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Home My WebLink About2621 OCEAN ST; B; CB154215; Permit12-02-2015 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit. Permit No:CB154215 Building Inspection Request Line (760) 602-2725 Job Address: 2621 OCEAN ST CBAD St: B Permit Type: PME Parcel No: 2031400500 Reference #: PC #: Project Title: MULLINS RESIDENCE GAS REPAIR Applicant: THE LONE ROOTER 2235. GLENDORA AVE. #206 GLENDORA 91741 Status: ISSUED Lot #: 0 Applied: 12/02/2015 Entered By: MDP Plan Approved: 12/02/2015 Issued: 12/02/2015 Inspect Area: Owner: MULLEN FAMILY TRUST 07-26-91 2617 OCEAN ST CARLSBAD CA 92008 Plumbing Fees . $163.00 Electrical Fees . $0.00 Mechanical Fees $0.00 Other PME Fees $0.00 TOTAL PERMIT FEES $163.00 Total Fees: $163.00 Total Payments To Date: $163.00 - Balance Due: $0.00 - FINAL APP V L Inspector: Date: Clearance: NOTICE Reese take NOTICE that appvva of your project includes the Inpesitiorf of fear,, dedications, reservations, or other exactions. hereafter collectively rofened toas fe tiens.' You hae 90 days from the date ths penrit ves issued to protest inps1t10n d these fe ia If you protest thaT OJ rYLat fdloN the protest pocathas sat forth in Gmerment Cede Section 66020(a), ai file the protest and any other mqured infan'elia, wth the Oty riagerfa processing in acaydenoeWth Carlsbad lAxicipai Cede Section 332.U0. Fkreto t,ayfdloNthat pcüewll b any subsequent legal ediontoattaic, review, sat aside, void, or ani their irition You as hereby RRfl-ER NOTIFIED that your nt to protest the specified fees(ects DOES NOTAPIRYtovetecad seerarwsdiai fees and capacity de, ru planng, zxnn gairig adJsirTiI&icabon prng a- service fees in camdia,wth the prqed. NCR DOES lTYto any feeseas dvihd, yaj have amiaaty been civen a NOTICE ennlar to ills, or as to WIth the statute of linitatia,s has aavdhaiWse eared ITHE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: DPLANNING DENGINEERING DBUILDING DFIRE DHEALTH DHAZMATIAPCD t(f • Building Permit Application City of 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Cdisbad email: building@carlsbadca.gov y p www.carlsbadca.gov Plan Check No. i Ll Z. Est. Value Plan Ck. Deposit Date f ( / jlswpi'p I JOB ADDRESS (çt çç 1SUITE#/SPACE#/UNIT# 1APN - - - ST/PROJECT a LOT C PHASE C # OF UNITS I C BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE CCC. GROUP )ESCRIPTION OF WORK: Include Square Feet of Affected Area(s) \ XIOk UIT EXISTING USE PROPOSED USE I I GARAGE (SF) I YEsI:I#. PATIOS (SF) I DECKS (SF) FIREPLACE N0II I I AIR CONDITIONING YES [—]NO I FIRESPRINKLERS YESIIN APPLICANT NAME Primary Contact PROPERTY OWNER ADDRESS )c ADDRESS c'cAt) CITY STATE c ZIP CPV CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL DESIGN PROFESSIONAL CONTRACTOR BUS. NAME ADDRESS ADDRESS -Pro .-r cc.' CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE EMAIL EMAIL STATE LICe STATE LIC.# S(07-:)' CLASS I c. g, 1 CI7j7yf (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, commendingwith 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 oenalty of not more than five hundred dollars ($500)). ®?0®() Workers' Compensation Declaration:! hereby affirm under penally of perjury one of the following declarations.- El I have and will maintain a certificate of consent to sell-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. [J 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 workers' compensation insurance carrier and policy number are: Insurance Co. Policy No. Expiration Data This VCtOn need not be completed if the permit is for one hundred dollars ($100) or less. Lf'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 works ' mpensation cove I and shall subject an employer to criminal penalties and Civil fines up to one hundred thousand dollars (9100,000), in addition to the cost of compensa s edri 0o de, interest and attorney's fees. DATE(2-2-7' 5— AGENT I hereby affirn that! am exempt from ContiacWs License Law for the following reason: [J 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 Contractors License Law does not apply loan 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 sate. 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 sate). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contracto?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). [J 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 [JYes [:]No - 2.1(have / 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, but I have hired the following person to coordinate, supervise and provide the major work (include name! address/phone! contractors' license number): 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name! address! phone! type of work): 'PROPERTY OWNER SIGNATURE []AGENT DATE ®)(?@ &(?O®ti ui(D(D. 0090a,@012)(2)Gi)O ®lJCSY - Is the applicant or future building occupant required to submit a business pIan,pcutely hazardous materials registration lbrm or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Yes r410 / Is the applicant or future building occupant required to obtain a permit from the air pollution control district or airqratfly 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. 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). Lender's Name Lender's Address O19? 00i10® IcertifythatI have read the application and slate thatthe above information is conectand thatthe Information on the plans isaccurate. IagreetecompIywith all Cityortilnances and State laws relating to buildingcenstnrction. 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 AGNNST SAID CITY IN CONSEQUENCE OFTHE GRANTING OF THIS PERMIT. OSHA An OSHA permit is required for excavations over 61Y deep and demolition or construction of structures over stories in height EXPIRATION: Every permit issued by the Building Of5dol under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit in not commenced within 180 days tom the date of such permit or if the b iding 0r uth rized4by such permit in suspended or abandoned at any time alter the work in commenced fora period of 180 days (Section 106.4.4 Uniform Building Code). ..'APPLICANT'S SIGNATURE / DATE W, 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 RTI FICATE• Fax (760) 602-8560, Email buiIdingcarIsbadca.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 ZIP Carlsbad CA PHONE f FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On P. 1) ASSOCIATED CB# MAIL TO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. iii NO CHANGE IN USE / NO CONSTRUCTION MAIL/ FAX TO OTHER: CHANGE OF USE! NO CONSTRUCTION ZAPPLICANT'S SIGNATURE DATE I • • Inspection List Permit#: CB154215 Type: PME MULLINS RESIDENCE GAS REPAIR Date Inspection Item Inspector Act Comments 12/02/2015 23 Gas/Test/Repairs AEK AP 12/02/2015 29 Final Plumbing AEK Fl Wednesday, December 02, 2015 Page 1 of 1