The URL can be used to link to this page

Home My WebLink About2021 Gayle Way; ; CBR2017-0687; PermitPrint Daie: 11/16/2017 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: 2021 Gayle Way BLDG-Residential 2051530400 $0.00 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Residential Permit www.carlsbadca.gov Work Class: P/M/E Lot#: Reference#: Construction Type: Bathrooms: Orig. Plan Check#: Plan Check#: Description: HARGIS: REPLACE WATER HEATER (LIKE FOR LIKE/ SAME LOCATION) PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT Total Fees: $166.00 Owner: TRUST HARGIS DEBORAH S REVOCABLE LIVING TRUST 04-19-01 2021 Gayle Way CARLSBAD, CA 92008 Total Payments To Date: $166.00 Status: Applied: Issued: Fina led: Inspector: Contractor: JERRYS HEATING AND AC 9717 Airport Vista Rd Santee, CA 92071-4212 619-449-1623 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. Permit No: CBR2017-0687 Closed -Finaled 04/04/2017 04/04/2017 CRenf $166.00 $0.00 THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: •PLANNING 0 ENGINEERING •BUILDING •FIRE •HEALTH 0HAZMAT/APCD , (tityof Building Permit Application Plan Check No. C,{j~ /7 -t'J/n RJ 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value Carlsbad Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit email: building@carlsbadca.gov Date t.-/ f, .. tf ,,_ www.carlsbadca.gov JOB ADDRESS SUITD/SPACEf/UNIT# IAPN - C..01..-1 (oA'Y'--C .,.,...., --- CT/PROJECT# I LOT# l PHASE# I# OF UNITS I# BEDROOMS H BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) lteP<Ac.€ Gi<1s-.,,.,r.,,, v-,P..-,e~ ~k-r..:~ EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE I AIR CONDITIONING I FIRE SPRINKLERS YES0, NO• YES •No• YES•No• APPLICANT NAME PROPERTY OWNER Primary Contact -C. __ ,.." • ~ L . . . -. , 1<. ADDRESS ADDRESS Cl""!-1"1. A .n~ ~-..._. L '"\b. ~A 1.oz..1 ,,.-.A, 'I ,,_ w-..1 CITY STATE ZIP CITY STATE ZIP t!''°' ...... e(..., ,._,,_ q'2-c:>~t ,,.. --~ -4>. ---' PHu1~E i\ f,-,"I '-'~'l -, ... ~ ~ I FAX (~ !!,)'-\\-z.. .. +~-:\ I FAX EMAIL , EMAIL -:r-H-J "'(... (";;) ~~..J .... c.... .. ,..,, ,_ DESIGN PROFESSIONAL CONTRACTOR BUS. NAME 4-A ~ .. ,. ·-u.,.__.,.... 1-K.. n .,,.-r,,,. '"' • ..,.-,c.) ... 11 o. 'b- ADDRESS ADDRESS . l"'L":h"'.:\-p,.-A A_~A-•·ST"oA ,,.., CITY STATE ZIP CITY STATE ZIP 51:h,JT~ Ur q2u•:1.1 PHONE I FAX PHONE /1o1q\t14"1-I• .1 ... I FAX EMAIL EMAIL ._,,. ·-;r.•-... , ~ ::ri.-1.JA-<.. . O(U,, I STATE LIC. # STATE LIC.# I CLASS ICITYB'"~~ t·--() 4,-• . ·•IP,. r:20 (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct. alter, improve, demolish or re air an structure, prior to its issuanc:ti, !ilso re"q\J1res the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License LawJC~a',"teri, commending with Section 7000 of D1v1sion 3 of the Business and Professions Code} or fuat he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 03 .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 affinn under penalty of perjury one of the following declarations D 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. ~have and will maintain workers' compensation, as required by 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 number are: Insurance Co. f'AuL « A( E-" Cun,&:: 4-CJ\;<) >At -r-y Policy No. PrT'v>O:-'\U.:U::~ Expiration Date _u,_._,{~,L/,_._1 'ov.------ This section need not be completed if the permit is for one hundred dollars ($100) or less 0 Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages as for in ion 3706 of the Labor code, interest and attorney's fees. _I$ CONTRACTOR SIGNATURE I hereby affinn that I am exempt from Contractor's License 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. 0Yes 0No 2. I (have I have not) signed an application for a building permit 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 I 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): _I$ PROPERTY OWNER SIGNATURE •AGENT DATE I Is the applicant or fi.Nure 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 Act? • Yes O No Is the applioent or future building occupant required to obtain a permit from the air pollution control district or air quality management district? • Yes • No Is 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 AND THE AIR POLLUTION CONTROL DISTRICT. I certify that I have read the application and state that the above infonnation is correct and that the lnfonnation on the plans Is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby aulholize represenlative of ~e City of Carlsbad lo enter upon ~e above mentioned properly for inspection pUl]JOSeS. 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 CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMrT. OSHA: An OSHA permit is required forexc.avations over 5'0' deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every pennit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void W the building or work authorized by such permit is not commenced within 180 days rom the date of such permit or if thebukling or work authorized by su nnit is suspended or abandoned at any ~me after the work is commenced for a period of 180 days (Section 106.4.4 Unifonn Building Code). AS 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 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 O PICK UP: • CONTACT (Listed above) o OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) • MAIL TO: • CONTACT (listed above) • OCCUPANT (Listed above) • CONTRACTOR (On Pg. 1) •MAIL/FAX TO OTHER: ________________ _ A5APPLICANT'S SIGNATURE CO#: (Office Use Only) OCCUPANT NAME BUILDING ADDRESS CITY STATE Carlsbad CA OCCUPANT'S BUS. UC. No. o ASSOCIATED CB#•------------ • NO CHANGE IN USE/ NO CONSTRUCTION o CHANGE OF USE/ NO CONSTRUCTION DATE ZIP Permit•Type: BLOG-Residential Application Oat.:· 04/04/2017 Ownor: TRUST HARGIS DEBORAH S REVOCABLE LIVING TRUST 04-19-01 Work Class: P/M/E Issue Date· 04/04/2017 Subdivision: CARLSBAD GARDENS UNIT# 1 Status: Closed -Finaled Exp·1ration Date: 05/14/2018 Address: 2021 Gayle Way Carlsbad, CA 92008-2017 IVR Number: 2926 Scheduled Actual Inspection Type Inspection No. Inspection Status Primary Inspector Reinspection Complete Date Start Date ··--··-····----·-------·----·--- 10/02/2017 10/02/2017 BLDG-25 Water 036436-2017 Failed Chris Renfro Reinspection Complete Heater/Vents Checklist Item COMMENTS Passed BLDG-Building Deficiency No 11/13/2017 11/13/2017 BLDG-25 Water 040197-2017 Passed Chris Renfro Complete HeaterNents Checklist !tom COMMENTS Passed BLDG-Building Deficiency Yes ··-·-··· ·---------------------November 16, 2017 Page 1 of 1