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Home My WebLink About2630 LUCIERNAGA ST; ; CB162423; Permit' •• City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 06-20-2016 Miscellaneous Permit Permit No: CB162423 Building Inspection Request Line (760) 602-2725 Job Address: 2630 LUCIERNAGA ST CBAD Permit Type: MISC Subtype: REPAIR Status: Parcel No: 2152901602 Lot#: 0 Applied: Valuation: $7,000.00 Entered By: Reference #: Plan Approved: PC#: Project Title: CRAWFORD: REPAIR DUE TO TERMIT DAMAGE ~~~ ~~ Issued: Inspect Area: IRC SERVICES, INC LOSAVIO JOHN&KERI M 1440 S GRAND AVE SANTA ANA CA 92705-4411 714-835-0135 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE 2630 LUCIERNAGA ST CARLSBAD CA 92009 ISSUED 06/20/2016 JMA 06/20/2016 06/20/2016 $130.00 $0.00 $0.00 $130.00 Total Fees: $130.00 Total Payments To Date: $130.00 Balance Due: Inspector: /11. ~ FINAL AP.P OVAL Date: 0 S I b Clearance: $0,00 NOTICE: Aeaseta<e NOTICE that aw<M1 ciyru l)tjed irdudes Ire "lrrpostioo' cif"'5, dedcaic:ra, reseovations, crctrer e><a::iioos t-aeaiter cxJledi-.ey r<terred toas ~eesiexa:tiors." You rave OOdays tiaTitredatetns pemil ""5 isa.allop,'dest irrpostion cl thesefeesi~ If )OJ µdes! trern )OJ m.o1 fdlo.vtre µctest prooad,es set fath in G:>lelTmrt Cooe Section 00'.12Q(a), and file Ire µdes! and a,; ctrer req.ired infarralion wlh Ire Oty Mmger fer µccessirg inaaudax::ewlh Ca1sbaj M.rid!B Cooe Section 3.32.0JJ. Falcretotirrayfdlo.vthat JJ006(l.n!wll ta-a,;sul:,;eq.Jerl legal aliontoatta::I<, re.,;Em, sE:t asiOO, vdd, er am tter irrµ:sitioo. You'"" r<retr,, F\RT1-ER NOTIFIED that yru ngt to µdes! Ire specified feesie><a::iic:ra = l',KJl' .APPL y tov.a« and -cxr,mon f"'6 ard ~ty ct-a"g35, ra panrg, zairg, ga:irg cr cttu sinilw c:Wicaiai pu:::essi~ a SE:Y\lire fees in c:x:rr-e:ii01 Wth tlis ptjed. l\ffi IXES IT AFft. Y to cfl./ f ·a,s widi have sinila-t this ast widi edlinitai ras ·rec1. 1 THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING 0BULDING □FIRE □HEALTH 0HAZMAT/APCD )< Ccicyof Building Permit Application Plan Check No. CB/lo, ?,t./'2?, 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value it?.m Carlsbad Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit email: building@carlsbadca.gov www.carlsbadca.gov Date '-l-7..6 It IA SWPPP ' 0'.'.!M 0 Lucre 12_/y' rJJ/1 SUITEI/SPACEI/UNITI IAPN --- CT/PROJECT # I LOT# I PHASE# # OF UNITS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I occ. GROUP -... ESCRIPTION Of WORK: Include Square Feet of Affected Area(s) (2 Cf}(}/ l'l/ r c ( &vv'I. ' fl<' IJ /;:J-e ~ /,tr1C //} -/'l~ ~lr'tr j-411 I f ' EXISTING USE I PROPOSED USE !GARAGE (SF} PATIOS (SF} I OECKS (SF) FIREPLACE I IAIR CONDITIONING I FIRE SPRINKLERS YESQ_ "'° YES □No □ YES□No□ APPLICANT NAME PROPERTY OWNER Primary Contact ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE )FAX PHONE I 'AX EMAIL EMAIL ' DESIGN PROFESSIONAL itNTRACTOR BUS. NAME :r12-c !:n• 11,,v I c ,. <, "f n.-C-. ADDRESS ADDRESS/ 1/t((} /',.., n...a ,i I) s CITY STATE ZIP CITY STATE ZIP /J, / ?v 'j .Sa ,'[,-'f ,a /fl-l't,,a e1r PHONE IFAX PHONE ,{i'Al( 71'-{ >'A<~O/} EMAIL EMAIL STATE UC.# STATE LIC77 / f1 3 )CLASS [3 ),cny BUS. Ll<i { 7 / (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, p_rior 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 JChapter 9, comme_nding with Section 7000 of DIVlsion 3 of the Business and Professions Code} or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 031.5 by any applicant for a permit subJects the applicant to a cIv1I penalty of not more than five hundred dollars {$500)). WORKERS. COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of pe,jury one of the following declaraUons: □ 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 pennit is issued ~ave and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the _perfonnan'1 ~ t!1 :rk ,r J.hich this J)Elrmit is i5!'e~-~f1~' compensation i~~uran;_ c8Aie;.i Icy number are: Insurance Co. ____________________ Polley No, '-::f___' l_. 