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Home My WebLink About2855 CARLSBAD BLVD; ; CB121598; Permit08-23-2012 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB121598 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # PC# Project Title 2855 CARLSBAD BL CBAD MISC 2032310100 $0 00 Subtype Lot# OTHER 0 Status Applied Entered By Plan Approved Issued Inspect Area HOLMBERG RES- REPLACE BATHTUB W/ NEW WALK-IN JACCUZZI TUB - IN MASTER BATHROOM ISSUED 08/23/2012 RMA 08/23/2012 08/23/2012 Applicant L J HAUSNER CONSTRUCTION Owner FRONT PORCH COMMUNITIES AND SERVICES 505 W FIRST ST 92780 1-800-433-0704 303 N GLENOAKS BLVD #1000 BURBANKCA 91502 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMITFEE $95 00 $0 00 $0 00 $95 00 Total Fees $95 00 Total Payments To Date $95 00 Balance Due $0 00 inspector INALAPPROVAL Date J "S'-Zj Clearance NOTICE Please lake NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter coilectvely referred to as 'fees/exactions" You have 90 days from the date this pemiil was issued lo protest imposition of these lees/exactions If you protest them, you must follow the protest procedures set forth in Govemment Code Section 66020(a), and file the protest and any other required infomiatiofi with tfie City Manager for processing in accordance with Carlsbad Municipal Code Section 3 32 030 Failure to timely follow that procedure will bar any subsequent iegal action to attack, review, sel aside, void, or annul Iheir imposition You are hereby FURTHER NOTIFIED that your nghl 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 pnacessing or service fees in connection with this pnDiect NOR DOES IT APPLY to any fees/exactions oi which vou have previouslv been given a NOTICE similar to Ihis. or as lo which the statute ot limitations has previously othenvise expired THE FOLLOWING APPROVALS REQUIRED PRIORTO PERMIT ISSUANCE • PUNNING • ENGINEERING • BUILDING • FIRE • HEALTH • HAZMAT/APCD CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave , Carlsbad, CA 92008 Ph 760-602-2719 Fax 760-602-8558 email buldl]ng@carlsbadca gov wvw carlsbadca eov Plan Check No. / 2 _ J -^^J^ Est. Value Plan Ck. Deposit, Date SWPP SUITE #/SPACE«/UNIIW J APN - CT/PROJEa» LOT fl PHASE # » OF UNITS tt BEDROOMS # BATHROOMS TENANT BUSINESS NAM CONSTR TYPE OCC GROUP DESCRIPTION OF WORK Inclurle Square Feet of Affected Area(s) EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPUCE AIR CONDITIONING FIRE SPRINKLERS YES • # NO • YES • NO • YES • NO • APPUCANT NAME {Primary Contact) I Q fn APPLICANT NAME (Secondary Contact) ADDRESS n , f ADDRESS CITY/T SJATE ZIP CITY STATE ZIP PHON£_ FAX PHONE FAX EMAiL PROPERTYdWNER NAME-T— . / , CONTRACTOR BUS NAME / / ADDRESS / J—,/--^ / CITY ^ STATE ZIP CITY STATE ZIP PHQHE, / n ^ „ - 1 FAX PHQUE FAX EMAIL , AHCH/DESIGNER NAME & ADDSESS STATE UC # CITYBUS-Uaw /' // / applicant for such permit to file a signeti statement that he is licensed pursuant to the provisions ofthe Contractors License Lawicfiapter 9 commentjmgwith Sectpn/OOO of Division 3 ofthe Business and Professions Code) or that he is exempt Uierefrom, and the basis for the alleged exemption Anyviolation of Section 7031 5 by any applicant for a permit subjects Uie applicant to a civil penalty of not more than five hundred dollars ($500)) Workers' Compensation Declaration / teeby affimi under penalty ot perjury one ofthe toilowing dedaraions d I have and will maintain a certificate of consent to self insure for workers compensalion as provided by Section 3700 of lhe LaborCode forthe performance ol lhe wor1( tor which this pennil is issued ^,^^1 have and will maintain woriter^jipmpensation as required by Secton 3700 of the LaborCode for the perfomiance of the vrork for which this permit is issigd Mv workers' compensajion insurance camer and policy numberare InsuranceCo g AJj^^tc.^*^ ^ Policy No C!/^ "Z-OO / 2-21^0 j<piralion Date C» / 2. ^ // ? Ttiis section need nol be completed ifthe pemiit is tor one hundred dollars ($100) or less n Certificate of Exemption I certify that in lhe performance of the work for which this pemiit is issued, I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California WARNING Failureto secure workers' compensation coverage Is unlawful, and shall subject an employer to cnminal penalties and civil fines upto one hundred thousand dollars (S100,000], in addition to the cost of compensation, dam^mes^^rovided for in Sect)oi>4^ p^the Labor code, Interest and attomey's fees vefcONTRACTORSIGNATURE .c^^^-^T^^-^ ARGENT DATE *2. 