HomeMy WebLinkAbout1628 MARITIME DR; ; CB142049; Permit08-19-2014
Job Address:
Permit Type:
Parcel No:
Reference #:
PC#:
Project Title:
Applicant:
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing/Mechanical/Electrical (PME) Permit
Permit No: CB142049
Building Inspection Request Line (760) 602-2725
1628 MARITIME DR CBAD
PME
2150821400 Lot#:
HEXOM RES-RUN NEW GAS LINE
FROM STUB-OUT TO BBQ IN REAR YARD
0
Owner:
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
08/19/2014
RMA
08/19/2014
08/19/2014
HEXOM ROBERT JR&DEBRA HEXOM ROBERT JR&DEBRA
1628 MARITIME DR
CARLSBAD CA 92011
760 464-1673
Plumbing Fees
Electrical Fees
Mechanical Fees
Other PME Fees
TOTAL PERMIT FEES
1628 MARITIME DR
CARLSBAD CA 92011
$158.00
$0.00
$0.00
$0.00
$158.00
Total Fees: $158.00 Total Payments To Date: $158.00 Balance Due:
Inspector: Date: Clearance:
$0.00
NOTICE: Please take NOTICE that approval of your project includes the "Im osition" fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." You have 90 days from the date this permit was issue 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.
THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING ,,
<l~ ~ CITY Of
CARLSBAD
Building Permit Application
1635 Faraday Ave,, Carlsbad, CA 92008
Ph: 760-602-2719 Fax: 760-602-8558
email: building@carlsbadca,gov
www.carlsbadca.gov
SUITI:f/SPACEI/UNIT#
□BUILDING □FIRE □HEALTH
Plan Check No.
Est. Value
Plan Ck. Deposit
)I.. SWPPP
# OF UNITS # BEDROOMS # BATHROOMS CONSTR. TYPE OCC. GROUP
DESCRIPTION OF WORK: Include Square Feet ot Affected Area(s)
l'lf=w ~o' v'"4~6'2,0l>t--1D rbAS
47Vg O VT AT BUAb, Fpc_E. 'TO
f'~TlO.
EXISTING USE
APPLICANT NAME
Primary Contact
ADDRESS
CITY
PHONE
EMAIL
DESIGN PROFESSIONAL
ADDRESS
CITY
PHONE
EMAIL
PROPOSED USE
STATE
FAX
STATE
FAX
GARAGE (SF} PATIOS (SF)
ZIP
ADDRESS
ZIP CITY
PHONE
EMAIL
STATE LIC. # STATE UC.#
I= }(1 <ST1 NG 1/ z' '
/\T lZ~A (2::...
AIR CONDITIONING
No[] YES0No0
I
STATE ZIP
FAX
CLASS CITY BUS. LIC.#
FIRE SPRINKLERS
vesONoO
(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 per_mIt to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law JChapter 9, comme_nding with Section 7000 of Div1s1on 3 of the B_usiness 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 a
cIvII penalty of not more than five hundred dollars {$500)).
WORKERS' COMP ENS AT ION
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
El 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 pelformance of the work for which this permit is issued.
I have and will maintain workers' compensation. as reauired bv Section 3700 of the Labor Code, tor the performance of the work for which this permit is issued. My workers' compensaUon insurance carrier and policy
number are: Insurance Co, _____________________ Policy No. ______________ fapiraUon Date _________ _
~section need not be completed if the permit is for one hundred dollars ($100) or less. LJ Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shalt not employ any person in any manner so as to become subject to the Workers' Compensation Laws of
California. WARNING: Fallure to secure Workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and clvll fines up to one hundred thousand dollars (&100,000), ln
addition to the cost of compensation, damages as provided for In Section J706 of the Labor code, Interest and attorney's f&es,
flS CONTRACTOR SIGNATURE □AGENT DATE
I hereby affirm that I am e;(empt from Contractor's License Law for the following reason:
□
·□
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).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions' Code: The Contract9r's License Law does not apply to an owner of
property wtio 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 construcUon of the proposed property improvement. 0Yes 0No
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 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/ address I phone I type of work):
i ..@'.S' PROPERTY OWNER SIGNATURE I □AGENT
Is the applicant or future bu1ld1ng occupant required to submit a business plan, acutely hazardous matenals registration form or nsk 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 permit from the air pollution control district or air quality management district? Yes No
Is the facility to be constructed 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.
I certify that I 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~lh atl City oldlnances and Stam lav.s relating to building construction.
I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property br inspection purp:;>Ses. 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 CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA permtt is required for excavations over 5'0' deep and demo@::in or construction of structures over 3 stories in height.
EXPIRATION: Every pemiit issued by the Building Official under the provisions of this C.ode shall expire by limitation and become null and vokl W the b'Jilding or oork authorized by such pem1it is not commenced 'Mthin
180 days from the date of such permit or if the building or authorized by such permit is suspended or abandoned at any time after the oork is commenced for a period of 180 days (Section 106.4.4 Unifonn Building Code) .
.Jl5 APPLICANT'S SIGNATURE DATE 4-
•
r,
' '
i l , ....•.. •' 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 building@car1sbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008.
CONTACT NAME
ADDRESS
CITY STATE
PHONE
EMAIL
DELIVERY OPTIONS
PICK UP:
MAIL TO:
CONTACT (listed above)
CONTRACTOR (On Pg. 1)
CONTACT (Listed above)
CONTRACTOR (On Pg. 1)
ZIP
FAX
OCCUPANT (Listed above)
OCCUPANT (Listed above)
MAIL/ FAX TO OTHER: _______________ _
,IS APPLICANT'S SIGNATURE
CO#: (Office Use Only)
OCCUPANT NAME
BUILDING ADDRESS
CITY STATE
Carlsbad CA
OCCUPANT'S BUS. UC. No.
ASSOCIATED CB#'-------------
NO CHANGE IN USE/ NO CONSTRUCTION
CHANGE OF USE/ NO CONSTRUCTION
DATE
ZIP
lnsp.ection List
Permit#: CB142049 Type: PME
Date Inspection Item
09/05/2014 29 Final Plumbing
09/05/2014 29 Final Plumbing
08/26/2014 23 Gas/TesURepairs
08/26/2014 23 Gas/TesURepairs
Monday, September 08, 2014
Inspector
SP
SP
HEXOM RES-RUN NEW GAS LINE
FROM STUB-OUT TO BBQ IN REAR YARD
Act Comments
RI
Fl
RI HEXOM RES
AP
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