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Home My WebLink About1537 WHITE SAGE WAY; ; CB122668; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 12-12-2012 Permit No: CB122668 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: 1537 WHITE SAGE WY CBAD PME 0000000000 Project Title: DAGATI: GAS & ELECT TO BBQ & FIREPIT Lot#: 0 Applicant: Owner: GREEN LAND CO 3213 FOSCA ST CARLSBAD CA 92009 760-432-9999 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Total Fees: $185.00 Total Payments To Date: Inspector: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 12/12/2012 JMA 12/12/2012 12/12/2012 $154.00 $31 .00 $0.00 $0.00 $185.00 $185.00 Balance Due: Clearance: $0.00 NOTICE: Please take TICE t at 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 I I x i n f w • h h v r vi I n iv n N Tl i 'I r hi r whi h h f limi i n I h rwi T~E F0LLQ);VING APPROVALS REQUIRED PRIDR TO PERMIT ISSUANCE: □PLANNING 0 ENGINEERING □BUILDING O ARE □HEALTH 0 HAZMAT/APCD ~ «-''» Building Permit Application Plan Check No. CR 12. ?f~ t,,R 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value ~ CITY OF Ph: 760-602-2719 Fax: 760-602-8558 CARLSBAD email: buldllng@carlsbadca.gov Plan Ck. Deposit www.<;_fJrl~badca.gov Date 12-(12,/ /7,,,,, ISWPP JOB ADDRESS 1537 ldf.f 1"~6 :5°t"C~ ~'/ SUITE#/SPACE#/UNIT# IAPN --- CT/PROJECT# I LOT. I PHA:SE # I # OF UNITS I # BEDROUMS # BATHROOMS I TENANT BUSINESS NAME rONSTR. TYPE I occ. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) Gtr5 k-£Lc;C-7 ?""o ~{i) ~ ;=/,,,q;;t?/ 7 EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) 'DECKS (SF) 'FIREPLACE !AIR CONDITIONING I FIRE SPRINKLERS . YES □#_ NO □ YES □ NO □ YES □ NO □ APPLICANT NAME (Primary Contact) ./" ~//9--I P £!!!!,f;> AAI 1 APPLICANT NAME (Secondary Contact) ADDRESS 3 ~ ~ ._./ ' { t/:3 0,5 G,f 6 "? • ADDRESS CITY '-STATE ZIP .a><J CITY STATE ZIP C~:SML> Cfi-~ PHONE I FAX PHONE I FAX EMAIL ltMAIL PROPERTY OWNER NAME ']:>L, --.P-)C>,W ·~, 7)/;f;tl-J:/~ V CONTRACTOR BUS. NAME <:;µ6.N l..-fr~J) ~- ADDRESS 17 7!i:k-< 1 ~ ~ k!/-1 I?°/; 5ttC.6 ./ ADDRESS :::5-1'. 153 -,_ (3t)../:3 r io.s Cfi CITY , STATE ;2-4; CITY STATE ZIP 9~~9' ~~6/t.P e.A-C!fi-AL :56ff .1) e..A- PHONE 3~o ~(q B8e,.5 I FAX PHONE I FAX t:.MAIL lt MAIL ARCH/DESIGNER NAME & ADDRESS ISTATEL6/(,.,q 1..~ _ ~UC.# I CLASS I CITY BUS. UC.# (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 1031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)). !!'Jkers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declaralions: C2f"' I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 or the Labor Code, for the performance of the work for which this perm it is issued. 0 I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the m rk for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co, ______________________ Policy No. _______________ Expiration Date _________ _ This secton need not be completed if the permit is for one hundred dollars ($100) or less. 0 Certificate of Exemption: I certify that in the performance of the or which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Cal~ornia. WARNING: Failure to secure workers' compensation over e i un wful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages s provided for i Secti 7 6 o the Labor code, Interest and attorney's fees. _Ji$ CONTRACTOR SIGNATURE □AGENT DATE I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: 0 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 himself or through his own employees, provided that such improvemenls 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). 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contraclor'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). O I am exempt under Section Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construclion of the proposed property improvement. 0 Yes 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 lhe 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 lo coordinate, supervise and provide the major work (include name/ address/ phone / contractors' license number): 5. I will provide some of the mrk, but I have contracted (hired) the following persons to provide the work indicated (include name I address I phone/ type of work): _Ji$ PROPERTY OWNER SIGNATURE □AGENT DATE Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials regislration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? □ Yes O No Is the applicant or future building occupant required to obtain a penmit 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 work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Address I certify that I have read the application and state that the abol'e infonnation is oorrect and thatthe inlonmation on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building oons1ruction. I hereby authorize representatNe of the City of Car1sbad lo enter upon the above mentioned property l:Jr inspecfun purposes. I Al.SO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST AI..L LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CllY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA perm! is requied for excavations over 5'0' deep and demomion or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Building Ottbal under the provisbns of this shall expire by Imitation and become null and void W the building or l'.O!k authorized by such permit is not comrrenced within 180days from the date of sld1 perm~ or if the buildrig or \\Olk au rized by such perm is spended abandoned at any time after the oork is commenced for a peliod of 180days (Sedioo 100.4.4 Unil:Jrm Building Code). RS 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. CERTIFICATE OF OCCUPANCY fCommerc,;,J J>roJects 0 n I y J Fax (760) 602-8560, Email www.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 ~P: o CONTACT (Listed above) o OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) □ MAIL TO: o CONTACT (Listed above) o OCCUPANT (Listed above) o ASSOCIATED CB# o CONTRACTOR (On Pg. 1) o NO CHANGE IN USE/ NO CONSTRUCTION □ MAIL/ FAX TO OTHER: o CHANGE OF USE / NO CONSTRUCTION ~ APPLICANT'S SIGNATURE DATE Inspection List Permit#: CB122668 Type: PME Date Inspection Item --- 05/14/2013 29 Final Plumbing 12/21/2012 23 Gas/T esURepairs 12/21/2012 31 Underground/Conduit-Wirin Tuesday, September 10, 2013 Inspector Act PY AP PY AP PY PA DAGATI: GAS & ELECT TO BBQ & FIREPIT Comments Page 1 of 1