HomeMy WebLinkAbout158 Acacia Ave; ; CBR2017-0980; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Print Date: 06/12/2017 Residential Permit Permit No: CBR2017-0980
www.carlsbadca.gov
Job Address:158 Acacia Ave
Permit Type:BLDG-Residential Work Class:P/M/E Status:Closed -Finaled
Parcel No:2042332203 Lot #:Applied:05/09/2017
Valuation:$0.00 Reference #:Issued:05/09/2017Occupancy Group:Construction Type:Finaled:
# Dwelling Units:Bathrooms:Inspector:MColl
Bedrooms:Orig. Plan Check #:
Plan Check #:
Project Title:
Description:CRUM: INSTALL NEW 100A PANEL
Applicant:Owner:
MACGRAY ELECTRIC INC TRUST CRUM FAMILY
167 Redwood Ave
2718 Waterbury Way CARLSBAD, CA 92008
Carlsbad, CA 92010-1369
760-802-0140
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.
1
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THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE:0 PLANNING 0 ENGINEERING 0 BUILDING 0 FIRE 0 HEALTH 0 HAZMAT/APCD
Ari."''
Building Permit Application Plan Check No.ce.Ra6 n _cis goVCity of 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value
Ph: 760-602-2719 Fax: 760-602-8558CarlsbadPh:
building@carlsbadca.gov Plan Ck. Deposit
www.carlsbadca.gov Date 5 iq A 7JOB ADDRESS /r 1-0-64-41E SUITEtt/SPACEtt/UNITO APN --
CT/PROJECT #LOT #' PHASE C #OF UNITS a BEDROOMS # BATHROOMS ' TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP
DESCRIPTION OF WORK:Include Square Feet of Affected Area(s)
/UAAJ 1 O0 /W /67f7'/Af/PJ
EXISTING USE PROPOSED USE GARAGE (SF)PATIOS (SF)DECKS (SF)FIREPLACE AIR CONDITIONING FIRE SPRINKLERS
YESElit.NOD YES DNOG YES0 NOD
APPLICANT NAME
‘4c1/4.11.)///f(07/(1 PROPERTY OWNER NAME 3e!(41;fMuniContact
ADDRESS ADDRESS r-j_71g 40 -fni.u/A1 ttiki tcv /04 telAt
CITY *it gf/49 STATE/ZIP
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CITY alit op STA*
ZIP ei-ey
PHONE FAX PHONE FAX
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EMAIL -_t. 14r.0 nt
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DESIGN PROFESSIONAL CONTRACTOR BUS. NAME /(016/Sf kte-'(47tt 44
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ADDRESS ADDRESS AN P1440111"(tk.4111
CITY STATE ZIP CITY W40 STAT4
ZIP
P6/11
PHONE FAX PHONE FAX70-ga -eyteo
EMAIL EMAIL r.frit t. 1 e_/clic 1447
STATE LIC. #STATE LIC.#a_67A-72 CLASS6-10
CITY iUS_. Lic.,#al 7.Sg'5
(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 theIapplicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License LawChapter 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 031.5 by any applicant for a permit subjects the applicant to acivil penalty of not more than five hundred dollars ($500)).
WORKERS'COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one ofthe following declarations:o 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.0 Ihave nd 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
n er are: Insurance Co.Policy No.Expiration Date
This tion need not be completed if the permit is for o •hundred dollars ($100) or less.
Certificate of Exemption:I certify that in the pe 1 .nce 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 worke .mpensation c.erage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundre. thousand dollars (&100,000), in
addition to the cost of compensation, damage
itrovided
fo in ••• •n 3706 of the Labor code, interest and attorney's fees.
AK CONTRACTOR SIGNATURE 0 AGENT DATE (c i
OW,N,E.,R -BUILDER DECLARATION
1-9-
I hereby affirm that I am exempt from Contractor's License Law for the following mason:
EiI,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).
ElI,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 Contractors License Law).
0 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.ales ON°
2.I (have / 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 / 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 following persons to provide the work indicated (include name /address / phone / type of work):
TKPIMPFRTY OWNER SIGNATURE nAGENT DATE
maAr7
.COMPLETE THIS SECTION FOR NON -RESIDENTIAX 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?0Yes 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?II Yes 0 No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?0 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.
CONSTRUCTION LENDING AGENCY
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 state that the above information is correct and that the information on the plans is accurate.I agree to comply vrith all City ordinances and State laws relating to building construction.
I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspection purposes.IALSO 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 INCONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA permit is required for excavations over Soil deep and derncri
or construction of structures over 3 stories in height
EXPIRATION: Every permit issued by the Building Offic',•er the provis'.fthis Code shall expire by imitation and become null and void if the building or work authorized by such permit is not commenced within
180 days from the date of such permit or if the build'$authorized by -ch permit is suspended or abandoned at any time after the work is commenced fora period of 1 I days r-$..$106.4.4 Unifomi Building Code).
../KAPPLICANT'S SIGNATURE DATE
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PERMIT INSPECTION HISTORY REPORT (CBR2017-0980)
Permit Type:BLDG-Residential Application Date:05/09/2017 Owner:TRUST CRUM FAMILY
Work Class:P/M/E Issue Date:05/09/2017 Subdivision:PARCEL MAP NO 16289
Status:Closed -Finaled Expiration Date:12/04/2017 Address:158 Acacia Ave
Carlsbad, CA 92008-3201
IVR Number:3603
Scheduled Actual
Date Start Date Inspection Type Inspection No.Inspection Status Primary Inspector Reinspection Complete
06/05/2017 06/05/2017 BLDG-33 Service 025219-2017 Passed Michael Collins Complete
Change/Upgrade
Checklist Item COMMENTS Passed
BLDG-Building Deficiency EMR called in to Kim.Yes
06/12/2017 06/12/2017 BLDG-Final 025925-2017 Passed Michael Collins Complete
Inspection
Checklist Item COMMENTS Passed
BLDG-Electrical Final Yes
June 12, 2017 Page 1 of 1