HomeMy WebLinkAbout2756 OLYMPIA DR; ; CB153882; Permit11-10-2015
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing/Mechanical/Electrical (PME) Permit
Permit No: CB153882
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
2756 OLYMPIA DR CBAD
PME Status: ISSUED
11/10/2015
SLE
11/10/2015
11/10/2015
Parcel No: 1674314800 Lot#: 0 Applied:
Reference #:
PC#:
Project Title:
Applicant:
ASI HASTINGS
STE 200
EARL Y:REPLACE NC FURNACE COIL
4870 VIEWRIDGE AV
SAN DIEGO CA 92123
619-590-9300
Plumbing Fees
Electrical Fees
Mechanical Fees
Other PME Fees
TOTAL PERMIT FEES
Entered By:
Plan Approved:
Issued:
Inspect Area:
Owner:
EARLY WILLIAM R FAMILY TRUST 05-28-87
2756 OLYMPIA DR
CARLSBAD CA 92010
$0.00
$0.00
$163.00
$0.00
$163.00
Total Fees: $163.00 Total Payments To Date: $163.00 Balance Due:
Inspector: Date: Clearance:
$0.00
NOTICE Aease ta<e NCJTI cl yo,: ?tjed irdudes Ire "I · ·or1• cl fees, declcaicrs, reservalia-., er cthEr .,,.;;crs remelta' oolledivay
ra'erradtoas "fees'e,ajjcn;." You raveOOdaysfrooltre-ttis pemil "85 iSSUldto prctest irrpositicr1 cltt-esefees'e,ajjcrs. If you prctest ttun you nu;t
fdlo.vtre i,ctest JJO(llCires set forth in GMmrs-1 OXB ~cr160020(a), au file tre prctest au any cthEr req..iroo infCllTBicr1 wth tre Oty Mr_.-fcr
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rEMew, set .sre, \tid, er~ thair ir'flXSition.
You a-e J-ereby FlRT1-ER NCJTIRED that yo,: ri!ft to prctest Ire specified fees'e,.,.;;crs DCES I\Of APF1_ Y to Wil.<r au ,e,,er OCl1nedcr1 fees au~
ctmges, ncr ?annll;J, zoing gaill;J er cther sinriler Wicaicn ~ll;l er sen,ia, fees in OCl1nedcr1 wth ttis ?tjed. t-rn DCES IT APfl_ Y to any
i exa:iiOlS W1i CE . wid, the lirritai
THE FOLLOWIMi APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING 0 ENGINEERING □BUILDING □FIRE □HEALTH 0 HAZMAT/APCD
<<~t Building Permit Application Plan Check No.(\ _In\ '5 38°'3' 2-_,
1635 Faraday Ave., Carlsbad, CA 92008 Est. Value ~ CITY OF Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit
CARLSBAD email: building@carlsbadca.gov
www.carlsbadca.gov Date I \/1()/l""i ISWPPP
JOB ADDRESS SUITEt/SPACEf/UNIT# IAPN 2756 OLYMPIA DR ---
CT/PRuJECT # I LOT# [PHASE# I# OF UNITS I# BEOROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I occ. GROUP
DESCRIPTION OF WORK: Include Square Feet of Affected Area(•)
CHANGE OUT AC, FURNACE, AND COIL
EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE IAIR CONDITIONING I FIRE SPRINKLERS
v,so •<O YES0No0 v,s□•oD
APPLICANT NAME JERMAINE MAEWEATHER PROPERTY OWNER NAME BETTIE EARLY .... -
ADDRESS ADDRESS
4540 KEARNY VILLA RD #213 2756 OLYMPIA DR
CITY STATE ZIP CITY STATE ZIP
san dieao ca 92123 CARLSBAD CA 92010
PHONE IFAX PHONE IFAX 619-590-9337 7604348812
EMAIL EMAIL
JERMAINE@WEGREENINC.COM
DESIGN PROFESSIONAL CONTRACTOR BUS. NAME asi hastinas
ADDRESS ADDRESS 4870 viewridge ave
CITY STATE ZIP CITY STATE ZIP
san dieao ca 92131
PHONE IFAX PHONE
619-590-9337 I FAX
EMAIL EMAIL
[STATE LIC. # STATE LIC.# l'LASS I CITY ,us. "'·1200804 513115 c20
(Sec, 7031.5 Business and P_rofess1ons Code: Any City or County which reqmres a permit to construct, alter, improve, demolish or repair any structure, p_rior to its issuance, also requires the apphcant 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 B_usiness and Professions Code) or that he 1s exempt therefrom, and the basis for the alleged exemption. Any v1olat1on of Section 1031.5 by any apphcanffor a permit subjects the applicant to a
civil penalty of not more than five hundred dollars {$500}).
