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Home My WebLink About1941 DOVE LN; 303; CB153111; Permit09-22-2015 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No:CB153111 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC #: Project Title: 1941 DOVE LN CBAD St: 303 PME 2131120700 Lot#: LA COSTA PALOMA-REPLACE WATER HEATER Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 09/22/2015 RMA 09/22/2015 09/22/2015 Applicant: CSR PLUMBING, INC Owner: DOVE FAMILY HOUSING ASSCS 8985 HAVETEUR WAY SAN DIEGO CA 92123-2316 619-699-9629 1820 S ESCONDIDO BLVD #101 ESCONDIDOCA 92025 Plumbing Fees Electrical Fees Mechanical Fees Ottier PME Fees $38.00 $0.00 $0.00 $60.00 TOTAL PERMIT FEES $98.00 Total Fees: $98.00 Total Payments To Date: $98.00 Balance Due: $0.00 Inspector: FINAL APf^RCA/AL Date: Clearance: tOlCE Rease take NOtCE ttiSt approval of your pnqject indudes ttie "Irrposition" of fees, dedications, reservations, or cither eactions hereafter collectively referred to as "fees'exactions." You have 90 days from ttie date this perrnit v\as issued to protest imposition of ttiese feesfexactiors. If you protest ttiem, you must foiiow ttie protest pnxedures s^ forth in Government (3ode Section 66020(a), and file the pnDtest and any ottier neqUiBd information with ttie Qty Manager for piTXjessing in acoordance vwth C^stad IVUiidpal (Ztode Section 3.32.030. Failure to timely fdlcwthat pnxedure will bar any subsequent legal action to attacK review, set aside, void, or amul ttieir imposition. You are heneby FUFOt-ER lsl(:fTlRED that yoj-ri^ to protest the spedfied fees/exactions [X3ES1^ ctianges, nor plaming, zoning, grading a other sinilar application pnxessing a servioe fees in oonnection with ttiis prqject. NOR DOES IT APPLY to any fees'exactions of wtiich vou have previouslv been ci ven a NOTICE similar to ttiis. or as to whch the statute of linitations has previouslv oltietVMse exared. .•4HE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: DPLANNING CjENGINEERING jBUILDING •FIRE CUHEALTH • HAZMAT/APCD Ccityof Carlsbad Buiiding Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov PlanCheckNo. I S.7 j f I Est. Value ' Plan Ck. Deposit Date //n^ J^BJADDI ,S _ ^ SUITE#/JBACE#/UI CT/PROJECT # PHASE» » OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TVPE OCC. GROUP DESCRIPTION OF WORK: Ineluie Squaie Feet ofAtfected Area<s) /^^/'^Ac^r t/o 6>A^^,o/^^ K.^r^ H/^A-r^sy^ EXISTINQ USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPUCE AIRCONDITIONING FIRESPRINKLERS YEsQ* No| 1 YES QNO • YES| |NO| | APPLICANT NAME . / . , ^, / , , Primary contact U V^T^ /^/f^/^ PROPERTY OWNER ADDRESS y, , . ADDRESS CITY STATE ZIP 779-^n^ nx i FAX PHONE FAX EMAIL DESIGN PROFESSIONAL CONTRACTOR BUS. NAME /^<>/7/?/^^ ADDRESS ADDRESS - CITY STATE ZIP CITY STATE _2IP PHONE FAX PHONE J. , ^ . y. FAX ^ EMAIL STATE LIC. » STATE LIC.» cuss y Cirr BUS. uc# ^ _ (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construcL alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicantfor such permitto file a signed statement that he is licensed pursuantto the provisions ofthe Contractor's License Law (Chapter 9, commendingwith Section 7000 of Division Sof 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 Worker*' Compensation Declaration: / hereby affirm under penalty of perjury one ofthe follomng declarations: LJ I hive and wlll maintain i certificate of consent to self-inture for worlters' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued. Izjlriiva and will maintain workers' compensation, as required bv Section 3700 of the Labor Code, for the perfomiance of the woik for whk:h Ihis pemiit Is issued. My workers' compensatkin iny ranee cagler jnd polk:y number are: Insurance Co._ PolfcyNo. Expiration Date. itkin insurance carder an ^17/ This sectkin need not be completed If the permit is for one hundred dollars ($100) or less. I I Ceitificate of Exemption: I certify that in the perfonnance of the work for whfch this pemilt Is Issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensatkin Laws of Califbmia. WARNING: Failure to secure workere' compensation coverage it unlawful, and shall tubjact an employer to criminal penaitiet and civil fines up to one hundred thoutand dollare (Sf00,000), in addition to the cott of compensation, damagn at provided for In SectiQ|i 3706 of the Labor code, Interett and attomey't feet. CONTRACTOR SIGNATURE /sJyiy'U^ /^^^''\^ QAGENT DATE ^/-^^j / ^ O W N E R- B U i L O E R D E C L A R A TI O N. / hereby affirm (hat / am exempf from Confracfor's Ucense Law for (he folkming reason: j I