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Home My WebLink About1675 DOVE LN; MP; CB121601; Permit08-24-2012 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Piumbing/Mechanical/Electrical (PME) Permit Permit No: CB121601 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC #: Project Title: 1675 DOVE LN CBAD St: MP PME 0000000000 Lot#: TIME WARNER: 100AMP MET PED. Status: ISSUED Applied: 08/24/2012 Entered By: Plan Approved: Issued: Inspect Area: JMA 08/24/2012 08/24/2012 Applicant: L&G CABLECONSTRUCTION Owner: 2776 E MIRALOMA AV 92806 714-630-6174 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees $0.00 $150.00 $0.00 $0.00 TOTAL PERMIT FEES $150.00 Total Fees: $150.00 Total Payments To Date: $150.00 Balance Due: $0.00 Inspector: FINAL APPROVAL Date: Clearance: NOTICE: Please take NOTICE that approval of your project includes the 'Imposition' of fees, dedications, reservations, or other exactions hereafter collectively refenred to as 'fees/exactions.' You have 90 days from the date this pemnit was Issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Govemment Code Section 66020(a), and file the protest and any other required infonnation with the City Manager for processing in accordance with Cai1st>ad Municipal Code Section 3.32.030. Failure to timely follow that procedure will t>ar any sut)sequent 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 vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previouslv othenwise expired. THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: • PLANNING • ENGINEERING • BUILDING DRRE • HEALTH • HAZMAT/APCD ^ CITY OF CARLSBAD Building Permit Appiication 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: buldllng@carlsbadca.gov wm/.ca risbadca .gov Plan Check No.(2 • I (gtOt Est. Value Plan Ck. Deposit Date SWPP JOB ADDRESS ^ ^ , ^ ^ r\ CT/PR0JECT# ^ LOT#^ I PHASE» ffOFUf SUITE#/SPACE#/UNrr# # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE DESCRIPTION OF WORK: /ncfiide Squaro Faot ofAffscted AraaCs; EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YES • # NOD AIR CONDITIONING YES • NOD FIRE SPRINKLERS YES O NO • APPUCANT NAME (Primary Contact) APPUCANT NAME (Seconifary Contact) ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE EMAIL FAX PHONE EMAIL FAX PROPERTY OWNER NAME ADDRESS CONTRACTOR BUS. N, ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE — >»i f'WC . OTlL EMAIL ARCH/DESIGNER NAME & ADDRESS ST/WE LIC.# err*' BUS. Lic.# (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 applioantfor such permit to file a signed statement that he is licensed pursuant to the provisions ofthe Contractor's License Law (Chapter 9, commending with Section 7(X)0 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 Workers'Cotnpsnsatlon Dedaration: //lereby affirm uixferperia/fy of peqfuy one of the (b/Zowin^ n I have and will maintain a cartificate of content to aalf-lnsure for workers' compensation as provided by Section 37(Xlof the Labor Code, for the perfonnance o( the work for which this pennit Is issued. ^ I have and will maintain workers' compensation, aueguired by Section 3700 of the Labor Code, for the performance of Ihe work for which this peimit is issued. My workers' compensatkin insurance canier and policy number are: Insurance r.n ^HtfAfJuM f>lk)p. tJU«6.W Policy No. g^g. |4 t S^,^ g> Expiratton Date 'I'/^/^^C? l"^ This section need not be completed if the pennit is for one hundred dollars ($100) or less. n Certificate of Exemptian: I certify that in the perfomiance of the work fbr whch this pemiit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Califomia. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shaii subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In addition to the cost of compensation, damaggiJS provided for l|^actlan 3706 of the Labor cods, Interest and attomey's fees. ><Ef CONTRACTOR SIGNATURE _ ^XA^ /^^U*-''*— £]AGENT DATE O W NER-BUILDER DECLARATION / hereby affirm that I am exempt from Contractor's Ucense Law for the foUamng reason: • I, as owner of the property or my employees with wages as their sole compensation, will do the work and the stmcture is not intended or offered for sale (Sec. 7044, Business and Professtons Code: The Ck>ntractor's Ucense 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, provkled that such improvements are not intended or offered for sale. If, however, the building or improvement is soto within one year of completion, the owner-builder will have the burden of proving that he dkl not build or improve for the purpose of sale). 13 I, as owner of the property, am exclusively contracting with licensed contractois to constmct 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). • I am exempt under Section Business and Professtons Code for this reason: 1.1 personally plan to provkle the major labor and materials for construction of the proposed property improvement • Yes • No 2.1 (have / have not) signed an application for a building permit for the proposed wori<. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' Itoense number): 4.1 plan ki provkle portions of the work, but I have hired the foltowing person to coordinate, supenrise and provide the megor work (include name / address / phone / contractors' license number): 5.1 will provkle some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): VCTPROPERTY OWNER SIGNATURE •AGENT DATE COMPLETE THIS SECTION FOR N O N - R E S I D E N T i A L BUILDINC PERMITS ONLY Is the appltoant 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 Ad? OYes • No Is the applicant or future buikling occupant required to obtain a pemiit 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? OYes QNo 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 afUm) that there is a construction lending agency for the perfonnance of the work this pemiit is Issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address APPLICANT CERTIFICATION I certi^ that I have read the appikatton and state that the above InltamiatkHi Is ooriect and that the Info^ I hereby authorize representative of the City of Cailsbad 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 CffY IN CONSEQUENCE OF THE GRANTING OF THIS PERMff. OSHA An OSHA pennK Is lequired Ibr excavations over 301 deep and demolitbn or construction of structures over 3 skxies In height. EXPIRATION: Every pennit issued by the Buikling Oftdal under the proviskms of this Code shal expire by limitatkm and become nul and vokl if the buikling or work authorized by such pemiit is not commenced within 180 days from the date of such pennit or if the buiding or vwik authorized by such peimit is suspended or abandoned at any lime alter the vwik is commenced for a peifod of 180 days (Sectkm 106.4.4 Uniform Buikling Code). DATE 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 www.buildina@carisbadca.oov or Mail the completed fomi to City of Carisbad, Building Division 1635 Faraday Avenue, Carisbad, Califomia 92008. C0#: (Offlca 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: • CONTACT (Usted above) • OCCUPANT (Usted above) • CONTRACTOR (On Pg. 1) • MAIL TO: • CONTACT (Usted above) • OCCUPANT (Listed above) • CONTRACTOR (On Pg 1) • MAIL/FAX TO OTHER: • ASSOCIATED CB# • NO CHANGE IN USE / NO CONSTRUCTION • CHANGE OF USE/NO CONSTRUCTION • ASSOCIATED CB# • NO CHANGE IN USE / NO CONSTRUCTION • CHANGE OF USE/NO CONSTRUCTION >CS'APPUCANT'S SIGNATURE DATE Inspection List PermlW: CB121601 Type: PME TIME WARNER: 100AMP MET PED. Date Inspection Item Inspector Act Comments 09/25/2012 32 Const. Service/Agricultural - Rl 09/25/2012 32 Const. Service/Agricultural MC AP 09/25/2012 39 Final Electrical MC Fl CALLED IN TO MONICA Wednesday, September 26,2012 Page 1 of 1