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Home My WebLink About1274 PINE AVE; ; CB122266; Permit10-26-2012 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No: CB122266 Building Inspection Request Line (760) 602-2725 Job Address' Permit Type Parcel No Valuation Reference # PC# Project Title 1274 PINE AV CBAD MISC 2050200400 $0 00 Subtype Lot# OTHER 0 FISCHBACH RES- UNDERGROUND PLUMBING & WASTE DRAIN ONLY - NO NEW CONSTRUCTION Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 10/26/2012 RMA 10/26/2012 10/26/2012 Applicant 1284 PINE PARTNERS LLC ATTN DAVID FISCHBACH 1821 S COAST HWY OCEANSIDE CA 92054 760 580-1776 Owner- 1284 PINE PARTNERS LLC ATTN- DAVID FISCHBACH 1821 S COAST HWY OCEANSIDE CA 92054 760 580-1776 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees INSPECTION FEE $154 00 $0 00 $0 00 TOTAL PERMIT FEES $154 00 Total Fees $154 00 Total Payments To Date. $154 00 Balance Due: $0.00 Inspector FINAL APPROVAL Date /^g'•S'/^/Z-Clearance NOTICE Please take NOTICE ttiat approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions" 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 anv subsequent legal action to attack, review, set aside, void, or annul their imposition You are hereby FURTHER NOTIFIED that your nght 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 vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previouslv othenwise expired THE POILOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE; • PlANNING • ENGINEERING • BUILDING • RRE • HEALTH • HAZI«AT/APCD Plan Check No. (j^ j ^ ;2 fjj^ ^ CITY OF CARLSBA Building Permit Appiication 1635 Faraday Ave., Carlsbad, CA 92008 Pfi: 760-602-2719 Fax: 760-602-8558 email buldling@carlsbadca.gov www carlsbadca gov Est. Value Plan Ck. Deposit JOBADDRESS /"s » ^ A » SUITE#/SPACE#AJJ<IT# ^ APN' TJ^r -01. JO -0/ 00 CT/PROJECT# LOT# '^ PHASES # OF UNITS" tt BEDROOMS tt BATHROOMS TENANT BUSINESS NAME CONSTR TYPE OCC GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) ^Ij,/ / ^ ^ EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES • # NO • YES • NO • YES • NO • APPUCANT NAMEiPf/mary Contact) i , . APPLICANT NAME (Secondary Contact) ADDRESS CITY . , STATE _ . 'ZV^ _ ^ , , CITY STATE ZIP FAX PHONE FAX EMAIL EIVIAIL PROPERTY OWNER NAME f/Sfclyt 1-,- 'T^, -i. i i Xl CONTRACTOR BUS NAME , \ ADDRESS ,^ ^ , >. 1 ADDRESS I ^ CITY ^STATE 0 ZlV CITY 1 STATE ZIP PHONE Ifco, ^Bo. niG Hfeo t3iH3. iq.a£> PHONE FAX EMAIL ARCH/J)ESIGNER NAME & ADDRESS STATELIC # STATE LIC tt CLASS CITY BUS LIC # (Sec 7031 5 Business ancf Professions Code Any City or County wtiicti requires a permit to construct, alter, improve, demolish or repair any structure, prior tc its issuance, also requires the applicant for such permit to-file a signed statement that he is licensed pursuant to the provisions ofthe Contractor's License Lavi; (Chapter 9, commending v*ith Section 7000 of Division 3 of the Business 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 civil penalty of not more than five hundred dollars ($500)) Workers' Compensation Declaration / hereby affirm underpenalty of perjury one ofthe following declarations • 1 have and will maintain a certificate of consent to self-insure for worlters' compensation as provided by Section 3700 of the Lator Code, for the performance of the wori< for which this permit is issued O 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 IVIy workers' compensation insurance carrier and policy number are Insurance Go Policy No Expiration Date This section need not be completed if the permit is for one hundred dollars ($100) or less n Certificate of Exemption I certify that in the pertormance of the work for which this pemiit is issued, I shall not employ any person in any manner so as to become subject to the Wortiers' Compensation Laws of California WARNING' Failure to secure worlters' compensation coverage is unlawful, and shall subject an employerto criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, mterest and attorney's fees. JS$ CONTRACTOR SIGNATURE OAGENT DATE / hereby affimi that I am exempt from Contractor's bcense Law for the following reason 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 tor 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) vCl 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 matenals for construction of the proposed property improvement • Yes O No 2 I (have / have not) signed an application for a building permit for the proposed wort( 3 I have contracted with the following person (fimn) to provide the proposed construction (include name address / phone / co nti actors' license number) 4 I plan to provide portions of the wori<, but I have hired the followmg person to coordinate, supervise and provide the major work (include name / address / phone / contractors' license number) 5 I will provide some of the wort<, but I havemntracted (hired) the following persons to provide the wort( indicated (include name / address / phone / type of wori<) ygS'PROPERTY OWNER SIGNATURE •AGENT DATE Is the applicant or future building occupant required to submit a business plan, acutely hazardous matenals registration form or nsk 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 distnct 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 hereby affirm that there is a constmction lending agency for the performance of the work this permit is issued (Sec 3097 (i) Civil Code) Lender's Name Lender's Address I certifyttiat I have read theapplicaton and statethattheabove infoirnaboniscoriectand thatthe iirlbirnation on the plans isaccura^ I agreetocomply with all City oidinancesand State lavs lelabng to building constuction. I hereby authonze 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 50' deep and demolition or constmction of staictures over 3 stones in height EXPIRATION Every pennit issued by the BuildiDg-GfliciakJnder the provisioris^iJhis Oade shall expire by limitation and become null and void if the buildini 180 days from the date of such pemiit opHlebuilding or wijf^thonzed/klfsupli pennit is suspended or abandoned at any time after the work is commeni vgfAPPUCANT'S SIGNATURE W [c/i^ a ^,/yn^/7?y^1 DATE ^, ; autjAnzed by such Qennit is not commenced within for apmod of 180days JSection 106 4 4 Unifomi Building Code) STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. CERTIFiCATE O C C U P . Fax (760) 602-8560, Email mm buildinp(a!carisbadca gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008 C0#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE CiTY ZiP Carlsbad CA PHONE FAX OCCUPANT'S BUS LIC No DELIVERY OPTIONS , n PICK UP: • CONTACT (Listed above) • OCCUPANT (Listed above) • CONTRACTOR (On Pg 1) • MAIL TO: o CONTACT (Listed above) • OCCUPANT (Listed above) • CONTRACTOR (On Pg 1) • MAIL / FAX TO OTHER: • ASSOCIATED CB#- • NO CHANGE IN USE / NO CONSTRUCTION • CHANGE OF USE / NO CONSTRUCTION ygf APPLICANT'S SIGNATURE DATE Inspection List Permit*: CB122266 Type: MISC OTHER FISCHBACH RES-UNDERGROUND PLUIVIBING & WASTE DRAIN ONLY - NO N Date Inspection Item Inspector Act Comments 10/30/2012 21 Underground/Under Floor - Rl 10/30/2012 21 Underground/Under Floor PB AP 10/30/2012 29 Final Plumbing PB Fl Wednesday, October 31, 2012 Page 1 of 1