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Home My WebLink About135 ACACIA AVE; A; CB150316; Permit02-03-2015 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No:CB150316 Buiiding Inspection Request Line (760) 602-2725 Job Address: 135 ACACIA AV CBAD St: A Permit Type; PME Status: ISSUED Parcel No: 2042311100 Lot#: 0 Applied: 01/29/2015 Entered By: JMA Reference*: Plan Approved: 01/29/2015 PC#: Issued: 01/29/2015 Inspect Area: PD Project Title: FRADIN: GAS LEAK REPAIR-BOTH UNITS A & C (SDG&E MISTAKENLY SHUT OFF GAS METER FOR WRONG UNIT-CAUSING REPAIRS FOR BOTH UNITS) Applicant: FRADIN LIVING TRUST 03-05-09 Owner: FRADIN LIVING TRUST 03-05-09 POBOX 2014 CARLSBAD CA 92018 314-629-4379 POBOX 2014 CARLSBAD CA 92018 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees $160.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $160.00 Total Fees: $160.00 Total Payments To Date: $160.00 Balance Due: $0.00 Inspector: FINAL APPROVAL Date: g " 3 - /v5^ Clearance: NOTICE; Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively refenied to as "fees/exactions," You have 90 days from the date this pennit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Govemment Code Section 66020(a), and file the protest and any other required information with the City IVlanager for processing in accordance with Carisbad 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 vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previouslv otherwise expired. THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: QPLANNING QENGINEERING nBUILDING DFIRE •HEALTH •HAZMAT/APCD City of Csrlsbsd Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax:760-602-8558 email; building@carlsbadca.gov www.carlsbadca.gov U H it A PlanCheckNo. C&iC O Sl h Est. Value Plan Ck. Deposit Date I i IS SWPPP JOB ADDRESS CT/PHOJEl PVIASE* # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: (nc/ude Square Feet of Affected Areafs; A ^ EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FlRESPRINKLERS YEsfT* No| 1 YESQNOQ YES| |NO| 1 PHONE / ^ FAX DESIGN PROFESSIONAL CONTRACTOR BUS. NAIVIE ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL STATE LIC. # STATE LIC.# CLASS CITY BUS. LIC.# (Sec. 7031.5 Business and ProTessions 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 is licensed pursuantto the provisions ofthe Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3 ofthe 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)). tr OR IN; CRS' COMPENSATION Workers' Compensation Declaration: / herefcy affirm under pena/fy ofpeijury one of ttie following declarations: • I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for wtiich this permit is issued. • I have and will maintain worlters' compensation, as required bv Section 3700 of the Labor Code, for the perfomiance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. Policy No. Expiration Date This section need not be completed if the permit is for one hundred dollars ($100) or less. I I Certificate of Exemption: I certify that in the perfomiance of the wort for which this pemiit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Califomia. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employerto criminal penalties and civil Fmes 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 attomey's fees. JS^ CONTRACTOR SIGNATURE • AGENT DATE ,0 W,M"'t ff - B U I L D DCCLARATIOI / hereby affimi that I am exempt from Contractor's Ucense Law for tlie following reason: I, as TOper of the property or my employees wilh 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 Li»(^ Law does not apply to an owner of property »iho 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 Se. If, however, the building or improvement is sold within one year of completion, the owner-builder wil! have the burden 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 constmct 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(E) licensed pursuant to the Contractor's License Law). I am exempt under Section _ ^Business and Professions Code for this reason: 1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement. nYes I iNo 2.1 (have / have not) signed an application for a building pemiit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed constriction (include name address / phone / contrxtors' license number): 4.1 plan to provide portions of the wort, but I have hired Ihe followinq Defjon toMOrtin^tSr sypscvise and provide the major work (include name / address / phone / contractors' license number): 5.1 will provide some of the work, bul I have contracted (hired) Jhl^fflkwngo^oiij/roQW work indicated (include name / address / phone / type of work): PROPERTY OWNER SIGNATURE •AGENT DATE B U I L O I H G P E i? IM I jr S O Is the applicant or future building occupant required to submit a business plan, acutely hazanlous materials registration form or risk 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 pennit from the air pollution control district or air quality management district? Yes No Is the fxility to be constnjcted 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. O N S,T RUCTION LENDI ti G _ A G E N, C Y, I hereby affirm that there is a constmction lending agency for the perfonnance of the work this pemiit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address APPilCANT CERTIFICATION I certi^ that I have read the application and state thatthe above information is conEct and thatthe infomiation on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building constmction. I hereby aulhorize representative ofthe City of Cartsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CfTy OF CARLSBAD AGAINST Aa UABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICj^ MAYJiTMiy WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA pemiit is required fbr excavations over 5'0' dee^3^ de^wion orajiSmj^ of stmctures over 3 stories in height. EXPIRATION: Every pemnit issued by the Building Offcial updenfeg^Sroionj^^ expire by limitatbn and become null and void if the building or viork authorized by such permit is not commenced within 180 days from the date of such permit or if tK^^i^^^f^^xS^^b^^^i^^ilfss^ife!^ or abandoned at any time after the vrork is commenoejl fbr a period of 180 da^ (Section 106.4.4 Unifbrm Building Cedg)^ ^eS"APPLICANT'S SIGNATUR T DATE Id 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 buildina(5)carlsbadca.aov or Mall the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carisbad, Califomia 92008. C0#: (Office Use Only) CONTACT NAIVIE OCCUPANT NAIVIE ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAILTO: 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 jeSAPPLICANT'S SIGNATURE DATE Inspection List Permit#: CB150316 Type: PME Date Inspection Item 02/03/2015 23 Gas/Test/Repairs 02/03/2015 29 01/30/2015 23 01/30/2015 29 01/30/2015 39 Final Plumbing Gas/Test/Repairs Final Plumbing Final Electrical Inspector Act PD AP PD AP PD AP PD AP Rl FRADIN: GAS LEAK REPAIR-BOTH UNITS A & C (SDG&E MISTAKENLY SHUT Comments GAS LEAK REPAIR/ PM PLEASE Tuesday, February 03, 2015 Page 1 of 1