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Home My WebLink About1222 MARIPOSA RD; ; CBR2017-0190; PermitPrint Date: 03/15/2017 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: 1222 Mariposa Rd BLOG-Residential 2122210300 $0.00 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Residential Permit www.carlsbadca.gov Work Class: Alteration Status: Lot#: Applied: Reference#: Issued: Construction Type: Finaled: Bathrooms: Inspector: Orig. Plan Check#: Plan Check#: Description: MIYAKE: INSTALL FIRE-RATED OOOR TO COMPLY WITH RCFE REGULATIONS (R3 OCCUPANCY TO R3.ll Applicant: GERALDINE ADAYA 1222 Mariposa Rd CARLSBAD, CA 92011 8S8-216-S613 BUI LO ING PLAN CHECK FEE (BLDG) MANUAL BUILDING PERMIT FEE Total Fees: $2SS.00 Owner: REX T MIYAKE Po Box 3388 RANCHO SANTE FE, CA 92067 Total Payments To Date: $2SS.00 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: CBR2017-0190 Closed -Finaled 01/30/2017 03/02/2017 $0.00 $12S.OO $130.00 • T.HE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING 0 ENGINEERING □BUILDING □FIRE □HEALTH OHAZMAT/APCD (city of Carlsbad Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov Plan Check No. Cf>'<201"1-OAO Est. Value Plan Ck. Deposit Date 1-00-SWPPP JOB ADDRESS/ O O ). l f .,_ "'-1v1C-Lr i° APN CT/PROJECT# LO # PHASE # f UNITS # BEDROOMS fl BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) lvi-s+l\.ll f11-.'~-ro..+e,t &Doi--+o c.ovr.ply wi+~ ~C~t:. ~31,.;..l(l..+;cns k~ to R~, I cc.cu EXISTING USE PROPOSED USE APPLICANT NAME • P,/ma, Contaot -e,ra.. lc\ I VI fl., CITYC ' cu--1 sha-£ STATE PHON~Sl?-.;1./(,9 ~ 5(..-, 13 FAX EMAIL ADDRESS CITY STATE PHONE FAX EMAll GARAGE (SF) ZIP STATE UC.# PATIOS (SF) PROPERTY OWNER C h Q. r r ADD SS ti. 3. 3 I) .D-.uDX <1. AIR CONDITIONING No□ YES □No □ CIT'f1 h £'> • f STATE c·· A f\(,ll'\( C .::,(L!I\ I 0-e FAX CLASS FIRE SPRINKLERS YES□No□ (Sec, 7031.5 Business <?nd P_rofessions Code: Any City or Cqun_ty which requires a permit to_c~instruct, alter, imprJ:l\(e, ~emolish or repair any structure, prior t9 its iss!Jance, also re_quires the applicant for such permit to file a signed statement ttiat he Is licensed pursuant to the provIsIons of the Contractbr;, 1,/icense lawJChapter 9. commending with Section 7000 of DIvis1on 3 of the B_usiness and Professions Code) or (hat he is exempt therefrom, and the basis for the alleged exemption. Any vio~tio!li of Section 031.5 by any applicant for a permit subJects the applicant to a civil penalty of not more than five hundred dollars {$500}). WORl<ERS' COMPENSATION Worlters' Compensation Declar'atiOii":Tfmrebye#imumdd("~ena"y of perjury one of the following declarations· D I have and will maintain a certificate of consent to self.i~~~re-fO/WOfKEifS' compe.os;;i~on as provided by Section 3700 of the Labor Code, for the performance of the wor\( for which this permit is issued. D I have and will maintain workers' compensation, as reQuired by Section 3700 of the Lab~r 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 _________ _ need not be completed if the permit Is for one hundred dollars ($100) or less. ate of Exemption: I certify that in the performance of the work. for which this permit is issued, I sh.3I not employ any person in any mannef so as lo become subject to the Workers' Compensation Laws of Ca ifornia. WARNING: Failure to secure workers' compenstition coverage is unlawful, and shall subject an employer to crimtnal penalties and civil ftnes up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages as provided for In S ·on 3706 of the Labor code, interest and attorney's fees. ~ CONTRACTOR SIJ;IIA_T_U!l_E~" I hereby affirm that I am exempt from Contractor's License Law for the following reason: l O I, as owner of the property or my employees w~h 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 ellllloyees, 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). ~ 1, as owner of the property, am exclusively contracting with license\! contractors lo 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 contraclor(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 laOOr and materials for construction of the proposed property improvement 0Yes 0No 2. \ (have / have not) signed an application for a building pennit for the proposed worl<. 