HomeMy WebLinkAbout2426 WEST RANCH ST; ; CB161393; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing/Mechanical/Electrical (PME) Permit
04-12-2016 Permit No : CB161393
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
2426 WEST RANCH ST CBAD St: MP
PME Status:
Parcel No: 0000000000 Lot#: 0 Applied :
Reference #:
PC#:
Project Title:
Applicant:
TIME WARNER CABLE: 100 AMP
METERED PEDESTAL
ESPINOZA CABLE CONSTRUCTION
1833 RANCHO VILLA RD
RAMONA CA 92065
619 988 3688
Plumbing Fees
Electrical Fees
Mechanical Fees
Other PME Fees
TOTAL PERMIT FEES
Entered By:
Plan Approved :
Issued:
Inspect Area :
Owner:
TIME WARNER CABLE
858-635-8775
ISSUED
04/12/2016
SLE
04/12/2016
04/12/2016
$0 .00
$163.00
$0 .00
$0.00
$163.00
Total Fees: $163.00 Total Payments To Date: $163.00 Balance Due:
Inspector:
FINAL APPROVAL
Date: /fJ ·2½-16 Clearance:
$0.00
NCJTlCE: Rease ta<e N'.JTICE that~ ct ~r prtject indudes tre "ln,n;ition" ct fees, doocalions, resa-vations, or ctrer exa:tions rereafter roledively
referred to as "fees'exa:tions." Yoo have 00 dcfys frcrn tre date tlis ~t v.as issued to pretest in,n;ition ct trese fees'exa::tions. If~ pretest them, ~ rrust
fdlON tre pretest ~ set forth in G:Nerm-ent Code Section 60020(a), a-d file tre prctest a-d arr-/ ctrer re:p..ired infooration wth tre Oty IVa1ager for
pucessirg in oo::rn:la"re wth Ca1sba:J M.ridJ:EI Code Section 3.32.030. FailLre to tirrely fdlON that p-cxro.re wll l::a' arr-/ sublec:µnt 1833i oction to atta:I<,
re.iiew, set aside, -.tid, or arru !tar irrpa;ition.
Yoo ere herecy FlRTI-ER N'.JTIRED that~ rig-t to p-ctest tre si:a:ified fees'exa::tions cx::ES !'Of .APPLY to mer a-d f!l:N-.ff oonned:ion fees ard ~
c:ha"ges, nor plarirg, zairg, ga::irg or ctrer sirrilar wication pucessirg or savire fees in oonned:ion wth tlis prtjed:. f\.cR cx::ES IT .APPLY to arT-f
fees'exa::tions ri wich have ·rus1 been ·va, a NCJTlCE sirrilar to Ins or as to wich tre statute ri lirritctions ras ·rus1 ctrawse ·red.
• THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH 0 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. C,6 I UU ·3
Est. Value
Plan Ck. Deposit
Date
CT/PROJECT# LOT # PHASE# # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s)
2.>Js
EXISTING USE GARAGE (SF) PATIOS (SF) DECKS (SF)
APPLICANT NAME
Primary Contact
ADDRESS
77/0
CITY 5
EMAIL
ADDRESS
CITY
PHONE
EMAIL
C A-12lc .s lo
STATE
FAX
-z..z& c...
ZIP
STATE UC.#
ADDRESS
/f>'/50
CITY 5"-"\ j),-C
PHONE
CONTRACTOR BUS. NAM~
ADDRESS
CITY
EMAIL
STATE UC.# 'Iii 3'89 CLAS~
(_~,
SWPPP
CONSTR. TYPE OCC. GROUP
FIRE SPRINKLERS
YES□No□
(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 (Cha'f.ter 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 703 .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 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 ot the Labor Code, for the performance of the work for which this permit is issued. ~ have and will maintain workers' compensation, as required by 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
numberare:lnsuranceCo. ZNn lr/511/t:wt<>(, ~,..lflrl'l PolicyNo. 4,lf/,/1,/717 ExpirationDate 3--Z.13-:z.017
~section need not be completed rt 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 workers' compensation coverage is unlawful nd 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 ection 3706 oft abor code, interest and attorney's fees.
~ CONTRACTOR SIGNATURE
I hereby a/film that I am exempt from Contractor's Ucense 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 himse~ 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 ves O No
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 / 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 /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 I type of work):
~ PROPERTY OWNER SIGNATURE □AGENT DATE
Is the af.."licant 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 work 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 information is correct and that the information on the plans is accurate. 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 enter upon the above mentioned property br inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD
AGAINST ALL LIABIUTIES, 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 required for excavations over 5'0' deep and demolition or construction of structures over 3 stories in height.
EXPIRATION: Every perm rt issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void ~ the building or v.ork authorized by such permit is not oommenoed y.;thin
180days from the date of such permit or if the building orv.ork au • by such permit is suspended or abandoned at any time after the v.ork is commenced for a period of 180 days (Seeton 106.4.4 Uniform Building Code).
/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 C !._' P f. 0' C " I : o ri 111 c r c i r 1 -7 / fj ; ~· ( 0 .._-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
PICK UP: o CONTACT (Listed above) o OCCUPANT (Listed above)
o CONTRACTOR (On Pg. 1)
o ASSOCIATED CB# MAIL TO: o CONTACT (Listed above) o OCCUPANT (Listed above)
o CONTRACTOR (On Pg. 1) o NO CHANGE IN USE / NO CONSTRUCTION
MAIL/ FAX TO OTHER: o CHANGE OF USE / NO CONSTRUCTION
.Jt5 APPLICANT'S SIGNATURE DATE
Inspection List
Permit#: CB161393 Type: PME
Date Ins ection Item ------
10/24/2016 33 Service Change/Upgrade
10/24/2016 34 Rough Electric
10/24/2016 39 Final Electrical
10/24/2016 39 Final Electrical
Tuesday, October 25, 2016
Inspector Act
PB AP
PB
RI
RI
AP
TIME WARNER CABLE: 100 AMP
METERED PEDESTAL
Comments
Page 1 of 1
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