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Home My WebLink About2745 LA GRAN VIA; ; CB112515; Permit11-30-2011 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 PJumbing/Mechanical/Electrical (PME) Permit Permit No: CB112515 Building Inspection Request Line (760) 602-2725 2745 LA. GRAN VIA CBAD PME 2163200400 Lot#: 0 IRWIN: REPAIR GAS LEAK@ GARAG Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 11/30/2011 JMA 11/30/2011 11/30/2011 BERCKS OLD TIME PLUMBING IRWIN PATRICIA J TR 38415 INNOVATION CT STE E 92563 951 676 7197 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES 2712 184TH ST REDONDO BEACH CA 90278 $150.00 $0.00 $0.00 $0.00 $150.00 Total Fees: $150.00 Total Payments To Date: $150.00 Balance Due: Inspector: FINAL APPROVAL Date /Z ·/· f/ Clearance: $0.00 NOTICE: Please take NOTICE ttiat approval of your project includes the "lmposttion" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this pennlt was issued to protest imposition of these fees/exactions. 11 you protest them, you must follow the protest procedures set forth in Gover'lment Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that proced•Jre will bar any subsequent legal action to attack, review. set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right 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 tees in connection with this project. NOR DOES IT APPLY to any f x in thih h NT imitr hi ihh i inh rvi I hi <<1.fJ> Building Permit Application Plan Check No. B( I· 2Sl s- 1635 Faraday Ave., Garlsbad, CA 92008 Est. Value ~ CITY OF 760-602-2717 / 2718 / 2719 CARLSBAD Fax: 760-602-8558 Plan Ck. ~eposi~ www.carlsbadca.gov Date 1\(30( /( lswPP C JOB ADDRESS )__ SUITE#/SPACE#/UNIT# IAPN ?-74-5 "1 r,: ,.(,r,1 Vi"IJ --- CT/PROJECT# rOT# I PHASE# I# OF UN/TS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I occ GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(sJ {e r11:,1 (,-1/5 L Ille_ EXISTING USE I PROPOSED USE I GARAGE {SF) PATIOS (SF) I DECKS {SF) I FIREPLACE IAIR CONDITIONING I FIRE SPRINKLERS YES □#_ NO □ YES □ NOD YES D NO □ APPLICANT NAME (Primary Contact) r: t <'( Jf ( (71,u APPLICANT NAME (Secondary Contact) ADDRESS 2'1fr4- ADDRESS (-,' f/,fr Ii ;e ,/ CITY STATE ZIP CITY STATE ZIP /11 I:',,,'(" t' (' CA '7,S-(:5 PHONE (,,I(. I FAX PHONE I FAX 'f>l TNT "'"'"'" EMAIL PROPERTY OWNER NAME V'lle CONTRACTOR BUS. NAME ,5 erc/15 otd 7,',,.,e /'L~,.,1,,, /111/ 1'7d ADDRESS ADDRESS '3 84 /) ,Q 74-5 L4 Cl/ht l/ ii/ /11 Hdi'J 1/11-7 cl CITY (_ 1..-I> bf,! STATE ZIP CITY STATE ZIP C"I CJ Z 06') /t'fpr,, e 71 C 1 qlf{J PHONE I FAX PHONE I FAX 't SI t'i!J S" ,J ci G, i'C (, Z> Z 0?1 '/>t /j 7 (, 71 'f 7 I c.,v,AIL EMAIL ARCH/DESIGNER NAME & ADDRESS I STATE UC.# STATE UC.# &z z f{.f !°LASS CMC'J( I CITY BUS. UC.# 12Zf'!c7 (Sec, 7031.5 Business and Professions Code: Any Crty or Coun_ty which requires a permit to. construct, alter, improve, demolish or repair an~ structure, pnor 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 /Chaoter 9, commending with Section 70_00 of Division 3 of the Business and Professions Code) orfhat he Is exempt therefrom, and the basis for the alleged exemption. Any vIolatIon of Section 1031.5 by any applicant for a permit subiects the applicant to a civil penalty of not more than five hundred dollars {$500}). WORKER$' COMl'li'N$ATION Workers' Compensation Declaratlon: I hereby affirm under penalty of pe,jury one of the following declarations· □ I have and wm maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Lat>or Code, for tM performance of the work for which this permit is issLJed. 