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Home My WebLink About2055 BASSWOOD AVE; ; CB151668; Permit06-01-2015 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CBI51668 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC #: Project Title: 2055 BASSWOOD AV CBAD PME 2051603100 OMEARA: GAS LEAK REPAIR Lot #: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 06/01/2015 JMA 06/01/2015 06/01/2015 Applicant: OMEARA FRANCES E TRUST 08-09-13 Owner: OMEARA FRANCES E TRUST 08-09-13 2055 BASSWOOD AVE CARLSBAD CA 92008 760-729-1753 2055 BASSWOOD AVE CARLSBAD CA 92008 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees $160.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $160.00 Total Fees: $160.00 Total Payments To Date: $160.00 Balance Due: $0.00 Inspector: FINAL APPROm Date: O' ' ^' Clearance: NOTICE: Please take NOTICE that approval of your project includes tfie "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." 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 Govemment Code Section 66020(a), and file the protest and any other required infomiation 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 attacl<, 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 vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previouslv othenA/ise expired. THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: OPLANNING nENGINEERING •BUILDING •FIRE • HEALTH OHAZMAT/APCD Ccityof 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. (""^(S' \Q>G>Q Est. Value Plan Ck. Deposit Date SWPPP JOB ADDRESS SUITE#/SPACEi/UNIT# APN - CT/PROJECT # LOT# PHASE# # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP pESCRIPTION OF WORK: /nc/ude Square Feet of Affected Aiea{s) EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YES[~|# N0| I AIR CONDITIONING YES I INO I I FIRE SPRINKLERS YES I |NO| I APPLICANT NAME Primary Contact OPESJY OWNER , . , ADDRESS ADDRESS CITY STATE ZIP CITY,^ STATE ZIP PHONE FAX PHONE FAX ElVIAIL EMAIL DESIGN PROFESSIONAL CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY STATE CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL CLASS CITlf BUS. LIC.# (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permitto construcL 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 ofthe Contractor's License Law (Chapter 9, commending v^ith Section 7000 of Division 3 ofthe 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' COMPfiMiATIOM Workers' Conipensation Declaration: I hereby affinn under penalty of petjuty one of the following declaratbns: I 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 perfonnance of the work for which this pemiit Is issued. I I have and will maintain worlters' compensation, as required by Section 3700 of the Labor Code, for the perfonnance of the work for which this permit is issued. My workers' compensation insurance canier and policy number are: Insurance Co. Policy No. Expiration Date Thjs section need not be completed if the permit is for one hundred dollars ($100) or less. I I Certificate of Exemption: I certify that in the perfonnance of the work for which this pemiit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Califomia. 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 provided for in Section 3706 of the Labor code, interest and attomey's fees. ygS" CONTRACTOR SIGNATURE AGENT DATE ownuft.-mM'i%P'MM oettAnA^TION / hereby affirm that I am exempt fmm Contractor's Ucense Law for the following mason: I I I, as owner of the property or my employees with wages as their sole compensation, will do the work and the stnicture is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's 1 License Law does not apply to an owner of praperty 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^Xl, as owner of the property, am exdusively contracting with licensed contractors to constmct 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 I I am exempt under Section Business and Professions Code for this reason: 1.1 personally plan to provide the major labor and materials for construction of the praposed property improvement. QYes I iNo 2.1 (have / have not) signed an application for a building pemiit for the proposed work. 3.1 have contracted with the following person (finn) to provide the proposed constniction (include name address / phone / contractors' license number): 4.1 plan to pravide portions of the work, but I have hired the following person to coordinate, supen/ise and provide the major work (include name / address / phone / contractors' license number): 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): >eS'pROPERTY OWNER SIGNATURE GENT DATE IS PtBTB T M,I,.,S'.„» i C TI O il FOR '^M'O; Is the applicant or future building occupant required to submit a business plan, xutely hazanlous materials registration form or risk management and prevention program under Sections 25505,25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Yes No Is the applicant or future building occupant required to obtain a pemiit from the air pollution control district or air quality management district? Yes No Is the facility to be constmcted 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. * Mill jfa'jhiiftflBimii 4 JuVt TI O N 1. END INGAGENCY 1 hereby affirm tfiat ttiere is a construction lending agency for tfie perfomiance of tfie worit this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address A PJ^ LICANT C81?TIFlCATIO» I certify ttiat I have read ttie applkation and state ttiat ttie above infbnnatton is conect and thatthe infonnation on ttie plans is accuiatEi I agree to comply witti all City onJinances and State laws relating to building consttnction. 1 hereby authorize representative ofthe City of Caiisbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HAFiMLESS THE CITY OF CAFILSBAD AGAINST ALL LIABlLmES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCFiUE AGAINST SAID CfTY IN CONSEQUENCE OF THE GFiANTING OF THIS PERMfr. OSHA: An OSHA pemnit is required fbr excavations over 5'0' deep and demolitbn or constaiction of stmctures over 3 stories in height. EXPIRATION: Every pemiit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the building or vwjik authorized by such pemiit is not commenced within 180 days from the date of such pemiit or if Ihe building or wik authorized by such pennit is suspended or abandoned at any tme after the work is commenced for a period of 180 days (Section 106.4.4 Unifonn Building Code). vfiTAPPLICANT'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 buildinQ(S)cai1sbadca.Q0V or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, Califomia 92008. C0#: (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. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAILTO: 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 ^APPLICANT'S SIGNATURE DATE