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Home My WebLink About2616 LA COSTA AVE; ; CB122006; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 10-04-2012 Permit No: CB122006 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2616 LA COSTA AV CBAD PME Status: Parcel No: 2162800300 Lot #: 0 Applied: Reference #: PC#: Project Title: Applicant: AIR CONCEPTS STE E HAZELWOOD RES-REPLACE A/C FAU, COIL AND DUCTS 801 S LAKEVIEW AV PLACENTIA CA 92870 714· 779-1000 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Entered By: Plan Approved: Issued: Inspect Area: Owner: HAZELWOOD HUGH 2616 LA COSTA AV CARLSBAD CA 92009 714-616-3980 ISSUED 10/04/2012 LSM 10/04/2012 10/04/2012 $0.00 $31.00 $154.00 $0.00 $185.00 Total Fees: $185.00 Total Payments To Date: $185.00 Balance Due: Inspector: EXPIRE.D PERMIT PERMIT HAS EXPIRED IN ACCORD SECTl~~11.~; AMENDED B DATE. IGNATUREH'i-JI----- FINAL APPROVAL Date: 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 pennit 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 x i n fwh· h i I N Tl E imil r hi r hi h h I' h i THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING 0 ENGINEERING DsutLDING □FIRE □HEALTH 0 HAZMAT/APCD ~--Building Permit Application Plan Check No.(!£) ( ~ ~0,b « ... ~ 1635 Faraday Ave., Garlsbad, CA 92008 Est. Value ~ CITY OF Ph: 760-602-2719 Fax: 760-602-8558 CARLSBAD email: buldllng@carlsbadca.gov Plan Ck. Deposit www.carlsbadca.gov Date 10/4-/ 17 lswPP JOB ADDRESS SUITE#/SPACE#/UNIT# IAPN J.6/b L .. C,,$1q A11, --- CT/PROJECT# ILOT# I PHASE# I# OF UNITS I # BEDROOMS # BATHROOMS rENANT BUSINESS NAME I CONSTR TYPE I OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Al'ler;ted Atea(s) H.(11 .,_,11j 4/c. <.•fldM>--»_J ,,,, //-/ f'.,_,(/"-(,e,, cu/~ a,, d, d "-'-1-s uJ/Gt-&-T EXISTING USE ' I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS {SF) I FIREPLACE IAIR CONDITIONING I FIRE SPRINKLERS YES □#_ NO~ YESI( NO □ YES ONO& APPLICANT NAME (Primary ContactJ APPLICANT NAME (Secondary Contact) S -.,I M ..... c ADDRESS , ADDRESS b'SIJ r -lk cf,, I Work CITY A1u. he,,,,., STATE ZIP CITY STATE ZIP c.. qJ..s-o, PHONE I FAX PHONE IFAX 71./-3'J/-6{l 31 EMAIL '"'""" PROPERTY OWNER NAME ti .. ~ f.-1 •-c,, l1v10 J CONTRACTOR BUS. NAME A ,er c,,. t, • ,J <'. ADDRESS -ADDRESS I 'J.611. L. r_~L .A..,~. '80! S.l.,k.-;e A,~ "'f CITY STATE ZIP CITY l'li STATE ZIP C. ¾"IS ba J C'.., q)..Oo'l q--.... -:I-.. ~ (.,, "h fl:'7n PHONE IFAX PHONE IFAX 7t4. 6/ b-~"R" 7l'f-17"1-/rJOY> EMAIL "'""" ARCH/DESIGNER NAME & ADDRESS I STATE LIC. # STATE LIC.# l''<'.J~ ! CITY BUS. LIC.# S-3 LI 7 .l-2,. (Sec: 7031.5 Business and Professions Code: Any City or Coun_ty which requires a permit to construct, alter, improve, demolish or repair any structure, pnor to its issuance, also requires the applicant for such per_mit 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 ls exemP.t therefrom, and the basis for the alleged exemption. Any violation of Section 1031.5 by any applicant for a perm1tsub1ects the apphcant to a civil penalty of not more than five hundred dollars ($500)). WORKERS" COMPENSATION Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain a certificate of consent to self-Insure for workers' compensation as provided by SectlOn 3700 of the Labor Code, for the performance of the work for which this pem1it is issued. II., I have and will maintain wo ers' compen!ation, as required by Section 3700 of the Labor Code, for the perfonnance4of.Jbe work for which this permit is issued. My workers' compensation insurance cam er and policy numberare:lnsuranceCo. , . PolicyNo. C.. -, l)a, 5"rl-Expiration Date .,(Oe;,cl,.1.;.lc,/-..l>------, I 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 perfom1ance of the work for which this pennil is issued, I shall not employ any person in any manner so as lo become subject lo the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage I& unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&10Q,O 0), addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, interest and attorney's fees, ~ CONTRACTOR SIGNATURE I hereby 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 himselt" 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 lo 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 Lk:ense Law). □ I am exempt under Section _____ ,Business and Professions Code for this reason- 1. I personally fian to provide the major latxir and materials for construction of the proposed prOperty improvement. □ Yes □ No 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 I contractors' license number): 4. I plan lo provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name/ address I phone I contractors' license number): 5. twill provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name I address/ phone I type of 'M:lrk): ~ PROPERTY OWNER SIGNATURE □AGENT DATE COMPtJiTii THIS SECTION fol! NON·l!fSID&NTIAl BUILDING Plil!MIT$ ONI.Y Is lhe 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? O Yes O No Is the applicant or future building occupant