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Home My WebLink About2177 VISTA LA NISA; ; CB162165; Permit06-03-2016 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: ASI HASTINGS STE 200 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB162165 Building Inspection Request Line (760) 602-2725 2177 VISTA LA NISA CBAD PME 2552620500 Lot#: 0 FORSYTHE RES-ADD NEW A/C UNIT NO NEW ELECTRIC Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: FORSYTHE FAMILY TRUST 02-17-12 ISSUED 06/03/2016 RMA 06/03/2016 06/03/2016 4870 VIEWRIDGE AV SAN DIEGO CA 92123 619-590-9300 2177 VISTA LA NISA CARLSBAD CA 92009 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Total Fees: $163.00 Total Payments To Date: Inspector: (1,1 • ~.5 $0.00 $0.00 $163.00 $0.00 $163.00 $163.00 Balance Due: Clearance: ------ $0.00 NOTlCE: Rease ta<e NOTlCE that~ cl~ ptjErl irdudes Ire "IJ11Xl,itioo" cl fees, dedcatioos, resavciims, CY c:iha" exoctioos t-ereEdter rolooively rdesred to as "fees'exoctioos." Yoo have 00 days fran Ire date tlis panit 'A0S issued to pretest iJ11Xl,itioo cl trese fees'exoctioos. If yO.J pretest trerr\ yO.J rrust fcilo,v tre pretest p-oced.res set forth in G::M:mrert Cale Sa::iioo ~a), ard file tre potest ard any cther l'Eq.ired infarratia, v.ith tre Oty IVa1ager fer µocessirg in aan-dcrre v.ith Ca1slm Mridpa Cale Sectioo 3.32.03). FaillJ'e to ijrrefy fcilo,v that l)"OClrlre v.ill l:a' any~ legi'i a::iioo to altcd<, re..iew, set aside, vdd, er anj treir iJ11Xl,itim Yoo ere herecy FlRll-ER I\OllRED that~ rigi to pctest tre sp:cifioo fees'exoctioos cx::ES NOT APPLY to v,eter ard -cxmErlioo fees ard ~ cta,ges, ncr plmrg, zorirg, ga:irg er cther sirrila-Wicaia, µocessirg er servire fees in CXJTIErlia, v.ith tlis ptjErl. t--rn cx::ES IT .AJ=H.. Y to any t exoctioos cl ooch have ·a.,s1 been ·ven a NOTlCE sirrila-to tlis er as to vh tre statue ct lirritatioos has ·a.,s1 dherv.ise ·red THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING 0 ENGINEERING □BUILDING QFIRE ~ALlH □>HAZMAT/APCD «'~ Building Permit Application Plan Check No. ( ':10 /6 'A/'7 1635 Faraday Ave., Carlsbad, CA 92008 ------Est. Value ~ C I T Y 0 F Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit CARLSBAD email: building@carlsbadca.gov (M www.carlsbadca.gov '"'Date /,, I ·~ / / /_ lswPPP JOB ADDRESS SUITEf/SPACEf/UNIT, I APN 2177 VISTA LA NISA CARLSBAD 92009 --- CT/PROJECT# I LOT# I PHASE# I # OF UNITS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I occ. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) INST ALL AC, TO AC READY HOME. EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE ! AIR CONDITIONING !FIRE SPRINKLERS YESO NcQ YES □No □ YES□No□ APPLICANT NAME JERMAINE MAEWEATHER PROPERTY OWNER NAME DAVE FORSYTHE Prfnan, Contact ADDRESS ADDRESS 3645 RUFFIN ROAD# 330-335 2177 VISTA LA NISA CARLSBAD 92009 CITY STATE ZIP CITY STATE ZIP san dieqo ca 92123 CARLSBAD CA PHONE IFAX PHONE I FAX 619-590-9337 (858) 449-9991 EMAIL EMAIL JERMAINE@WEGREENINC.COM DESIGN PROFESSIONAL CONTRACTOR BUS. NAME asi hastinQs ADDRESS ADDRESS 4870 viewridge ave CITY STATE ZIP CITY STATE ZIP san dieao ca 92131 PHONE IFAX PHONE 1FAX 619-590-9337 EMAIL EMAIL I STATE UC.# STATE UC.# I CLASS I CITY BUS. LIC.1200804 513115 c20 (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct. alter, improve, demolish or repair ant structure, pnor to its issuance, also requires the applicant for such permit to file a sil(ned 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)). Workers' Compensation Declaration: / hereby affirm under penalty of petjur; 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 pertormance of the work for which this permit is issued. [Z] I have and will maintain workers' compensation, as reQuired bv Section 3700 of the Labor Code, for the pertormance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. CYPRESS INSURANCE COMPANY Policy No. ASWC605204 Expiration Date 9/112016 ~section need not be completed~ the permit is for one hundred dollars ($100) or less. LJ Certificate of Exemption: I certify that in the pertormance 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 a rovided for in Section 3706 of the Labor code, Interest and attorney's fees. JiS CONTRACTOR SIGNATURE I hereby affirm that t am exempt from C.Ontractor's License Law for the lot/owing reason: □ □ □ I, as owner of the property or my employees ..;th wages as their sole compensation, ..;11 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 IMthin one year of completion, the owner-builder .,;11 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 IMth 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. 0 Yes 0 No 2. I (have / have not} signed an application for a building permit for the proposed work. 3. I have contracted 1Mth the follolMng person (fi construction (include name address / phone/ contractors' license number}: 4. I plan to provide portions of the worl<, but I hav rson to coordinate, supervise and provide the major work (include name / address / phone/ contractors' license number): 5. I .,;11 provide some of the work, but I have cont t ( • JiS 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. of the worik this permit 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 correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating 1D building construction. I hereby authorize rep-esentative of the Cily of Carlsbad IO enter upon the atxive mentioned property for inspection purposes. I ALSO AGREE TO SA VE, 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 permtt is required for excavations over 5'0' deep and demolijion or conslruction of structures over 3 stories in height. EXPIRATION: Every penmit issued by the Building Official under lhe provisions of this Code shall expire by limitation and become null and void ~ the ooilding or l'.Orik authorized by such permit is not oornmenre:l v.ithin 180 days from the date of such penmit or if the building orw:ft-a~~ permij is suspended or abandoned at any time after the l'.Orik is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code) . .,@S' APPLICANT'S SIGNATURE t V -DATE - Inspection List Permit#: CB162165 Type: PME Date Inspection Item 07/05/2016 43 AirCond/Furnace Set 07/05/2016 43 AirCond/Furnace Set 07/05/2016 49 Final Mechanical 07/05/2016 49 Final Mechanical Inspector Act MC MC RI AP RI Fl FORSYTHE RES-ADD NEW A/C UNIT NO NEW ELECTRIC Comments