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Home My WebLink About1330 Poinsettia Ln; ; CBC2017-0127; PermitPrint Date: 05/09/2017 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: 1330 Poinsettia Ln BLDG-Commercial 2150704900 $0.00 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Commercial Permit www .carlsbadca.gov Work Class: lot#: Reference#: Construction Type: Bathrooms: Orig. Plan Check#: Plan Check#: P/M/E Status: Applied: Issued: Finaled: Inspector: Description: NORTH COAST CALVARY CHURCH: RELOCATE OUTLET ON STAGE AREA 4' FROM CURRENT LOCATION Applicant: NORTH COAST CALVARY CHAPEL JACK SHUBIN 760-929-0029 x122 PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT Total Fees: $166.00 Owner: CALVARY CHAPEL NO COAST 1330 Poinsettia Ln CARLSBAD, CA 92011 Total Payments To Date: $166.00 Balance Due: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." 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 planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitation has previously otherwise expired. --------···· Permit No: CBC2017-0127 Closed -Finaled 03/20/2017 03/20/2017 MColl $166.00 $0.00 lHE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: 0 PLANNING 0 ENGINEERING □BUILDING □FIRE { Cicyof Carlsbad JOB ADDRESS I Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov SUITEf/SPACEI/UNITI Plan Check No. Est. Value Plan Ck. Deposit Date CT/PROJECT# LOT# PH # OF UNITS # BED # BATHROOMS TENANT BUSINESS NAME DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) APPLICANT NAME VAC-/C 5~&,,,J PROPERTY OWNER Primary Contact AD/~"?o Po u-,.t 1ii A lk1J~ ADDRESS Pc,, /-=3:.;>_,a CITYC Sc'EA ZIP ~ A,et-'J 40 9'70// PHONE ~ ciiq-arz q X /ZZ.. t')/(,,"'} t:tC../:@--Jllor-f.h UJ <t 'Ir C ,Al<J,itl DESIGN PROFESSIONAL CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY STATE ZIP CITY STATE PHONE FAX PHONE FAX EMAIL EMAIL STATE LIC. # STATE UC.# CLASS □HEALTH 0 HAZMAT/APCD 7-0/J.. - CONSTR. TYPE OCC. GROUP ZIP CITY BUS. UC.# (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such per_mIt to file a si~ned statement that he is licensed pursuant to the provisions of the Contractor's License Law /Chapter 9, comme_nding 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 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 Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: D I have and will maintain a certificate of consent to self-insure for mrkers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued, D I have and will maintain workers' coml)ensation, as required by Section 3700 of the Labor Code, for the perfonnance of the work for which this oennit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. _____________________ Policy No. _____________ _ Expiration Date _________ _ ~section need not be completed if the permit is for one hundred dollars ($100) or less. LJ Certificate of Exemption: I certify that in the perfomiance of the work for which this pennit 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. ,a5 C0NTRACT0RSIGNATURE □AGENT DATE ~ --- O W NE R -BU IL DER DECLARATION I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: D 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 0No 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 (finn) 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 pel'Son to coordinate, supervise and provide 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 (include name I address I phone I type of work)· JI$ PROPERTY OWNER SIGNATURE 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 regis1ralion form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D 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? □ Yes □ No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 Yes □ 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the performance of the work this permit Is issued (Sec 3097 (1) C1v1I Code) Lender's Name Lender's Address APPLICANT CERTIFICATION I certify that I have read the applk:atlon and state that the abcwe lnfonnation Is coirectand that the information on the plans Is accurate. I agree to comply~ all City ordinances and S1ate laws relating to building constructlon. I hereby authOOze representative of the City of Carlsbad to enter upon the alxlve menOOned property IDr ins~on purp:ises. I ALSO AGREE TO SAVE, INDEMNIFY Af\lD KEEP HARMLESS THE CITY OF CARLSBAD AGAINST All LIABILITIES, JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEOJENCE OF THE GRANTING OF THIS PERMIT, OSHA: M OSHA pennlt is required for excavations over S'O' deep and demolition or constnJction of structures over 3 stories in height EXPIR/fflON: Every permit issued by the Building Official under the provisions of this Cooe shall expire by limitation and become null and void if the building orv-.ork authorized by sudl permit is not mmmenced Vvithin 180days from the date ofsudl permit orif lhe building o£X-O(k authorized by such ~It is suspended or abandoned at any time after the VIOrk is mmmenced for a pertod of 180 days (Section 100.4.4 Uniform Building Code), o f?~ #-1!< U' 0 F-N c. a:..... ..@S' APPLICANT'S SIGNATURE , DATE "Zc) • it,14f1,e.44 • 2e,j • 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 buildinq@carlsbadca.gov or Mail the completed form to City of Carlsbad. Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CO#: (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. 1) □ ASSOCIATED CB#------------□ MAIL TO: o CONTACT (Listed above) □ OCCUPANT (Listed above) □ CONTRACTOR (On pg_ 1) □ NO CHANGE IN USE/ NO CONSTRUCTION □MAIL/FAX TO OTHER: ________________ _ □ CHANGE OF USE/ NO CONSTRUCTION A! APPLICANT'S.SIGNATURE DATE ' I : PERMIT INSPECTION HISTORY REPORT (CBC2017-0127) Permit Type: BLDG-Commercial Application Date: 0312012017 Owner: CALVARY CHAPEL NO COAST Work Ctass: PIMIE Issue Date: 03/20/2017 Subdivision: Status: Closed -Finaled Expiration Dato: 10/0212017 Address: 1330 Poinsettia Ln Carlsbad, CA 92011-4081 IVR Number: 2632 Scheduled Actual Date Start Date Inspection Type Inspection No. Inspection Status Primary Inspector Reinspection Complete 04/0412017 04/04/2017 BLDG-34 Rough 018668-2017 Passed Michael Collins Complete Electrical Checklist Item COMMENTS Passed BLDG-Building Deficiency Wheelchair lift receptacle. Yes 04/10/2017 04110/2017 BLDG-Final 019423-2017 Failed Michael Collins Reinspection Complete Inspection Checklist Item COMMENTS Passed BLDG-Building Deficiency No BLDG-Plumbing Final No BLDG-Mechanical Final No BLDG-Structural Final No BLDG-Electrical Final No 05/09/2017 05/09/2017 BLDG-Final 022942-2017 Passed Michael Collins Complete Inspection Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes BLDG-Electrical Final Yes May 09, 2017 Page 1 of 1