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Home My WebLink About1804 COTTONWOOD AVE; ; CB142791; Permit10-20-2014 City of Carlsbad 1635 Faraday Av Carlsbad.CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB142791 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC #: Project Title: 1804 COTTONWOOD AV CBAD PME 2155033716 Lot #: SEAPORT HOA-GAS LINE REPAIR LEAK BY METER- SDG&E SHUT OFF Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 10/20/2014 RMA 10/20/2014 10/20/2014 Applicant: MISSION COAST PLUMBING INC Owner: PAKULA FAMILY TRUST 06-19-90 3568 9TH ST SAN MARCOS CA 92078-2316 760-295-3346 1804 COTTONWOOD AVE CARLSBADCA 92011 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees $160.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $160.00 Total Fees: $160.00 Total Payments To Date; $160.00 Balance Due: $0.00 Inspector: FINALA Date: IA Clearance: NOTICE: Please take NOTICE that approval of your project Includes the "Irtiposlti^of fees, dedications, resen/ations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this pemiit 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 information with the City Manager for processing In accordance with Carisbad 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 vou have oreviouslv been given a NOTICE similar to this, or as to which the statute of limitations has previously othenA/ise expired. %\-rm FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: •PLANNING OENGINEERING nBUILDING OFIRE OHEALTH •HAZMAT/APCD ^ City of Carlsbad Building Permit Appiication 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov www.carisbadca.gov Plan Check No. Est. Value V I Plan Ck. Deposit ^ W APN SWPPP CT/PROJECT tt |L0T# I PHASE # |#0f SUITE#/SPACE*/UNITl OF UNITS # BEDROOMS tt BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: /ncfude Square Feet of Affected Areafs) EXISTING USE PROPOSED USEI GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YES I |# N0| I AIR CONDITIONING YES QNO I I FIRE SPRINKLERS YES I |NO[ I APPLICANT NAME Primary Contact PROPERTY OWNER ADDRESS CITY STATE ZIP '"°7^^ jPm- EMAIL 7^ ^ PHONE FAX EMAIL DESIGN PROFESSIONAL CONTRACTOR BUS. NAME_ _ , ADDRESS ADDRESS CITY STATE ZIP CITY iTE ZIP PHONE FAX RHONE ^ FAX/- EWAIL A . , _ 7\ I EMAIL (See. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demoiish or repair any structure, prior to its applicantfor such permitto file a signed statement that he is licensed pursuantto the provisions ofthe Contractor's License Law (Chapter 9, commendingwlth Seat!/ _ _ . 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 applicantfor a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)). : R s ' c omPA > N Workers' Compensation Declaration: / /lereby affirm under penalty ofpeijury one ofthe following declarations: J I have and will maintain a certificate of consent to selMnsure for workers' compensation as provided by Section 3700 of the Labor Code, for the perfonnance of the work for which this pennit is issued. .oThave and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performarice of the work for wfch thi^err|i[t i|Jssued. My workers' compensation iijsurani^ carrier arid^ policy numberare: InsuranceCo. h^<ZJ(l^\VJSVA.\2JWC1. Cl This section need not be completed if the permit Is for one hundred dollars ($100) or less. otkars' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which thiafierrait isissued. My workers' compensation iijsuranffi carrier and pi r^<ZJtiet^\VJSvX>2JWCl. ClOM^/Wy Policy No KVM^U3Q3Mg)B^ Expiration Date Ol/Ot JZOIS' . .. ...,..-ted if the permit Is for one hundred dollars ($100) or less. I I Certificate of Exemption: 1 certify that In the perfomiance of the work for which this perniit 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 shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In addition to the cost of compensatlo^^^mages as rifovided i&r in SectioA 3706 of the Labor code, interest and attomey's fees. . >^ CONTRACTOR SIGNATURE ^XGENT DATE 101.^-OI I If OWNER-BUItDER DECLARATION / hereby affm that I am exempt from Cortractor's License Lai* for the following reason: I I 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 I I, as owner of the property, am exclusively contracting with licensed contractors 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). • am exempt under Section _ _BuEiness and Professions Code for this reason: t. I personally plan lo provide (he major labor and materials for eonsiruction of the proposed property improvement •Yes •NO 2.1 (have / have not) signed an appiication for a building pemiit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed constmction (include name address / phone / contractors' license number): 4.1 plan to provide portions of the work, but I have hired the following person to coordinate, supereise and provide the major work (include name / address / phone / contractors' license number): 5.1 will provide some of the work, but I have contracted (hired) fhe following persons to provide the work indicated [include name / address / phone / type of work): jgS'pROPERTY OWNER SIGNATURE •AGENT 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 Sectbns 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 fxility to be constmcted 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 hereby affirm that there Is a construction lending agency for the performance of the wori< this permit is issued (Sec. 3097 (1) Civil Code). Lender's Name Lender's Address I certIV that I have read the application and state thatthe above Infonnation is conect and thatthe inibmiation on the plans is accurate. I agree to complywith 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. 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 CfTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA pemnit is required for excavations over 5'0' deep and demolitfon or constmction of stmctures over 3 stories in heght. EXPIRATION: Every permit issued by the Building Ofiicial under the provisons ofthis Code shall expire by limitatfon 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 building or mk authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Sectfon 106.4.4 Unifomi Building Code). APPLICANT'S SIGNATURE 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 buildinqOcarlsbadca.aov or Mail the completed form to City of Carisbad, Building Division 1635 Faraday Avenue, Carisbad, Califomia 92008. C0#: (Office Use Only) CONTACT NAIVIE OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE FAX EIVIAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAILTO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAIL / PAX TO OTHER: ASSOCIATED CB#- NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION jgf APPLICANT'S SIGNATURE DATE Inspection List Permit*: CB142791 Type: PME Date Inspection Item 10/21/2014 23 Gas/Test/Repairs 10/21/2014 23 Gas/Test/Repairs 10/21/2014 29 Final Plumbing Inspector Act Rl SP AP SP Fl SEAPORT HOA-GAS LINE REPAIR LEAK BY IVIETER- SDG&E SHUT OFF Comments Wednesday, October 22, 2014 Page 1 of 1