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Home My WebLink About2326 LA COSTA AVE; B; CB154366; Permit' , City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 12-10-2015 Permit No: CB154366 Building Inspection Request Line (760) 602-2725 Job Address: 2326 LA COSTA AV CBAD St: B PME Permit Type: Parcel No: 216310141~ Lot#: o Status: Applied: Entered By: Reference#: Plan Approved: PC#: Issued: Inspect Area: Project Title: JACOBS: CHANGE OUT FAU ON ROOF Applicant: LILLIAN JACOBS PO BOX4576 CARLSBAD CA 92018 760-316-4118 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Owner: MILLER BARBARA L 7668 EL CAMINO REAL #104 CARLSBAD CA 92009 ISSUED 12/10/2015 SLE 12/10/2015 12/10/2015 $0.00 $0.00 $163.00 $0.00 $163.00 Total Fees: $163.00 Total Payments To Date: $163.00 Balance Due: Inspector: Clearance: $0.00 r-.oTlCE Aease ta<e r-.oTlCE Iha _,,✓,:j rJ yo., i:,tject irdudes Ire "lrrpc,aitioo" rJ f-declcaicrs, """"81ia,s, c:, cir<r exalicrs -cdleciMfy rdern,d to as 1ee,/e,aiicn;" Yoo have 00 <la),; fr<:mtre-Uis pe,nit ""8 issued to f'dest irrpcstia, rJ these fees'exaiia,s If )W J>desl lrerr\ )W rrust fdlC>Ntre J>desl Jmll(l.res set fo1h in GMmra:it Qxle Sectia, amo{a), ard file tre J>desl ard ;n; ctr<r req.ired irlooraion wth tre Oty flla1ager fer i:,oo,ssirg in .uoda a, Mh Ga1sboo Mridpal Qxle Sectia, 3.32.000. Falu-eto tirreyfdlC>Ntral proorlrewll ba' ;n;stbla:µrt lega ~a,to~ revi6YI, set aside, vdd, er clTIJ treir irrp:stioo. Yoo ae h3rel1y F\.RTl--ER r-.oTlFIED that yo., ngt to J>desl tre specified fees'exa:tiais DCES NOr APFI. Y tov.aer ard """"'ocrrediai fees ard ~ cra-ges. nc:, ~irrirg, mrg gairg c:, cir<r srrila-Wicalla, i:,oo,ssirg c:, ser.ioe fees in ocrredia, wth Uis i:,tject. l'tR DCES IT APFI. Y to ,n; f dwi I\OTl vJi lini . . THE FOLiOWING~PPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH 0HAZMAT/APCD C_cicyof Building Permit Application Plan Check No. O{!) I ~ ..J.':2../ nl n 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value Carlsbad Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit email: building@carlsbadca.gov www.carlsbadca.gov Date j 2-11'1-/, lswPPP JOB ADDRESS -;;f,";J>(/ /P TAP 'l Aue fr b SUITEI/SPACEI/UNITI IAPN --- . ) CT/PROJECT# I LOT# PHASE# # OF UNITS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME ICONSTR. TYPE I occ. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) roof 0;}~ow-'Pa~ tY'I EXISTING USE FIREPLACE I PROPOSED USE IGARAGE (SF) PATIOS (SF} I DECKS (SF) YES[), IAIR CONDITIONING I FIRE SPRINKLERS No[] YES □No □ YES□No□ APPLICANT NAME PROPERTY OWNER V/ [///)Al/ 1 ]1, {,OW/,--),,/ Primary Contact ADDRESS ADDRESS t"O f)()Y, ~~7l, CITY STATE ZIP CITYC/4 f( o~h a: z1r,r:k} /2) PHONE IFAX PHON'7(t{) '!7lf,L/J/1b IFAX EMAIL EMAIL DESIGN PROFESSIONAL CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE IFAX PHONE YAX EMAIL EMAIL STATE UC.# STATE UC.# I CLASS I CITY BUS. LIC.# (Sec. 7031.5 Business and Professions Code: Any City or County 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 signed statement that he 1s 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} orfhat 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: / hereby affirm under penatt;, of perjury one of the following declarations: B I have and will maintain a certificate of consent to self-insure for WJrkers' 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' 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: lnsurance Co. _____________________ Policy No. ______________ Expiration Date _________ ~ ~sec~on need not be completed if the permit is for one hundred dollars ($100) or less. LJ Certificate of Exemption: l 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: Fallure 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 attorney"s fees. 85 CONTRACTOR SIGNATURE □AGENT DATE OWNER~BUILDER DECLARATION 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 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 ot 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 roperty 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. r 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/ contractors' license number): 85 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 Acr? Yes No Is the applicant or future building occupant required to obtain a pemnit from the air pollution control district or air quality management districr? 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. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read the appllc:atlon and state that the above lnfonnatlon Is conectand that the Information on the plans Is accurate. I agree to comply with all Clfyordlnances and State laws relating to building oonstruction. I hereby authorize representaijve of the City of Carlsbad to enter upon the a'oove menOOrled J)'Operty br inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY /IJ'JD KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL Ll/'81LITIES, JUDGMENTS, SAND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA: AA OSHA permit is requred fore · ns over 5'0' deep and demolition or construction of structures over 3 stories in height EXPIRATION: Every ~rmil issued by Bui Ing · un the provisk>ns of this c.ode shall expire by limitation and become null and voKI Wthe buik:ling or'Mlrk authorized by such permit is not commenced 'Mlhin 100days from the date of such permit ddi or'Mlrk a thorized rmil is sus~nded or abandoned at any ijme after the 'Mlrk is commenced for a ~riod of 180 days · n 1 .4 Uniform Building Coc1e) ~ APPLICANT'S SIGNATU DATE I • 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. CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY Carlsbad STATE 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: _______________ _ ,.65 APPLICANT'S SIGNATURE ASSOCIATED CB#'------------- NO CHANGE IN USE/ NO CONSTRUCTION CHANGE OF USE/ NO CONSTRUCTION DATE ZIP ' . Inspection List Penni!#: CB154366 Type: PME Date Inspection Item 12/14/2015 43 AirCond/Furnace Set 12/14/2015 43 AirCond/Furnace Set 12/14/2015 49 Final Mechanical 12/14/2015 49 Final Mechanical Monday, December 14, 2015 Inspector Act AEK AEK RI AP RI Fl JACOBS: CHANGE OUT FAU ON ROOF Comments LATE PM PLEASE LATE PM PLEASE Page 1 of 1