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155 CHINQUAPIN AVE; ; CBR2016-0260; Permit
City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Print Date: 12/30/2016 Residential Permit Permit No: CBR2016-0260 www.carlsbadca.gov Job Address:155 Chinquapin Ave Permit Type:BLDG-Residential Work Class:P/M/E Status:Issued -Active Parcel No:2060700900 Lot #:Applied:12/05/2016 Valuation:$0.00 Reference #:Issued:12/05/2016 Occupancy Group:Construction Type:Finaled: #Dwelling Units:Bathrooms:Inspector: Bedrooms:Orig. Plan Check #: Plan Check #: Project Title: Description:CHINQUAPIN LLC: GAS LINE REPAIR TO EXTERIOR Applicant:Owner: BILL RIECHERS C B CHINQUAPIN L L C 155 Chinquapin Ave 858-334-9927 CARLSBAD, CA 92008 PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT $166.00 Total Fees:$166.00 Total Payments To Date:$166.00 Balance Due:$0.00 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. FINAL 4.PeKOVAL 0ArE /2 . 3 ri—it c/LEARANCE_,,___— _ SIGNATURt__,ke.4-A____•------ ,.._,—...: THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE:DPLANNING ©ENGINEERING DBUILDING AFIRE EDHEALTH 0 HAZMATIAPCD Building Permit Application Plan Check No612a0 1 t.0°2 _(90CCity of 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value Ph: 760-602-2719 Fax: 760-602-8558Carlsbademail: building@carlsbadca.gov Plan Ck. Deposit www.carlsbadca.gov Date I af5/11.fitAIPPP JOB ADDRESS/...--SUITEV VSPACEUNITII APN *5 S..--CH/tif Qti 94.?/ Ai A a -•--- CT/PROJECT #LOT #PHAS ##OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUPVy DESCRIPTION OF WORK:Include Square Feet of Affected Area(s)•G As-N — S.16r A.4 i ...S WO—viA-A-/... EXISTING USE ...,PROPOSED USE GARAGE (SF)PATIOS (SF)' DECKS (SF)I FIREPLACE AIR CONDITIONING ' FIRE SPRINKLERS -f--1/ t/2 01 / f yEsgitt____Nop YES ON01:54:1 YESO NOZI, pAPriPmLlaCrAyN ContactTNAME 73 ;id/g/A...cfbE.. der PROPERTY OWNER v../ C 13 Cbifivoa4oitt;L.L. ADDRESS ADDRESS N..t //.‘'S—'C -1/9Ar C &XV)Ko X41-‘C if'.I"(.ti Oil/Ai Al ‘'/' CITY 9fIATE ZIP CITY S ZIP(#4.F-1s &-.1-.0 C ---2.2 00,7 C4 g ir94-1)c4-p 2_cdod- PHONE FAX PHONE FAX-..?3 y 9R27 rfe 7 7 4(29'•7 EMAIL 1 N-i /‘EMAIL A 0 i I ..9 / 7( ty e cl,e "-I - @?..41.111 .ea-A-1 i ei ri e c 4 f' r-i'0 ?AA//.‘c DESIGN PROFESSIONAL CONTRACTOR BUS. NAME , ' ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE 6.©„^...,//2...yives) FAX EMAIL Z STATE LIC. #STATE LIC.#CLASS CITY BUS.Licit (Sec.7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires theapplicant 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 theBusiness 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'C.4OIVIPENSATION/... Workers' Compensation Declaration: I 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. 111 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 This section need not be completed if the permit is for one hundred dollars ($100) or less.0 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 (8100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. AS CONTRACTOR SIGNATURE 0 AGENT DATE OWNER -BUILDER DECLARATION '... I hereby affirm that I am exempt from Contractor's License Law for the following reason:0 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 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). ATI,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). ElI 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 ENo 2.I (have / have not) signed an application fora 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, butI have hired the following person to coordinate, supervise and provide the major work (include name / address / phone / contractors' license number): 5.I will provide some of the work, but I have contracted (hired) the followAiin. . -rsons to provide the work indicated (include name / address / phone / type of work): follow AKPROPERTYOWNER SIGNATURE (/Al ..i1.*GENT DATE /2/S4C//6 .11=semem mr rin=COMPLETE THIS FCIR.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?CI Yes 0 No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?CI Yes CI No Is the facility to be constructed within 1,000 feet of the outer boundary ofa school site?CI Yes 0 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. 17.Pik nITMI.H.rISECONSTRUCTIONLENDINGAGENCY I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address APPLICANT CERTIFICATION I certify thatI have read the application and statetattleabove information is correct and that the information on the plans is accurate.I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representative of the CityofCarlsbad 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 CITYIN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over 5'0' deep and demolit.•t construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Building Offidal under the pro sffs Code shall expire by limitation and become null and void if the building or work authori by such /nit is not commenced within 180 days from the date ofsuch permit or if the building or irkautho •:4 N z•ch permitissuspended or abandoned at any time after the work is commenced fora period f180 da Section 106.4.4 Uniform Building Code). 4/1. r's JeAPPLICANT'S SIGNATURE 0 DATE / STOP 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 buildingecarlsbadca.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 ZIP Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICK UP:o CONTACT (Listed above)o OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) o ASSOCIATED CB#MAIL TO:o CONTACT (Listed above)o OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1)o NO CHANGE IN USE /NO CONSTRUCTION MAIL /FAX TO OTHER:o CHANGE OF USE /NO CONSTRUCTION ..4KAPPLICANT'S SIGNATURE DATE PERMIT INSPECTION HISTORY REPORT (CBR2016-0260) Permit Type:BLDG-Residential Application Date:12/05/2016 Owner:C B CHINQUAPIN L L C Work Class:P/M/E Issue Date:12/05/2016 Subdivision: Status:Issued -Active Expiration Date:06/05/2017 Address:155 Chinquapin Ave Carlsbad, CA 92008 IVR Number:602 Scheduled Actual Date Start Date Inspection Type Inspection No.Inspection Status Primary Inspector Reinspection Complete 12/07/2016 12/07/2016 BLDG-23 004446-2016 Passed Jonathan West Complete Gas/Test/Repairs Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes BLDG-Final 004712-2016 Passed Jonathan West Complete Inspection Checklist Item COMMENTS Passed BLDG-Plumbing Final Yes January 11,2017'Page 1 of 1