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Home My WebLink About1027 KNOWLES AVE; ; CB142083; Permit,: 08-20-2014 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: CB142083 Building Inspection Request Line (760) 602-2725 1027 KNOWLES AV CBAD PME 1552713500 Lot#: 0 JOHNSTON RES -REPAIR GAS LEAK Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 08/20/2014 SKS 08/20/2014 08/20/2014 JOHNSTON RICHARD B JR JOHNSTON RICHARD B JR 15106 EASTVALE RD POWAY CA 92064 760-637-5995 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES 15106 EASTVALE RD POWAY CA 92064 $158.00 $0.00 $0.00 $0.00 $158.00 Total Fees: $158.00 Total Payments To Date: $158.00 Balance Due: Inspector: 4ff Date: Clearance: $0.00 NOTICE: Please take NOTICE that approval of your project includes the "I position" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this pennit 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 f s/ex i n f which ou hav vi usl een iven Tl E imilar to hi or as whi h the tatute f limit i ns has r vi I h rwise ex ir d. THE Fa' .. LOWING Afr'ROVAL~ REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH 0 HAZMATIAPCD • «1 Plan Check No. Cf) I L(-Z,0 f3 Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value ~ CITY OF Ph: 760-602-2719 Fax: 760-602-8558 CARLSBAD email: building@carlsbadca.gov Plan Ck. l\eposlt. www.carlsbadca.gov tlF\ Date VJ "U:>f lC/ ISWPPP JOB ADDRESS / __ A SUITEf/SPACEf/UNITt IAPN /6;).7 ,V_. --- CT/PROJECT# I'"" PHASE# I# OF UNITS I# BEDROOMS # BATHROOMS 1 TENANT BUSINESS NAME ICONSTR. TYPE I occ. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) 0'4S le-,.,<. EXISTING USE FIREPLACE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) YES0, rR CONDITIONING I FIRE SPRINKLERS NO□ YES □No □ YES□No□ APPLICANT NAME PROPERTY~ER ~ d Primary Contact 1c.l,-;1:J J.,/4.,/•r-r, ADDRESS ADDRESS f=,4 ...,. 1,1,a 1-A ~ /5;--CL. CITY STATE ZIP CITY /4 STATE qZIP J Q_A,..,, C ,4 -(.,, £ PHONE I FAX P,E '~7--. I FAX , 6tJ-~J ~ C-'?Y\ EMAIL EMAIL DESIGN PROFESSIONAL CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE IFAX PHONE I FAX EMAIL EMAIL I STATE UC.# STATE LIC.# I CLASS I CITY BUS. UC.# (Sec, 7031.5 Business and Professions Code: Any City or C~un_ty which requires a permit to_c~rnstruct, alter, improve, (!emollsh or repair any structure, p_rior to its issuance, also requires the applicant for such per_mIt 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 B_usiness and Professions Code} or that 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 cIvII penalty of not more than five hundred dollars ($500}). ,WORKERS' COMPENSATION -' ' Workers' Compensation Declaration: I hereby affirm under penalty of petjury one of the following declarations: El I have and will maintain a certificate of con1ent 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 workers' comi:iensation, as reoulred bv Secbon 3700 of the Labor Code, for 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 if the permit is for one hundred dollars ($100) or less. LJ Certificate of Exemi:ition: 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 lo 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 Seetlon 3706 of the Labor code, interest and attorney's fees. JiS CONTRACTOR SIGNATURE □AGENT DATE I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: D 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 owr1 employees, provided that such improvements are not intended or offered for _ ~f, 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 contrac~ng 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 pro~ide the major labor and materials for construction of the proposed property improvement. 0Yes 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 I contractors' license number)· 4. I plan lo provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name I 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 I phone I type of work)· /. RS PROPERTY OWNER SIGNATURE □AGENT DATE • ~OM1'LETE T'ius SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY M M M S ' 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. 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 t.o comply with all City ordinances and State laws relating tD building construction. I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspection purp,:,ses. 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: M OSHA perm~ is required for excavations over 5'0' deep and demolrtioo or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Building Official under the provlsKJns of this Code shall expire by limitation and become null and void ~ the blJilding or w:irk authorized by such permit is not commenced 'MIilin 180 days from the date of such perm rt or if the bui · or w:>11< authorized by such permit is suspended or abandoned at any time after the mr1< is rommenced for a perwxl of 180 days (Section 106.4.4 Uniform Buikling Code). ,85.PPLICANT'SSIGNATURE ~ 4 -Lk DATE e-5 o _ / (11 STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. 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. CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAIL TO: CONTACT (Listed above) CONTRACTOR (On Pg. 1) OCCUPANT (Listed above) MAIL/ FAX TO OTHER: _______________ _ ..IS APPLICANT'S SIGNATURE ASSOCIATED CB#------------ NO CHANGE IN USE/ NO CONSTRUCTION CHANGE OF USE/ NO CONSTRUCTION DATE ZIP . . • Inspection List Permit#: CB142083 Type: PME JOHNSTON RES -REPAIR GAS LEAK Date Inspection Item Inspector Act Comments 08/22/2014 23 GasrresURepairs SP AP Wednesday, January 28, 2015 Page 1 of 1