HomeMy WebLinkAbout1168 Oak Ave; ; CBR2017-2920; Permiti)' City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Print Date: 01/08/2018 Residential Permit Permit No: CBR2017-2920
Job Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Group:
# Dwelling Units:
Bedrooms:
Project Title:
Description:
1168 Oak Ave
BLDG-Residential
1561800900
$0.00
www.carlsbadca.gov
Work Class: P/M/E
Lot#:
Reference #:
Construction Type:
Bathrooms:
Orig. Plan Check#:
Plan Check#:
HICKEY: REPLACE 40 GALLON WATER HEATER, SAME LOC
Owner:
Status:
Applied:
Issued:
Fina led:
Inspector:
Contractor:
Closed -Finaled
12/07/2017
12/07/2017
TFraz
ELIZABETH HICKEY
1168 Oak Ave
CARLSBAD, CA 92008
760-729-4799
AFFORDABLE WATER HEATERS AND
PLUMBING INC
PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT
Total Fees: $98.00 Total Payments To Date: $98.00
28358 Constellation Rd, 698
Valencia, CA 91355-5044
661-259-7131
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.
$0.00
$98.00
Tlj FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: 0 PLANNING D ENGINEERING
C cifyof
Carlsbad
JOB ADDRESS
Building Permit Application
1635 Faraday Ave., Carlsbad, CA 92008
Ph: 760-602-2719 Fax: 760-602-8558
email: building@carlsbadca.gov
www.carlsbadca.gov
SUITEt/SPACEt/UNITt
0 BUILD1NG O FIRE
Plan Check No.
Est. Value
Plan Ck. Deposit
CT/PROJECT# '""' # BATHR OMS TENANT USINESS NAME
DESCRIPTION OF WORK: Include Square Feet of Affected Area(sJ
0 HEALTH D HAZMAT/APCD
SWPPP
CONSTR. 1'/PE OCC. GROUP
~O (} a/Io n
(J Q IY) e_
We-i tev hea_ier
EXISTING USE PATIOS (SF) DECKS (Sf)
APPLICANT NAME PROPERTY OWNER NAME f, I ,
'/t
FAX
Co tY7
DESIGN PROFESSIONAL CONTRACTOR BUS. NAME
PHONE FAX
EMAIL
STATE UC.#
2 1 2
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permil to construct. alter. improve, demolish or repair anl 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 !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 civil penalty of not more than five hundred dollars ($500)).
[ WORKERS ' COMP ENS AT ION . -. ·-. __ , .:.· ~ ... -= _ . . .. ~ .... u]
Workers' Compensalion Declarallon: I heroby alfi"" under penalty of perjury one of /he following declarations:
D I Jilv• and will maintain a certificate of consanl to self-Insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work tor which this permit is issued.
Q{ have and wilt maintain workers' compensation, as required bv Section 3700 of the Labor Code. for the performance of the work for which this permit is issued. My workers' compensalion insurance carrier and policy
numberare:lnsuranceeo./rp:u r:a ace. Co, o-f: H1e 1-v' e,r t: PolicyNo. 5 0 Ci 2 L/ CZ 7 o O Expiration Date I, /, I CL
~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 lo criminal penalties and clvll fines up to one hundred thousand dollars (&100,000), in
addition to the cost of compensation, damages as provided for In Section 3706 ot the Labor coda, interest and attorney's fees. /
J!5 CONTRACTOR SIGNATURE av1
i::gi(GENT DATE , 1 2 i 17
I hereby affirm that tam 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 ottered for sale (Sec. 7044, Business and Professions Code: The Contracto(s
License Law does not apply to an owner ot 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 tor
sale. If, however, the building or improvement is sold within one year ot completion, the owner-builder will have the burden ot proving that he did not build or improve for the purpose of sale).
D
D
t, 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 ot
property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contracto(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. 0 Yes 0 No
2. I (have I have not) signed an application tor a building permit for the proposed work.
3. I have contracted with the following person (firm) to provide the propo;ed construction (include name address I phone I 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 Onctude name I address I phone I 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):
J!5 PROPERTY OWNER SIGNATURE ~T DATE
Is the applicant or futlJ'e building occupant required to submll a business plan, acutely hazardous materials registration fom, or risk management and prevention program under Sections 25505, 25533 or 25534 of the
Presley-Tanner Haza-dous Substance Account Act? D Yes D No
Is lhe applicant or MIJ'e bl.ilding occupant required to obtain a petmit from the air pollution control disulct or air quality management dlslrict? D Yes D No
Is the facility to be constructed l'ithln 1,000 feet ol the outer bounda,y or a school slle? 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.
I certify that I have read the application and state that the aboYe Information is conect and that the lnfo011ation on the plans is accurate. I agree to comply with all City ordnaOOIS and State laws relating to building construdlon.
I hereby au1horize represenlalive or lhe City or Carlsbad to enler upon lhe above menliroed prope,1y b' rlSp8dioo puqx>ses. I ALSO AGREE TO SAVE. INDEMNIFY ANO KEEP HARMLESS THE CITY a: CARLSBAD I
AGAINST All UABILITIES, JUOGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY AGa~UE AGAINST SAID CITY IN C(),ISEQUENCE a' THE GRANTING a' THIS PERMIT. I
OSHA: An OSHA peonl is ,equi'lld tlr excavations over 5'0' deep and demolfon or conslruction or slructules over 3 stories i1 height. I
EXP1RA TION: Eveiy pennit i.5sued by lhe aiikling Official under lhe provisons or lhis c.ooe shall expire by imilaoon and become nul and -.oo ii Iha buklirl:) or v.oi11 aulhorized by su:h pennit is not camioo:ed wilhil
100 days from lhe dale or su:h pennit or K lhe btiklirl,) or v.oi1I authorized by su:h poonil is suspended or abandoned at any tine after lhe WOik is commenced b' a per'od of 180 days (Section 100.4.4 Unibm BuMi1g c.ode). j
·------------DA-TE _,~\ ....... 1 2=~K-......../ t._.._ ________ j ~ APPLICANT'S SIGNATURE
Permit Type:
Work Class:
Status:
Scheduled
Date
BLDG-Residential
P/M/E
Closed -Finaled
Actual
Start Date Inspection Type
Application Date: 12/07/2017 Owner:
Issue Date: 12/07/2017 Subdivision:
Expiration Date: 07/09/2018 Address:
IVR Number: 8195
Inspection No. Inspection Status Primary Inspector
01/08/2018 01/08/2018 BLDG-25 Water
HeaterNents
045251-2018 Passed Tim Frazee
January 08, 2018
BLDG-Final
Inspection
Checklist Item
BLDG-Building Deficiency
045252-2018
Checklist Item
BLDG-Plumbing Final
COMMENTS
Passed Tim Frazee
COMMENTS
ELIZABETH HICKEY
TOWN OF CARLSBAD AMENDED
1168 Oak Ave
Carlsbad, CA 92008-1927
Re inspection Complete
Complete
Passed
Yes
Complete
Passed
Yes
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