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Home My WebLink About1677 BUENA VISTA WAY; C; CB120831; Permit05-04-2012 City of Carlsbad 1635 Faraday Av Carlsbad.CA 92008 Plumbing/IVIechanical/Electrical (PME) Permit Permit No: CBl 20831 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC #: Project Title: 1677 BUENA ViSTA WY CBAD St: C PME 1562001500 Lot#: MEDINA PROPERTY- EMERGENCY GAS LiNE REPAIR FROM METER TO UNIT Applicant: K DRURY AND SONS CONSTRUCTION 399 ESCONDiDO AVE VISTA 92084 760 822-2508 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED - 05/04/2012 LSM 05/04/2012 05/04/2012 Owner: MEDINA CONSTANTINO JR FAMILY TRUST 05-14-01 2448 FLAMETREE RD VISTA CA 92084 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees $30.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $30.00 Total Fees: $30.00 Total Payments To Date: $30.00 Balance Due: $0.00 Inspector: FINAL APPROVAL Date: ST-f'/Z. Clearance: NOTICE: Please take NOTICE that approval of your project Includes the Imposition" of fees, dedications, resen/ations, or other exactions hereafter coiiectiveiy refen-ed to as "tees/exactions." 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. Faiiure 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/exactlons DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or sewlce fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which vou have previouslv been oiven a NOTICE similar to this, or as to which the statute of limitations has previously othenvise expired. ^ CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718/ 2719 Fax: 760-602-8558 www.carlsbadca.gov PlanCheckNo. ^ fQ~O^S I Est. Value Plan Ck. Deposit Date s7¥// 2^ SWPP JOBADDRESS ^ _ t 1 / ^^}/ SUITE#/SPACE#^mifT# \ APN AKt) - CT/PR0JECT# L0T(f ' ' PHASE # # OF UNITS # BEDROOMS # BATHR90MV V JS^ANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: /nc/ude Square Favt of Affected AreafsJ 'i^o c^AS Lijje /'A<^/^ /ner^/i-s /o UA//T<i EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) RREPLACE AIRCONDITIONING FIRESPRINKLERS YES O # NO • YES • NO • YES D NO • APPUCANT NAME (Primary Contaet) APPUCANTNAME (Secontfaiy Contact) ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL PROPERTY OWNER NAME J - ^ ./^/l CP^-'/AJjSr ADDRESS CITY STATE ZIP PHONE FAX PHONE ^ EMAIL ARCH/DESIQNER NAME & ADDRESS STATE LIC. # STATE LIC.# CLASS ^ CITY BUS. LIC.# ^ -.^ 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, commenaing 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 Woiicera' Compensation Declantion: / hereby affirm under penalty of perjury aie of the following declara&ins: O I have and will maintain a certificate of consent to seif-insure for woricers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this pemiit is issued, n I have and will maintain woriien' compensation, as required by Section 3700 of the Labor Code, fbr the performance of the work for which this pemiit is Issued. My workers' compensatkin insurance carrier and poltey number are: Insurance Co. Policy No. Expiration Date tsection need not be completed ifthe pemiit Is <br one hundred dollars ($100) or less. Certificate of Exemption: I certify that in the perfbrmance of the work for wheh this permit is issued, I shall not employ any person In any manner so as to become subject to the Woriters' Compensation Laws of Califbmia WARNING: Failure to secure workers' compensation coverage is uniawfui, and shaii subject an empioyer to criminai penalties and chril fines up to one hundred thousand doiiars (&100,000), in addition to the cost of compensation, tSggSg^lk provMedjprta Se{Us»W06 of the Labor code, interest and attomey's fees. >ef CONTRACTOR SiGNATURE •'^'^^^^^^^^^^'^'^y^ aAGEMT DA^'^-/ 2^ OWNER-BUILOER DECLARATION / ftereby affirm that I am exempt from Contractor's Ucense Law for the following reason: a I, as owner of the property or my employees with wages as their sole compensation, will