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Home My WebLink About2630 LEWIS LN; ; CB151601; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 05-26-2015 Cogeneration Permit Permit No:CB151601 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: 2630 LEWIS LN CBAD COGEN 1552722100 $6,800.00 Sub Type: PHOTO Lot#: 0 Constuction Type: NEW Reference #: Status: ISSUED Applied: 05/26/2015 Entered By: RMA Plan Approved: 05/26/2015 Issued: 05/26/2015 Inspect Area: Plan Check #: Project Title: STALEY RES-PHOTOVOLTAIC SYSTEM 17 ROOF/FLUSH MOUNTED MODULES-4.85 KW-NO ELECT PANEL UPGRADE Applicant: HOME UNPLUGGED 3525 HIGHLAND DR CARLSBAD CA 92008 858 349-2369 Building Permit Add'I Building Permit Fee Plan Check Add'I Plan Check Fee Plan Check Discount Strong Motion Fee Green Bldg Stands (SB1473) Fee $87.73 $0.00 $61.41 $0.00 $0.00 $1.00 $1.00 Owner: STALEY ERIK 2630 LEWIS LN CARLSBAD CA 92008 PLUMBING TOTAL ELECTRICAL TOTAL MECHANICAL TOTAL Additional Fees TOTAL PERMIT FEES Total Fees: $151.14 Total Payments To Date: $151.14 Balance Due: Inspector: Clearance: $0.00 $0.00 $0.00 $0.00 $151.14 $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 infonnation 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 rignt 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 I x er i h r viousl CE imil ich th tatut o itation r ·ousl d. THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING Ccityof Carlsbad JOB ADDRESS Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov SUITEI/SPACEI/UNITI □BUILDING □FIRE Plan Check No. Est. Value Plan Ck. Deposit Date SWPPP APN CT/PROJECT# # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) AIR CONDITIONING FIRE SPRINKLERS ves0No0 v,s□NoD APPLICANT NAME ~,._ PROPERTY OWNER it.J br. ADDRESS Cl1Y ZIP f CITY PHONE FAX - EMAIL EMAIL CONTRACTOR BUS. NAME u (,., ✓ .._ ADDRESS ADDRESS /)/ CITY STATE ZIP CITY STAT~ ZI~ PHONE FAX FAX EMAIL EMAIL STATE LIC. # STATE LIC.# C, (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to_construct, alter, improve. demolish or repair any structure, J>rior to its issuance, also requires the applicant for such permit to file a signed statement that he 1s licensed pursuant to the provisions of the Contractor's License Law {Chapter 9, comme_ndmg with Section 7000 of Division 3 of the Business and Professions Code} or that he is exemP.t therefrom, and the basis for the alleged exemption. Any violation of Section 1031.5 by any applicant for a perm rt subjects the applicant to a civil penalty of not more than five hundred dollars {$500}). WORKERS· COMPENSATION Workers' Compensation Declaratlon: 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 worllers' compensation as provided by Section 3700 of the Labor Code, for the perfomiance of the work for which this permit is issued. D I have and will maintain workers' compensation, as reauired bv Section 3700 of the Labor Code, for the performance of the wori!; for which this permit is issued. My worllers' compensation insurance carrier and policy number are: Insurance Co, _____________________ Policy No. ______________ Expiration Date _________ _ ection need not be completed if the permit is for one hundred dollars ($100) or less. Certificate of Exemption: I certify that in the perfomiance of the work for which this permit is issued, I shall not employ any person in any marmer so as to become subject to the Worllers' Compensation Laws of mia. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and clvll fines up to one hundred thousand dotlars (&100,000), in addition to the cost of compensation, damag s provided for in Section 3706 of the Labor code, Interest and attorney's fees. ,8$ 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 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). 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. Ores ONo 2. I (have I have not) signed an application for a building pem,it 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 to provide portions of the wori!;, but I have hired the following person to coordinate, supervise and provide the major wori!; (include name/ address/ phone/ contractors' license number): 5, I will provide some of the wori!;, but l have contracted {hired) the following persons to provide the wori!; indicated (include name I address I phone I type of wor1!;): ~ PROPERTY OWNER SIGNATURE □•GENT DATE COMPLETE THIS SECTION FOR NON•RESIOl!NTIAL BUILDING Pl!RMITS ONLY Is the applicant or future building occupant required to submit a business pla~utely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Sl/bstance Account Act? Yes <::No> Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air Quali!YJ.!lanagement district? Yes ~ Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Yes ~ 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. CONSTRUCTION LENDING AGENCY I hereby affinn that there 1s a construction lending agency for the performance of the work this permit IS issued (Sec 3097 (1) Civil Code) Lender's Name Lender's Address APPLICANT CERTIVCATION I certify that I have read the application and state that the above Information Is oolTBCtand that the lnfonnation on the plans Is accurate. I agree 1D c:ompl-jv.ilh all City on::linances and State liMs relating to buUdlng construction. I hereby authorize representative of the City of Carlsbad b enter u~xm the above mentioned property klr inspection p.JrJX)SeS. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CAALSBAD 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 .Ari OSHA penntt is required for excavations over 5'0' deep and demolitbn or CXJ11slruction of structures over 3 stories in heil;jht. EXPIRATION: Every permit issued by the Buik:ling Offx:ial under the provisbns of this Code shall expire by limilatbn and become null and void W the buik:ling or 'Mlrk authorized by such l):lrmlt is not oommenced 'Mlhin 180 days from the date of sl.dl permit or if the bui · g ti v.ork,authorized by sudl pennlt is susl):lnded or abandoned at any time after the 'Mlrk is rommenced 'bf a period of 180 days (Section 106.4.4 Uniform Building Code). ,l!5 APPLICANT'S SIGNATURE DATE /4 --V M~ 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 buildinq@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. UC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAIL TO: CONTACT (Listed above) CONTRACTOR (On Pg. 1) OCCUPANT (Listed above) MAIL/ FAX TO OTHER: _______________ ~ A$ APPLICANT'S SIGNATURE ASSOCIATED CS#•------------- NO CHANGE IN USE/ NO CONSTRUCTION CHANGE OF USE/ NO CONSTRUCTION DATE ZIP • Inspection List Permit#: CB151601 Type: COGEN PHOTO Date Inspection Item Inspector Act 06/01/2015 35 Photo Voltaic (PV) RI 06/01/2015 35 Photo Voltaic (PV) AEK AP 06/01/2015 39 Final Electrical RI 06/01/2015 39 Final Electrical AEK Fl Monday, June 01, 2015 STALEY RES-PHOTOVOLTAIC SYSTEM 17 ROOF/FLUSH MOUNTED MODULES• 4. Comments STALEY RES, AM Page 1 of 1