121 I have and will maintain wo'il:ers' com_E9?ation, as required by Section 3700 of the Labor Code, for the perform. ane:e of the work for which th!s permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. l,(..,' 'l l If 1 (2 6 C:. Policy No 51,,,,, ( I 6 0 S 1 9' j Expiration Date / t · 2 ( I Z This section need not be completed if the permit is for one hundred dollars ($100) or less. □ Certificate of Exemption: I certify that in the performance of the work for which this pennit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Fallureto secure workers' compensation coverage ls 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 pro ·~or in S 'the Labor code, interest and attorney's fees. _6! CONTRACTOR SIGNATURE (a'AGENT 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 throagh his own employees, provided that such improvements are not intended or offered for sale. ti, however, the building or improvement is sold within one year of compleHon, the owner-builder _will have the burden of proving that he dkl 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 lo an owMr 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 cof\Struction of the proposed property improvement. □ Yes 13'No 2. I (have/ have not) signed an application for a building permit for the proposed work 3. I have contracted with the following peraon (firm) to provide the proposed construction (include name address/ phone/ contractors' lk:ense number)· 4. I plan to provkle portions of the work, 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 work, but I have contracted (hired) the following persons to provide the work indicated (include name I address I phone I type of work): ,6$ PROPERTY OWNER SIGNATURE ( 1!!fAGENT DATE 0" " COMl>Llittl tHU SliCTIOlll FOR NON•RIUIOIIH'UAL IUII.OUIG PERMITS ONI.Y 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? □ Yes □ No ls 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 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 ANO THE AIR POLLUTION CONTROL DISTRICT. I hereby affirm that there Is a coostruction lending agency for the performance of the work this penmt Is issued (Sec 3097 (1) CIvll Code) Lender's Name lender's Address I certify that I have read the application and state that the above lnfunnatlon Is oorrec:t:and that the infunnation on the plans Is accurate. I agree to oomplywlth all Cllyordlnances and Sta1e laws relating to buHding oonstructlon. I hereby authorize representative of the Otyof Carlsbad to enter upon the above mentoned property tir inspedbn !JJrpoSes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN AfN WAY ACCRUE AGAINST SAID CllY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: Pl! OSHA permrt is required br excavatk:lns over 5'0' deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Buik::ling Oifcial under the provisions of this Code shall expire by limitalkm and become nu! and void if the buik::ling or oork authorized by such pennrt is not commenced v.ithITT 100 days from the date of such permrt or if the buik::I~ authorized by ~~91-~.rm~~s suspended or abandoned at any time after the w:irk is commenced for a period of 1BO days (Seeton 100.4.4 Uniform Buik::ling Code). ~APPLICANT'SSIGNATURE __..-:_~ f ~ DATE / / ? Gi I «~'> ~ CITY OF CARLSBAD UNSCHEDULED BUILDING INSPECTION B-44 Development Services Building Division 1635 Faraday Avenue Carlsbad CA 92008 760-602-2700 DA TE: ~\1....,-,..c-3~0,.,,,c.>.u,.___ ___ _ INSPECTOR: a~ ------- PERMIT #: \ \?-.S. ts CONTACT: ______ _ JOB ADDRESS: )...'1~ 1 q.. G "A---1..l,, b--<' DESCRIPTION: PHONE#: -------- ----------------------- CODE DESCRIPTION ACT COMMENTS ,- c°'"".;geo) 'k •~a,:,_ M ~ f-t /1 If<- Bldg Inspection Form Page 1 of 1 Rev. 06/09