HomeMy WebLinkAbout2601 LEVANTE ST; ; CB151347; Permit05-04-2015
Job Address:
Permit Type:
Parcel No:
Reference #:
PC#:
Project Title:
Applicant:
' City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing/Mechanical/Electrical (PME) Permit
Permit No: CB151347
Building Inspection Request Line (760) 602-2725
2601 LEV ANTE ST CBAD
PME
2161804100 Lot#: 0
SMITH RES=REPAIR LEAKING GAS
LINE ( INTERIOR)
Owner:
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
05/04/2015
LSM
05/04/2015
05/04/2015
SMITH FAMILY TRUST 09-22-06 SMITH FAMILY TRUST 09-22-06
2601 LEVANTE ST
CARLSBAD CA 92009
760-753-8204
Plumbing Fees
Electrical Fees
Mechanical Fees
Other PME Fees
TOTAL PERMIT FEES
2601 LEVANTE ST
CARLSBAD CA 92009
$160.00
$0.00
$0.00
$0.00
$160.00
Total Fees: $160.00 Total Payments To Date: $160.00 Balance Due:
FINAL APPROVAL
Inspector: Date: ,(: • J.-0 · /0 ' 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 "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
f fwhi h ve rev\ I T E imil rt hi r whi h h t Ii i i r i u I herwi x ire .
THE FOLLOWING APPRQVALS R~UIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH QHAZMATIAPC0
Ccicyof Building Permit Application Plan Check No. Q.S f 5 \ '3•-f1
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 5"/411" lswPPP
JO?~•m lGV/ff/T'E: STRU:3T ClrftLJ'BlrtfJ SUITEf/SPACEf/UNITI IAPN ---
CT/PROJt.CT # I LOT# I PHASE# I# OF UNITS I# 8EOROOMS # BATHROOMS I TENANT BUSlnESS NAME ICQNSTR.TYPE I Ovu.GRQUP
DESCRIPTION OF WORK: Include Squa,e Feet of Affected Anta(s) /.I' /tJS'p~c:r fofi:'r'A/£ ju lt,I-HoUS'E M47VtzAL GA-S' ,P;.P/::t, b-fOUJ/3
A~/?/c..O )C 37 'i"/54iti' OW, PillmB~ T1) /1-1,4~ {2-1~ 'A/I< c,t,,,v(_
CAI'( fOa._ /r/J'f'~CT7Dfl l)VfZ.JJlf /Dfe6f5'llfl1=../ L,G4~ ~ cAl4
EXISTING USE FIREPLACE I PROPOSED USE rARAGE (SF) PATIOS (SF) I DECKS (SF)
YES[],,
IAIR CONDITIONING I FIRE SPRINKLERS
N<Q YEsONoO YESONoO
APPLICANT NAME PROPERTY OWNER !<Ol)fteT ~ L-/Nc>A S'Mltl/ Primary Contact
ADDRESS •~io1 l~ VfJ /I TE ' !;'-/--Tf2_o---f-
CITY STATE ZIP CITY C.A (c. lS' I? ,4{) ST~ ZIPqz 00 °I
PHONE I"" n°lo -t S-3 -f?·7 nq.f.AX
EMAIL
EMAIL Rg.s:/11/r)(ccs@ AOL. CiJf11
DESIGN PROFESSIONAL CONTRACTOR BUS. NAME
ADDRESS ADDRESS
CITY STATE ZIP CITY STATE ZIP
PHONE l'AX PHONE l'AX
EMAIL EMAIL
I STATE UC.# STATE UC.# !"ASS I CITY BUS. UC.#
{Sec. 7031.5 Busmess and Professions Code: Any City or County which reQuIres a permit to construct, alter, improve, demolish or repair an): structure, p_nor to its Iss~ance, 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, comme_ndIng with Section 7000 of Division 3 of the Business and Protessions Code} or that he is exemP.t therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any apphcanffor a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500)).
WORKERS' COMPENSATION
Workers' Com pens atlon Declaration: I hereby affirm under penalty of perjury one of the following declarations:
B 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 'NDrk for which this permit is issued.
