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Home My WebLink About2165 VISTA LA NISA; ; CB150702; Permit03-06-2015 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 150702 Building Inspection Request Line (760) 602-2725 2165 VISTA LA NISA CBAD PME 2552620800 LEGERE: GAS LEAK REPAIR Lot#: 0 Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 03/06/2015 JMA 03/06/2015 03/06/2015 LEGERE CHRISTOPHER D&MINDY B LEGERE CHRISTOPHER D&MINDY B 2165 VISTA LA NISA CARLSBAD CA 92009 760-809-1613 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES 2165 VISTA LA NISA CARLSBAD CA 92009 $160.00 $0.00 $0.00 $0.00 $160.00 Total Fees: $160.00 Total Payments To Date: $160.00 Balance Due: Inspector: fVl. ~,; FINAL APPROVAL Date: 0 zt 0 , /JJ. 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 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 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 of which vou have nreviouslv been niven a NOTICE similar to this or as to which the statute of limitations has nreviouslv otherwice exnired. . □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH 0 HAZMAT/APCD THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: C cicyof Building Permit Application Plan Check No. rf=St_5 · 0 7 Qz_ 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value Carlsbad Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit email: building@carlsbadca.gov www.carlsbadca.gov DateJ/ tp/ IS" lswPPP + • JOB ADDRESS '2_ / {t § 11t~-1a ~ Nr.sn SUITEt/SPACEt/UNITI APN --- --).. 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 Afrected Area(s) ~~ Luk /U-ptt,11 EXISTING USE FIREPLACE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) YESO I AIR CONDITIONING I FIRE SPRINKLERS NcQ m O No O m O NoO APPLICANT NAME PROPERTY OWNER Chr 1-s ~/JA« l ~c.,e.. Primary Contact -'-- ADDRESS ADDRESS I LJ. ,AJ/s V,, ?-t~s-//t~f,.. CITY STATE ZIP CITY t:k If" ~41 STATE{ 4 ZIP </2f;o9 PHONE I FAX PHOO~E 'i ~ ~ ~ /6 \ FAX {)-V7.---13 EMAIL EMAIL /:nrl S' /eq ~vC ~ lu.f-mtt i /. L(JW7 DESIGN PROFESSIONAL CONTRACTOR BUS. NAME V ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE I FAX PHONE I FAX EMAIL EMAIL I STATE UC.# STATE UC.# !CLASS I CITY BUS. UC.# (Sec. 7031.5 Business and Professions Gode: Any City or County which requires a permit to construct, alter, improve, demolish or repair ant 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 fhat 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)). ~t"'TT! < ".,"1'"" ~ •-" •-;;~ '1"X "'-v -V ( .. .,...~'""A"""'b·-"" _ .. "'"-':;'"1ls -~-,._~ ""'' ,..-,~ ' .,. .. ,.,,,.,.,~ !,".',~" ,..,,, • ~-' ~ "1~w~ry~=" .. "'-"1'.,""' -"d' " ~-.-"'✓="''"' .... ..,.~,.,,,, • ~ ~, ,c=r "''.C";r.:';J ~~~~~~~,.I~~~~~c .... ~~~!,~~s~NA_H_~--4-uw..-~"~~fit .. 4w ~; ~ ~, ll. > ¼ ~ ,~~~~J~.::~·l {-,4y~£d!ii,~~4 ~-~~'.t~M.'~4L ?A.~--d~J,~--~~~ .. .,t-H~ Workers' Compensation Declaration: I hereby affirm under penally of perjury one of the following declarations: 8 I have and will maintain a certificate of consent to self-Insure for workers' compensation as provided by Section 3700 ot the Labor Code, for the pertormance of the work lor which this permit is issued. I have and will maintain workers' compensation, as required bv Seclion 3700 of the Labor Code, for the pertormance of the work for which this permit is issued. My workers' compensalion insurance carrier and policy number are: Insurance Co. Policy No._______________ Expiration Date _________ _ ~section need not be completed ff the permit is tor one hundred dollars ($100) or less. LJ Certificate of Exemption: I certify thal in lhe pertormance of the work for which this permit is issued, I shall not empioy any person in any manner so as lo become subjecl lo lhe Workers' Compensalion 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 Section 3706 of the Labor code, interest and attorney's fees. ~ CONTRACTOR SIGNATURE □AGENT DATE I hereby affirm that I am exempt from Conlractor'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 (or sale (Sec. 7044, Business and Professions Code: The Conlractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himsett or lhrough his own employees, provided that such improvemenls are not intended or offered for sale. If, however, the building or improvemenl is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve (or the purpose of sale). , as owner of the property, am exclusively contracting with licensed contractors to construct lhe 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 lhe Contractor's License Law). I am exempl under Section _____ Business and Professions Code for this reason: 1. I personally pian to provide the major labor and materials for construction of the proposed property improvement. 0 Yes 2. I (have I have nol) 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/ phone I contractors' license number): 4. I plan lo 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 / contractors' license number): 5. I will provide some ol the work, but I have contracted (hired) the following persons to provide the work indicated (include name/ address /phone/ type of work): ~ 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. I hereby affirm that there is a construction lending agency for the performance of the woril this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address I certify that I have read the application and Slate that the above information Is oomactand that the information on the plans ls accurate. I agree to oomply'Mth all City ordinances and State laws relating to building construction. I hereby authorize re~tative of the City of Carlsbad to enter upon the above menooned property br inspecoon purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILfTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA perm rt is requred for excavations over 5'CY deep and demolrron or constructon of structures over 3 stories n heght. EXPIRATION: Every permit issued by the Buikling Ofli::ial under the provisi:>ns of this Code shall expire by tmrration and beoome null and voi:l ff the buikling or v.ork authorized by such permit is not commenced v.ithin 180 days from the date of such permrr or if the buildng orv.ork authorized by such permrr is suspended or abandoned at any time after the v.ork is rommenced for a period of 180days (Section 1CX5.4.4 Uniform Buikling Code). _KS 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. C E II T I F I C A T E OF OCCUPANCY /Commcrc,.,1 f'roJCCtS 0 n 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 Carlsbad CA PHONE I FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICKUP: 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 ~ APPLICANT'S SIGNATURE DATE Inspection List Permit#: CB150702 Type: PME LEGERE: GAS LEAK REPAIR Date Inspection Item ----Inspector Act Comments 02/09/2016 29 Final Plumbing RI PM PLEASE 02/09/2016 29 Final Plumbing MC Fl 09/08/2015 23 Gasrr esURepairs MC AP EXTERIOR WALL TO ISLAND 03/09/2015 39 Final Electrical MC WC 03/06/2015 23 Gasrr esURepairs MC PA METER RELEASE CALLED IN TO DEBBIE Wednesday, February 10, 2016 Page 1 of 1