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HomeMy WebLinkAbout2611 OCEAN ST; ; CB140303; PermitCity of Carlsbad 163 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 02-07-2014 Permit No: CB140303 Building Inspection Request Line (760) 602-2725 Job Address: 2611 OCEAN ST CBAD Permit Type: PME Status: ISSUED Parcel No: 2031400302 Lot #: 0 Applied: 02/07/2014 Entered By: LSM Reference #: Plan Approved: 02/07/2014 PC #: Issued: 02/07/2014 Inspect Area: Project Title: . WELLS RES- REPAIR GAS LINE DUE TO LEAK Applicant: Owner: WELLS BRADLEY H REVOCABLE 1997 TRUST WELLS BRADLEY H REVOCABLE 1997 TRUST 2611 OCEAN ST 2611 OCEAN ST CARLSBAD CA 92008 CARLSBAD CA 92008 Plumbing Fees $158.00 Electrical Fees $0.00 Mechanical Fees $0.00 Other PME Fees $0.00 TOTAL PERMIT FEES $158.00 Total Fees: $158.00 Total Payments To Date: $158.00 Balance Due: $0.00 lnsDector: FINAL APPROVAL Date: 2 - it/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 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 ITHE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: DPLANNING DENGINEERING EJBUILDING DFIRE DHEALTH DHAZMATIAPCD I Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 \' CITY 0 F Ph: 760-602-2719 Fax: 760-602-8558 CARLSBAD email: building©carlsbadca.gov www.carlsbadca.gov Plan Check No. Est. Value Plan Ck. Deposit Date .4 ofi L/ SWPPP JOB ADDRESS 2611 OCEAN ST SUITEI/SPACE#/UNIT# 1APN - - - CT/PROJECT C LOT C PHASE II C OF UNITS C BEDROOMS Ii BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE 0CC. GROUP DESCRIPTION OF WORK: include Square Feet of Affected Area(s) GAS LINE REPAIR DUE TO LEAK EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YES NODYES AIR CONDITIONING [:]NOD FIRE SPRINKLERS YES J NO[:] APPLICANT NAME (Primary Contact) APPLICANT NAME (Secondary Contact) ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL PROPERTY OWNER NAME STAY WELLS CONTRACTOR BUS. NAME ADDRESS 2611 OCEAN ST ADDRESS _____________________ CITY STATE ZIP CARLSBAD CA 92008 CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LIC. C STATE LIC.# CLASS Cli',' BUS. LIC.# (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, aemolisn or repair any structure, prior to its issuance, aiso requires me 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 8usiness 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 ,,k,ii nanalty nf nnt mnro than fivA h,,nrlrM i1alIrs I&flOOhl 3@thø' €®1YO® Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: t:i 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. 1.211 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' compensation insurance canter and policy number are: Insurance Co. Policy No. _______________________________________ Expiration Date I 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 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 (8100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, Interest and attorney's fees. CONTRACTOR SIGNATURE 0 AGENT DATE 0011(U) ®0®() 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 employees, provided that 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 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). lam 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 DYes [:]No 2.1(have I have not) signed an application for a building permit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address! phone/contractors' license number): 4. I plan to provide portions of the work, bull have hired the following person to coordinate, supervise and provide the major work (include name! address! phone contractors' license number): will_pFavide some oft work, but I have contracted (hired) the following persons to provide the work indicated (include name! address! phone! type of work): M"r I n Ww1i .P RTYOWNE S NATURE []AGENT DATE 74 1 1 zo ((4 : 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? 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. .o®a ®@€ I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). LendeYs Name Lenders Address D€Li? DOO@1?000 IcertIfy that i havereadtheappllcationandstatethattheabovelnfonnatlonlscenectand thatthe Information on the plans lsaccurate. IagreecompIywith all Cityordinanoes and State [am relating tobuildingoonstruction. I hereby authorize representative of the City 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 excavations over 50' deep and demolition or construction of structures over 3stories in height EXPIRATION: verypernift issued by the Building Ofidal under the provisions of this Code shall expire by limitation and become nut and void if the building or work authorized by such permit is not commenced withhi 180 days thi e date of such permit or if the budding or work authorized by such permit is suspended or abandoned at any time after the work is commenced bra period of 180 days (Section 106.4.4 Uniform Budding Code). LAPPLI I) DATE 7 — - . STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. CE RTIFICATE O OCCUPANCYtI(Com mercial-Projects Only) Fax (760) 602-8560, Email buiIdinQ(CarISbadCa.OV 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: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg, 1) ASSOCIATED CB# MAIL TO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On NO CHANGE IN USE / NO CONSTRUCTION MAIL/ FAX TO OTHER: CHANGE OF USE / NO CONSTRUCTION ..'APPLICANT'S SIGNATURE DATE Inspection List Permit#: CB140303 Type: PME WELLS RES- REPAIR GAS LINE DUE TO LEAK Date Inspection Item Inspector Act Comments 02/07/2014 23 Gas/Test/Repairs PB AP Monday, February 10, 2014 Page 1 of 1