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Home My WebLink About2352 Altisma Way; 14; CBR2017-0624; PermitPrint Date: 08/16/2017 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: 2352 Altisma Way, 14 BLDG-Residential 2152402014 $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: WORNER: INSTALL NEW A/C WITH ELECTRICAL PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT Total Fees: $166.00 Owner: COOWNER WORNER DAVID HAND JENNIFER p 2352 Altisma Way, 14 CARLSBAD, CA 92009 Total Payments To Date: $166.00 Status: Applied: Issued: Fina led: Inspector: Contractor: COASTAL REFRIGERATION 6525 Paseo Frontera, Apt L Carlsbad, CA 92009-4534 760-683-5683 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: CBR2017-0624 Closed -Finaled 03/29/2017 03/29/2017 $0.00 $166.00 -. !HE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: 0 PLANNING D ENGINEERING 0BUILDING D FIRE 0 HEALTH C_cityof 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.Ql:')R '2..011-0Le2. Est. Value Plan Ck. Deposit Date o-'l.C\ -I -=I- SUITEt/SPACEf/UNIT4' --A IL\ APN # BATHROOMS TENANT BUSINESS NAME DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) /ls-;/;?// !Wwl' ~ ~41 r rd EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) APPLICANT NAME Prlmar Contact ADDRESS CITY PHONE EMAIL DESIGN PROFESSIONA ADDRESS CITY PHONE EMAIL STATE ZIP FAX STATE ZIP FAX STATE UC.# SW PPP NSTR. TYPE OCC. GROUP FIRE SPRINKLERS YES O NoO (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 ttiat 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 Chat he is exemP.t 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)). ;·::::}.~-.. ~·,, --· ''• -, 't ,,-,,;-.... ~--~-..,··----:,.,1,··.:..,-,,-·,;., • ·=-· '-,.--, ... ;·-,, •• , ,,-, ... ,; ;\WORl<ERS ' COMPENSATION , ,·., . ,', · ', · . . .. '. · . :: .. , ,". t ,,.. _--· '... ' -' ' '' '•.-' -' <:.JJ~ ,,,...~ .!...t ,,l\_,. -" '• -~ .. t~ ..... ~~ , •• JC ... )> ~ ' -\,.,. .. ~__,.:.! ... , .... Workers' Compensation Declaration: I hereby aff'rm under pena#y of perjury one of the following declarations: D !)r{ve 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. [J'i have and will maintain wor~p~ rep<! by Section 3700 of the Labor Code, for the performance of the work for which ~uedv::ers' compensation · r, ce and policy number are: Insurance Co. ,Y "CT Policy No. 76M£6~ Expiration Dale 2 CS This section need not be completed W 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 pennit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compe ation Laws of California. WARNING: Failure to secure workers' co ensation coverage· unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundr thousand liars (&100,000), in addition to the cost of compensation, dam vided for In ·on O f the Labor code, interest and attorney's fees. ~ CONTRACTOR SIGNATURE I hereby aff'rm that I am exempt from Contractors License Law for the following reason: D D 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 lhe project (Sec. 7044, Business and Professions Code: The Contracto(s License Law does not apply to an owner of property who builds or improves thereon, and cootracts for such projects wtth contractor(s) licensed pursuant to the Contracto(s License Law). I am exempt under Section Business and Pro!essilns Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. O ves Do 2. I (have f 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 coolractors' 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 cootracted (h~ed) the following persons to provide the work indicated (include name I address I phone I type of work): Iii< oonor:1>Tv nw~n=r? im,NATURE 0AGENT DATE 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? a Yes a No · Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? a Yes a No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? O Yes a 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 certlfythatl haYe read the application and state that the abol'e lnfonnation 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 ailhorize representative cJ the City cJ Car1sbad to enter upon the above mentioned property for nspection purposes. I ALSO AGREE TO SAVE, IND~IFY AND KEEP HARM-ESS THE CrTY OF CARLSBAD AGAINST All LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN AfN WAY ACCRUE AGAINST SAID CrTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is requred for excavations CHef 5'0' deep and demolition or construction cJ struciJ.res CHef 3 stories in height EXPIRATION: Eve!)' pennit issued by the BuikJing Official the provisions of this Code shall expire by imitation and become nun and void if the building or work authorized by such pennit is not COl1lTlel ICed v.ilhn 180 days fi'om the date of such pennit or if the b M authorized by such permit is suspended or almdoned ata,y time after the work is coomenced for a period cJ 180 (Section 106.4.4 Unifoon Building Code). _,,g 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, Gartsbad, California 92008. CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. UC. No. DELNERY OPTIONS 0 PICK UP: o CONTACT (listed above) o OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) o ASSOCIATED CB#------------0 MAIL TO: o CONTACT (Listed above) o OCCUPANT (listed above) o CONTRACTOR (On Pg. 1) o NO CHANGE IN USE/ NO CONSTRUCTION D MAIL/ FAX TO OTHER:----------------o CHANGE OF USE / NO CONSTRUCTION ...@S'APPLICANT'S SIGNATURE DATE . PERMIT INSPECTION HISTORY REPORT (CBR2017-0624) Permit Type: BLDG-Residential Application Date: 03/29/2017 Owner: Work Class: P/M/E Issue Date: 03/29/2017 Subdivision: Status: Closed -Finaled Expiration Date: 09/25/2017 Address: IVR Number: 2803 Scheduled Date Actual Start Date Inspection Type Inspection No. Inspection Status Primary Inspector 08/16/2017 08/16/2017 August 16, 2017 BLOG-43 Air Cond./Furnace Set 031778-2017 BLDG-Final Inspection Checklist Item BLDG-Building Deficiency 031780-2017 Checklist Item BLDG-Building Deficiency BLDG-Plumbing Final BLDG-Mechanical Final BLDG-Structural Final BLDG-Electrical Final Passed Chris Renfro COMMENTS Passed Chris Renfro COMMENTS COOWNER WORNER DAVID H AND JENNIFER P LA COSTA VALLEY #5 2352 Altisma Way, 14 Carlsbad, CA 92009-6318 Re inspection Passed Yes Passed Yes Yes Yes Yes Yes Complete Incomplete Complete Page 1 of 1