:30 10:30 PLS 8:30 -10:30 PLS Page 1 of 1