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Home My WebLink About2726 WILSON ST; ; CB150794; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 03-16-2015 Permit No: CB 150794 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: 2726 WILSON ST CBAD PME 1561 521500 Status: Lot#: 0 Applied: Entered By: Plan Approved: Issued: Inspect Area: Project Title: HAWKINS RES-GAS LINE REPAIR Applicant: HAWKINS WADE P&GEORGINA D 2726 WILSON ST CARLSBAD CA 92008 760-828-7717 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Owner: HAWKINS WADE P&GEORGINA D 2726 WILSON ST CARLSBAD CA 92008 ISSUED 03/16/2015 LSM 03/16/2015 03/16/2015 $160.00 $0.00 $0.00 $0.00 $160.00 Total Fees: $160.00 Total Payments To Date: $160.00 Balance Due: Inspector: FINAL APP~VAL Date: 'j -2 't ~ 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 ou have reviousl en iven a NOTICE similar to this or as to which the tat f limi ati n h I th rwi F THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH O HAZMAT/APCD ( City of 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. CB / :::,-0 7 't PHASE# DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) EXISTING USE APPLICANT NAME Primary Contact ADDRESS CITY PHONE EMAIL DESIGN PROFESSIONAL ADDRESS CITY PHONE EMAIL PROPOSED USE STATE FAX STATE FAX Est. Value Plan Ck. Deposit Date SWPPP SUITEt/SPACEt/UNIU # OF UNITS # BEDROOMS # BATHR MS TENANT BUSINESS NAME GARAGE (SF) PATIOS (SF) 0ECKS (SF) ADDRESS ,;z ZIP EMAIL CONTRA ADDRESS ZIP CITY STATE ZIP PHONE FAX EMAIL STATE UC.# STATE UC.# CLASS 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 anl structure, prior to its issuance, also requires the applicant ror such permit to file a signed statement that he is licensed pursuant to the provisions or the Contractor's License Law (Chapter 9, commending with Section 7000 or Division 3 or the Business and Professions Code} or !hat 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 c1v1I penalty of not more than five hundred dollars ($500)). Workers' Compensation Declaration: / hereby affirm uncle, penalty of peljury one of the following declarations: 0 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 performance of the work for which this permit is issued. 0 I have and will maintain workers' compensation, as reouired by Section 3700 of the Laber Code, tor the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: Insurance Co. ______________________ Policy No. _______________ Expiration Date _________ _ ~ 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 Calrtomia. 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. £S CONTRACTOR SIGNATURE O AGENT DATE I hereby affirm that I am exempt from Contractor's License Law for the following reason: fC7l 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 himsett or through his own employees, provided that such improvements are not intended or offered tor 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 tor the purpose of sale). •. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contracto(s License Law does not apply to an owner of I' -•-1y who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law) . .. • ,empt under Section _____ Business and Professions Code for this reason: " J 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. O Yes 0 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 f phone/ contractors' license number): 4. I plan lo provide portions of the work, but I have hired lhe following person to coordinate, supervise and provide the major work (include name/ address/ phone/ contractors' license number): 5. I • provide some of the work, but I h e conlracted (hired) the following persons to provide the work indicated (inclvde name I address/ phone/ type ot work): DATE f Is lhe 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 lhe Presley-Tanner Hazardous Substance Account Act? Yes No Is lhe 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 tacihty 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 OISTRICT. of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Address I certify thatl have read the application and rate that the above lnfonnation is correct and that the lnfonnation on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize represenlative of the City of Carlsbad kl enter upon the above mentioned property br ilspedion purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CllY OF CARLSBAD AGAINST ALL 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 pelTTI~ is requi"ed br excavations over 5'0' deep and demolition or construction of structures over 3 sklries i1 height. EXP1RATION: Every pelTTiit issued by the Bui • Official under the provisKll1s of this Code shan expire by im~alion and become nun and voi:l ~ the buikling or v.ori< authorized by such permit is not commenced v.ithin 180days from thedateof sudl pe1Tnitorif 'klilgorv.Qlkauthorized , ~such pelTTI~ndedorabandcned at anytime afterthev.011<DisAToomE ~,/periodLo/f 180/~ys/'.~:Kll1100.4.4 Unroon Buikling Code). ~APPLICANT'S SIGNATURE ~ J O J 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 fCommcrcial 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. LIC. 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 ,KS APPLICANT'S SIGNATURE DATE Inspection List Permit#: CB150794 Type: PME Date Inspection Item ____ _ 03/24/2015 23 Gas/TesURepairs 03/24/2015 29 Final Plumbing Wednesday, July 22, 2015 HAWKINS RES-GAS LINE REPAIR Inspector Act Comments PB AP PB AP Page 1 of 1