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Home My WebLink About1569 Cormorant Dr; ; CBR2017-2266; PermitPrint Date: 10/03/2017 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: 1569 Cormorant Dr BLDG-Residential 2156500203 $0.00 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Residential Permit www.carlsbadca.gov Work Class: P/M/E Lot#: Reference #: Construction Type: Bathrooms: Orig. Plan Check #: Plan Check#: Description: GURBAXANI RANDALL: REPLACE HVAC -A/C SYSTEM -LIKE FOR LIKE PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT Total Fees: $170.00 Owner: TRUST GURBAXANI RANDALL FAMILY TRUST 05-12-14 506 Dahlia Ave, Unit B CORONA DEL MAR, CA 92625 619-855-0141 Total Payments To Date: $170.00 Status: Applied: Issued: Fina led: Inspector: Contractor: BEST SERVICE CO 5360 El Arbol Dr Carlsbad, CA 92008-4318 760-438-3989 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: CBR2017-2266 Closed -Finaled 09/27/2017 09/27/2017 $0.00 $170.00 . ( City of Carlsbad Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 780-602-271.9 Fax: 760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov Plan Check No. C.,Of-?,D\ ( - Est. Value Plan Ck. Deposit Date ....,_ {1 # OF UNITS # BEDROOMS DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) e EXISTING USE PROPOSED USE GARAGE (SF) ZIP o t> B DESIGN PROFESSIONAL NAME ADDRESS CITY STATE ZIP PHONE FAX EMAIL STATE UC.# SUITE#/SPACE#/UNIT# # BATHROOMS TENANT BUSINESS NAME CITY STATE PHONE FAX i?.22 CONSTR. TYPE OCC. GROUP AIR CONDITIONING YES D NOD ZIP ZIP 9~ool? FIRE SPRINKLERS YES D NOD (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 the applicant 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 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: I hereby affirm under penalty of perjury one of the following declarations: D I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of lhe Labor Code, for lhe performance of lhe work for which this permil is issued. D I have and will maintain workers' compensation, as required by Section 3700 of lhe Labor Code, for the performance of the work for which this permil is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. Policy No. Expiralion Date ---------- Thi~on need not be completed if lhe permil is for one hundred dollars ($100) or less. li2J'" Certificate of Exemption: I certify lhat in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as lo become subjecl to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penallies and civil fines up to one hundred thousand dollars (& 100,000), in addition to the cost of compensation:iarages as provid~or in Section 3706 of the Labor code, interest and attorney's fees. ~ CONTRACTOR SIGNATURE J,{_/tl ~, 0AGENT I hereby affirm that I am exempt from Contractor's License Law for the following reason: D I, as owner of the property or my employees wilh wages as their sole compensation, will do lhe work and lhe structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does nol apply lo an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided thal 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 lhal he did not build or improve for the purpose of sale). D I, as owner of the property, am exclusively contracting wilh licensed contraclors lo conslruct 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}. D I 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. D Yes D No 2. I (have I have not) signed an application for a building 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 provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name I address I 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 ClAGEf,IT DATE 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? D Yes D No Is the applicant or future building occupant required to obtain a penmit from the air pollution control district or air quality management district? D Yes D No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D Yes D 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 ANO THE AIR POLLUTION CONTROL DISTRICT. I certifythatl have read the application and state that the above infonnation is correct and that the infonnation on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authonze representative of the City of Car1sbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARM..ESS 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 permtt is required for excavations (]yef 5'0' deep and demolition or construction of struciures (}lef 3 stories in height EXPIRATION: Every permtt issued by the Building Official undef the provisions of this Code shall expre by limitation and become nul and void if the building or work authonzed by such pemit is not coovnenced within 180 days from the date of such pennit or if the b ilding or work authonzed by such permtt is suspended or abandoned at any tine aftef the work is coovnenced for a period of 180 days (Section 106.4.4 Unifoon Building Code). ~ APPLICANT'S SIGNATURE DATE PERMIT INSPECTION HISTORY REPORT (CBR2017-2266) Permit Type: BLDG-Residential Application Date: 09/27/2017 Owner: Work Class: P/M/E Issue Date: 09/27/2017 Subdivision: Status: Closed - Finaled Expiration Date: 04/02/2018 Address: IVR Number: 6593 Scheduled Date Actual Start Date Inspection Type Inspection No. Inspection Status Primary Inspector 10/03/2017 10/03/2017 October 03, 2017 BLDG-43 Air Cond./Fumace Set 036595-2017 BLDG-Final Inspection Checklist Item BLDG-Building Deficiency 036596-2017 Checklist Item BLDG-Building Deficiency BLDG-Plumbing Final BLDG-Mechanical Final BLDG-Structural Final BLDG-Electrical Final Passed Chris Renfro COMMENTS Passed Chris Renfro COMMENTS TRUST GURBAXANI RANDALL FAMILY TRUST 05-12-14 CARLSBAD TCT#90-14 1569 Cormorant Dr Carlsbad, CA 92011-4003 Reinspection Complete Complete Passed Yes Complete Passed Yes Yes Yes Yes Yes Page 1 of 1