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Home My WebLink About2357 MICA RD; ; CB120501; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 03-21-2012 Permit No: CB120501 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: 2357 MICA RD CBAD PME 2132821500 Lot#: 0 Project Title: KHU RY RES-ELECTRIC & GAS TO BRAZILIAN BBQ IN REAR YARD (NOT TO EXCEED 6 FT IN Applicant: HARLOW LANDSCAPE 1922 CASABLANCA CT VISTA CA 92081 760-271-7240 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Owner: RICARDO KHURY 2557 MICA RD CARLSBAD CA Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 03/21/2012 RMA 03/21/2012 03/21/2012 $30.00 $150.00 $0.00 $0.00 $180.00 Total Fees: $180.00 Total Payments To Date: $180.00 Balance Due: Inspector: FINAL APPROVAL Date: %-/'(-/Z. Clearance: $0.00 NOTICE: Please take NOTICE ttmt approval of your project includes the "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 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 \T APPLY to any t i n f imil r f limi i n h i <<~')> ~ CITY OF CARLSBAD JOB ADDRESS CT/PROJECT# LOT# Building Permit Application 1635 Faraday Ave., Garlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 www.carlsbadca.gov # OF UNITS # BEDROOMS # BATHROOMS DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) +o P.:, 8 <3 Plan Check No. ~05P. Est. Value /5 -co ONSTR. TYPE OCC. GROUP EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES □#_ NOD YES □ NO □ YES O NO □ CITY o-;z_? l - PROP RTY OWNER NAME 'c_.a._,r-<J}.... ADDRESS Z35 7 All ARCH/DESIGNER NAME & ADDRESS STATE ZIP C/\-"!'l.O FAX ZIP FAX STATE LIC. # APPLICANT NAME (Secondary Contact) ADDRESS CITY STATE ZIP PHONE FAX MAIL PHONE FAX EMAIL CL.ASS CITY BUS. UC.# L-ix.7 /Z ~ "330 (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 per_mIt to file a signed statement that he is hcensed pursuant to the provIsIons of the Contractor's License LawJChapter 9, commending with Section 70_00 of D1v1sion 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 031.5 by any applicanffor a permit subJects the applicant to a civil penalty of not more than five hundred dollars {$500)). Workers' ComJ)llnsation Oeclaratlon: I hereby affirm under penalty of perjury one of the following declarations: □ 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' compensation, as required by Section 3700 of the Labor Code, for lhe performance of ttie work for which this permit is issued. My workers' compensation insurarice carrier and policy number are: Insurance Co. ______________________ Policy No.-------------~ Expiration Date _________ _ Certificate of Exemption: I certify that in the performance of the wor11 for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' CompensatKln Laws of ~ is ction need not be completed if the permit is for one hundred dollars ($100) or less. alifornia. 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 provld r in Section 3 e Labor code, interest and attorney's fees. _6S CONTRACTOR SIGNATURE I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: □ I, as ov.Tier 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 ov.Tier of property who builds or improves thereon, and who does such wor11 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 buikl or improve for the purpose of sale). □ I, as ov.Tier 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 latx>r and materials for construction of the proposed property improvement. □ Yes □ No 2. I (have I have not) signed an application for a building permit for the proposed wor11. 3. I have contracted with the following person (firm) lo provide the proposed construction (include name address I phone I contractors' license number): 4. I plan lo provide portions of the work, but I have hired ttie 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 contracted (hired) the following persons to provide the work indicated (include name I address I phone I type of wor11): L PROPERTY OWNER SIGNATURE □AGENT 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 Sectons 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? □ Yes □ t-o Is the applicant or future building occupant required to obtain a pennit 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 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. I certify that I have read the application and state that the above infonnation Is correct and that the Information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representative of the City of Carlsbad to enter UJXln the alxlve mentioned ~perty br inspection purJX!ses. 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 CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA pennlt is required for excavations over 5'0' deep and demolition or ronslructkln of structures Ovef 3 stories in heMJh!. EXPIRATION: Every pennit i.ssued by the Bu\kling Official under the provisions of this Ccxle shall expire by limitation and become null and vokl W the buikling or w::irk authorized by such pennit is notrommenced 'Mthin 180 days from the date of sucil pennit or if the buildi orV!Qrk orized by such dis suspended or abandoned at any ~·me after the V!Qrk is rommenced fcr a perbd of 180 da (Section 106.4.4 Uniform Buildrlg Code~ AS APPLICANT'S SIGNATURE DATE .3 2-/ /""2:-__ 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 www.buildinq@car1sbadca.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 STATE ZIP Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. UC. No. DELIVERY OPTIONS □ PICK UP: o CONTACT (Listed above) □ OCCUPANT (Listed above) □ CONTRACTOR (On Pg. 1) □ ASSOCIATED CB# ..... □ MAIL TO: □ CONTACT (Listed above) □ OCCUPANT (Listed above) □ CONTRACTOR (On Pg. 1) □ NO CHANGE IN USE/ NO CONSTRUCTION D MAIL/ FAX TO OTHER:---------------~ □ CHANGE OF USE/ NO CONSTRUCTION A$ APPLICANT'S SIGNATURE DATE Inspection List Permit#: CB120501 Type: PME Date lnspec!ion_lt_em 08/13/2012 29 Final Plumbing 08/13/2012 29 Final Plumbing 08/13/2012 39 Final Electrical 08/13/2012 39 Final Electrical 08/08/2012 29 Final Plumbing 08/08/2012 29 Final Plumbing 08/08/2012 39 Final Electrical 08/08/2012 39 Final Electrical 03/22/2012 23 Gas/Test/Repairs 03/22/2012 31 Underground/Conduit-Wirin Tuesday,August14,2012 Inspector Act RI PB AP RI PB AP RI PB NR RI PB NR PB AP PB AP KHURY RES. 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