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Home My WebLink About2114 Pine Crest Way; ; CBR2017-0348; PermitPrint Date: 03/31/2017 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: 2114 Pine Crest Way BLDG-Residential 1563320200 $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: VANLANCKER: REPLACE HEAT AND AC PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT Total Fees: $166.00 Owner: TRUST VANLANCKER JILL R REVOCABLE TRUST 01-20-11 3355 Scadlock ln SHERMAN OAKS, CA 91403 Total Payments To Date: $166.00 Status: Applied: Issued: Finaled: Inspector: 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: CBR2017-0348 Closed -Finaled 02/21/2017 02/21/2017 $166.00 $0.00 , THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING [Bt!\JLDING □FIRE □HEALTH Ccicyof 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.~17 -c'3',\ JOB ADDRESS CT/PROJECT# PHASE# DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) EXISTING USE APPLICANT NAME Primary Contact J ADDRESS CITY PHONE EMAIL DESIGN PROFESSIONAL ADDRESS CITY PHONE PROPOSED USE STATE FAX STATE FAX Est. Value Plan Ck. Deposit Date SUITE#/SPACE#/UNITI # OF UNITS # BE OOMS # BATHROOMS TENANT BUSINESS NAME GARAGE (Sf) PATIOS (SF) DECKS (SF) Cre..s+ 4) ZIP CITY ST& PHONE FAX EMAIL ZIP SWPPP CONSTR. lYPE OCC. GROUP FIRE SPRINKLERS YES□No□ (Sec. 7031.5 Business and Professions Code: Any City or Coun_ty which requires a permit to_ c_onstruct. alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such per_mIt 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 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 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' compensation as provided by Section 3700 of the Labor Code, for the pertormance of the work for which this permit is issued. ~ave and will maintain workers' com ensiia.snr by Section 3700 of the Labor Code, for the pertormance o~ work for which this pe it E)~d-y rkers' compensation insu nee rri rand policy number are: Insurance Co._,'-"""-'-,r=='-'""'-------------Policy No. we_ Qd Expiration Date _ _,_,~:,;)ec_,__,_,__L.. __ ilh. section need not be completed if the permi for one hundred dollars ($100) or less. Certificate of Exemption: I certify that i ormance 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 omia, WARNING: Failure to re workers' overage is unlawful, and shall subject an employer to crlmtnal penalties and civil fines up to one hundred thousand dollars (&100,000), In ection 3706 of the labor code, interest and attorney's fees. I hereby affirm that I am exempt from Contractor's License Law for the following reason: □ □ D 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. OYes ONo 2. I (have/ 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/ phone/ contractors' license number): 4. I plan to provide ~rtions of the work, but I have hired the following person to coordinate, supeNise and provide the major work (include name I address/ phone/ 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 t address/ phone/ type of work): ,.S 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 Substance Account Act? □ Yes O No Is the applicant 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? O 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, CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read the application and state that the above infonnation Is conectand that the lnfonnation on the plans Is accurate. I agree to comply with all City ordinances and Stare laws relating to building construction. I hereby authorize representaWe of the City of Carlsbad to enter u~n the above mentioned property br inspection purp:ises. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSMD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQJENCE OF THE GRANTING OF THIS PERMIT OSHA: Ari OSHA permit is required for excavations over 5'0' deep an emolition or constl\JClion of structures o-.er 3 stories in height. EXPIRATION: Every permit issued by the · proviso fthis C.ode shall expire by hmltaOCll'l and berome null and vod t the building oroork authorized by such permit is notrommenced 'Mlhin 180days from the date of such permit I au rized by su permit is suspended or abandoned at any time after the oork is commenced for a period of 180 da (Section 100.4.4 Uniform Building Oxle) .A$ 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 buildinq@carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CONTACT NAME ADDRESS CITY STATE PHONE FAX EMAIL DELIVERY OPllONS PICK UP: p CONTACT (Listed above) □ OCCUPANT (Listed above) □ CONTRACTOR (On Pg. 1) MAIL TO: o CONTACT (Listed above) □ OCCUPANT (listed above) o CONTRACTOR (On Pg. 1) ZIP MAIL/ FAX TO OTHER: _______________ _ A5 APPLICANT'S SIGNATURE CO#: (Office Use Only) OCCUPANT NAME BUILDING ADDRESS CITY STATE ZIP Carlsbad CA OCCUPANT'S BUS. UC. No. o ASSOCIATED CB#------------- □ NO CHANGE IN USE/ NO CONSTRUCTION □ CHANGE OF USE/ NO CONSTRUCTION DATE '&: 1. J '"A H" ,, ' , ;1 ,;/i :z :, ',;,1:;,~ -~!;.' ¥':ii,:iPERMIT INSPECTIC>:,"!,HIST:~RY REPORT (CBR~017..0348) " Permit Type: BLDG-Residential Application Date: 02/21/2017 Owner: TRUST VANLANCKER JILL R REVOCABLE TRUST 01-20-11 Werk Class. P/M/E Issue Date: 02/21/2017 Subdivision: Stat11s. Closed -Finaled Expiration Date· 0912712017 Address: 2114 Pine Crest Way Carlsbad, CA 92008-6848 IVR Number: 2044 Scheduled Actual Date Start Date Inspection Type Inspection No. Inspection Status Primary Inspector Reinspection Complete 03/31/2017 03/31/2017 BLDG-43 Air 018415-2017 Passed Andy Krogh Complete Cond./Fumace Set BLDG-Final 018414-2017 Passed Andy Krogh Complete Inspection Checklist Item COMMENTS Passed BLDG-Mechanical Final Yes -----·-··-·------March 31, 2017 Page 1 of 1