HomeMy WebLinkAbout2324 La Costa Ave; A; CBR2017-0684; Permit• ..
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Print Date: 04/05/2017 Residential Permit Permit No: CBR2017-0684
Job Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Group:
# Dwelling Units:
Bedrooms:
Project Title:
Description:
2324 La Costa Ave, A
BLDG-Residential
.,,,, 31014-01
$0.00
www.carlsbadca.gov
Work Class: P/M/E
Lot#:
Reference #:
Construction Type:
Bathrooms:
Orig. Plan Check#:
Plan Check#:
ALTA VERDE HOA: GAS LOCKOUT -OUTSIDE LINE
Owner:
Status:
Applied:
Issued:
Finaled:
Inspector:
Contractor:
Closed -Finaled
04/04/2017
04/04/2017
ALTA VERDE HOA
EUGENE BELLEN
BILL HOWE PLUMBING HEATING & AIR
COND. INC
858-922-2329
PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT
Total Fees: $166.00 Total Payments To Date: $166.00
9085 Aero Dr, B
San Diego, CA 92123-2377
619-245-5469
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 wi!l 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.
$0.00
$166.00
THE FOLLQ)VING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE -..
(City of
Carlsbad
LOT#
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.
Est. Value
Plan Ck. De
Date
5UrT£#/SPACE#/UNIT~ APN
# BATHROOMS TENANT BUSINESS NAME
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s)
EXISTING USE
APPLICANT NAME
Primary Contact
ADDRESS
CITY
PHONE
EMAIL
DESIGN PROFESSIONAL
ADDRESS
CITY
PHONE
EMAIL
PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF)
STATE ZIP
FAX
CONTRACTOR BUS. NAM~•,\\
STATE ZIP CITY
FAX
STATE LIC. #
□HEALTH 0HAZMAT/APCD
CONSTR. TYPE OCC. GROUP
FIRE SPRINKLERS
YES□No□
II/fa vv-d~ t+oA
(Sec. 7031.5 Business and P_rofessions Code: Any City or Coun_ty 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 s1.e;ned statement tliat he is licensed pursuant to the provisions of the Contractor's license Law /Chapter 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 1031.5 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: / 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 performance of the work for which this permit is issued.
~ I have and will maintain workers' COR)Pensatlon, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insur nee carrier and policy
number are: Insurance Co. {J {). l ,~ f u r '1 : a~ ..-P/1 S, ( c:) Policy No. q j $3 9(, 8 t/ $ CJ /Q/ Expiration Date _ _,l-=-"'~'--L----
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
Galifornia. WARNING: Failure to secure wo ers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hund thou nd dollars {&100,000), in
addition to the cost of compensation, da es as provided for in Section 3706 of the Labor code, Interest and attorney's fees.
If CONTRACTOR SIGNATURE
I hereby affirm 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 compensaUon, 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 lo the Contracto(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 perm~ for the proposed work.
3, ) have contracted with the following person (firm) to provide the proposed construction (include name address/ phone I contractors' license number):
4. I plan to prov Kie portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name/ 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 I address I phone I type of work)·
If PROPERTY OWNER SIGNATURE □AGENT DATE
C.> MP'..: ET E TH I$ $EC TIO N FOR NON· RE$ IDEN TI AL BU IL DING PERMIT$ 0 NL Y
\ \
Is the appk3nl or future building occupant required to submit a business plan, acut~azardous 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 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 r
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 ANO THE AIR POLLUTION CONTROL DISTRICT.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there 1s a construction lending agency for the performance of the work this permit 1s issued (Sec 3097 (1) C1v1I Code)
lender's Name lender's Address
APPLICANT CERTIFICATION
I certify that I have read the application and state that the abc:M:: infonnatlon Is correct and that the infonnatlon on the plans Is accurate. I agree to comply with all City oldinances and State taws relating to building construction.
I hereby aulhOlize rep1"58111alive of 1he City of Carlsbad lo enter upon 1he above mentioned property for inspection purposes. I ALSO AGREE TO SAVE. INDEWl'IIFY AND KEEP HARMLESS THE CITY OF CARLSBAD
AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH W.Y IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: Afl OSHA permit is required for excavations over 5'0' deep and demolition or CXll'lstruction of strucb.Jres <JoM 3 stories in height.
EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the building or woot uthortzed by such permit is not commenced \lo'ithin
180 days from th of such · · e building or woot authorized by such permit is suspended or abandoned at any time after the WOO( is commenced for pe · 180 days (Section 106.4.4 Unifonn Buiklilg Code).
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 fonn to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008.
CO#: (Office Use Only)
CONTACT NAME OCCUPANT NAME
ADDRESS BUILDING ADDRESS
CITY STATE ZIP CITY STATE
Carlsbad CA
PHONE FAX
EMAIL OCCUPANT'S BUS. UC. No.
DELIVERY OPTIONS
PICK UP: CONTACT (Listed above) OCCUPANT (Listed above)
CONTRACTOR (On Pg. 1)
MAIL TO: CONTACT (Listed above)
CONTRACTOR (On Pg. 1)
OCCUPANT (Listed above)
MAIL/ FAX TO OTHER: _______________ _
~APPLICANT'S SIGNATURE
ASSOCIATED CB#------------
NO CHANGE IN USE/ NO CONSTRUCTION
CHANGE OF USE/ NO CONSTRUCTION
DATE
ZIP
PERMIT INSPECTION HISTORY REPORT (CBR2017-0684)
Permit Type; BLDG-Residential Application Date: 04/04/2017 Owner: ALTA VERDE HOA
Work Class: P/M/E Issue Date: 04/04/2017 Subdivision:
Status: Closed -Finaled Expiration Date: 10/02/2017 Address: 2324 La Costa Ave, A
Carlsbad, CA 92009
IVR Number: 2921
Scheduled Actual Relnspection Complete
Date Start Date Inspection Type Inspection No. Inspection Status Primary Inspector
04/06/2017 BLDG-Final 019200-2017 Passed Paul Burnette Complete
Inspection
Checklist Item COMMENTS Passed
BLDG-Building Deficiency No
BLDG-Plumbing Final Yes
BLDG-Mechanical Final No
BLDG-Structural Final No
BLDG-Electrical Final No
04/06/2017 04/05/2017 BLDG-23 018999-2017 Passed Paul Burnette Complete
Gas/Test/Repairs
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
April 06, 2017 Page 1 of 1