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Home My WebLink About2732 YORK RD; ; CB150146; Permit01-15-2015 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: REPIPE 1 STE 201 19326 VENTURA BL T ARZANA CA 91356 818-342-2927 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB150146 Building Inspection Request Line (760) 602-2725 2732 YORK RD CBAD PME Status: 1673913700 Lot#: 0 Applied: Entered By: Plan Approved: Issued: Inspect Area: DORNISCH RES-REPIPE HOME WITH PEX -BOTH HOT & COLD WATER-FROM UNDERGROUND TO OVERHEAD Owner: DORN I SCH FAMILY TRUST 06-26-05 2732 YORK RD CARLSBAD CA 92010 ISSUED 01/15/2015 RMA 01/15/2015 01/15/2015 $160.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $160.00 Total Fees: Inspector: $160.00 Total Payments To Date: $160.00 Balance Due: FINAL APPROVAL Date: 2 'z_ ,..IS-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 hav reviousl been iven a NOTICE similar to this or a to which the statute of limitations ha reviousl oth rwise ex ired. THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING C cicyof Carlsbad ioeADDRESs 1... 131--Yori( Rd Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov SUITEI/SPACEI/UNIT# CT/PROJECT# LOT# PHASE# # OF UNITS # BEDROOMS # BATHROOMS DESCRIPTION OF WORK: Include Square Feet of Affected Area(s 1 ___/ {le. p•pe I, V l.\>e 0Prk /)tfJ.T tf- □BUILDING □FIRE Plan Check No. Est. Value SWPPP CONSTR. TYPE OCC. GROUP FIREPLACE YES(]# AIR CONDITIONING FIRE SPRINKLERS YES□No□ Nc:0 YES □NO□ APPLICANT NAME Primary Contact ADDRESS CITY EMAIL u on DESIGN PROFESSIONAL ADDRESS CITY PHONE EMAIL STATE ZIP FAA STATE ZIP FAA STATE UC.# PROPERTY OWNER p i .e, -re r ADDRESS CITY STATE ZIP PH0NE7 bV FAA EMAIL CONTRACTOR BUS. NAME r<e e -j.. ADDRESS I q I 32-b B I CITY 'ICiJ l 011 li STATE (...4 PHONE 81 3 Y I 2-, 2--1 2.. 7 FAA EMAIL STATE UC.# q 1,. 7 g 9 ,z_ CLASS C.J b (3 (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 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 lhat 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 ($5001). -7 ., ., " ~ WORKERS' COMPENSATION ,._,. ,,;= "=~"-" " ,c,;, _.,.,,_,_~maws,,.. M ,., ~ ,;;;w, ,.., •,; o ,_,.,,~,,., = ~-~ /2,, », ~>-="'~=~• -"""""j'"'"''-" S _,. .,>,;v Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Di 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. ~ I have and will maintain worke9-' compensation, as required bv Section 3700 of the Labor Code, for the performance of the wor1( for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. V e. ) L. O Policy No. V w" (., l 1 0 L I 'f I 8 Expiration Date-~~~(_,-____ _ ~section need not be completed if the permit is for one hundred dollars ($100) or less. LJ Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages as provided for in Section 3 6 of the Labor code, interest and attorney's fees . .Ji'$ CONTRACTOR SIGNATURE ll~l!~!~l~lia~ra ~GENT I hereby affirm that I am exempt from Contractor'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 wor1( 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 himsett 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 Yes O No 2. I (have f 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 I address / phone / type of work): .fi'5 PROPERTY OWNER SIGNATURE □AGENT DATE Is the applicant or future building occupant required to submit a business plan, acutely hazardous materi~s 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 a bow infonnation is cormctand that the infonnation on the plans is accurate. I agree to comply..;th all City ordinances and State laws relating to building construction. I hereby authorize representative of the City of Carlsbad to enter upon the aoove mentioned property for inspedion purp,JSeS. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CAALSBAD 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 perm rt is required for excavations over 5'0' deep and demolrtion or construction of structures over 3 stolies i:1 height. EXPIRATION: Every permit issued by the Building Offcial under the provisons of this Code shall expire by limitation and berorne null and YOd ~ the building or v.ork authorized by such permit is not commenced 'hithin 180 days from the date of such permrt or if the buildi:lg orv.orkauthorized by such permrt is suspended or abandoned at any time after the v.ork is commenced for a period of 180 days (Seeton 11:6.4.4 Uniform Building Code). ~ 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. CEf?TIFICATE 0 F occurANCY ( C o m m r.: r c , ., r Pro1ccts 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 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 ~ APPLICANT'S SIGNATURE DATE Inspection List Permit#: CB150146 Date lnspec!!on Item 01/29/2015 29 Final Plumbing 01/29/2015 29 Final Plumbing 01/23/2015 24 Rough/Topout 01/23/2015 24 Rough/Topout Friday, January 30, 2015 Type: PME Inspector PB PB Act RI AP RI AP DORNISCH RES-REPIPE HOME WITH PEX -BOTH HOT & COLD WATER-FROM Comments Page 1 of 1