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Home My WebLink About2851 ANDOVER AVE; ; CB153500; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 10-16-2015 Patio/Deck Permit Permit No: CB153500 Building Inspection Request Line (760) 602-2725 Job Address: 2851 ANDOVER AV CBAD Permit Type: PATIO Status: ISSUED Parcel No: 1674801855 Lot #: 0 Applied: 10/16/2015 Valuation: $10,000.00 Construction Type: 5B Entered By: JMA Reference #: Plan Approved: 10/16/2015 Issued: 10/16/2015 Inspect Area: Plan Check#: Project Title: TREMBICKI: DECK REPAIR W/ WATE PROOFING, STUCCO Applicant: Owner: HARBRO CONSTRUCTIION TREMBICKI KAREN 455 54TH ST 2851 ANDOVER AVE SAN DIEGO CA 92114-2220 CARLSBAD CA 92010 619-398-0200 Building Permit $114.59 Add'I Building Permit Fee $0.00 Plan Check $80.21 Add'I Plan Check Fee $0.00 Strong Motion Fee $1.30 Green Bldg Standards (SB1473) Fee $1.00 Renewal Fee $0.00 Add'I Renewal Fee $0.00 Other Building Fee $0.00 Additional Fees $0.00 TOTAL PERMIT FEES $197.10 Total Fees: $197.10 Total Payments To Date: $197.10 Balance Due: $0.00 FINAL PTOVAL Inspector: Date: / ,11Clearance: NOTICE: Please take NOTICE that approval d your project includes the "Imposition" d fees, decications, reservations, or other exactions hereafter odledivdy referred to as ' Fees/exactions." You have 90 days from the date this pern-it wes issued to protest irrpositicn d these fees/exactions. If you protest therm you mist fdloN the protest procedures set forth in Goverrrnent Code Section 66020(a), and file the protest and any other required infom1aticn withthe 0ty Manager for processing in aooadance with Carlsbad Minicipal Code Section 3.32030. Failure to timely fdlowthat procedure will bar arty subsequent legal action to attack, review, set aside, void, or air d their imposition. You are hereby FURI}-IIER NOTI R ED that your right to protest the specified fees/exactions DOES NOT APPLY to water and seeer connection fees and capacity changes, nor planning, zoning, gracing or other simlar application processing or serviov fees in connection with this project. NOR DOES ITAPPLY to arty THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: OPLANNING EJENGINEERING DBUILDING [:]FIRE [:]HEALTH ElHAZMATIAPCD Building Permit Application plan Check No. S CCity of 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value Carlsbademail:Ph: 760-602-2719 Fax: 760-602-8558 plan Ck. Deposit building@carlsbadca.gov Date (J 16 • , SWPPP www.carisbadca.gov JOB ADDRESS SUITE#/SPACE#/UNIT# APN 2A Q VIeEAllhe, - - - CT/PROJECT # LOT # PHASE # # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OOC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Areas) EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS 1 YES ❑# NO❑ YESE]NO YESE]i APPLICANT NAME // Primary Contact PROPERTYeWNER ""�e"r>� ADDRESS ADDRESS 0 LI/1 CITY y dP t /' STATE ZIP CITY C?-& STATE CA, ZIP G 1. PHONE FA� ^ PHONE FAX EMAIL EMAIL ' r C DESI N PROFESSIO L CONTRACTOR BU NAME ti / ADDRESS /� {! ADDRESS J CITY Sl1, 1 �-� 0 STATE � ZIP � CITY STATE �_ " r.' � � � c� ZIP�� // ty�-// PHONE FAX PHONE F EMAIL EMAIL i STATE LIC. # ST LIC.# S CLASS CITY BUS. LIC.# _ AP19 W loec. rusJ_.o Business and Hrotessions (;ode: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuadc 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 7 00 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 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)). Workers' Compensation Declaration: 1 herebyafrm under penalty ofpedury one ofthe following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performanceof the wooryl� for which this permit is issued. My workers' compensation in ran arrie and policy numberare:Insurance Co& eriywil L+�rrtrw �'i14/-a4]":C, Cti6, Policy No.Wx `%i7 �� l� ® Expiration Date 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 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' compensati 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, damagS"s proviod f� Section 3706 of the Labor code, interest and attorney's fees. )K CONTRACTOR SIGNATURE / ! 0 �Q /,/ � � AGENT DATE 1 hereby arm that I am exempt from Contractor's License 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 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). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner 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. 1 personally plan to provide the major labor and materials for construction of the proposed property improvement. QYes ❑No 2. 1 (have / have not) signed an application for a building permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): 4. 1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone / contractors' license number): 5. 1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): )KPROPERTY OWNER SIGNATURE AGENT DATE STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. Fax (760) 602-8560, Email bullding(okaflsbadca.gOV or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. r0#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. i) ASSOCIATED CB# MAIL TO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (on Pg. i) NO CHANGE IN USE / NO CONSTRUCTION MAIL / FAX TO OTHER: CHANGE OF USE / NO CONSTRUCTION A!SAPPLICANT'S SIGNATURE DATE Inspection List Permit#: CB153500 Type: PATIO Date Inspection Item 11/18/2015 19 Final Structural 11/18/2015 19 Final Structural 11/18/2015 19 Final Structural 11/02/2015 18 Exterior Lath/Drywall 10/20/201514 Frame/Steel/Bolting/Weldin TREMBICKI: DECK REPAIR W/ WATE PROOFING, STUCCO Inspector Act Comments - RI - RI PD AP PD AP PD AP Wednesday, November 18, 2015 Page 1 of 1