3 " / "Z— / fiereby affimi 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, Busmess and Professions Code The Contractor s License Law does not apply to an owner of property who builds or improves thereon, and wtu does sxh work himsell or through his own employees, provided that such improvements are not intended or offered for sale If however the building oi improvement is sold wthin one year ol complebon, 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 constnjct the project (Sec 7044, Business and Professions Code The Contractor's License Law does not apply lo an owner of praperty who builds or improves Ihereon, and contracts for such projects with conlractor[s) licensed pursuant lo the Contractor's License Law) O I am exempt under Section Business and Professions Code lor this reason 1 I personally plan to provide the major labor and matenals for construction of the proposed property improvement • Yes O No 2 I (have / have not) signed an application lor a building permit for the praposed work 3 I have contracted with the following person (firm) to provide the praposed construction (include name address / phone / contractors' license number) 4 I plan to provide portons of Ihe work but 1 have hired tfie following person to coordinate, supennse and provide the major work (indude name / address / phone / contractors license number) 5 I will provide some of the work but I have contracled (hired) the following persons to provide the wotk indicated (include name / address / phone / type of work) PROPERTY OWNER SIGNATURE •AGENT DATE Is the applicant orfuture building occupant required to submit a business plan acutely hazardous matenals registration form or nsk managemeni and prevention program under Sections 25505,25533 or 25534 of the Presley Tanner Hazardous Subslance Account Acf • Yes • No fs the applicant or future buildingoccupantrequired to obtain a permit fram the air poliubon control distnct or air quality management distnct? • Yes • No Is the facility to be constructed withm 1 000 feet of the outer boundary of a school site? • Yes O 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 AND THE AIR POLLUTION CONTROL DISTRICT I hereby affirm that there is a constnidion lending agency for the performance of (he worit this permit is issued (Sec 3097 (i) Civil Code) Lender's Name Lender's Address l(£rtfyttiat I have read the application and state l^attheaboveinfbmiatjon IS conectand thatthe tnforrnaton on the plans tsa building construction I heretjy authonze representative of the City of Carlsbad to enterupon the above mentioned property far inspection purposes I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGI/ENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CfTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMfT OSHA /v\ OSHA permit is required (or excavabms over 50 deep and demolitonBr constmcton of structures over 3 stones r height EXPIRATION Every pemi! issued by he Butldiog Offafel under ihe prome^&iSf his Code shall expire by limrtation and Emime nul and void if the buildmg or vmrk authonzed by such pemiit s not commenced vnthm ISOdays from the date ofsuch permit or if Ihs^iidijH or vcrkaulhomi^^^ perniit is suspended or abandoned alany time after the wrk is oammenced forapenod ol ISOdays {Section 106 4 4 Unlom Building Code) yfif APPLICANT'S SIGNATURE yVL^— 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. CERTIFICATE OF OCCUPANCY ICommercial Projects Only) Fax (760) 602-8560, Email www builjingjgjcailsbadca gov or Mail the completed form to City of Carisbad, Building Division 1635 Faraday Avenue, Carisbad California 92008 C0# (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CiTY STATE ZiP CITY STATE ZIP Carlsbad CA PHONE FAX EMAiL OCCUPANTS BUS LIC No DELIVERY OPTIONS • PICKUP • CONTACT (Listed above) • OCCUPANT (Usted above) O CONTRACTOR (On Pg 1) • MAILTO • CONTACT (Listed above) • OCCUPANT (Listed above) • CONTRACTOR (On Pg 1) n MAIL / FAX TO OTHER • ASSOCIATED CB# • NOCHANGEINUSE/NOCONSTRUCTION • CHANGE OF USE / NO CONSTRUCTION • ASSOCIATED CB# • NOCHANGEINUSE/NOCONSTRUCTION • CHANGE OF USE / NO CONSTRUCTION ^APPLICANT'S SIGNATURE DATE Inspection List Permits CB121598 Date 03/01/2013 03/01/2013 03/01/2013 03/01/2013 01/30/2013 01/11/2013 01/11/2013 09/26/2012 09/26/2012 Inspection Item 19 Final Structural 19 Final Structural 29 Final Plumbing 29 Final Plumbing 29 Final Plumbing 29 Final Plumbing 84 Rough Combo 29 Final Plumbing 39 Final Electrical Type MISC OTHER Inspector Act Rl PB AP Rl PB AP MC CO MC CO MC CA MC CO MC CO HOLMBERG RES- REPLACE BATHTUB W/NEW WALK-IN JACCUZZI TUB-IN MA Comments MEET MAINT MAN ON SITE SEE CARD, MISSING BOND PER CONTRACTOR NO CONTRACTOR Tuesday, fyiarch 05, 2013 Page 1 of 1