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Home My WebLink About2661 GALICIA WAY; ; CB161835; Permit'' City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit ' 05-11-2016 Permit No: CB161835 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2661 GALICIA WY CBAD PME Status: Parcel No: 2162200900 Lot#: 0 Applied: Reference#: PC#: Project Title: Applicant: IWAISAKO RES-NEW NC UNIT WITH ELECTRIC BREEZE POINT HEATING & AIR 1518 SEABROOK LN SAN DIEGO CA 92139 858 864-3780 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Entered By: Plan Approved: Owner: BILL IWAISAKO 2661 GALICIA WY CARLSBAD CA 92009 760 863-8333 Issued: Inspect Area: ISSUED 05/11/2016 RMA 05/11/2016 05/11/2016 $0.00 $38.00 $163.00 $0.00 $201.00 Total Fees: $201.00 Total Payments To Date: $201.00 Balance Due: Inspector: FINAL APPROVAL Date: ft,-/'f-lb Clearance: $0.00 t-OllCE Rease ta<e CE Iha~ ri \W' prqed irdl.des tte '1,rpc,;tiorl' ri fees, dedceiicrs, resav.:licn, a ctrer emcrs -aJlectively referred to as 1ees'emcrs." You hMlOOclaysfromtte-ttis pemit = iSSUldtop,desl ifTlX)Sitioo rithasefeeslemcrs. If )00 p,desl then\ )00 rrust fcll""'tte p,desl prooedres set !ooh in GMmrert Old, Sectioo €0020(a), ard file tte protest ard fnf drer reqjred inforrmlioo wth tte Oty r-.t,-ager fcr i:rores,irg in awdawwth Ca1stm tv\rid,a Old, Sectioo 3.32.03). FailLJetotirreyfdloothal Jl'OC"drewll bEr fnf sut,,eq.Jert lega ooion to attad<, re.-ieN, sa cEde, \ad, a aTIJ trar irrp:stion. You ,re taet,y FLRTI-ERt-OllFIEDtrat \W' rigt to p,desl tte specified feeslemcrs OCES !\Of AFRYto""'-erard se,,er cxrrernonfees ard ~ cta-ges, ra i;lannr>J, zr:ring 9"0"J a ctrer smla-,wiceiioo i:roressi"J a servioe fees in OCl1nectiCl1 wth tlis prqed. l\ffi OCES IT AFR Y to ITTf t c:twi have · CE ·m a-totlis tom linitcti THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: •PLANNING •ENGINEERING ('city of Carlsbad Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov •BUILDING •FIRE Plan Check No. Est. Value SWPPP LOT# CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affecte~o _ o,<J Cl GARAGE (SF) PATIOS {SF) DECKS {SF) AIR CONDITIONING YES0,JDO FIRE SPRINKLERS YES•ND[jJ' PROPERTY OWNER IJ'l FAA EMAi DESIGN PROFESSIONAL CONTRACTOR BUS. NAME ""'/,</t( f-C ADDRESS ADDRESS / ,57'!} CITY STATE ZIP CITY 'Z/~c;' PHONE FAA EMAIL 0-0111. STATE LIC. # STATE LIC.# CLASS \J 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, prior to its i suance, also requires t e 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, comme_nding with Section 7000 of 01v1s1on 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 penalty of not more than five hundred dollars {$500)). WORKERS. COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: El I have and will maintain a certificate of consent to self-insure for 'M:!rkers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for whictl this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. _____________________ Policy No. ______________ Expiration Date _________ _ ~lion need not be completed if the permit is for one hundred dollars ($100) or less . .teL~~rtificate of Exemption: I certify that in the perfo 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 wo com pen ·on coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thous d dollars {&100,000), in addition to the cost of compensation, da es as provided fo in Section 3706 of the Labor code, interest and attorney's fees. _8S 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 exclusive~ 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 buiids 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. 0Yes 0No 2. I (have/ 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/ contractors' license number)· 4. I plan to provide IX)rtions of the work, but I have hired the following person to coordinate, supervise and provide the major work {include name f address/ phone I contractors' license number): 5, I will provide some of the work, but I have contracted (hired) the following persons to provide the well( indicated (include name I address/ phone I type of work): a$ PROPERTY OWNER SIGNATURE •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 ActJ • 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 JF 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 I certify that I have read the appllcation and state that the above infonnatlon Is correct and that the infonnatioo on the plans Is accurate. I agree to comply with all CHyordinances and State lav.s relating to building construction. I hereby authorize rep-esentativeof the Crtyof Carlsbad toenteruJX)!l lhe atove mentioned property br inspectkJn pu~. I ALSO AGREE TO SAVE, INDEMNIFY .AND KEEP HARMLESS THE CITY OF CARLSBAD AG\INST ALL LIABllJTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AG\INST SAID CITY IN CONSEOJENCE OF THE GRANTING OFTHIS PERMIT OSHA: M OSHA permit is required br excavations over 5'0' deep and demciition or 001strudion of structures over 3 stories in height. EXPIRATION: Every pennlt issued by the Bui · Ia r the provisOns of this Oxle shall expire by limitation and be<Xlme null and vok:I ~ the buikling orv.or'K authorized by sudl permit is not oommenced Vwffhin 180days from the date of sudl permit or i e building orv.or'K rized by sudl permit is suspended or abandoned at any time after the w:,rk is commenced for a perioo of 180 days {Sec!On 100.4.4 Uniform Building Oxle). ..@S° APPLICANT'S SIGNATURE DATE <-f'-II -?-0 /j • 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 Carlsbad STATE 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) • OCCUPANT (Listed above) • CONTRACTOR (On Pg. 1) MAIL/ FAX TO OTHER: _______________ _ A$ APPLICANT'S SIGNATURE o ASSOCIATED CB#'-----------~ • NO CHANGE IN USE/ NO CONSTRUCTION o CHANGE OF USE/ NO CONSTRUCTION DATE ZIP Inspection List Permit#: CB161835 Type: PME Date lnsl)ection Item 10/04/2016 43 AirCond/Furnace Set 10/04/2016 49 Final Mechanical Monday, October 24, 2016 Inspector Act JW AP JW AP IWAISAKO RES-NEW A/C UNIT WITH ELECTRIC Comments Page 1 of 1