The URL can be used to link to this page

Home My WebLink About2365 MICA RD; ; CB120766; Permit" ... City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 04-25-2012 Permit No: CB120766 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Tille: Applicant: 2365 MICA RD CBAD PME 2132821700 ARCIBAL RES= INSTALL GAS & Lot#: 0 ELECT TO FIREPIT, GAS FOR PORTABLE BBQ Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 04/25/2012 LSM 04/25/2012 04/25/2012 HARLOW LANDSCAPE 1922 CASABLANCA CT VISTA TAYLOR MORRISON OF CALIFORNIA LL C CA 92081 760-271-7240 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES 15 CUSHING IRVINE CA 92618 $150.00 $30.00 $0.00 $0.00 $180.00 Total Fees: $180.00 Total Payments To Date: $180.00 Balance Due: Inspector: FINAL APPROVAL Date: q '1.J · (« Clearance: $0.00 NOTICE: Please take NOTICE that 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 tees/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 wm 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 I i h n Tl im'I r limi ir «~ ... Building Permit Application Plan Check No . Q£ I '2.f)7~fo . 1635 Faraday Ave., Garlsbad, CA 92008 Est. Value ~ CITY OF 760-602-2717 / 2718 / 2719 CARLSBAD Fax: 760-602-8558 Plan Ck. Deposit www.carl§badca.gov 'f/Z,6:f,-z.... fswPP Date JOB ADDRESS SUITE#/SPACE#/UNIT# APN 2.~ res ...... ,; .,._ _.,. r .J. . -- CT/PROJECT# LOT# PHASE# I# uf UNITS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE l occ. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) /-c,_,;. ~ Cf,, kr~c... fl,,,.. 'i\ J....,.... .r; r, -: I l ~ l \ --'G. n"' ' . ' EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF} I DECKS (SF) !·FIREPLACE YES □#_ NOD IAIR CONDITIONING I FIRE SPRINKLERS YES D NOD YES □ NOD APPLICArn' NAME (Primary Contact) APPLICANT NAME {Secondary Contact) ';) -1 ~~reA. .... ADDR1:.-:i::i ADDRESS I "i 'L '2. C <..S "'-I:, (c._....._c,_ .,__ (_ -I:- CITY STATE ZIP CITY STATE ZIP I I i. <; +-c._ c.(lr ';'2.C-;,-I PHONE I FAX PHONE I FAX 7(,,() -"7 7 I -71'-10 -E,v,,..IL ' "' It.MAIL '--~..-( ; .,. :::::i .,_ ,..._.,_\ L , Car-- PROPERTY OWNER NAME le..~.,....,, L ,r"/ 1' f.... ( ~NTRACTOR BUS. NAME l4c...-' · , I ,:. -I __ .-""'7\(L_ ADDRESS ADD~ I ?<t./:.t:: M~ C ... e.. ,.I._ • CITY STATE ZIP CITY STATE ZIP l;,. r Is 1,,.._ ., cA--"/t!O:J y PHONE IFAX PHONE I FAX /?C,O-«'l'-1-.., ~,.., c.MAIL EMAIL- C« re, \oc.. l '.) a -..c,,.' ... \ C. 0,,-- ARCH/DESIGNER NAME & ADDRESS • I STATE UC.# STATE LIC.# I CLASS I Cl; B~S. ;·#-"2 ? -~ q" ;z 7 C, ... L-27 Workers' Compensation Declaration: I hereby affinn 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. 0 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: Insurance Co. ________________________ Policy No. _______________ Expiration Date __________ _ This section need not be completed if the permit is for one hundred dollars [$100) or less ,Cl/Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of c)lifornia. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penaltles and civil fines upto one hundred thousand dollars (&100,000), In addition to the cost of compensation, damages as provided for In Section 06 of the Labor code, Interest and attorney's fees. ,,,6$ CONTRACTOR SIGNATURE I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: □ I, as owner of the properly or my employees with wages as their sole compensation, will do the worll 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 Elxclusively 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. D Yes □ No 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 portions of the worlc, but I have hired the following person to coordinate, supervise and provide the major work (include name/ 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 I address / phone I type of work): ,ft$ 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 Sections 25505, 25533 or 25534 of the Presley-Tanner HazarOOus Substance Account Act? □ Yes □ No I 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 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 certify that I have read the application and state that the above Information is correct and that the Information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to buildlngconstruction. I hereby authorize representative of the City of Cartsbad to enter upon the above mentioned property for inspection puiposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD 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 permit is required for excavations over 5'0' deep and demolition or construction of structures over 3 stories in heght EXPIRATION: Every pennit issued by the Buikling Official under the provisions of this Code shall expire by imitation and become nul and void ~ the buWding or wOlk authorized by such pennit is not commenced 'MIilin 180 days from the date of such pennitor if the bu~ding or work authorized by such pennit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Unifonn Buik:ling Code). A5 APPLICANT'S SIGNATURE ~ ;;;;!. DATE 1/ /4~ ./ --------~ 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.building@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: □ CONTACT (Listed above) □ OCCUPANT (Listed above) □ CONTRACTOR (On Pg. 1) o ASSOCIATED CB# .. --~~-----···----. □ MAIL TO: □ CONTACT (listed above) o OCCUPANT {Listed above) o CONTRACTOR (On Pg. 1) o NO CHANGE IN USE/ NO CONSTRUCTION □ MAIL/ FAX TO OTHER: o CHANGE OF USE/ NO CONSTRUCTION A$ APPLICANT'S SIGNATURE DATE .. ---·----............ ____ _ Inspection List Permit#: CB120766 Type: PME ARCIBAL RES= INSTALL GAS & ELECT TO FIREPIT, GAS FOR PORTABLE Date lnspection_ltem Inspector Act Comments 09/12/2012 29 Final Plumbing PB AP 09/12/2012 39 Final Electrical PB AP 04/30/2012 23 Gas/Test/Repairs PB AP 04/30/2012 31 Underground/Conduit-Wirin PB AP Thursday, September 13, 2012 Page 1 of 1