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Home My WebLink About1880 OUTRIGGER LN; ; CB163225; Permit------------------ 08-22-2016 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: CB163225 Building Inspection Request Line (760) 602-2725 1880 OUTRIGGER LN CBAD PME 2074013000 Lot#: 0 BAYUS: INSTALL A/C & ELECTRIC REPLACE FURNACE Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 08/22/2016 SLE 08/22/2016 08/22/2016 ACTION AIR COND & HEATING-SD BAYUS DEBORAH K REVOCABLE TRUST 02-24-09 2750 S SANTA FE AV SAN MARCOS CA 92069 760 727 4152 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES 1880 OUTRIGGER LN CARLSBAD CA 92008 $0.00 $38.00 $163.00 $0.00 $201.00 Total Fees: $201.00 Total Payments To Date: $201.00 Balance Due: Inspector: FINAL APPROVAL Date: //J'/J-16 Clearance: $0.00 NOTICE: Aease ta<e NOTICE that~ cJ )l'.U J>tjed indudes the "lrrposition' cJ fees, declcalioro, -= c, clt>;r e,ooia,s -cdledivay referred toas "feas'e,ooicn," Yru rave OOda'ysfromthe-ttis pemit1M1S iSSLed to p,ctest irrposilion citresefeesle,ooicn, If yru p,ctestlhem yru nust fcJlo.vthe ?"(test proc:sct,es set forth in Gc7Jerm-ent Code Section 600:!J(a), erd file the ?"(test erd ,rr; ctt-.r req.jred infooreticn wth the aty ~fcr poa,ssirg in ~wth Calsbad M.ridr;a Code Sedicn 3.321m. Falu-etotirrelyk:llo.vthel procecirel'JII ba-w:r;subse<µrt lega a:licnto~ reJieN, set aside, vdd, a clTU tt-eir irrpa;ition. Yru ere i...et,; FUmER NOTIFIED that )l'.U rig-t to p,ctest the specified feaslexa:lia,s DCES NOT />PPL Y tov.ata-erd _. cxrn,cticn leas erd c:ap,rity cnrg,s, nc, plannrg, zoorg ga:lrg cr ctt-.r sinrila-applicalicn JJOCBSSirg c, ...,.;a, leas in cxrn,cticn wth !tis J:'Cied. = DCES IT />PPL Y to w:r; W1 . si'I W1 Ii' THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH 0HAZMAT/APCD (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 Plan Check No. Ct) ( Est. Value Plan Ck. Deposit JOB ADDRESS \~O r CT/PROJECT# LOT# PHASE# DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) A S~<le. 'LDC EXISTING USE APPLICANT NAME PHONE FAX EMAIL DESIGN PROFESSIONAL ADDRESS CITY STATE PHONE FAX EMAIL Date SUITEf/SPACEf/UNIT# # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME GARAGE (SF) PATIOS (SF) PROPERTY OWNER ZIP 1, CONTRACTOR BUS. NAME (! . ' ADDRESS~ < 'l'.ar.J(? cz:1"5 0 .) ' ZIP STATE UC.# STATELIC.# 5011SOS SWPPP CONSTR. TYPE CCC. GROUP AIR CONDITIONING vesONoD FIRE SPRINKLERS vesONoO ZIP n -l ')...OO'b°' (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 permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law /Chapter 9, comme_nding with Section 7000 of Division 3 of the B_usiness and Professions Code) or (hat 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' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D I have and will maintain a certificate of consent to self-Insure for workers' comper.sation as provided by SecUon 3700 of the Labor Code, for the performance of the work for which this permit is issued ~ have and will maintain workers' compensation, as required br Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy aumbe, ace: lnsocance c,.::,:;:,.., {o. of ~½ I II Je-;,.-\ Pol;cy No. (.,/;Sb6<2 7-..g-11 ~s &p;,at,on Date I 'k} 3 \ / 2.o1 (, Jllj§.seclion need not be completed if tt,e 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 shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Fa Hu re 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 compensation, damages as p vlded for in Secti 3706 of the labor code, Interest and attorney's fees. ,g CONTRACTOR SIGNATURE ~GENT I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: □ □ □ I, as 0W11er of the property or my employees with wages as their sole compensation, will do the work and the structure is l'lOt 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 0W11er-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 controctors 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. 0Yes 2, I (have/ have not) signed an application for a building permit for the proposed work. 3. I have contracted with the foliowing person {firm) to provide the proposed construction (include name address/ phone/ 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 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/ phone I type of work): ,8$ PROPERTY OWNER SIGNATURE □AGENT DATE COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY 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 Sections 25505, 25533 or 25534 of the Presley~Tanner Hazardous Substaoce 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? 0 Yes □ No ls 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 ANO THE AIR POLLUTION CONTROL DISTRICT. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certtfythat I have read the application and state that the aoo.<e information is col1'8Ct and that the lnfonnatlon on the plans is accurate. I agme ID comply with atl Cityoldinances and State !IMS relating ID building construction. I hereby authorize reiresentativeof 111e City of Carlsbad to enter up:m the above mentioned property br ins~n pu!J:X)SeS. I ALSO AGREE TO SAVE, INDEMNIFY Af',JD KEEP HARMLESS THE CfTY 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 permit is required for excavations oYer 5'0' deep and demdition or construction of structures over 3 stories i1 height EXPIRATION: Every permit issued by the Building Official under the provisk'.lns of this Oxle shall expire by li"nitation and become null and vod ~the building oroork. authorized by such permit is notrommenced v-mhin 100 days from the date of such permit or if the building ~th~ permit is suspended or abandoned at any time after 111e oork 0 oATO'.llllE ;;ced :r ;;~ 1 . (of 1;30 days (Seeton 100.4.4 Uniform Building Code) ../1$APPLICANT'SSIGNATURE ~~ (// ~' l'J • STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. Fax (760) 602-8560, Email building@carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. DELNERY OPllONS PICK UP: □ CONTACT (Listed above) □ OCCUPANT (Listed above) □ CONTRACTOR {On Pg. :1.) MAIL TO: □ CONTACT (Listed above) □ OCCUPANT (Listed above) □ CONTRACTOR (On Pg. :1.) MAIL/ FAX TO OTHER: ________________ _ A$ APPLICANT'S SIGNATURE o ASSOCIATEDCB#------------- 0 NO CHANGE IN USE/ NO CONSTRUCTION o CHANGE OF USE/ NO CONSTRUCTION DATE ZIP Inspection List Permit#: CB163225 Type: PME Date Inspection Item 10/13/2016 43 AirCond/Furnace Set 10/13/2016 43 AirCond/Furnace Set 10/13/2016 49 Final Mechanical 10/13/2016 49 Final Mechanical Friday, October 14, 2016 Inspector Act RI JW AP RI JW AP BAYUS: INSTALL A/C & ELECTRIC REPLACE FURNACE Comments Page 1 of 1