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Home My WebLink About2560 ORION WAY; ; CB053679; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 10-28-2005 Miscellaneous Permit Permit No: CB053679 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: Applicant: CITY OF CARLSBAD 2560 ORION WY CBAD MISC Subtype: REPAIR 2090502600 $0.00 SAFETY AND SERVICE CENTER REPLACE CHILLAR Lot#: 0 Owner: CITY OF CARLSBAD Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: PUBLIC AGENCY 00000 PUBLIC AGENCY 00000 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: $0.00 Total Payments To Date: FINAL AP~ROVAL Date: L-~ -o G; $0.00 Balance Due: Clearance: ISSUED 10/26/2005 MOP 10/28/2005 10/28/2005 $0.00 $0.00 $0.00 $0.00 $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 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 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 fees/exactions of which ou have reviousl been iven a NOTICE similar to this or as to which the statute of limitations has reviousl otherwise ex ired. FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO( /3~ :3c:4 CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST.VAL. __________ _ Plan Ck. Deposit--------- Validated By __________ _ Date _______________ _ 1. PROJECT INFORMATION Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Sr'1Ft;tj t'b.l ,() Se-fl.\]1 lC Ct:::Nre..(_ Address (include Bldg/Suit~#) j' 2 '.5 ft, D o ..e. lo ,,0 W '1 Assessor's Parcel # Existing Use Proposed Use Description of Work SO. FT. #of Stories Of'f;ll .. t: BvlLQrLJV, ~t>q o 5""0 ;)..(p Do # of Bedrooms # of Bathrooms ']Z.d'h t'l C.e'° C EJJ112.l H)(.p,1-L C ""{IGLC°L 2. CONTACT PERSON (If different from applicant) Name Address APPLICANT D Contractor D Agent for Contractor fl. SodUo<. • D Owner Jl!l(t Name Address 5. CONTRACTOR • COMPANY NAME City (B'Agent for Owner CIJr'llSS,tD City State/Zip Telephone# Fax# State/Zip Telephone # Telephone# (Sec. 7031 .5 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 applicant for such permit to file a signed statement that 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 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 [$500)). Name Address City State/Zip Telephone# State License # ----------License Class ----------City Business License # -------- Designer Name Address City State/Zip Telephone State License # ---------- 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I 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' 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 worker's compensation insurance carrier and policy number are: Insurance Company Policy No. Expiration Date. _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100] OR LESS) 0 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. SIGNATURE _____________________________ _ 7. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 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 own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is so1¥ithin 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). (0" 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 contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). 0 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. 0 YES ONO 2. I (have I 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 I address I phone number 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 number I contractors license numberl:..,..........,ff-----,rl'----------------------------------------- 5. I will provide some of the work d (hired) the following persons to provide the work indicated (include name I address I phone number I type of work):. __________ .,1,...-1-....u-./-.f-.~J./.,jr..e:::;,.£----------------------..J.----+-------------- Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration for'3Y6"r risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES (B" NO / Is the applicant or future building occupant required to obtain a permit from the air pollution control district o~quality management district? 0 YES (9""No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site 7 0 YES [B""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. 8. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME _____________ _ 9. APPLICANT CERTIFICATION 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 building construction. I hereby authorize representatives of the Citt of Carlsbad to enter upon the above mentioned property for inspection purposes. 