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Home My WebLink About2485 LA COSTA AVE; ; CB112169; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 10-11-2011 Permit No: CB112169 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: 2485 LA COSTA AV CBAD PME 0000000000 Lot#: 200 AMP TEMP POWER FOR CONSTR. 0 Applicant: Owner: POWER FABRICATING INC 625 S FEE ANA ST PLACENTIA CA 92870 714 223-3600 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Total Fees: $150.00 Total Payments To Date: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 10/11/2011 JMA 10/11/2011 10/11/2011 $0.00 $150.00 $0.00 $0.00 $150.00 $150.00 Balance Due: Inspector: -:Ff2 FINAL APPROVAL Date: , I Clearance: $0.00 NOTICE: Please take NOTICE tl",a'. approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collecuvely referred to as "fees/exactions." You have 90 clays from the date this permit was issued to protest imposition of these fees/exactions. lf 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 I f i «1~ Building Permit Application Plan Check No. Cb ( J • 2..1 6 9 1635 Faraday Ave., Garlsbad, CA 92008 Est. Value ¥ CITY OF 760-602-2717 / 2718/ 2719 CARLSBAD Fax: 760-602-8558 Plan Ck. Deposit WY:£:!i...carlsbadca.gov Date l l I I ( lswPP to ~o•'f~,~ k Co~Jc._ Ave . SUITE#/SPACE#/UNIT# IAPN ... ---. ,s CT/PROJECT # I LOT# I PHASE# I# OF UNITS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CUNSTR. TYPE I occ. UROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) l •:, <er --r,:. .• r, .A r_-l~~ ?o\.c:: -r $--'---,n,.....l= t ' I 2.on fu-v,.n I EXISTING USE I PROP0SED USE I GARAGE (SF} PATIOS (SF) I DECKS (SF) ,.FIREPLACE rR CONDITIONING I FIRE SPRINKLERS YES □#_ NOD YES □ NO □ YES □ NO □ APPllCANT NAME (Primary Contact) APPLICANT NAME (Secondary Contact) ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX ,:;1v,All 100,a,L PROPERTY OWNER NAME } -~ .:.\,.....--\;-l\.c,._., I'> ~ 1:-\--' ~ACTOR BUS. ~ME ~uk ..... .s --_L .. ,c~ I tc" ,:, 1· ow€, r ADDRESS -ADDRESS 1, I .,, S-'7 '1 -'.I. f2, /'. "'l,_)r, ff) C.:Zs -Fct /I •• CITY STATE ZIP CITY STATE ZIP Dr ... JO ~,9..·tck.G (.IL q,., ~ ", {:, ? \c..__ce,,ut ,r ,. A f''l P.=lD PHONE FAX PHONE FAX "1-c.o -(_q~ -0034 "":1-1 c.j -;}_;). ?., -5 (., 0c, EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS \5TATE LIC. # "t,'ft, 1-t 3 CLASS ltf:i'tt~ C::::.lo (Sec_. 7031.5 Business and Professions Code: Any City or Coun_ty which requires a permit to.construct, alter, improve, demolish or repair an~ structure, prior to its issuance, also requires the applicant for such per_m1t to file a signed statement that he is licensed pursuant to the prov1s1ons of the Contractor'_s License Law {Chapter 9, comme_nding with Section 7000 of D1v1s1on 3 of the Business and Professions Code) or that he is exem9.t therefrom, and the basis for the alleged exemption. Any violation of Section 1031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)). Wor'tl;en' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: □ I have and wHI 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 pem1it is issued. □ I have and wlll maintain workers' comp.1nsatlon, as required by Sec~on 3700 of the Labor Code, for the performance of the work for Which this pem1it is issued. My workers' compensation?urr.: carrier and policy number are: Insurance Co. A< O"--0 Policy No. A.IL(?c./'t 6:6 /{0S: Expiration Date £0 µ ,-a This section need not be completed if the permit is for one hundred dollars ($100) or less, □ Certificate of Exemption: I certify that in the perfonnal\Ce of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employarto criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In addition to the cost of compensation, dameges as provided for ln Section 3706 of the Labor code, Interest and attorney's fees. A$ CONTRACTOR SIGNATURE t... f>-; -□AGENT I here~ affirm that I am exempt from Contractor's Ucense Law for the following reason: □ 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 OWf1 employees, provided Iha\ 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 Professklns 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. □ 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 I 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/ 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/ address/ phone/ type of work): A$ PROPERTY OWNER SIGNATURE • v-------□AGENT " " (OMPl.l!TII THIS SE<:'flON 1'011 NoN-1111uo11NTh\L BUILl>ING PIIIIMITS ONLY 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 within 1,000 feet of the outer boundary of a school site? D 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 ~nd state that the above infonnatlon Is correct and that the Information on the plans is accurate. I agree to complyv.ith all Clly ordinances and State lav.s relating to building construction. I hereby authorize representative of the City of Carisbad lo enler u!X)n the above mentioned property tir insp:!Clion pul'J)'.)Ses. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE C\TY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN C~SEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: MOSHA permit is required tx excavations over 5'0' deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit i.ssued by the Buildirg Offcial under the provisions of this Code shall expre by limitatOn and become null and void if the building orv.ork authorized by such permit is not oommenred 'Mthin 100 days from the date of such penrilt or if the building or v.ork authorized by such permit is suspended or abandoned at any lime alter the v.ork is oommenred for a percd of 180 days {SectK>n 100.4.4 Uniform Building Ccxle), _6$ APPLICANT'S SIGNATURE DATE lo ll City of Carlsbad Bldg Inspection Request For: 10/12/2011 Permit# CB112169 Title: 200 AMP TEMP POWER FOR CONSTR. Description: Type: PME Sub Type: Job Address: 2485 LA COSTA AV Suite: Lot: 0 Location: APPLICANT POWER FABRICATING INC Owner: Remarks: Total Time: CD Description Act Comments 32 Const. Service/Agricultural AP 7)·1f? Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act lnsp Comments Inspector Assignment: Phone: 7143667017 Inspector: i=£&. --rF Requested By: RICH Entered By: JANEAN