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HomeMy WebLinkAbout2822 FOREST VIEW WAY; ; CB112465; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 11-21-2011 Permit No: CB112465 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2822 FOREST VIEW WY CBAD PME Status: Parcel No: 1563202800 Lot #: 0 Applied: Reference #: PC#: Project Title: Applicant: KOZLOSKI: MINOR ELECTRIC & PLUMBING IN KITCHEN NEW LIFE CONSTRUCTION 6550 NANCY RIDGE ROAD SAN DIEGO CA 92121 858-638-1900 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Entered By: Plan Approved: Issued: Inspect Area: Owner: KOZLOSKI MARK&MELINDA A 2822 FOREST VIEW WAY CARLSBAD CA 92008 ISSUED 11/21/2011 JMA 11/21/2011 11/21/2011 $150.00 $30.00 $0.00 $0.00 $180.00 Total Fees: $180.00 Total Payments To Date: $180.00 Balance Due: Inspector: yi,t. {o...ee.,:....< 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. 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 plann·1ng1 zon·1ng, grad·1ng or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any f fw · h h v r I ii r hi r hi Iii I «1'>> ~ CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Garlsbad, CA 92008 760-602-2717 / 2718/ 2719 Plan Check No. Est. Value Plan Ck. Deposit Fax: 760-602-8558 www.carlsbadca.gov Date l/ SWPP EXISTING USE PROPOSED USE NAME (Prim ry Cpin!,ct) -v ,tt ~ .. C, c.. ~STATE ZIP ,~12, FAA ARCH/DESIGNER NAME & ADDRESS STATE UC.# SUITE#/SPACE#/UNIT# # BEDR OMS # BATHROOMS TENANT BUSINESS NAME GARAGE (SF) PATIOS {SF} DECKS (SF) FIREPLACE YES O # APPLICANT NAME (Secondary Contact) ADDRESS CllY PHONE CONSTR. TYPE DCC. GROUP AIR CONDITIONING FIRE SPRINKLERS NOD YES D NOD YES O NOD STATE ZIP FAA ''73 (Sec. 7031.5 Business and P.rofessions Code: Any City or Coun.ty which requires a permit to.construct. alter, impro e, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is ltcensed pursuant to the provisions of the Contractor's License Law JChapter 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 v1olat1on of Section 031.5 by any applicant for a permit subJects the applicant to a civil penalty of not more than five hundred dollars {$500)). WORKEIU' COMPll!NIATION Workers' Compensation Declaration: I hereby affirm under penalty of perjUf'f one of the following declarations: Cl l.)ave and will maintain a certificate of consent to self-insure for wo.rkers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this. permit is issued r!tr" have and will maintain work 'com pens on, as re u1 d by Section 3700 of the Labor Code, for the performance of the~~ !Or which this ~=it is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. ,.,,..... ') Policy No. c;v>__lf_ L.7 ZL~ Expiration Datd/-/::::Z ---..::: This section need not be completed if the permit is for one hundred dollars ($100) or less. 0 Certificate of Exemption: I certify that in the performance 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 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 I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: l:J I, as owner of the property or my employees with wages as their sole compensatkln, 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). l:J 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 to an owr.er of property who builds or improves thereon, and contracts for such iroJects with contractor(s) licensed pursuant to the Contractofs License Law). l:J I am exempt under Section Busir.ess and Professions Code !Or this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement l:J Yes l:J No 2. I (have I 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 I contractors' license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and i:rovide the major work (include name I address I phone I contractors' license number): 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (incllXle name I a:ldress I pl one I type of work): .I$ PROPERTY OWNER SIGNATURE Cl AGENT DATE t ---~ --~ C:OMPLl!'l'I! tl'IU Sl!C:'l'ION !'Oil NON-RIUliillNll'IAL 11uu.:i:11NG l'l!RMl'I'$ 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 Act? Cl Yes [l.lilo Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? lj Yes ~o Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Cl Yes ~ 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. I certify that I have read the application and state that the above infmmation Is correct and that the lnfonnatlon on the plans Is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize rep-esentative of the Qty of Carlsbad to enter u1xm the aOOve mentOned property klr inspection p..il'JX)Ses. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY 0:-CARLSBAD AGI\INST All LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGI\INST SAID CITY IN cm SEQUENCE OF THE GRANTING OF THIS PERMIT OSHA An OSHA permit is required brexcavations over 5'0' deep and demolition orconstructKln of structures over 3 stories in hei;Jht. EXPIRATION: Every permit issued by the Building Oflk;ial under the provisions of thts Code shall expire by imitatkJn and oocome null and void if the building or 'M:lrk authorized by such permit is not oommencad 'Mlhin 180 days from the date of sud! permit or if the building or 'M:lrk authorized by such permit is suspended or abandoned at anytime after the 'M:lrk ts oommencad for a pencx:I of 180days (Secoon 100.4.4 Uniform Building Code). ~ APPLICANT'S SIGNATURE DATE II-;_,// City of Carlsbad Bldg Inspection Request For: 03/20/2012 Permit# CB112465 Title: KOZLOSKI: MINOR ELECTRIC & Description: PLUMBING IN KITCHEN Type:PME Sub Type: Job Address: 2822 FOREST VIEW WY Suite: Lot: 0 Location: APPLICANT NEW LIFE CONSTRUCTION Owner: KOZLOSKI MARK&MELINDA A Remarks: Total Time: CD Description Act Comments 29 39 Date Final Plumbing Final Electrical Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# lnsi:1ection Histo!Y Description Act lnsp Comments Inspector Assignment: MC --- Phone: 6198472027 Inspector: /vf,~ -~--- Requested By: RICK Entered By: CHRISTINE 01/09/2012 29 Final Plumbing CA MC 1106 G3, PER CONTRACTOR 11/28/2011 17 Interior Lath/Drywall AP PD 11/22/2011 24 Roughfropout AP MC 11/22/2011 34 Rough Electric AP MC \. \ \ ' ' -$-u 1 ' '.fl-DR F<;l.c t-.l-l ' J 1r," ut-:1'\:>e-q_ C /\t.11-lt: 1 © ( I \ © .,,. I .,, \ ~ ' .... I / --- I I I I I \ (J) G')(IC.:.Tf, .. )I .... +~IL, T @ °?€1.J"D~..rr t..T APPROVED BY IJVW\-------' NOV 21 2011 City of CARLSBAD BUILDING DEPT / I I 1 Alt '"'""""k>na ,12c dc.•lt,,;;;11,,ns --· 111Thl• 1, 11r1 urt1:inal dc11lgn tnW muat ~pcd: 9/!noTtl I ~lwn. aro 5u~jc!cl tu verlttcar:lon an not be rclca.11cd nr 1,.-upicd unlca I Prtntod: 4n/?.Ol 1 Job •itc and 111dJu111lrnr.nt to fltjnh oppUcahlc ~ h11s bocn paid ar Jolt ~ 1COE{)sloW51;:i I~ n,dc•pl0<od r ~ I I -' ,---,--__ J 19030916 .kit l,l\l1(T1t1lltmc,l11nuul .... .,--II, << 80'121£909[