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Home My WebLink About1917 PALOMAR OAKS WAY; ; CB121661; Permit08-29-2012 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: PACIFIC RIM MECH. City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB121661 Building Inspection Request Line (760) 602-2725 1917 PALOMAR OAKS WY CBAD PME 2120911900 Lot#: 0 INSTAL LIKE FOR LIKE C.OOLING TOWER. EXTEND ELECTRIC 1 OFT Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 08/29/2012 JMA 08/29/2012 08/29/2012 WASATCH CORNERSTONE HOLDINGS LL C 7635 CONVOY CT 92121 858-97 4-6500 595 S RIVERWOODS PKWY #400 LOGAN UT 84321 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Total Fees: $180.00 Total Payments To Date: $0.00 $30.00 $150.00 $0.00 $180.00 $180.00 Balance Due: r7 /'7 ~ FINAL APPROVAL Inspector:~ Date: 'f'-]e~/z Clearance: $0.00 NOTICE: Please take NOTICE that approval of your project includes the "lmpasition' of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions.' You have 90 days from the date this pem,it 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 infom,ation 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 impasition. 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 f i n f i h h v r vi I n iv n N Tl E imil r hi r hi h f limi i n i THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: 0 PLANNING D ENGINEERING Oeu1LDING 0FIRE 0HEALTH 0HAZMAT/APCD «~~ ~ CI TY O F CARLSBAD EXISTING USE APPLICANT NAME (Primary Contact) ADDRESS CITY PHONE PROPERTY OWNER NA E ADDRESS CITY PHONE MAIL ARCH/DESIGNER NAME & ADDRESS Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: buldllng@carlsbadca.gov www.carlsbadca.gov SUITE#/SPACE#/UNIT# PATIOS (SF) DECKS (SF) Plan Check No. BtZ Est. Value Plan Ck. Deposit Date ~ V'f { 1-z. SWPP NAME FIREPLACE YESD #_ NOD AIR CONDITIONING YES D NOD APPLICANT NAME (Secondary Contact) ADDRESS STATE ZIP CITY STATE ZIP FAX PHONE FAX STATE ZIP FAX STATE LIC. # FIRE SPRINKLERS YES D NO D (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 (Cha'f.ter 9, commending 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 703 .5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)). i rkers' Compensation Declaration: I hereby affltm under penalty of petjury one of the following declara~ons: I have 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. I have and will maintain workers' compen~,tion, as required by Section ~00 of the Labor Code, for the performance of the work for which this pe~ issued. My workers· compensation insurance carrier and policy number are: Insurance Co . .2 V;f'/cff Me/;C,';J.,4/ Policy No. 44/C. 36 76 7..!ft:7 l). Expiration Date_/_/_-~/_ .... ~/_2 ____ _ This section need not be completed if the permit is for one hundred dollars ($100) or less. 0 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 Wor1<ers' Compensation Laws of California. WARNING: Failure to secure workers' compensati 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 provi in Section 3706 of the Labor code, Interest and attorney's fees. _NS CONTRACTOR SIGNATURE I hereby affltm that I am exempt from Contractor's Ucense Law for the following reason: Cl I, as owner of the property or my employees with wages as their sole compensation, will do the wor1< and the sl/\Jcture 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 won< himseff 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}. Cl 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). Cl 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. D Yes D No 2. I (have I have not) signed an application for a building permit for the proposed wor1<. 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 wor1<, but I have hired the following person to coordinate, supervise and provide the major wor1< (include name I address I phone I contractors' license number): 5. I will provide some of the wor1<, but I have contracted (hired} the following persons to provide the wor1< indicated (include name I address I phone I type of work}: _NS PROPERTY OWNER SIGNATURE CJAGENT DATE I certify that I have read the application and slate that the above information is correct and that the Information on the plans is accurate. I agree to comply~ all Cily ordinances and State law.. relating to building construction. I hereby aulhorize rei:resentative of lhe City of Cartsboo to enter upon lhe alx>ve mentioned i:xoperty br inspection purJX)SeS. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CllY OF CARLSBAD AGAINST All LIABILJTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAJD CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA pem11t is required for excavations over 5'0' deep and demolioon or oonstruclon of structures over 3 skllies il height. EXPIRATION: Every permrt issued by the BuikJing Offcial under lhe provisons of this Code shaU expire by Imitation and berome nul and void ~ the buikJilg or v.orl< authorized by such permit is not commenred withil 180 days from the date of such permil or if the buikJi r rk authorized such permit is suspended or abandoned at any time after the v.orl< is commenced bra perbd of 180 days (Section 106.4.4 Unifoon Buil:fng Code). ,a$ APPLICANT'S SIGNATURE • STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. CERTIFICATE OF OCCUPANCY (Commcrc,al PrOJCCtS on I y I Fax (760) 602-8560, Email www.building@carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. f CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE I FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS D PICK UP: o CONTACT (Listed above) o OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) o ASSOCIATED CB# D MAIL TO: o CONTACT (Listed above) o OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) o NO CHANGE IN USE / NO CONSTRUCTION D MAIL/ FAX TO OTHER: o CHANGE OF USE / NO CONSTRUCTION ,6$ APPLICANT'S SIGNATURE DATE .Inspection List Permit#: CB121661 Date Inspection Item 09/19/2012 39 Final Electrical 09/19/2012 39 Final Electrical Wednesday, September 19, 2012 Type: PME Inspector Act RI PB AP INSTAL LIKE FOR LIKE COOLING TOWER. EXTEND ELECTRIC 1 OFT Comments Page 1 of 1