'f O tfU 'f 7 ( Expiration Date _~b~~'-~,H/~~__,__ This section need not be completed if the permit is for one hundred dollars ($100) or less. 0 Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages as provi e for in Section 3706 of the Labor code, interest and attorney's fees. 8$ 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 woni. and the structure is r,ot 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 bu11ds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sa\e. If, however, the building or improvement is sold within one year of comp~tion, 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 ~---~•usiness and Professions Code for this reason: 1. I personally plan to provide the majOr labor and materials for construction of the proposed property improvement. Oves ONo 2. I (have/ have not) signed an application for a building permit for the proposed work 3. I have contracted with the followirg person (firm) to provide the proposed construction (include name address/ phone I contractors' license number): 4. I plan to provide portions of the rk, but I have hired the following person to coordinate, supervise and provide the major work (include name I address I phone/ contractors' license number): 5. I will provide some of the wo , b t I e hire the following persons to provide the work indicated {include name I address/ phone I type of work): Jt5 PROPERTY OWNER SIGNA □AGENT DATE 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? O Yes O 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 O No Is the facility to be constructed within 1,000 feet of the outer bounday 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. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION 1 certify that I have read the application and state that the above infonnation is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authofize representative of the City of Carlsbad to enter u1xm the above mentioned prop::!rty br inspec:!al purJX)ses. 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: lv1 OSHA permit is required for excavations over 5'0' deep and demolitkm orronstruction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Building Offi:::ial under the provlsbns of this Code shall expire by lllitatial and ooa::me rull and vok:l if the building orv-.ork authorized by sud:7 permit is not commenced 'Mthin 180 days from the date of such permit or if the building or't\Ol1< authorized by sudl permit i.5 suspended or abandoned at anytime after the v.ork is commenced for a period of 180 days (Sectk:ln 100.4.4 Uniform Building Code). -@S'APPUCANT'SSIGNATURE ~ DATE 0\AV\e I o\ • 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@car1sbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CONTACT NAME ADORE S CITY STATE PHONE FAX EMAIL DELIVERY OPTIONS PICK UP: o CONTACT {Listed above) □ OCCUPANT (Listed above) □ CONTRACTOR (On Pg. 1) MAIL TO: □ CONTACT (Listed above) □ OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) ZIP MAIL/ FAX TO OTHER: ________________ _ A$ APPLICANT'S SIGNATURE CO#: (Office Use Only) OCCUPANT NAME BUILDING ADDRESS CITY STATE Carlsbad CA OCCUPANT'S BUS. UC. No. □ ASSOCIATED CB#------------- 0 NO CHANGE IN USE/ NO CONSTRUCTION o CHANGE OF USE/ NO CONSTRUCTION DATE ZIP • Inspection List Permit#: CB162423 Date Inspection Item _ 07/19/2016 19 Final Structural 07/19/2016 19 Final Structural Type: MISC 06/29/2016 11 Fig/Foundation/Piers 06/29/2016 92 Compliance Investigation Wednesday, July 20, 2016 REPAIR Inspector Act RI MC Fl MC MC WC PA CRAWFORD: REPAIR DUE TO TERMIT DAMAGE Comments WORK COVERED WITH OUT INSPECTION. ENTRY COLUMN Page 1 of 1