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Home My WebLink About2702 JACARANDA AVE; ; CB154419; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 12-15-2015 Permit No: CB 154419 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: 2702 JACARANDA AV CBAD PME 2551131900 Lot#: 0 Project Title: KRUPINSKY: REPLACE FURNACE Applicant: MICHAEL KRUPINSKY 2702 JACARANDA AVE CARLSBAD CA 92009 858-525-1396 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 12/15/2015 JMA 12/15/2015 12/15/2015 $0.00 $0.00 $163.00 $0.00 $163.00 Total Fees: $163.00 Total Payments To Date: $163.00 Balance Due: Inspector: /11-to,(b,;,,.'l FINAL APPROVAL Date: Db/U./14 Clearance: $0.00 11.0llCE: Aease ta<e 11.0llCE Iha 'WM ct )OJI" prtjoct indt.des Iha "lrrpa;itiorf ct fees, dE<lcaicns, reservaticns, or cttor exa::ticns -ooledivay referral to as "fees'exa::ticm"" Yoo haYe 00 days !rem Iha dale lhs pemit""' i""-'ld to prdest irrpositim ct ttese fees'e>micros. If )OJ prdest lhlrT\ )OJ llUlt fdloothl pretest poceci.res set forth in G:Msrrmrt Code Section a.J2Q(a). a--d file Iha prdest a--d a,y cttor req.ired irlam;jja, wth Iha aty Mngerfor l)"OCSSSirg in ocroda <ewth Orlsboo Mridpa Code Sedim 3.32030. Faluetotirmyfdloothal IJ003(1.rawll Ila" a,ysu,;e:µrt lega a:limtoallack, review, set asic~, \ad, a a-ru tter irrp::Eitioo. Yoo ..-e t...-eby FlRTI-ER 11.0llRED that )OJI" rig! to prdest Iha specified fees'e<adims lXES NOf APPLY towter a--d se,.e, o::medim f"'6 a--d cap,rity cJu-g,s, rrr pla-nrg, =irg ga:lrg or cttor snilar wicaim l)"OCSSSirg or senice f..,, in o::medim wth lhs prtjoct. lsl.:R lXES IT APPLY to a,y 'cnsdWlifTI _,1-,~~ '-' • · ... -.......... CEc:irril-tn~ ... -~tomm••-' 'Ii . . . . . ( 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 SUITE#/SPACE#/UNIT# JOB ADDRESS "I .70J. J~A-iJbA; ~ ~ Plan Check No. Est. Value Plan Ck. Deposit Date t SWPPP CT/PROJECT# LOT# PHASE# # OF UNITS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(•) Rcfc..ltcE ~tt,..,,,-Pt<E EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIRE SPRINKLERS YESD NoC CITY EMAIL DESIGN PROFESSIONAL CONTRACTOR BUS. NAME . IAa if'!' ~ '\JV~~~ 5(ER_./(l,t: co . ADDRESS 0~37 CITY STATE ZIP CITY STATE C PHONE FAX PHONE LI 7i o-7J.. 7-7'JJ I FAX EMAIL EMAIL GL/:lvlv@ JowES.SCR.t1tCc. N,rT STATE LIC. # STATE UC.# ~s~ 93s-- CLASS CITY BUS. LIC.# (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. commending with 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 1031.5 by any applicant for a permit subjects the app\\cant to a civil penalty of not more than five hundred dollars ($500)). Workers' Com pens at ion Declaration: I hereby affirm under penalty of perjury one of/he following declarations. DI have and will maintain a certificate of consent to self-Insure for v«lf'kers' compensation as provided by Section 3700 of the Labor Code, for the performance of the v«lf'k for which this permit is issued. DI have and will maintain workers' compensation. as reouired bv Section 3700 of the Labor Code. for the performance of the v«lf'k for which lh1s permit is issued My workers' compensation insurance earner and policy number are: Insurance Co. Poicy No. _____________ Expiration Date ________ _ ~section need not be completed if the permit 1s for one hundred dollars ($100) or less LJ Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person 1n any manner so as to become subject to the Workers' Compensation Laws of Caifornia. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. ~ CONTRACTOR SIGNATURE □AGENT DATE I hereby affirm that I am exempt from Contractor's License Law for the following mason: 0 I, as owner of the property or my empbyees with wages as their sole compensation, v.;11 do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's LIC8flse Law does not apply to an owner of property who builds or improves thereon. and who does such work himself or through his own empbyees, provided that such improvements are not intended or offered for sale. If, howe\ler, the buildmg or improvement 1s sold v.;thin one year of completion, the owner-builder will have the burden of proving that he did not build or improve lor the purpose of sale). ,$" I, as owner of the proper1y, am exclusively contracting with icensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Controotor's Lioense Law does not apply to an owner of property who builds or improves thereon, and contracts for such proiects v.;th contractor(s) icensed pursuant to the Controotor's License Law). □ I am exempt under Section _____ BuStness and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. Q es D o 2 I (have / have not) signed an appication for a building permit for the proposed work. 3 I have contracted v.;th the following person (firm) to provide the proposed construction (include name address I phone/ controolors' lioense number): ired the folbv.;ng person to coorcinate. supervise and provide the major v«lf'k (include name/ address/ phone / contractors' license number): ted (hired) the following persons to provide the v«lf'k indicated (include name/ address I phone/ type of v«lf'k). Is the applicent or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention progam under Sections 25505, 25533 or 25534 of the Presley-Tinner HSZir"dous StibstanceAccount Act? □ Yes □ No ls the f:WIIC8nt or future building occupant required to obtain a permit from the air pollution control district or air qua~ty management district? □ Yes □ No Is ttu~ fa:;ility to be constructed within 1,000 feet of the outer lxlundary 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 I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. '2i!J7 (i) Civil Code) Lender's Name Lender's AOOress APPLICANT CERTIFICATION I ces11tf '4latl have read lie a~ and stale that the allow lnfomalon is correct and hat the infonnatim m fie plans is a<XU81e. I a,ee tocon1)1yMlfl all Qty ordlnaooes and Stale laM relali1I:., lddq; coonuclon. I hereby aJ!IKrize r'l)reS9111ative of the Cfy c/Cal,t,adlo enter upon the ,t,o,e rrertioredprope'ly for iropedrn pcqx,ses. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSl'AD AGAINST ALL UAllLITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUEAG,>JNST &\ID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA: AA OSHA. permt is required fcr excavations over 5'0' deep anddemcirtlOll cr oonstrudion of stn..ciLJffi ova: 3 stores in height. EXPIRATION: Every perm rt issued by the BU Icing Official urderthe r:rovisions of this Co:le shall e)(J)ireby hmitalionaOO ooo:me null and void if the OOik:lirg or WOO< authorized bys 100 cays from the dale d such i:;ermrt or if the bui or autrorized bY. rt is s ded or aterdcried at any time after the w::irk is canrrenced for a peri of 1 &l AS APPLICANT'S SIGNATURE {' DATE permrt is nct oomrnence:l within (Section 100. 4.4 UiiooTI Buiktlg Code). Inspection List Penni!#: CB154419 Type: PME Date lrlspection Item _____ _ 06/16/2016 43 AirCond/Furnace Set 06/16/2016 49 Final Mechanical 05/13/2016 43 AirCond/Furnace Set 05/13/2016 43 AirCond/Furnace Set 05/13/2016 49 Final Mechanical Friday, June 17, 2016 Inspector MC MC MC MC MC Act AP Fl AP co NR KRUPINSKY: REPLACE FURNACE Comments 2ND STOP 1ST STOP, NO ACCESS NEED T-24. Page 1 of 1