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Home My WebLink About2424 LA COSTA AVE; ; CB122340; Permit' . City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 11-06-2012 Permit No: CB 122340 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2424 LA COSTA AV CBAD PME Status: Parcel No· 2161600700 Lot#: 0 Applied: Reference# F>C #: Project Title Applicant \/VONG RES -FIX GAS LEAK, MOVED TANKLESS WATER HEATER WONG HARVEY&SHIRLEY A 2424 LA COST A AVE CARLSBAD CA 92009 760-720-0256 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Entered By: Plan Approved: Issued: Inspect Area: Owner: WONG HARVEY&SHIRLEY A 2424 LA COSTA AVE CARLSBAD CA 92009 ISSUED 11/06/2012 SKS 11/06/2012 11/06/2012 $154.00 $0.00 $0.00 $0.00 $154.00 Total Fees: $154.00 Total Payments To Date: $154.00 Balance Due: Inspector: INAL APPROVAL l/-~-/2.,,, 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 "lees/exactions.' You have 90 days from the date this perrnlt 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 1n accordance with Carlsbad Municipal Code Section 3.32 030. Failure to timely follow that procedure will bar a11y 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 capactty changes, nor planning, zoning, grading or other similar application processing or service tees in connection with this project. NOR DOES IT APPLY to any ' r . I ' . ·v n N ' i 'i ( t . h f Ii i•· . h . h i THE FOLMJWING Af>PR"VALS REQUIRED PRIOR TO PERM IT ISSUANCE: 0 PLANNING .. .. 0 ENGINEERING «~ ~ CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Garlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: buldllng@carlsbadca.gov www.carlsbadca.gov □BUILDING □FIRE □HEALTH 0 HAZMAT/APCD Plan Check No. U 0 Est. Value Plan Ck. Deposit (Z_ SWPP LOT# # BATHROOMS CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Al'l'ected Artla(s) °oQ~ 1-uJ--l V\.,U\.JccQ_~"-\4c~ EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIDNING FIRE SPRINKLERS YES □#_ NOD YES □ NO □ YES □ NO □ APPLICANT NAME (S&corrdary Cont•ct) ADDRESS CITY STATE ZIP PHONE FAX EMAIL CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LIC. # STATELIC.# CLASS CITY BUS. UC.# {Sec. 7031.5 Business and Professions Code: My 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 statementthat 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 Gode) or That he 1s exempt therefrom, and the basis for the alleged exemption. Any vIolati0n of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five huMred dollars {$500)1. WORKERS' COMPENSATION Workers' Compenution Declaration: I hereby affltm under penalty of perju,y one of the foJ/owing declarations: D I have and will maintain a certiflcate 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 perm it 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' oompensation Insurance carrier and policy number are: Insurance Co. ____________________ Policy No. _____________ Expiration DalE _________ _ This section need not be oompleted ~ the permit is for one hundred dollais ($100) or less. D Certlflcate of ExempUon: 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 secum workers' compensation coverage 1, unlawful, and shall subject an emptoyerto criminal penalties and civil fines up to one hundred thousand dollars (& 100 ,OOOJ, In addition to tha cost of compensation, damages as provided for in Section 3706 of the Labor code, Interest and attorney'& fees, ,i! CONTRACTOR SIGNATURE □AGENT DATE . . . OWNl·R·BUIL-DJ!ff DECLARATION l.:.?by affltm that I am exempt from Contractor's License Law for tile following reason: 7' 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 nol apply to Bil owner of property who builds or improves thereon, and who does such work himse~ or through his own employees, provided that such improvements are not intended or offered for ..,...aeie. If, however, the building or improvement is sold within one year of oompletion, the owner-builder will have the burden of proving that he did not build or improve lor the purpose of sale). M"" I, as owner of the property, am exclusively contracting with licensed contractors to construct the project {Se1;. 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 Contractors License Law). Cl 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. □ Yes □ No 2. I (have I have not) signed an application tor 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 contractors' license number): 4e I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major war!( (include name I address I phone I contractors' license number): 5. I will PfOVide some of the worl(, but I have contracted (hired) the following persons to provide the work indicated (include name/ address I phone I type of work): ,i! PROPERTY OWNER SIGNATURE □AGENT DATE l( -b ~ c:.£)1.~ .. C O M P L E T E TH I 5 :S E C TI O N F O R N D N • R E $J t'fB N T I A t. S U i L b I H G P E R M I T S O N L Y 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? □ Yes □ No 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 wtthin 1,000 feet of the outer boundary of a school stte? □ 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 hereby affirm that there is a construction lending agency for the performance of the work this permtt 1s issued (Sec 3097 (1) Civil Code) Lender's Name Lender's Address I C8111fylhatl have read theappllcatlon and state lhattheabovelnfonnatlon Is correct and that the infonnation on the plans is aoourate. I agree to romplyv.ith all City mdlnances and State,_ relating to bull ding oonslruction. I hereby au1horize representative of 1he Ci1y of CartsbaJ to enteru;:on the aoove mentioned JXUpert)' for nspaclion rxirroses. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMlESS THE CrrY OF CARLSBAD AGAINST AU. LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGANST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA perrntt is required for excavations over 5'0' deep and demolttkm or rons!ruclion of structures over 3 stories in height. EXPIRATION. Every perrnitissued by the Bliiding Official under the p10'lisions of this C-Ode shall expi'e by limrtalion and berorne null and void ~ the bl.Jikling or 0011\ authorized by such perm rt is nol rommenced 'M!h11 180 days from the date of such permit or if the buiidng oroork authorized by such perrntt is suspended or aba/looned at any time after Ille 0011\ is rommenced for a peood of 180 days (Sectbn 100.4.4 Uniforrn Blilding C-Ode) ~ APPLICANT'S SIGNATURE .['--DATE 1 r -6 -2-0 (<z___-. 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.buitding@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 ZIP Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS □ 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) □ CONTRACTOR (On Pg. 1) o NO CHANGE IN USE/ NO CONSTRUCTION Cl MAIL/ FAX TO OTHER: ________________ _ o CHANGE OF USE/ NO CONSTRUCTION .c$' APPLICANT'S SIGNATURE DATE Inspection List Permit#: CB122340 Type: PME Date Inspection Item 11/07/2012 23 Gas/Test/Repairs 11/07/2012 23 Gas/fest/Repairs Wednesday, November 07, 2012 Inspector Act RI PB AP WONG RES -FIX GAS LEAK, MOVED TANKLESS WATER HEATER Comments GAS LEAK Page 1 of 1