do the woric 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 woric himself or through his own empkiyees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is soki 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 Contractor's License Law does not apply to an owner of property who bulUs or improves thereon, and contracts fbr siich projects with contractor(s) licensed pursuant to the Contractor's Ucense Law). I am exempt under Section Business and Professions Code for this reason: 1.1 personaiiy plan to provide the major labor and materials for construction of the proposed property improvement • Yes O No a 2.1 (have / have not] signed an application for a building permit for the proposed woric. 3.1 have contracted with the following person (fimi) to provide the proposed construction (include name address / phone / contractors' license number): 4.1 plan to provide portions of the woric, but I have hired the toltowing person to coordinate, supen/lse and provide the major woric (Include name / address / phone / contractors' license number): 5.1 will provide some of the work but I have contracted (hired) the tollowing persons to provide the work Indicated (include name / address / phone / type of woric): veTpROPERTY OWNER SIGNATURE •AGENT DATE ,l»fcETe THIS SBCTION FOR NON-RESIDENTIAL BUILDING PERIWITS ONLY ^ applicant or future building occupant required to submit a business plan, acutely hazardous materials registration torm or risk management and prevention program under Sections 25S0S, 25533 or 25534 of the ^pIssley-Tanner Hazardous Substance Account Act? • Yes • No Is Ihe applicant or future buikling occupant required to obtain a permit from the air pollutton control district or air quaiity management district? • Yes • No Isthefaciiity to be constnjcted within 1,000 feet of the outer boundary of a school site? OYes • No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTiFiCATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPUCANT 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 woric this permit is issued (Sec. 3097 (i) Civil Code). I Lender's Name Lender's Address APF>LICANT CERTIFICATION I ceitify ttiati have read the appltoation and slate that the above infoimatkin is conect and thatthe infbnnatkxi on the pians is accuiate. I agiee to complywith aH CHy ordinances and Stats laws relating to buiiding constnicdon. I hereby authorize representative of Ihe Cily of Carisbad to enter upon the above inentkxied pn^ AGAWST AU LIABILfTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY N ANY WAY ACCRUE AGAINST SAD CITY IN CONSEQUENCE OF THE GRANHNG OF THIS PEIMT. OSHA: An OShlA permit Is required for excavatkins over 5'0'deep and dernolilkin or constructkm of stnjclu^ EXPiRATiON: B«ry pemiit issued by Ihe Building Offnai under the piovisnns of this Code shal expie 180 days Irom the date of such pemiit w If^^^^^woricaul^^ yeTAPPLICANT'SSiGNATURE 'Z^^i^^^^^'^ J y"^'"^':)''^ "ATE ^ 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 vww.bulldlnqaicailsbadca.aov or Mail the completed form to City of Carisbad, Building DIviston 1635 Faraday Avenue, Carlsbad, Califoniia 92008. Cd#: (Ofnce Use Only) CONTACT NAIVIE OCCUPANT NAIME ADDRESS BUILDiNG ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE FAX EMAiL OCCUPANT'S BUS. LIC. No. DEUVERY OPTIONS a PICK UP: • CONTACT (Usted above) • OCCUPANT (Usted above) • CONTRACTOR (On Pg. 1) • MAILTO: • CONTACT (Usted above) • OCCUPANT (Usted above) • CONTRACTOR (On Pg. 1) a MAIL / FAX TO OTHER: • ASSOCIATED CB«- • NO CHANGE IN USE/NO CONSTRUCTION • CHANGE OF USE / NO CONSTRUCTION ^pTAPPUCANrs SIGNATURE DATE Inspection List Permit*: CB120831 Type: PME Date Inspection Item 05/08/2012 23 Gas/Test/Repairs 05/08/2012 29 Final Plumbing 05/04/2012 23 Gas/Test/Repairs Inspector Act Rl PB AP PB AP MEDINA PROPERTY- EMERGENCY GAS LINE REPAIR FROM METER TO UNIT Comments Wednesday, May 09, 2012 Page 1 of 1