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Home My WebLink About2504 CHESTNUT AVE; ; CB121441; Permit08-01-2012 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Eiectrical (PME) Permit Permit No:CB121441 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC #: Project Title: 2504 CHESTNUT AV CBAD PME 1672703800 SMILEY: UPDATE ELECTRIC IN KITCHEN Lot#: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 08/01/2012 JMA 08/01/2012 08/01/2012 Applicant: WORTHING INC, B. A. SUITE #201 690 CARLSBAD VILLAGE DR CARLSBAD, CA 92008 760-729-3965 Owner: SMILEY DENNIS B&PATRICIA L 2504 CHESTNUT AVE CARLSBAD CA 92010 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees $0.00 $150.00 $0.00 $0.00 TOTAL PERMIT FEES $150.00 Total Fees: $150.00 Total Payments To Date: $150.00 Balance Due: $0.00 Inspector: FINAL APPROVAL Date: ^ Y/V^ Clearance: 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 pennlt was Issued to protest Imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Govemment Code Section 66020(a), and file the protest and any other required Infonnation with the City Manager for processing In accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will t>ar any sut)sequent 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 connectton with this project. NOR DOES IT APPLY to any fees/exactions of which vou have previously been olven a NOTICE similar to this, or as to which the statute of limitattons has oreviousiv othenvise expired. ^ • dT Y OF CARLSBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 www.carlsbadca.gov Plan Check No. Cg> ^ Lf t-f / Est. Value Plan Ck. Deposit Date SWPP CT/PROJECT # »BEDROOMS DESCRIPTION OF WORK: Inc/ude Square Feet of Affected Area(s) SUITE#/SPACE#/UNIT# » BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE I OCC. GROUP EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPUCE YES D # NO • AIR CONDITIONING YES • NO • FIRE SPRINKLERS YES • NOD APPi ICANT NAME (Primarv Contactj itss ' ' " J V lOHl APPLICANT NAME (Secondary Contact) ADDRESS RO. ADDRESS Bex CITY STATE ZIP CITY STATE ZIP PHONE lex-72^1- 3^(^S FAX 7^- IZH - 0784 PHONE FAX bcivoofM'i\n^'ii^\(^/J^ Mahoo- com Er^AIL PROPERTY OWNER NAME . , , . , CONTRACTOR BUS. NAME ADDRESS PO- BOA \iac. ADDRESS lo4 CITY STATE ZIP cm . STATE CA. ZIP ^2018 PHONE FAX PHONE EMAIL ifeieNERNAMe&AObReSS \ | |STATtuC.# EMAIL ARCH/DESIGNER NAME & ADDRESS ;TATE LlC.# ~^ {CLASS STATE LIC.# CITV BUS. LIC.# (Sec 70315 Business and Professions Code: Any City or County which requires a permit to construct alter, improve, demolish or repair any structure, prior to its issuance, also requires the aoDlicant for such oermit to file a slBled statement that he is licensed pursuant to the provisions of the Contractor's Ucense Law (Chapter 9. commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500j). Workers' Compensation Declaration: / hereby affimi under pena/(y of peijufy one of (/le following declarations: • I have and will n\aintain 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 perm it is issued. I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the perfomiance of the wo* fi^ vjAich thljDemiit is issued. My workers' compensation insurance carrier and policy ^ .....K„,.,..i—.r-o ra^Hti FblA-h KuVir>ial [r^. Co. PollcyNo. W-BC12^3-12. ExplraUonDate Ol/Ol / 13 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 performance of the work for which this pemnit is issued, I shall not employ any person in any manner so as to become subiect to the Workers Compensatimi Laws o WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminai penalties and civil fines up to one hundred thousand dollars (4100,000), in ided for ii(\Section 3706 of the Labor code, interest and attomey's fees. i , California. addition to the cost of compensation, JS^ CONTRACTOR SIGNATURE I tierebvatTm ttiat I am exempt froinContractots Ucense Lawpr the follmnireason: „ TU ^ . ... rrasownerof^epropeiormyemployeeswlth.^^^^^^^^ tr^rvrth^SK^^^^^^^ , • lasownerofthepropertyamexcluslvelycontrac^ng^licensedcontractorstoconstructtheprcj^ prope^whluX oS'rove^^^^^^^ contracts for such projects with contract^{s) licensed pursuant to the Contractors Ucense Law). • I am exempt under Section Business and Professions Code for this reason: 1.1 personally plan to provide the major labor and materials for constnjction of the proposed property improvement • Yes • No 2 I (have/have not) signed an application for a building permit for the proposed work. 1 I have contracted with the following person (fimi) to provide the proposed construction (include name address / phone / contractors license number): J l "n .rproX^^^^^^^^ 5 J ll provide some of the work, but I have contracted (hired) the fdlowing persons to pravide the work indicated (include name / a ^PROPERTY OWNER SIGNATURE OAGCMT DATE if^^f*o** HOH-nesiouNi%At nuikGinG PERMITS ONLY "3 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 Haza«lous 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? • Yes • No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPUCANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. ION t-lM0INa AGENCY I hereby affirm that tfiere Is a construction lending agency for the performance of tfie work this permit is issued (Sec. 3097 (I) Civil Code). Lender's Name Lender's Address Cf RTIFICATION I cetti^ that I have read the application and state thatthe above Infonnation is conect and thatthe Infonnation on the plans is accurate, i agree to comply wItti all City ordinances and State laws relating to building constmction. I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property ix inspeclion 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 S'O' deep and demoHtkm or construction of stnjctures over 3 stories h height EXPIRATION: Every permit issued by Ihe Building OfSdal imder Ihe provisions of this (3ode shal expire by imitation and become nul and void if the building or woric authorized by such pemiit B not commenced within 180 days from the date of sudi permit or if Ihe building or vmrk aultaized by such pamit B SUSP ^eS*APPLICANT'S SIGNATURE ""^^/^V/THM^MW-XK "ATE Inspection List Permit#: CB121441 Date Inspection Item 10/10/2012 29 Final Plumbing Type: PME 10/10/2012 29 10/10/2012 39 10/10/2012 39 08/22/2012 34 Final Plumbing Final Electrical Final Electrical Rough Electric Inspector Act RI PB AP RI PB AP PB AP SMILEY: UPDATE ELECTRIC IN KITCHEN Comments Thursday, October 11, 2012 Page 1 of 1