HomeMy WebLinkAbout2758 OLYMPIA DR; ; CB143405; Permit12-04-2014
Job Address:
Permit Type:
Parcel No:
Reference #:
PC#:
Project Title:
Applicant:
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing/Mechanical/Electrical (PME) Permit
Permit No: CB143405
Building Inspection Request Line (760) 602-2725
2758 OLYMPIA DR CBAD
PME
1674314900 Lot#: o
HENDRICKSON RES -REPLACE FAU
AND NC UNIT IN SAME LOCATIONS
Owner:
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
12/04/2014
SKS
12/04/2014
12/04/2014
WEST COAST APPLIANCE SERVICES INC
DBA WEST COAST SOLAR
HENDRICKSON LINDA TRUST 09-21-05
1282 FAYETTE ST
EL CAJON CA 92020
619-557-0446
Plumbing Fees
Electrical Fees
Mechanical Fees
other PME Fees
TOTAL PERMIT FEES
2758 OLYMPIA DR
CARLSBAD CA 92010
$0.00
$0.00
$160.00
$0.00
$160.00
Total Fees: $160.00 Total Payments To Date: $160.00 Balance Due:
FINAL APPROVAL
Inspector: Date: /-ZZ -1 S-Clearance:
$0.00
NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in Government 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 procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition.
Building Permit Application
1635 Faraday Ave., Cartsbad, CA 92008
Ph: 78CMI024717 Fax: 760-602-8558
email: bulkllng@carlsbadca.gov
www-carlsbadca,goy
Plan Check No. ffi / Cf 3'-( as-
Est. Value
Plan Ck.
)~Date SWPP
SUITE#/SPACE#JUNIT#
GROUP
DESCRIPTION OF WORK: lnol-Square Fe« of Affected ArN(s)
EXIS11NG USE USE GARAGE (SF) PATIOS (SF) DECKS (SF) A REPLACE AIR CONDITIONING ARE SPRINKLERS
YES □#_ NO □ YES □ NO □ YES □ NO □
APPLICANT NAME (Secoadary Contact)
PHONE FAX
EMAIL
CONTRACrOR BUS. NAME
ZJP C,-u,10
PHO~E lPS"D· ~/. 0't=tL,,
EMAIL
ARCH/DESIGNER NAME & AOORESS STATE UC.#
(Sec. 703:LS Business and Professions Code: Any Cl!:Y or Coul!tY which requires a ~nnit to construct. alter, improve, demoliSh orJiir anr stru re. prior to Its Issuance, alSO IJIQUires the applicant tor such permit to file a Sfll'led statement ttiat he iS llcensed pursuant to the provisions of the Contractor's License Law 1aoter 9, co n<llnil:wtth Section 7000 of OMsion 3 of the B.u~lness and Professions Code} orfhat he is exem_pt therefrom, and the basis tor the alleged exemption. Any vlolatlon of Section 031.5 by any appllcantfor a permit subjects the applicant to a cMI penalty of not more than five hundred dollars {$500}).
WORKERS COMPENSATION
-•Comp,n_, _, I hnbyalffnn l.flderpenaltyolpet/lly°"" olthefolluoing-
□ Ihm and wW -1 c«tlflcate of consent to Hlf-in111reforwakera' compensallon as provided by Section 3700 of the labor Code, for the pe,fu,11aa.e of the _for which lhis pennit is iss1Jed. 'F I h,ve and will maintain WQ)b!s• compe11..uon: _;pqufrecttJ• HJX}:the Labor Code, fill' the ~the work forwNch this pen'!!!t~ ~ued My worbra' canpensaliol} ~ cri!r and oolicy
nu-ae: Insurance eoL"'7 ;I\ J,y\11 ~~ · Pacy NoJ ~~Cl)( :r:>f'-c,1~ Expiration Dals _ _c"Z...:,,~,,_,,::,r, ___ _
This -not be com~ W the pennit is for one hundred d0lars ($100) or less.
Certfflcate of Exemption: I eertify that in the perfo,1118ix:e of the work for which this permit Is issued, I shal not employ any person In a,y mainerso as to become sub;ectto the Wori(ers' Compensation Laws of
ifomla. WARNING: Failure to securewortrin' c;ompen ~.:'.::~and shall subject an employer to crlrinal penalties and civil fines up to one hundred thousand dofln {&100,000). In
addlion to the coat of compenlllll"'tl!!!"-"'9 pro,~j :JI orcode, Interest and attorney's fea.