I, as owner of the properly or my emptoyees wilh wages as their sole compensadon, will do the woik and (he s(mc(ure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Conlrador's Ucense Law does not apply to an owner of property who buikis or Improves thereon, and who does such work himself or through his own emptoyees, provkled that such Improvements are not Intended or oflered for sale. II. however, the building or Impravement Is soto within one year of comptetion, the owner-bulkier will have the burden of proving that he dkl not buikl or improve for the purpose of sale). I I I, as owner of the propeity, am exclusively contracting with licensed contractors to constroct the project (Sec. 7044, Business andTtMassions Code: The Contractors Lfcense Law does not appiy to an owner of property who buitos or improves theieon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's Ucense Law). I I I am exempt under Section Business and Professions Code (or this reason: 1.1 personally plan to provide the major labor and materials for constnictton of the proposed property Improvemenl FHYes •NO 2.1 (have / have not) signed an appltoatton for a buikling pemilt for the proposed wort<. 3.1 have conlracted with the foltowing person (fimi) to provtoe the proposed construction (include name address / phone / contractors' Iteense number): 4.1 plan to provkle porttons of the work, but I have hired the foilowing person to coordinate, supervise and provide the major worit (Include name / address / phone / contractors' lfcense number): 5.1 wlll provide some of (he work, but I have conlracled (hired) (he foltowing persons (o provide Ihe work indfcaled (include name / address / phone / type of wortt): -^PROPERTY OWNER SIGNATURE •AGENT DATE !<|M|0)t K T m T 11^ f e cn o F O N aNt - R I O E WT I A B u i k a t itro» PERMITS O iwb^ir Is tho applicant or future building oaupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention pragram under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Acr? Yes No Is the applicant or future building txxupant required lo obtain a pemiit from the air pollutton control district or air quality management district? Yes No I Is the facilily lobe constracted within 1,000 feel of the outer boundary of a school sile? 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 G iCi a l#S.T R l»CTI O N» L E N D I M <g AGENC V I hereby affirm that there is a construction lending agency for the performance of the work this pemiit is issued (Sec. 3097 (i) Civil Code). Lenders Name Lender's Address AI»^PLfCAMV CERTIFICATION^ I certify that I have read the appltoatton and slate that Die above intbrniation is conectand Uiat the Infoimation on the plans is accurats. I agree to complywith all C% oidinances and State laws relating to building oonsbuctton. I hereby auihorize representative of the City of Carisbad to enter upon the above menttoned property Ibr inspedton 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 CriY IN CONSECXIENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA perniit is required fbr excavations over 5'0' deep and demolitton or constmctton of stmctures over 3 stories in height. EXPIRATION: Every pemiit ssued by the Building Oflicial under the provisbns of this Code shall expire by limitatton and become null and void if the buiiding or vwrit authorized by such pemiit is nol commenced within 180 days from the date of such perniit or if the buiklra or vwrit authorized by such pennit is suspended or abandoned at any time after the vwrit is commenced fbr a period of 180 days (Section 106.4.4 Unifomi Building (Me). ) 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. R r 1 F J C A T E O F O C C U l» A M C Y ( C o ,n ,n « r -:: i ,i i 1> r •> j c « t i •> .1 I y Fax (760) 602-8560, Email buildina(S)carlsbadca.aov or Mail the completed form to City of Carisbad, Building Division 1635 Faraday Avenue, Carlsbad, Califbmia 92008. COf: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Usted above) CONTRACTOR (On Pg. 1) IVIAILTO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg 1) IVIAIL / FAX TO OTHER: ASSOCIATED CB# NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION ASSOCIATED CB# NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION APPLICANT'S SIGNATURE DATE Inspection List Permit*: CB153111 Type: PME LA COSTA PALOMA-REPLACE WATER HEATER Date Inspection Item Inspector Act Comments 10/01/2015 25 Water HeaterA/ents - Rl AM PLEASE 10/01/2015 25 Water HeaterA/ents PY AP 10/01/2015 29 Final Plumbing - Rl 10/01/2015 29 Final Plumbing PY AP Monday, October 05, 2015 Page 1 of 1