HomeMy WebLinkAbout2525 WILSON ST; ; 74-505; Permit~ J j r
BUILDrNG PERMIT APPLICM.-ION
P . ),1 / ...,,-v ✓--City of CARLSBAD, CALIFORNIA 92008 erm1t No ' <... -·1
Applicant· to complete numbereaspaces only. Phone 7 29-1181
JOB ADDA ESS
LEGAL I 1 OUCR,
LOT NO,
OWNU'
2
CON TfltAC TOllt
3
ARCHITECT OR OE51GNtR
4
r OCK
1
--1 TRACT
, / MAIL AOO .. E5S
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~· --MAIL ADDRESS
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MAIL ADOAE55
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tOscc ATTACHED SHEET)
PHONE LICENSE NO.
ENG IN EE flt MAIL AOORE5S PHONE LICCN5E NO,
5
LENOE.flt MAIL AOOJlll[SS 8fllANCH
6
USE 01"" BUILDING
7
8 Class of work: □NEW 0 ADDITION 0 ALTERATION 0 REPAIR □MOVE 0 REMOVE
9 Describe work:
10 Change of use from
Change of use to
11 Valuation of work: $ PLAN CHECK FEE I PERMIT FEE
.. s_P_E_C_I_A_L_C_O_N_D_I_T_I_O_N_S_: __________________ ___, Type of
Const.
1--------------------------------t Size of Bldg. (Total) Sq. Ft.
Occupancy
Group
No. of
Stories
Olvlslon
Max.
0cc. Load
Use Fire Sprinklers
0
~ z "' ll
L. 0
[J)
► 0 0
ll "' VI VI
1-----------,,-----------.-------------4 Fire APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY Zone Zone Required DYes D N o
l ·,..r ..,,. V No. of
_.-, "-./'lo Dwelling Units
NOTICE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB•
ING, HEATING, VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMIN ED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL T HE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
(DAT£)
Special Approvals
ZONING
HEALTH DEPT.
F IRE DEPT.
SOIL REPORT
OTHER (Specify)
OFFSTREET PARKING SPACES:
Covered I Uncovered
Required Received Not Required
' V (/ I WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN Cl-fECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
INSPECTOR
INSPECTION RECORD
DATE REMARKS INSPECTOR
FOUNDATIONS:
SET BACK
TRENCH
REINFORCING
FOUNDATION WALL &
WEATHER PROOFING
CONCRETE SLAB
FRAMING
INT. LATHING OR DRYWALL
EXT. LATHING
MASONRY
'
FINAL 4-2-74 All O.K. to file away T. Mata
USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC.
01-22-2015
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 150204
Building Inspection Req uest Line (760) 602-2725
2525 WILSON ST CBAD
PME
1561301300 Lot#:
KEMMER RES-REPLACE GAS LINE
Status:
0 Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
FROM GAS METER, AROUND GARAGE CORNER & THEN ENTERS IN TO
HOUSE. SDG&E SHUT OFF DUE TO LEAK.
Owner:
ISSUED
01/22/2015
RMA
01/22/2015
01/22/2015
MEDNICKS PLUMBING
862 S. MELROSE DR
VISTA CA
KEMMER LIVING TRUST 07-19-91
181 1 CALIFORNIA ST
OCEANSIDE CA 92054 92081
760-630-424 7
Plumbing Fees
Electrical Fees
Mechanical Fees
Other PME Fees
TOTAL PERMIT FEES
Total Fees: $160.00 Total Payments To Date:
Inspector: Date:
$160.00
$0.00
$0.00
$0.00
$160.00
$160.00 Balance Due:
Clearance:
$0.00
I of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." You have 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 whi h hav reviou I been iven a N Tl E similar t thi or as to which th tatute of limitations has reviousl otherwise ex ired.
' T~WING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING
C_ City of
Carlsbad
JOB ADDRESS
CT/PROJECT# LOT#
Building Permit Application
1635 Faraday Ave., Carlsbad, CA 92008
Ph: 760-602-2719 Fax: 760-602-8558
email: buildjng@carlsbadca.gov
www.carlsbadca.gov
s SUITEf/SPACU/UNIT#
PHASE# # OF UNITS # BEDROOMS # BATHROOMS
□BUILDING □FIRE
Plan Check No.
Est. Value
SWPPP
CONSTR. lYPE OCC. GROUP
EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) AIR CONDITIONING FIRE SPRINKLERS
YESO N0O NoCJ YES ONO □
APPLICANT NAME
Primary Contact
ADDRESS
CITY
PHONE
EMAIL
DESIGN PROFESSIONAL
ADDRESS
CITY
PHONE
EMAIL
STATE
FAX
STATE
FAX
ZIP
~ ; /. ~
co
AD
ZIP ZIP '7 t.c) I
STATE UC.#
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct. alter, improve. demolish or repair an~ structure. prior to Its issu 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 Sectio Business and Professions Code) or {hat he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 703 .5 by any applicant for a permit civil penalty of not more than five hundred dollars ($500)).
Workers' Compensation Declaration: I hereby affirm under penalty of pe,ju,y one of the following declarations:
□ 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 perlormance of the work for which this permit is issued.
~ have and will maintain workers' compensation, a reQuired by Se ion 3700 oft ~r Code, for the perlormance of the work for which this permit is issued. My workers' compensation insurance carrier and policy
number are: Insurance Co. ;./(I-. IV\ ).-,, ... f_ Policy No. s w c... I 0 r1i2? Expiratk>n Date YI :J -/J
~ section need not be completed if the permit is for one hundred dollars ($100) or less. • LJ Certificate of Exemption: I certify that in the perlormance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of
California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in
addition to the cost of compensation, damages as provided for· Sect n 370 of the La •. Interest and attorney's fees.
,If$ CONTRACTOR SIGNATURE O AGENT DATE
I hereby affirm that I am exempt from Confractor'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 Contracto(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 within one year or 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 lo construct the project (Sec. 7044, Business and Professions Code: The Contracto(s License Law does not apply to an owner of
property who builds or improves thereon, and contracts for such projects with contraclor(s) licensed pursuant to the Contraclo(s License Law).
I am exempt under Section _____ ,Business and Professions Code for lhis reason:
1. I personally plan to provide lhe major labor and materials for construction of the proposed property improvement. O Yes • O No
2. I (have f have not) signed an applicalion 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 f phone f 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 I 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 f phone f type of work):
£5 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 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 above information Is correct and that the information on the plans is accurate. I agree to comply"1th 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 for inspection purposes. I ALSO AGREE TO SAVE, 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 permn is required for excavations over 5'0' deep and demolition or construction of structures over 3 stories il height.
EXPIRATION: Every permit issued by the Building Official under e provisions of this Code shall expire by limnation and become null and void ff the building orv.ori< authorized by such permit is not commenced l'oithin
180days from the date of such permit or if the build119 mrk a • such • • suspended or abandoned at any time after the v.oik is commenced for a period of 180days (Section 106.4.4 Uniform Building Code).
Ji5 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 /Commercial Projects On 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. UC. 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
,IS APPLICANT'S SIGNATURE DATE
Inspection List
Permit#: CB150204 Type: PME
Date Inspection Item
01/22/2015 23 Gas/Test/Repairs
01/22/2015 29 Final Plumbing
01/22/2015 39 Final Electrical
Wednesday, January 28, 2015
Inspector Act
PY AP
PY AP
RI
KEMMER RES-REPLACE GAS LINE
FROM GAS METER, AROUND GARAGE C
Comments
EMR
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