HomeMy WebLinkAbout1412 OCEAN CREST AVE; ; CB112637; Permit·City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing/Mechanical/Electrical (PME) Permit
12-15-2011 Permit No: CB112637
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Reference #:
PC#:
Project Title:
Applicant:
1412 OCEAN CREST AV CBAD
PME
2150430400 Lot #: 0
NIELSEN RES-REPAIR GAS LINE
FOR COOK TOP -UNDERNEATH THE CABINET
Owner:
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
12/15/2011
RMA
12/15/2011
12/15/2011
TOWN & COUNTRY PLUMBING
321 N ENGEL ST
NIELSEN MARJORIE A LIVING TRUST 02-08-01 ET AL
ESCONDIDO
92027
745-0337
Plumbing Fees
Electrical Fees
Mechanical Fees
Other PME Fees
TOTAL PERMIT FEES
1412 OCEAN CREST AVE
CARLSBAD CA 92011
$150.00
$0.00
$0.00
$0.00
$150.00
Total Fees: $150.00 Total Payments To Date: $150.00 Balance Due:
Inspector: fYI-~<
FINAL APPROVAL
Date: l?f 1 '3 { 11 Clearance:
$0.00
NOTICE: Please take NOTICE that approval of your project includes the "Imposition' of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES ff APPLY to any
f h T ·1 r I
~ «,..~
~ CITY OF
CARLSBAD
LOT#
Building Permit Application
1635 Faraday Ave., Garlsbad, CA 92008
760-602-2717 / 2718 / 2719
PHASE#
Fax: 760-602-8558
www.carlsbadca.gov
# OF UNITS # BE ROOMS
SUITE#/SPACE#/
# THROOMS
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) c;
Plan Check No.
Est. Value
Plan Ck. Deposit
SWPP
TENANT BUSINESS NAME OCC. GROUP
EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (Sf) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS
YES □#_ NOD YES □ NO □ YES □ NO □
APPLICANT NAME (Primary Contact) APPLICANT NAME (Secondary Contact)
ADDRESS ADDRESS
CITY STATE ZIP CITY STATE ZIP
PHONE FAX PHONE FAX
EMA
STATa ZIP
FAX
ARCH/DESIGNER NAME & ADDRESS STATE LIC. # STATE LIC.# CLASS c-~
' .
WOIUOIIU' «:OMPl!N$ATJOH ,
Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations:
0 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 which this permit is issued.
--Ef'lhave and will maintain workers' compensation, as required by Secl"lon 3700 of the labor Code, for the performance of the 'M'.!rk for which this permit is issued. My workers' compensation insurance carrier and policy
""mbe,a,e lasu,anceCo. 11?..Vc w: (kl5<M'MICF @cl:f4tvtFPolicyNo. A:1158'.IJOk(L 8<0,alonDate_'i?,.,_"_1~-.. 1l.~----
This section need not be competed If the permit is for one hundred dollars ($100) or less. D Certificate of Exemption: I certify th irt the pertormance of the work for which this pennit is issued, I shall not employ any persort in any manner so as to become subject to the Workers' Compensation Laws of
California. WARNING: Failure to se re orkers' compensation coverage is unlawful, and shall subject an employer to criminal peniffias and civil fines up to one hundred thousand dollars (&100,000), In
addition to the cost of compensatlo dam g as pr for In Section 3706 of the labor code, Interest and attorney's fees.
~ CONTRACTOR SIGNATURE
I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason:
□ I, as owner of the property or my employees with wages as their sole compensation, wlll 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 employees, provided Iha! such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of comple~on, the owner-builder will 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 construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owr\Br 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 construcbon of the proposed property improvement. □ Yes □ No
2. I (have I have no0 signed an application for a builcf1ng permit for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction (include name address I phone I contractors' license number):
4. I plan to 11ovide 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 I address/ phone I type of work):
,A$ PROPERTY OWNER SIGNATURE □AGENT DATE
City of Carlsbad Bldg Inspection Request
For 12/16/2011
Permit# CB112637 Inspector Assignment:
Title: NIELSEN RES-REPAIR GAS LINE
Description: FOR COOK TOP -UNDERNEATH THE CABINET
Type:PME Sub Type:
Phone: 7605804225
Job Address: 1412 OCEAN CREST AV
Suite:
Location:
Lot: 0
Inspector: (~
OWNER NIELSEN MARJORIE A LIVING TRUST 02-08-01 ET AL
Owner: NIELSEN MARJORIE A LIVING TRUST 02-08-01 ET AL
Remarks:
Total Time: Requested By: ABEL TANNER
Entered By: LETICIA
CD Description Act Comments
23 Gas/Test/Repairs ~--------------
-rt
Comments/Notices/Holds
CN, 5-:> ajn:, ....1 U
Associated PCRs/CVs/SWPPPs Original P # l="°o/2. ~ ~.S-8:-
Inspection History
Date Description Act lnsp Comments