I have and wlll maintain workers' compensation, as required bv 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 'NDrk 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 ol
California. WARNING: Failure to secure workers' compensation coverage ls unlawful, and shall subject an employer to criminal penalties and civll 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,
Af5 CONTRACTOR SIGNATURE O AGENT DATE
OWNl!R-BUHDl!R DECLARATION
I hereby affirm that I am exempt from Contractor's License Law for the following reason· D 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 emptiyees, provided that such improvements are not intended or offered for
sa\e. 11, however, the building or improvement is sold withirfor.e year of completio11, the owner-builder will have the burden of proving that he did rrot build or improve for the purpose of sale) a \, as owner of the property, am exclusively contracting with icensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply lo 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 0Yes 0No
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 address I phone/ contractors' license number):
4. I plan kl provide portions of the work, but I have hired the following person lo coordinate, supervise and provide the major work (include name/ address I phone/ contractors' icense number):
5. I will provide some of the work, but I have contracted {hired) the following persons to rovide the work indicated (include name I address / phone I type of work):
k$ PROPERTY OWNER SIGNATURE □AGENT DATE f'IA
I
!
COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS 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 bui!ding occupant required to obtain a permit from the air pollullon control disbict or air ciua\ity 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 SE 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 affirm that there 1s a construction leod1rg agency for the performance of the wor1< this perr111t 1s issued (Sec 3097 (1) C1v1I Code)
' Lender's Name Lender's Address
APPLICANT CERTIFICATION
I certify that I have read the application and state that the above infom,ation Is ooll'8Cl:and that the inlormalion on the plans is accurate. I agiee ID comply with all Clly orcl\naooes and S. laws relating ID building oonstruction.
I hereby aulholize rei:resentative of the City of Cartsbad b enter UJ'.Xlfl the alx>ve mentioned ~perty tir inspecoon pu!lX)SeS. I ALSO AGREE TO SAVE, INDEMNIFY .AND KEEP HARMLESS THE CITY OF CARLSBAD
AGAINST All LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN AfN WAY ACCRUE AGAINST &\ID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: Ari OSHA pennft is required for excavations over 5'0' deep and demolitbn or construction of structures over 3 sbies in he'ght.
EXPIRATION: Eveiy peimit issued by the Buikjing Official under the provisOOs of this c.ode shall expire by l'milaron and beoome null and vokl tt the b.Jikjing or YoOfk. authorized by such permit is not commenced within
180 days from the dale of sldl pennlt or if the Wilding or w:irk authorized by sud1 ft~ suspended or abandoned at any time after the 'M'.lrk is commenced bra perkxl of 1&l days (Eection 100.4.4 Unitlrm Building COOe)
,#6 APPLICANT'S S1GNATURE M4 DATE ?-tJ; s--
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 NA.ME
ADDRESS BUILDING ADDRESS
CITY STA.TE ZIP CITY STATE
Carlsbad CA
PHONE FAX
EMAIL OCCUPANT'S BUS. LIC. No.
DELIVERY OPflONS
PICK UP: CONTACT (Listed ebove) OCCUPANT (Listed above)
CONTRACTOR (On Pg. 1)
MAIL TO: CONTACT (Listed above)
CONTRACTOR (On Pg. 1)
OCCUPANT (listed above)
MAIL/ FAX TO OTHER: ________________ ~
,.S APPLICANT'S SIGNATURE
ASSOCIATEDCB#-------------
NO CHANGE IN USE/ NO CONSTRUCTION
CHANGE OF USE/ NO CONSTRUCTION
DATE
ZIP
• •
Inspection List
Permit#: CB151347 Type: PME
Date Inspection Item .
05/20/2015 23 GasfTesVRepairs
05/20/2015 23 GasfTesVRepairs
05/20/2015 29 Final Plumbing
Friday, May 22, 2015
Inspector Act
RI
PD AP
PD AP
SMITH RES=REPAIR LEAKING GAS
LINE ( INTERIOR)
Comments
AM PLEASE
Page 1 of 1