required lo obtain a permit from the air pollution control district or air quality management dJStrict? □ Yes □ No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 Yes □ No IF ANY OF THE ANSWERS ARE YES, A ANAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES ANO THE AIR POLLUTION CONTROL DISTRICT. ON$Tl!UCTION L&NPtNG AGfNCY I hereby affirm that there 1s a construction lending agency for the performance of the work this permit 1s issued (Sec 3097 (1) C1v1I Code) lender's Name lender's Address I certify that I have read the appllcatlon and s1ate that the above Information Is correct and that the infonnation on the plans is accurate. I agree to complyYlflh all City 01tlinanoes and State laws ielatlngto building construction. I hereby authorize re~tative of the Qty of Carlsbad to enter up:in the alxlve mentioned r,roperty br inspectbn J)Jrposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD AGI\INST All LIABILITIES, JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAIO CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA M OSHA pelTTltt is required for excavations over 5'0' deep and demolition or oonstructkln of slruct\Jres over 3 stories in height. EXPIRATION: Every permit issued by the Buik:ling Official under the provisions of this Code shall expire by limijaOOn and beoome nuft and void if the lx.Jilding or "MJrk authorized by sudl pelTTltt is not commenced 'Mlhin 100 days from the date of sudl ~ITTlil or if the buikling or "MJrk auth~ by such permij is suspended or abandoned at any ~me after the 'MJrk is oommenced br a ~ood of 180 days (Section 106.4.4 Unitlnn Buik:lrlg Code). ,@S' APPLICANT'S SIGNATURE 'J / / DATE 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 www.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 NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. OELIVERY OP'llONS □ PICK UP: o CONTACT (Listed above) □ OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) □ MAIL TO: □ CONTACT (Listed above) □ OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) □MAIL/FAX TO OTHER: _______________ _ ,65 APPLICANT'S SIGNATURE o ASSOCIATED CB#------------- □ NO CHANGE IN USE/ NO CONSTRUCTION □ CHANGE OF USE/ NO CONSTRUCTION DATE ZIP (~CARLSBAD Community & Economic Development www.carlsbadca.gov February 26, 2013 Permit Number: CB122006 Issue Date: October 4, 2012 HAZELWOOD HUGH 2616 LA COSTA AV CARLSBAD CA 92009 RECORD COPY RE: BUILDING PERMIT EXPIRATION PERMIT TYPE: PLUMB/MECH/ELECT PERMIT FURNACE ADDRESS: 2616 LA COSTA AV PLEASE CALL FOR AN INSPECTION IF WORK IS COMPLETE Our records indicate that your building permit will expire by limitation of time on April 2, 2013 The provisions of CBC, Section 105.5 as amended by the Carlsbad Municipal Code state: "EXPIRATION." Every permit issued by the Building Official under the provisions of this code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within one hundred eighty calendar days from the date of such permit, or if the building or work authorized by such permit is stopped at any time after the work is commenced for a period of one hundred eighty calendar days, or if the building or work authorized by such permit exceeds three calendar years from the issuance date of the permit. Work shall be presumed to have commenced if the permittee has obtained a required inspection approval of work authorized by the permit by the Building Official within one hundred eighty calendar days of the date of permit issuance. Work shall be presumed to be stopped if the permittee has not obtained a required inspection approval of work by the Building Official within each one hundred eighty day period upon the initial commencement of work authorized by such permit. Before such work can be recommenced, a new permit shall be obtained to do so, and the fee therefore shall be one half the amount required for a new permit for such work, and provided that no changes have been made or will be made in the original plans and specifications for such work, and provided further that such suspension or abandonment has not exceeded one year. In order to renew action on a permit after expiration, the permittee shall pay a new permit fee. Any permittee holding an unexpired permit may apply for an extension of time within which work may commence under that permit when the permittee is unable to commence work within the time period required by this section for good and satisfactory reasons. Please check below indicating your intentions and return this letter to us. Project abandoned. A new permit will be obtained prior to commencing work. No fee extension requested for 180 days. (must attach a letter of explanation) Renewal permit requested. If the project has been completed and only a final inspection is needed, please call the inspection request line at 760- 602-2725. If you have any questions, please contact the Building Inspection Division at 760-602-2700. Janean Hawney Office Specialist Building Division 1635 Faraday Avenue, Carlsbad, CA 92008-7314 T 760-602-2700 F 760-602-8560