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Home My WebLink About2412 LA MACARENA AVE; ; CB162437; Permit06-21-2016 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: RASSMAN City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB162437 Building Inspection Request Line (760) 602-2725 2412 LA MACERENA AV CBAD PME 2550701600 Lot#: 0 RASSMAN: INSTALL NEW 125A PANEL Owner: RASSMAN Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 06/21/2016 JMA 06/21/2016 06/21/2016 2412 LA MACARENA AVE CARLSBAD CA 92009 858-334-957 4 2412 LA MACARENA AVE CARLSBAD CA 92009 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES $0.00 $163.00 $0.00 $0.00 $163.00 Total Fees: $163.00 Total Payments To Date: $163.00 Balance Due: Inspector: FINAL APPROVAL Date / • S· /] Clearance: $0.00 OO!lCE Rease take 00110= that~ cl )OOr prqeci irdudes tre "lrrpc,;itiori' cl fees, cie:jications, reserwtions, or ether exactions rereafler rolectively referred to as 'Toes'exactionS-" You have 9J days frtmtre date tns pemit was iSSl.Ed to pretest irrpc,;itia, cl trese fees/exactiais If )00 pretest them )00 rrust fctlo,itre pretest Jr()CSdures set forth in G:lvemrert Oxle Sectiai OOJ.!O(a), and file tre pretest ard aiy ether r,qured irfum:liai 1Mth Ire Qty 1\/enager for processrg in acx:on:larre\Mth C!,1s:,oo MJnidpal Oxle Sectiai 3.32.000. Failuretotirrelyfctlo,ithal J>ll(l>1u'e1MII bar any su:,sequ,rt legal actia,toattad<, review, set aside, void, cr annul their if'Tl)OSition. You are hereby FlRTl-ER OO!lFIED that 'fOI rig1 to pretest Ire specified fees/exactions OCES r-or />PR. Y to 'Mtef ard ee,,er oa,neciia, fees ard ~ changes, nor ~amrg, zoorg, gra:irg or ether snilar """iamai processrg or senice fees in oorneciiai 1Mlh tns prqeci. ~ OCES IT />PR. Y to any . 'nil W1i I' I . • THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH 0HAZMAT/APCD j- 'f c·cityof Building Permit Application Plan Check No. CB1 lo· 2..-1-fs 7 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 rn I z.i/ t J,, lswPPP JOB ADDRESS (__, ..... M, SUITE#/SPACEI/UNfT• IAPN Ju 1-Z... c.a.·A_, --_.. I-Ve: --- CT/PROJECT# I LOT# PHASE# I# OF UNITS # BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I occ. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) I'°\<> l Li ,:, ( "(...,,, . ..: - "" A'('. \ L ' \ EXISTING USE I PROPOSED USE GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE l AIR CONDITIONING I FIRE SPRINKLERS YESO,_ No□ YES □No □ YES□No□ APPLICANT NAME .... ROPE~ (l -Primary Contact < I("{/'-~- ADDRESS ' AllDRESS,Q_(./ lt;... Mv.~aer1,1 AvE'..-I -z._ CITY STATE ZIP Clr'f (J, w { ( "' At7f selr ZIP °' q1,.()[) PHONE IFAX p"frJ J{,, .. qs+'I IFAX ' EMAIL EMAIL (V} L ll-A s-sm..A-r..J {E) I j /'rtfCD DESIGN PROFESSIONAL CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE IFAX PHONE IFAX EMAIL EMAIL I STATE LIC. # STATE UC.# I CLASS I CITY BUS. LIC. # (Sec, 7031.5 Business and Professions Code: Any City or Cqun_ty which requires a permit to_c_onstruct, alter, improve, demolish or repair any structure, p_nor t,;> 11s issuance, also req1:11res the applicant for such per_mit to file a signed statement that he 1s licensed pursuant to the prov1s1ons of the Contractor's License Law (Chapter 9, commending with Section 7000 of D1v1s1on 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 subiects 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' oompensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. D I hawi 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 _________ _ ~section need not be completed if the permit is for one hundred dollars ($100) or less. LJ 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 California. 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 as provided for in Section 3706 of the Labor code, interest and attorney's fees . ..65 CONTRACTOR SIGNATURE Ill~ □AGENT DATE I, as owner of the property or my employees with wages as their sole compensation, 'Nill do the work and the stn.Jcture 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 oontracts for such projects with contraclor(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 OYes ONo 2. I (have I have not) signed an application for a building permit for the proposed work. 3. l have contracted with the follo\Mng person (firm) to provide the proposed construction (include name address/ phone I contractors' 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 contracted (hired) the following persons to provide the work indicated (include name/ address/ phone/ type of work): _6$ PROPERTY OWNER SIGNATURE □AGENT DATE 1..1 lb COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a business ~an. acutely hazardoos materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley. Tarmer Hazardous Substance Account Act? □ Yes O No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality manar;iemenl 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. CONSTRUCTION LENDING AGENCY I hereby affim1 that there Is a construction lending agency for the perfonnance of the work this permit Is Issued (Sec. 3097 (1) Civil Code) Lender's Name Lender's Address APPLICANT CERTIFICATION I certify that I have read the application and state that the above infonnation is correct and that the infonnation on the plans is accurate. I agree to comply\\fth all City ordinances and Slate laws relating to builcHng construction. I hereby authorize rei:re;entative of the Qty of Carlsbad to enter uJX)n the atx:Jve mentioned property klr inspection p..1rp::ises. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF C.ARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN COO SEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: M OSHA permit is required for excavations over 50' deep and demolltion or construction of structures over 3 stories i'l height. EXPIRATION: Every permit issued by the Buikling Offdal under the proviskms of this Code shall expire by limitation and become nun and vok:I W the lxlilding or v.ork authorized by sudl permit is not commenced '-Mthin 180 days from the date of such permit or if the buikling orv.ork authorized by such pemilt is suspended or abandoned at any time after the v.ork is commenred for a perioo of 180 days (Section 100.4.4 Uniform Buikling Code). NfAPPLICANT'SSlGNATURE -1'),------j/? 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, 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. LIC. No. DEi.NERY OPTIONS PICK UP: □ CONTACT (Listed above) □ OCCUPANT (Listed above) o CONTRACTOR (On Pg. :1.) MAIL TO: □ CONTACT (Listed above) o OCCUPANT (Listed above) □ CONTRACTOR (On Pg. 1) MAIL/ FAX TO OTHER: _______________ _ A$ APPLICANT'S SIGNATURE o ASSOCIATEDCB#------------ o NO CHANGE IN USE/ NO CONSTRUCTION o CHANGE OF USE/ NO CONSTRUCTION DATE ZIP Inspection List Permit#: CB162437 Type: PME Date ln_spection Item_ 06/30/2016 33 Service Change/Upgrade Monday, January 09, 2017 Inspector Act PD AP RASSMAN: INSTALL NEW 125A PANEL Comments ----------- Page 1 of 1