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Home My WebLink About1176 LARKSPUR LN; ; CB163015; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 08-08-2016 Permit No: CB163015 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 1176 LARKSPUR LN CBAD PME Status: Parcel No: 2054300700 Lot#: 0 Applied: Reference #: PC#: Project Title: Applicant: BROWNSTEIN: UPGRADE PANEL TO 200A BROWNSTEIN MICHAEL 1176 LARKSPUR LN CARLSBAD CA 92008 760-861-6712 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Entered By: Plan Approved: Issued: Inspect Area: Owner: BROWNSTEIN MICHAEL 1176 LARKSPUR LN CARLSBAD CA 92008 ISSUED 08/08/2016 JMA 08/08/2016 08/08/2016 $0.00 $163.00 $0.00 $0.00 $163.00 Total Fees: $163.00 Total Payments To Date: $163.00 Balance Due: Inspector: FINAL_,APPROV/2L Date: f-_:_2 1 • / Clearance: $0.00 NOTICE: Rease ta<e fOTICE that ,w-c,va ci yo., prcject irdudes tte "lr,µ,sitiorl' ci fa,s, derlcaticro, rese,-vaticre, or cther exa:iicro -aJledivay referred to as 'fee,/exacta,s." Yoo rave OOday.;fromtte-tns pemit v.as iss..ed top!clest ir,µ,sitiori cithesefee,/OJ<Dicro. If you p!clest ttern you rrust fdloott-e p!clest procect,es set forth in Qivarmrt Code Sedor, 68J20(a), ard file tte p!clest ard any cther raj.iroo inforrraiori wth tte Qty Mragerfcr ,rocessing in aor:ada'ce wth Caisboo Mnd;:a Code Sedor, 3.32.CID. Falu-etotirrey fdlo,,thal ~wll ti,,-anySl..ilseq.a11 lega actori toattad<, review, set aside, \.-Od, a aTIJ tteir irrp:Eitioo. Yoo ere t-erel>y F\RTI-ER fOTIFIEDthal yo., rigt to p!clest ttespecifieo fee,/exacta,s DCES ~ APPLYto\1,0\er ard se,.eroor,naclor, fees ard a,pocity ct-a-ges, nor J>m"ing, zi:rirg g,,dngorcther snila-wicatiori ,rocessing orser,,ioefees in oorinactori wth tns prcjed. I'm DCES IT APPL Yto any f ·ens \Mich ·rus1 ·vena sinila-to aast wi linitcti ·rus1 , THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH 0HAZMAT/APCD (City of Building Permit Application Plan Check No. CBt (e. 30(S"" 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value Carlsbad Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. D!IPOJit email: building@carlsbadca.gov www.carlsbadca.gov Date fs/8"{ tL ISWPPP ' 0"i1°1ii L..~l4~Pve2-SUITEt/SPACEt/UNIH IAPN / Lt4vt 'Z.. --- CT/PROJECT# I LOT# I PHASE# I# OF UNITS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I occ. GROUP .,ESCRIPTION OF WORK: Include Square Feet of Affected Area(s) ~ ~ Pl.CcT~ lC ()JJ,\M[l , 1PGRt411<" <::_ {-\ t4 11(,<T C<-> I ~ ~OP; EXISTING USE I PROPOSED USE IGARAGE (SF) PATIOS (SF} TDECKS (SF} FIREPLACE IAIR CONDITIONING I FIRE SPRINKLERS YESQ_ Nc0 YES □No □ YES□No□ APPLICANT NAME -f!OPER'Mi~u .(lz,, RD.,,_, >),/ h-£' / ;,1 Primary Contact ADDRESS AODRES( 11 c::: LAR1<'.5PuR Lt,.IJt,1{. CITY STATE ZIP CITY STG1 i:? a:.;<; (JA. 12. c-< 12 A D PHONE l'AX PJ:I0NE )/_,,-, C, I -C I I 2 l'AX EMAIL EMAIL CO'<.. Cll'\ \( M /\l. 0 <£ u-\-ot. Col-\ DESIGN PROFESSIONAL CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE I 'AX PHONE l'AX EMAIL EMAIL I STATE LIC. # STATE UC.# I CLASS I CITY BUS. UC.