WORKERS' COMPENSATION
Workers' Compensation Declaration: I hereby affl,m under penally of perjury one of the fol/owing declarations: D I have and will maintain a certificate of consent to 1alf-lnsure for "M>rkers' compensation as provided by Section 3700 of lhe Labor Code, for the perfonnance of the "M>rk for which this permit Is Issued.
[Z] I have and will maintain workers' compensation, as reaulred by Section 3700 of the Labor Code. for the perfonnance of the work for whk:h this pennlt Is Issued. My workers' compensation insurance carrier and policy
number are: Insurance Co. CYPRESS INSURANCE COMPANY Polk:y No. ASWC&D5204 Expiration Date 9111201&
Illl§.sectlon need not be completed if the permit Is for one hundred dollars ($100) or less. LJ Certificate of Exemption: I certify that in the performance of the v«Jrk for which this pennll ls Issued, I shall not emplOy any person In any manner so as to t>ecome subject to the Workers' Compensation Laws of
CaHfomia. WARNING: Fallure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penaltln and clvll fines up to one hundred thousand dollars (&100,000), In
addition to the cost of compensation, damagn as p~d_!d for In Section 3706 of the Labor code, interest and attorney'• fees.
AS CONTRACTOR SIGNATURE / V \._/-@AGENT
I hereby affirm that I am exempt from Contractor's License Law for the fol/owing reason:
□
□
□
1, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure iS not lntel'lded or offered !Or sale (Sec. 7044, Business and ProteSSions Cade: The Contractors
License Law does not apply to an owner of property whO builds or Improves thereon, and whO does such work himself or throllQh his own employees, provided that such Improvements are not intended or offered for
sale. If, however, the bulldlng 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 !Or the purpose of sale).
I, as owner of the property, am exclusively controctlng with llcensed contractors to construct the project {Sec. 7044, Business and ProtessiOns 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 controctor(s) licensed pursuant to the Controctor's License Law).
I am exempt under Section ____ B,usiness and Professlons Code for this reason:
1. I personally plan to provide the major labor al'ld materials for construction of the proposed property Improvement. Ores Do
2. I (have/ have not) signed ..,. appllCatlon for a btJlldlng permit 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 work, but I have hired the lollowlng person to coordinate, supervise and provide the majOr 'M>rk (Include name I oodress / phOoe / contractors' license number):
5. I 'MIi provide some of the work, but I have contracled (hired) the following persons to provide the work Indicated (Include name/ address/ phofle I type of work):
I\
_,g PROPERTY OWNER SIGNATURE
rvs.::::::
AGENT DATE
, .
r<O·MPLIITI JH1$ $11C'l'l0N FOll NON•R~SJD.IINTIAL BDILl>llll!I !"ltRlllll'l"S ONLY
Is the appllcant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk mooagement and prevention progran uoder Sections 25505, 25533 or 25534 of lhe
Presley-Tanner Hazardous Substance Account Act? D Yes □ No
Is the applicant or future building occupant required to obtain a pe,mlt from the air pollution control district or air quality management d~trlct? □ Yes □ No
ts the facillty to be constrocted within 1,000 feet of the outer bounday of a school site? D 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 certify that I haw 1'98d the application and state that the ab<M infonnatlon Is correct and thatthtt Information on the plans is accurate. I agiee to comply'Mth all Cify ordinances and State laws relating to building construction.
I hereby aulhortza rep11SE1nlalive of the City of Ca1sbad b enter UJ'.XX'l the atx>w mentbned property for insl):d)n purp:;ises. I ALSO AGREE TO SA VE, INDEMNIFY AND KEEP HARMLESS THE CllY OF CARLSBAD
AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGPJNST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT
OSHA: M OSHA permit is required for excavations over 5'0' deep and derrdioon or a::nstnx:lion of structures OYer 3 stories fl height
EXPIRi\ TION: Every permit issued by the Buikl,fpi OffK:ial under the provisbns of this Cocle shall expire by linltalkln and ta:ome l'IUI !Jld wk! if the building or work authorized by such pemil is not conmenood wilhfl
180 days from the date of such penrit or if the ik:lioJ or work authorized by such pennlt is suspended or abanooned at anytme afler the woo; is cx:mmenced for a perbd of 180 days (Sectia'l 106.4.4 Unimn Buildhg Cocle)
A! APPLICANT'S SIGNATURE DATE \ \ ' \ C/ ', \~
Inspection List
Permit#: CB153882 Type: PME
Date _ lnspe_ction Item _ ____ Inspector Act
04/04/2016 43 AirCond/Furnace Set RI
04/04/2016 43 AirCond/Furnace Set
04/04/2016 49 Final Mechanical
04/04/2016 49 Final Mechanical
Tuesday, April 05, 2016
PY
PY
AP
RI
AP
EARLY:REPLACE A/C FURNACE COIL
Comments
AM BY 11:30
AM BY 11:30
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