HomeMy WebLinkAbout2277 PLAZUELA ST; ; CB161081; Permit03-21-2016
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing/Mechanical/Electrical (PME) Permit
Permit No: CB161081
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
2277 PLAZUELA ST CBAD
PME Status: ISSUED
03/21/2016
RMA
03/21/2016
03/21/2016
Parcel No: 2163404400 Lot#: 0 Applied:
Entered By:
Reference #: Plan Approved:
PC#: Issued:
Inspect Area:
STINE RES-REMODEL MASTER Project Title:
BATH@ 1ST FLOOR, CONVERT TUB TO SHOWER-HOT MOP SHOWER PAN.
RELOCATE TOILET & SINK, ADD NEW EXHAUST FAN
Applicant:
NEW LIFE CONSTRUCTION
STEA
4855 RUFFNER ST
SAN DIEGO CA 92111
858-638-1900
Plumbing Fees
Electrical Fees
Mechanical Fees
Other PME Fees
TOTAL PERMIT FEES
Owner:
STINE L YLE&LOIS
2277 PLAZUELA ST
CARLSBAD CA 92009
$163.00
$38.00
$0.00
$65.00
$266.00
Total Fees: $266.00 Total Payments To Date: $266.00 Balance Due:
Inspector: Clearance:
$0.00
NOTICE Reese ta<e NOTICE that )OS ~ed ird~ the "lrrpcsitiai' ci fees, decicaiors, -= a cthar exaliors -rolectively
referrad to as ,..,.,exalicns," Yoo rave 00 da)stromthe-ttis ~Iv.as issuoo to pretest irrpcsition cittesefeesle,ajjons If yru pretest It-err\ yru rrust
fdlONlhe pretest IJOCS(i.res set forth in GcNerrmrt Qxle Section ll0Jal(a), ard file the pretest ard ~ cthar reqjred infarraion wth the Qty fl/a1ager fa
prores,;rg i" a:ruda rewth Qrisboo M.ncipa Qxle Section 3.32.llJO. FalcretotirreyldlONtt-at i:,oredrewll Ila' ~subsa:µnl lega actiontoatta:t<,
re,;e.,v, set aside, vtid, cr aTU ttar irrµ::sitioo.
Yoo ae heret7y FUm-ER NOTIFIED that )OS ri[tt to pretest the simfied f..,.,e,ajjors CCES l'KJr APPLY to mer ard se,.er cornection fees ard capa:ity
cta,gas, ra plaring, zairg, gaing a dher sinilcr Wiecti01 pa::essing er SE:J'.Are fees in cx:.roectial Wth ths !Jtject. I'm cx:ES IT AfR.Y to a-r,;
t 'cnsclwi t:een · sirril tn er v.Jidltre lini i
THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE:
Ccicyof
Carlsbad
Building Permit Application
1635 Faraday Ave., Carlsbad, CA 92008
Ph: 760-602-2719 Fax: 760-602-8558
email: building@carlsbadca.gov
www.carlsbadca.gov
Plan Check No,
# BEDROOMS
ZIP
'1:;J.11 I
PHOl-g.. 6 3
FAX
EMAIL
DESIGN PROFESSIONA
ADDRESS
CITY ZIP
PHONE FAX
EMAIL
STATE LIC. #
Est. Value
SUITEI/SPACEI/UNITI
# BATHROOMS TENANT BUSINESS NAME
PATIOS (SF) DECKS (SF)
STATE LIC.# b
SWPPP
CONSTR. TYPE OCC. GROUP
AIR CONDITIONING
ves0No0
FIRE SPRINKLERS
vesONoO
(Sec, 7031.5 Business ~nd Profes~ions Code: Any City or County which requires a permit to_c9nstruct. alter, improve, qemolish or repair an)'. structure, p_rior t~ its issuance, also re~~ires th applicant for such permit to file a signed statement that he 1s licensed pursuant to the prov1s1ons of the Contractor's License LawJCha'fter 9, commendmgw1th Section 7000 of D1v1s1on 3 of the Business and Professions Code) or (hat he 1s exempt therefrom, and the basis for the alleged exemption. Any violation of Section 03 .5 by any applicant for a permit subjects the applicant to a
civil penalty of not more than five hundred dollars {$500}).