. A!$ CONTRACTOR SIGNATURE
I heteby a/ltm that I am e,,empt from Contniclr,t's Uoense Law for the {ollcr,rjng reason:
□ I, as owner of lhe 1N'0l)8l1y or my employees wi1h wages as their sole ~. will do the -and lhe slruClule is not Intended or offered for sae (Sec. 7044, Bu&iness and Proless1ons Code: The ~•
License Law does not apply to ai owner c:I property who bl.ilds or improves thereon, and who does such work himself or through his own employees, pl'O'lided thal such ~ n not Intended or offemd for
sale. If, haM!Yer, the building or Improvement Is sold within one yea of completion, the owner-builder will have the burden of proving that he did not buBd or Improve for the purpose of•>·
□ I, as owner of the property, an exclusively contra::llng with licensed contra:tors to construct the pro;ect {Sec. 7044, Business aid Professions Code: The Contra:tor's license Law does not apply to an owner of
property who builds or Improves thereon, aid contracts for such proiects with contra.b:lr(s) licensed pursuant to the COntractor's Uc:ense Law).
O I an exempt under Section Business and Professions Code for this IMS1)n:
1. I personal~ plan to provide lhe major ~bor and -for cons1rud1on of lhe proposed 1N'01)811y lmprovemenl □ Yes □ No
2 I (have / ha,e nol) slgned an ap~icalion for • buildlng permit for the proposed m.
3. I have contracted with the following person (firm) ID provide the proposed construction (include name address / phone / contractors' licen&e number):
4. I plan t, provide portions of the work, but I have hired the following person to coordinate, supeM&Q .-id provide the major work [Include name I address / phone I contraclora' license number):
5. I will provide some ol lhe -, but I have coolraded (hired) lhe following pe1SOns to piovide the -ln<f,:aled Include nane / address / phone / type of-):
A!! PROPERTY OWNER SIGNATURE □AGENT DATE
C O M P L-E T E t H I S 5 E C T I O N F O R N O N · R E S I D E N T I A L B lJ I L D I N G P E R M I T S O N L Y
ls the applicant Or future bulkfmg occupant required ti submit a business plan, a::utely hazardous materials reglstniion bm or risk maiagement aid prevention progran under Sections 25505, 25533 or 25534 of the
Prasley-T anner HaurdolJ& Substance Account Nf! □ Yes □ No
Is~• applicant orfulure bul~ing occupant requied lo obtain a pennltlrom lhe lir pollutioo conlrol dis1lict or arquafdy management dlstricf? □ Yes □ No
Is ~efaolilylobecons11Uctedwilhin 1,000leeloflheouJerboundayof aschool si1B? □ Yes □ No
IF ANY OFTHE ANSWERS ARE YES, A FINAL CERTIFICATE Of OCCUPANCY IIAY NOT BE ISSUED UNlESS THE APPUCANT HAS IIET OR IS IIEETING THE REQUIREIIENTS OF THE OFFICE OF
EMERGENCY SERVICES AND THE AIR POLUmON CONTROL DISTRICT.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
l~lhetl have'"8<11healllJiJCallonandS18181hetlheaix.e-..uan 1sCDm1Ctandlhetlhelnbma1lollcrtlheplansls_ l_1Da,mpywfthallCityORllnaneesandSIIIBlaws-.glDlluldlngcanotructiOn-
l haebyllllhaio, rep,osentalMI of lhe Cityof Cafsbad IDenli!r_ lhe_menllanod properlyforilspecla, pirposes. I ALSO AGREE TO SA'IE, INIJEM,jlfY AND KEEP HARIA..ESS THE CITY OF CARlSBAD
AGAINST All LIABIUTIES,JUDGl.elra, COSTS AND EXPENWlMJICH 1/AY IN ANYWAY ACCRUE AGAINST SAID CITY IN CONSEQIENCE OF THE GRANTING OF THIS PERMT.
OSHA:M OSHApuntlsreqiiedfor-<Mr5'0'deep . -3-ilhe!llit
EXPRATlON: EverypermtiaJed bylhe · ~oftls Codesllal -aid become nul 81d voil flhe boJci11 or'Mllkadhaizad bysuch penntis ruw111eud wllli1
180cflr/sllom lhe dalaof such P"!!jt.,;11$ adhaizad bysuch pennil;. or-atarylineallerlhe'Mllkl, WliiOl..edfor a period of 180cflr/s (Secllon 106.4.4 lxiixm a.ti1g Code).
,,e:s' APPI.ICANT'S SIGNATU DATE /'Z..,
•
Inspection List
Permit#: CB143405 Type: PME
Date Inspection Item
01/21/2015 43 AirCond/Furnace Set
01/21/2015 43 AirCond/Furnace Set
01/21/2015 49 Final Mechanical
01/21/2015 49 Final Mechanical
Thursday, January 22, 2015
Inspector Act
RI
PB AP
RI
PB AP
HENDRICKSON RES · REPLACE FAU
AND A/C UNIT IN SAME LOCATIONS
Comments
AM PLEASE
AM PLEASE
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