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 worl<, but I have hired the following person to coordinate, supervise and provide the major work {include name JaaareSs / 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): ~ PROPERTY OWNER SIGNATURE [ii!'AGENT DATE '1 '<:OMl'LETE THIS 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 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 Yes □ No Is the applicant or future building occupant required lo 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 EMERGENCV SERVICES AND THE AJR POLLUTION CONTROL DISTRICT. I certify that I have read the application and state that the above infonnation is correct and that the lnfonnation on the plans ts accurate. I agree to comply with all City ordinances and State laws relating to bullding construction. I hereby aulhorize representawe of lhe City of Carlsbad lnenlerupon the above menioned property for ospeclfon purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARl,/LESS 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 PERMrT. OSHA: An OSHA pennit is required for excavations over 5'0' deep and demolition or construction of strucbJres CNer 3 stories in height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation aod become null and void W the building or work authorized by such pem,it is not commenced within 180 days fran lhe date of such pennit or if the building or WOO( authorized by such pennlt is suspended or abandoned at any time after the work is commenced for a period of 180 days (section 106.4.4 Unifonn Building Code). _,w5 APPLICANT'S SIGNATURE DATE I 3o J.e>/7 • 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 lhe completed fonn to City of Cartsbad, 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 D PICK UP: □ CONTACT (Listed above) □ OCCUPANT (Listed above) □ CONTRACTOR (On Pg. 1) D MAIL TO: □ CONTACT (Listed above) □ OCCUPANT (Listed above) □ CONTRACTOR (On Pg. 1) D MAIL/ FAX TO OTHER: ________________ _ AS° APPLICANT'S SIGNATURE □ ASSOCIATED CB#'------------- □ NO CHANGE IN USE/ NO CONSTRUCTION o CHANGE OF USE/ NO CONSTRUCTION DATE ZIP . PERMIT INSPECTION HISTORY REPORT (CBR2017-0190) Per nut Type: BLDG-Residential Application Date: 01/30/2017 Owner: REX MIYAKE Work Class: Alteration Issue Dato: 03/02/2017 Subdivision: Status· Closed -Finaled Expiration Date: 08/29/2017 Address: 1222 Mariposa Rd Carlsbad, CA 92011-4206 IVR Number: 1683 Scheduled Actual Inspection Type Inspection No. Inspection Status Primary Inspector Reinspection Complete Date Start Date 03/10/2017 BLDG-Final 016222-2017 Cancelled Paul Burnette Reinspection Complete Inspection Checklist Item COMMENTS Passed BLDG-Building Deficiency No BLDG-Plumbing Final No BLDG-Mechanical Final No BLDG-Structural Final No BLDG-Electrical Final No 03/15/2017 03/15/2017 BLOG-Final 016513-2017 Passed Paul Burnette Complete Inspection Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes BLDG-Plumbing Final Yes BLDG-Mechanical Final Yes BLDG-Structural Final Yes BLDG-Electrical Final Yes BLOG-Fire Final 015274-2017 Scheduled Cindy Wong Incomplete Checklist Item COMMENTS Passed FIRE-Building Final No March 15, 2017 Page 1 of 1 • STATE ?F cAuFORN(A-HEALTH ANO HUMAN SERVICES AGENCY Cje,rr:Lld;i1.R., Ado ... yr.:v (1?58') J.1C.-5G13 CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING FACILITY SKETCH (Floor Plan) Applicants are required to provide a sketch of the floor plan of the home or facility and outside yard. The floor sketch must label rooms such as the kitchen, bath, living room, etc. Circle the names of the rooms that will be used by staff/residents/clients/children. Door and window exits from the rooms must be shown in case of an emergency (see Emergency Disaster Plan). Show room sizes (e.g. 8.5 x 12). Keep close to scale. Use the space below. See back for yard sketch. 3SUED BY UC 999 (3199) w(t\"'l KCF£ Pesu !o.,__fions. ~2or1-01qo i • r 1 TD 40 Plus Years of Experience G .............. , .,, ......... ,oo f:.33 8iili63 .. O<.>r/r1tv1ro v~oc Carlsbad, CA 92011 (760) 822-9934 Ct C-t TERMS DESCRIPTION 1186 DATE Ylhv ze -r 7 J□s NO. -10B NAME _____ _ J□sc□CAT,□N L?c2 2 /7 /4--/< !Pc54 '2,) .. C:.. "o/YZC.. 5 /], ,4-f.) C /). . PRICE AMO LINT ' I -1----·r·· I I I ---.. T ... L. = .,_ ~ '---------1--~e,~~i2.c;.. .. t.J ....... ../rzAL ec...,cc•c._ _________ ~-----+-----------t ____ ,. ..... --+-. 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