WORKERS' COMPENSATION
Workers' Compensation Declaration: / he!eby affirm under penalty of perjury one of the following declarations: D !)lave and will maintain a certificate of consent to self-insure for 'M)rkers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
[3"i" have and will maintain workers' co~satlon, as~ by Section 3700 of the Labor Code, for the performance of the work for -..;iich this permit is issued. My workers' compensation insurance carrier and policy
numberare:lnsuranceCo. s (,8:-Zd ,./),,t't,/-, PolicyNo. 'tot(o 6' 0 Expiration Date a,-o
~section need not be completed if the perm~ is for one hundred dollars ($100) or less. LJ 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 rovided for In Section 3706 of the Labor code, interest and attorney's fees.
,85 CONTRACTOR SIGNATURE c:,(oENT
I hereby affirm that I am exempt from Contractor's Ucense 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 Contractor's 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. I personally plan to provide the major labor and materials for construction of the proposed property improvement. OYes ONo
2. I (have/ have not) signed an application for a building permit for the proposed work.
3. I have contracted with the folloWlng person (firm) to provide the proposed construction (include name address/ phone/ contractors' license number):
4. I plan to provide portions of the wor\c:, but I have hired the following person to coordinate, supervise and provide the major work (include name I address/ phone I contractors' license number):
5. I WIii provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name I address/ phone I type of work):
,85 PROPERTY OWNER SIGNATURE □AGENT DATE
COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS 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? □ Yes □ No
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D Yes □ No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ Yes □ No
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR lS MEETING THE REQUIREMENTS OF THE OFFICE OF
EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I certify that I have read the application and state that the above lnfonnatlon Is conectand that the infonnatlon on the plans Is accurate. I agt8e to comply'Mlh all Chy ordinances and State law. relating to building construction.
I hereby authorize representative of the City of Carlsbad toenteru~ the alxlve mentioned p!Op:!rty br insp3Ction pul'J))SeS. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD
AGAINST All. LIABILITIES. JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN /Wf WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: AA OSHA perm~ is requred for excavations over 5'0' deep and dermlitkm orcoostruction of structures over 3 stories n height.
EXPIRATION: Every ~rmit issued by the Buik:ling Offcial under the J;lltMsions of this Code shall expire by limitation and become null and vok:l Wthe building orWJr'K authorized by such permit is not commenced 'Mlhin
100days from the date of such permit or iflhe building orWJr'K authoozed by such ~rmit is sus~nded or abandoned at any time after the WJr'K is commenced for a ~rioo of 100 days (Sectbn 100.4.4 Uniform Building Code).
_65 APPLICANT'S SIGNATURE 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 building@carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008.
CONTACT NAME
ADDRESS
CITY STATE
PHONE FAX
EMAIL
DELIVERY OPTIONS
□ PICK UP: o CONTACT (Listed above) o OCCUPANT (Listed above)
□ CONTRACTOR (On Pg. 1)
□ MAIL TO: □ CONTACT (Listed above) □ OCCUPANT (Listed above)
o CONTRACTOR (On Pg. 1)
ZIP
□MAIL/FAX TO OTHER: ________________ _
A$ APPLICANT'S SIGNATURE
CO#: (Office Use Only)
OCCUPANT NAME
BUILDING ADDRESS
CITY STATE ZIP
Carlsbad CA
OCCUPANT'S BUS. UC. No.
□ ASSOCIATED CB#------------
□ NO CHANGE IN USE/ NO CONSTRUCTION
□ CHANGE OF USE/ NO CONSTRUCTION
DATE
Inspection List
Pennit#: CB161081
Date Inspection Item
08/09/2016 89 Final Combo
08/09/2016 89 Final Combo
03/22/2016 24 Roughrropout
Wednesday, August 10, 2016
Type: PME
Inspector Act
PY
PY
RI
AP
AP
STINE RES-REMODEL MASTER
BATH@ 1ST FLOOR, CONVERT TUB TO
Comments
AM PLS
Page 1 of 1
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Losi Stine
2277 Plazuela St .
Carlsbad, Ca 92009
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