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 EXPIRATION: Every permit issu by authorized by such permit is not at any time after the work is co APPLICANT'S SIGNATURE xcavations eve 5'0" deep and demolition or construction of structures over 3 stories in height. e building al under the provisions of this Code shall expire by limitation and become null and void if the building or work ed w· hin days from the date of such permit or if the building or work authorized brych permit is suspended or abandoned O days (Section 106.4.4 Uniform Building Code). DA TE /b g ~ h ~ , WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 05/05/2006 Permit# CB053679 Title: SAFETY AND SERVICE CENTER Description: REPLACE CHILLAR Type: MISC Sub Type: REPAIR Job Address: 2560 ORION WY Suite: Lot 0 Location: APPLICANT CITY OF CARLSBAD Owner: Remarks: call 2 hours prior to arriving at job Total Time: CD Description Act Comment Inspector Assignment: Phone: 8585184578 lnspecto,(l;t Requested By: DARYL BOWER Entered By: CW 34 Rough Electric ~>e< Gf1Jc, 44 Rough/Ducts/Dampers " I 49 Final Mechanical I Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act lnsp Comments TE-USL U.S. LABS Testing Engineers -U.S. Labs 7895 Convoy Court, Suite 18 San Diego, California 92111 Phone: (858) 715-5800 Fax: (858) 715-5810 Testing Engineers -Inland Empire 41146 Elm Street, Suite A Murrieta, California 92562 Phone: (951) 677-0366 Fax: (951) 677-5761 DSA File# DSA APPLICATION # Client P.O.# NTP# PROJECT# CONSTRUCTION INSPECTION REPORT Project Name Project Location Contractor I Date ______________ _ Time Arrived ___________ _ Time Departed ___________ _ Building Permit#-----------------Plan File# _______________ _ ~ Field Report D Notice to Comply NC#-------------Date Cleared------------ D Concrete D ACI Tech [] Welding D Other 0 Reinforcing Steel D Masonry D 0o1ting 0 Pre-Post Tensioned Tendon D Soils D Fireproofing D Batch Plant D Foundations D Metal Decking Weather _________ Man Power ________________ _ Documents Referenced D Soils Report D Plans Date------D Specs. Date----------D RFI # _____ D Codes Type of Equipment Used _______________________________ Calibration Dates _____________ _ Density Count-------Moisture Count--------------Gage Type _____________ Gage# _______ _ D Sample Type: Amount Madeffaken: I This Work D Was D Was Not Inspected, Tested, and Sampled in Accordance With Requirements of the DSA Approved Documents. The Work Inspected The Work Tested The Work Sampled D Met D Did Not Meet the Requirements of the DSA Documents. D Met D Did Not meet the Requirements of the DSA Documents. D Met D Did Not meet the Requirements of the DSA Documents. CERTIFICATION OF COMPLIANCE: To the best of my knowledge, all of the observed work, unless otherwise stated, is in Conformance with the approved plans and specifications and the workmanship provisions of the Applicable code. Cc: Proiect Architect: DSA Regional Office: Structural Engineer: School District: Inspector of Record: Certification # I Exp. Date Inspector's Signature Inspector's Name Approval signature I Name I Company ------------------------------------ Reviewed by ~: Architect Structural Engineer Project Inspector DSA Date Reviewed D Met D Did Not Meet. Date _____ _ TE -USL l1'l Testing Engineers -U.S. Labs 7895 Convoy Court, Suite 18 ~n Diego, California 92111 Phone: (858) 715-5800 Fax: (858) 715-581 O 11 Testing Engineers -Inland Empire 41146 Elm Street, Suite A Murrieta, California 92562 Phone: (951) 677-0366 Fax: (951) 677-5761 DSA Rle-* OSA APPLICATION # Client P.O. # NTP# PROJECT# U.S. LABS CONSTRUCTION INSPECTION REPORT Project Name Project Location Contractor Building Permit# CJ ... -c., Field Report ~ Concrete D ACI Tech D Welding ['.] Other Plan File# D Notice to Comply D D D Documents Referenced D Soils Report D Plans Date --=--'-'-=----'-- \ Date ..,.. ~ ""' Time Arrived ___________ _ 0 Time Departed-'------------ OSHPD # ------------ NC#------------Date Cleared------------ Reinforcing Steel Masonry Bolting 0 Pre-Post Tensioned Tendon D Soils D Fireproofing D Batch Plant D Foundations D Metal Decking Weather _________ Man Power ________________ _ D Specs. Date _________ _ Codes Type of Equipment Used _____________ __;:....__;-n==~..!..-~-----i"---.....!~~..:°'~-Calibration Dates---'------~~--'------ Density Coon! _______ Moisture Count--------------Gage.Type ____________ _ D Sample Type: Amount Made/faken: ~ p n,.-,"""' .,.... ,,. u l"T> ~ l..11~"' J:::i\ll~~ {/"\.U':. C. I ("V;;> ,.,.,r i - -\w· c., I. ~~ I <"'J )./ p p~, ,l.\ecp A<"">~ Ir ,,..,,. . C. _, This Work EJ Was D Was Not Inspected, Tested, and Sampled in Accordance With Requirements of the BSA Approved Documents. The Work Inspected Q Met D Did Not Meet the Requirements of the CSA Documents. The Work Tested D Met D Did Not meet the Requirements of the DSA Documents. The Work Sampled D Met D Did Not meet the Requirements of the DSA Documents. CERTIFICATION OF COMPLIANCE: To the best of my knowledge, all of the observed work, unless otherwise stated, is in Conformance with the approved plans and specifications and the workmanship provisions of the Applicable code. Cc: Project Architect: DSA Regional Office: Structural Engineer: Sohool District Inspector of Record: Certification # I Exp. Date Inspector's Signature ~-Inspector's Name Approval signature I Name I Company ----------'---''-------------------------- Reviewed by ~: Architect Structural Engineer Project Inspector DSA Date Reviewed 0 Met O Did Not Meet. Date _____ _