HomeMy WebLinkAbout1862 Outrigger Ln; ; CBR2017-0025; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Print Date: 02/13/2017 Residential Permit Permit No: CBR2017-0025
Job Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Group:
# Dwelling Units:
Bedrooms:
Project Title:
Description:
1862 Outrigger Ln
BLDG-Residential
2074012100
$0.00
www.carlsbadca.gov
Work Class: P/M/E
Lot#:
Reference #:
Construction Type:
Bathrooms:
Orig. Plan Check#:
Plan Check#:
RUFF: NEW AC UNIT W ELECTRICAL, REPLACE FURNACE LIKE FOR LIKE
Owner:
Status:
Applied:
Issued:
Finaled:
Inspector:
Contractor:
Closed -Finaled
01/05/2017
01/05/2017
JWest
TRUST RUFF FAMILY TRUST 01-14-15
1862 Outrigger Ln
ACTION AIR COND.& HEATING-5.D.
CARLSBAD, CA 92008
PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT
Total Fees: $166.00 Total Payments To Date: $166.00
2750 S Santa Fe Ave
San Marcos, CA 92069-5928
760-727-4152
Balance Due:
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.
$0.00
$166.00
• THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: 0 PLANNING 0 ENGINEERING □BUILDING □FIRE □HEALTH 0HAZMAT/APCD
~
' . (.._ City of
Carlsbad
JOB ADDRESS '
Building Permit Application
1635 Faraday Ave., Carlsbad, CA 92008
Ph: 760-602-2719 Fax: 760-602-8558
email: building@carlsbadca.gov
www.carlsbadca.gov
e.<" L"'-. SUITE#/SPACEI/UNITI
Plan Check No. ct,Q_2<> '1-cX:l.2-?
Est. Value
SWPPP
CT/PROJECT# LOT# # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) ►}f:.o.J "'/C. l),<'l-4--$ -\-011\
t"2-et1\u.e ~~'""'o-L.e
EXISTING USE
APPLICANT NAME
Primary Contact
ADDRESS3 C:. \ 'l-VJ La..
CITY
EMAIL
DESIGN PROFESSIONA
ADDRESS
CITY STATE
PHONE FAX
EMAIL
I,µ I €.le. (k'I" ~ c..J
101( «fl)
GARAGE {Sf) PATIOS (SF} DECKS (SF)
PROPERTY OWNER
ADDRESS
CONTRACTOR BUS. NAME
ADDRESS fL75()
ZIP
FIREPLACE
YES0,
PHONE ·11,,0-12--1-'-i rs '2.-
EMAIL
STATE LIC. # STATE LIC.# '5dl'isOS
AIR CONDITIONING
No0 YES □No □
L-n.
ZIP
FAX
CLASS
C ;i.o
FIRE SPRINKLERS
YES□NO□
.... ,e.
(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 Division 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' COMPENSATION
Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of fhe following dedarations:
l:Jj.i,>'e 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.
~ave and will maintain workers' compensation, as required ~ Section 3700 of the Labor Code, for the performance of the work for which this pelJlil is issued. My workers' compensation ins ran ca
nomberare,losuracceCc.:CV\5 (.t, C>+--4\.--.<i< w~PolicyNc. I.J:5D~02-~'f(o5 Exp,ralicoDate_1__..-:1-,LJJ_Ll___
~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 perfonnance of the work for which this pennit 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 workers' compe atlon ge 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 compensation, P. vi I0n 3706 of the Labor code, Interest and attorney's fees. ~ CONTRACTOR SIGNATURE _____ ~ENT
I hereby affirm that I am exempf from Contractor's Ucense 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 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 Professions Code for this reason:
1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. Oves 0No
2, I (have I have not) signed an application for a building pennit for the proposed work
3. I have contracted with the following person (firm) to provide the proposed construction (include name address I 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/ address I 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 I address/ phone I type of work):
~ PROPERTY OWNER SIGNATURE □AGENT DATE
• -COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY
Is the ap~licant 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 Acr? □ Yes □ No
Ts the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ Yes D No
Is the facility to be constructed within 1,000 feel of the outer boundary of a school site? □ Yes O 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 with all Cilyordlnances and State laws relating to building construction.
I hereby authorize representative of the City of Car1sbad to enter upon the at::ove mentioned property br inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD
AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CllY IN CONSEOJENCE Of THE GRANTING OF THIS PERMIT
OSHA: AA OSHA permit is required for excavations over 5'0' deep and demolition orcoostrudion of structures over 3 stories in height
EXPIRATION: Every pennlt issued by the Building Offdal under the provis· of this Code shall expire by lim~ation and become null and void ~the building oroork authorized by such permit is not commenced ......rthin
180 days from the date of such permit or if the building oroo ulh · uch permit is suspended or abandoned at any time after the oork is commenced for a perioo of 80 days (Secoon 100.4.4 Unifonn Building Code)
,@S° APPLICANT'S SIGNATURE DATE ( 5 11
• 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@carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008.
CONTACT NAME
ADDRESS
CITY STATE ZIP
PHONE FAX
EMAIL
DELIVERY OPTIONS
□ PICK UP: o CONTACT (Listed above) □ OCCUPANT (listed above)
□ CONTRACTOR (On Pg. 1)
0 MAIL TO: o CONTACT (Listed above) o OCCUPANT (Listed above)
o CONTRACTOR (On Pg. 1)
0 MAIL/ FAX TO OTHER: ________________ _
A$ APPLICANT'S SIGNATURE
CO#: (Office Use Only)
OCCUPANT NAME
BUILDING ADDRESS
CITY STATE
Carlsbad CA
OCCUPANT'S BUS. LIC. No.
□ ASSOCIATED CB#-------------
0 NO CHANGE IN USE/ NO CONSTRUCTION
o CHANGE OF USE/ NO CONSTRUCTION
DATE
ZIP
PERMIT INSPECTION HISTORY REPORT (CBR2017-0025)
Permit Type: BLDG-Residential Application Date: 01/05/2017 Owner: TRUST RUFF FAMILY TRUST
01-14-15
Work Class: P/M/E Issue Date: 01/05/2017 Subdivision:
Status: Closed -Finaled Expiration Date: 08/14/2017 Address: 1862 Outrigger Ln
Carlsbad, CA 92008-3781
IVR Number: 1268
Scheduled Actual Inspection Type Date Start Dato Inspection No. Inspection Status Primary Inspector Relnspectlon Complete
02/13/2017 02/13/2017 BLDG-43 Air 013181-2017 Passed Jonathan West Complete
Cond./Fumace Set
BLDG-Final 013182-2017 Passed Jonathan West Complete
Inspection
Checklist Item COMMENTS Passed
BLDG-Mechanical Final Yes
February 13, 2017 Page 1 of1