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Home My WebLink About1161 Chestnut Ave; TP; CBR2019-2372; Permit(City of Carlsbad Print Date: 09/04/2019 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelllng Units: Bedrooms: Project Title: 1161 Chestnut Ave, Tp BLDG-Residential 2052109600 $0.00 Residential Permit Work Class: P/M/E Lot#: Reference#: Construction Type: Bathrooms: Orig. Plan Check #: Plan Check#: Description: GOLDMAN: INSTALL TEMPORARY POWER POLE PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT Total Fees: $175.00 Owner: TRUST GOLDMAN IRWIN AND KIMBERLY FAMILY TRUST 1161 Chestnut Ave CARLSBAD, CA 92008 Total Payments To Date: $175.00 Status: Applied: Issued: Permit Finaled: Inspector: Final Inspection: Balance Due: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." 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 you have previously been given a NOTICE similar to this, or as to which the statute of limitation has previously otherwise expired. Permit No: CBR2019-2372 Closed -Finaled 08/29/2019 08/29/2019 9/4/2019 2:00:24PM $175.00 $0.00 1635 Faraday Avenue, Carlsbad, CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov (cicyof Carlsbad RESIDENTIAL BUILDING PERMIT APPLICATION B-1 Plan Check ---=-.....,__f<.---'--"-J-'-'6/"-'-q~-J.."---'--''-'--V Est. Value PC Deposit -----~--- Date -~)' /,'-"',J.-'-"1.L.;/1'-<J __ • Job Address / / 4/ c/, ~'.'5T,vl/l A /te_ , Suite: _____ APN: __________ _ CT/Project#: ___ -'-_____________ Lot#: ___ _ Fire Sprinklers: yes/ no Air Conditioning: yes/ no BRIEF DEscR1PT10N oF woRK: -~+--"~~-"'~Pl--'::...__,t;""~'---4"'"'---'c~-----'~'--"'cJ'-'-IN'-~ ______________ _ Electrical Panel Upgrade: yes / no □ Addition/New: _____ Living SF, ____ Deck SF, ____ Patio SF, ____ Garage SF Is this to create an Accessory Dwelling Unit? Yes/ No New Fireplace? Yes/ No, if yes how many? __ D Remodel: _____ SF of affected area Is the area a conversion or change of use ? Yes/ No □ Pool/Spa: ____ SF Additional Gas or Electrical Features? ____________ _ □ Solar: ___ KW, ___ Modules, Mounted: Roof/ Ground , Tilt: Yes/ No, RMA: Yes/ No, Battery: Yes/ No Panel Upgrade: Yes/ No D Reroof: ___________________________________ _ D Plumbing/Mechanical/Electrical Only: _ _____.Z:, ..... ✓-'. .. ~~-..... L~------------------ D Other: ____________________________________ _ APPLICANT (PRIMARY CONTACT) PROPERTY OWNER Name: _______________ Name: T40t, I C'°'IC"/o/,ntM> Address: Address: ..,b' .c'-4 ~ uitef d{!~ City: _______ State:. __ Zip: ____ City: (/f,y/£hpi State~ Zip:~2.afo Phone: _________________ Phone: __________________ _ Email: Email: ____________________ _ DESIGN PROFESSIONAL Name: _________________ _ Address: ________________ _ City: ________ State: __ ~Zip: ____ _ Phone: _________________ _ Email: _________________ _ Architect State License: ___________ _ CONTRACTOR BUSINESS Name: (tt\.:tL& rA '( ~ t:" &C Address: ~ LI (<'t, I QI T-C-/l,$1112.."1 IIJ1:::4... City: Lfkrl: I {6,,,,,./ State:O;,. Zip: 9 :£k / Phone: 7tfD~ ~"?-Q}(/0 Email: ___________________ _ State License: d?b'lZ. 72 Bus. License: fZ,UiFJ2 l7S '< .3, (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/she is licensed Pursuant to the provisions of the Contractor's license Law {Chapter 9, commending with SSction 7000 of Division 3 of the Business and Professions Code} or that he/she 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 {$500}). 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov B-1 Page 1 of 2 Rev. 06/18 ( OPTION A): WORKERS'COMPENSATION DECLARATION: lj:Jearby affirm under penalty of perjury one af the following declarations: fJ I have and will maintain a certificate of consent to self-insure for workers' compensation provided by Section 3700 of the Labor Code, for the performance of the work which this permit is issued. □ I have and will maintain worker's compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are; Insurance Company Name: ______________________ _ Policy No. ______________ Expiration Date: _________ _ 0 Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to be come subject to the workers' compensation Laws of California. WARNING: Failure to secure workers compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to$ , 0.00, in addition th o the cos f compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. CONTRACTOR SIGNATURE: ( OPTION B ): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt from Contractor's License 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 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). D 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). D 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. □ Yes □ 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/ 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 J have contracted (hired) the following persons to provide the work indicated (include name/ address/ phone/ type of work): OWNER SIGNATURE: __________________ □AGENT DATE: _____ _ CONSTRUCTION LENDING AGENCY, IF ANY: 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: _____________________ _ ONLY COMPLETE THE FOLLOWING SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY: 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 2S505, 25533 or 2S534 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? D Yes □ No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D Yes D 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. APPLICANT CERTIFICATION: 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 with 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 permit is required for excavations over 5'0' deep and demolition or construction of structures over 3 stories in height. 1635 Faraday Ave Carlsbad, CA 92008 B-1 Ph: 760-602-2719 Fax: 760-602-8558 Page 2 of2 Email: Building@carlsbadca.gov Rev. 06/18 PERMIT INSPECTION HISTORY REPORT (CBR2019-2372) Permit Type: BLDG-Residential Application Date: 08/29/2019 Owner: Work Class: P/M/E Issue Date: 08/29/2019 Subdivision: Status: Closed -Finaled Expiration Date: 03/02/2020 Address: IVR Number: 21418 Scheduled Date Actual Start Date Inspection Type Inspection No. Inspection Status Primary Inspector 09/0412019 09/0412019 September 04, 2019 BLDG-32 Const Service/Agricultural( Temp) 102864-2019 BLDG-Flnal Inspection Checklist Item BLDG-Building Deficiency 102866-2019 Checklist Item BLDG-Building Deficiency BLDG-Plumbing Final BLDG-Mechanical Final BLDG-Structural Final BLDG-Electrical Final Passed Paul York COMMENTS Passed Paul York COMMENTS TRUST GOLDMAN IRWIN AND KIMBERLY FAMILY TRUST 1161 Chestnut Ave, Tp Carlsbad, CA 92008-2512 Re inspection Passed Yes Passed Yes Yes Yes Yes Yes Complete Complete Complete Page 1 of1