# (Sec. 7031.5 Business and Professions Code: Any City or Coun_ty 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 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 perjury one of the following declarations: D I have and will maintain a certificate of consent to self-insure for 'Mlrkers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this pennit is issued. D I have and will maintain workers' 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 Co, Policy No ______________ Expiration Date _________ _ ~section need not be completed if the permit is for one hundred dollars ($100) or less. LJ Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, interest and attorney's fees. 8$ CONTRACTOR SIGNATURE □AGENT DATE OWNER~BUILDER DECLARATION I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: □ M □ 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 ttlereon, 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 Durden 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. OYes ONo 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 I 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/ address/ phone I type of work): .8$ PROPERTY OWNER SIGNATURE /)1· □AGENT DATE ,· COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a busirlE!ss plan, acutely hazardous materials registration form or risk management and prevent on program under Sectons 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 mana-Jement district? □ Yes □ No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ Yes □ No 1F 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 appllcatlon and state that the above infonnatlon Is correct and !hat the infonnatlon on the plans is accurate. I agree to comply'Mlh all City ordinances and State 1av.s relating to building construction. I hereby authorize representative of the City of Cartsbad to enter upon the aOOve mentioned property br inspection JXJIJX)SeS. I ALSO AGREE TO SAVE, INDEMNIFY ftND KEEP HARMLESS THE CITY OF CARLSeAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CITY IN CONSEGIJENCE OF THE GRANTING OF THIS PERMIT. OSHA: AA OSHA permit is required for excavations owr 5'0' deep and demdition or 001strudion of struch.Jres over 3 stories in height EXPIRATION: Every permit issued by the Buil:ling Offcial under the proV\Sbns of thts Code shall expire by limitation and berome null and vod ~the buil:ling orv.ork authorized by such permit ts not commenced wthin 180days from the date of such permit or iflhe building orv.ork autho · by such ~rmit ts sus~nded or abandoned at any time after the w;)rk ts commenced for a ~riod of 180 days (Section 100.4.4 Unibrm Building Cooe) . ..@S° APPLICANT'S S1GNATURE 17 ~, DATE ~ , ( C:. • 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. UC. No. DELIVERY OPTIONS PICK UP: o CONTACT (Listed above) o OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) MAIL TO: o CONTACT (Listed above) □ OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) MAIL/ FAX TO OTHER: _______________ _ A! APPLICANT'S SIGNATURE □ ASSOCIATEDCB#------------ 0 NO CHANGE IN USE/ NO CONSTRUCTION □ CHANGE OF USE/ NO CONSTRUCTION DATE ZIP PERMIT INSPECTION HISTORY REPORT (CB163015) Permit Type: BLDG-Residential Application Date: 08/08/2016 Owner: Work Class: P/M/E Issue Date: 08/08/2016 Subdivision: Status: Closed -Finaled Expiration Date: 02/21/2017 Address: 1176 Larkspur Ln Carlsbad, CA 92008 IVR Number: 716272 Scheduled Actual Date Start Date Inspection Type Inspection No. Inspection Status Primary Inspector Reinspection Complete 01/27/2017 BLDG-Final 011828-2017 Passed Peter Dreibelbis Complete Inspection Checklist Item COMMENTS Passed BLDG-Electrical Final Yes January 27, 2017 Page 1 of 1 • Inspection List Permit#: CB163015 Type: PME Date ln_spl!<:tion Item 08/19/2016 33 Service Change/Upgrade Monday, January 30, 2017 Inspector Act PB AP BROWNSTEIN: UPGRADE PANEL TO 200A Comments Page 1 of 1