HomeMy WebLinkAbout2520 LA COSTA AVE; ; CB151523; Permit05-19-2015
Job Address:
Permit Type:
Parcel No:
Reference #:
PC#:
Project Title:
Applicant:
GPS PLUMBING
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing/Mechanical/Electrical (PME) Permit
Permit No: CB151523
Building Inspection Request Line (760) 602-2725
2520 LA COSTA AV CBAD
PME
2163600200 Lot#: 0
CHRISTIAN RES-REPAIR GAS LEAK
AT STOVE
Owner:
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
CHRISTIAN CARRIE&KELLS
ISSUED
05/19/2015
RMA
05/19/2015
05/19/2015
8400 NORTH MAGNOLIA AV
SANTEE CA 92071
2520 LA COSTA AVE
CARLSBAD CA 92009
619 312-0585
Plumbing Fees
Electrical Fees
Mechanical Fees
Other PME Fees
TOTAL PERMIT FEES
$160.00
$0.00
$0.00
$0.00
$160.00
Total Fees: $160.00 Total Payments To Date: $160.00 Balance Due:
FINAL APPROVAL
Inspector: f'I\. ~< Date: 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 planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES !T APPLY to any
f ex ctions of which uh v r vi usl been iv n a N Tl E imilar I this or as to whi h th s lute f limit i h r vi sl oh rwi x ir d.
THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH 0HAZMAT/APCD
•
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.
JOB ADDRESS
CT/PROJECT#
DESCRIPTION OF WORK: Include Square Feet of Afl'ected Area(s)
C,,c;s ~ ~ srove
EXISTING USE
APPLICANT NAME
Primary Contact
ADDRESS
CITY
PHONE
EMAIL
DESIGN PROFESSIONAL
ADDRESS
CITY
PHONE
EMAIL
PROPOSED USE
STATE
FAX
STATE
FAX
Est. Value
# BEDROOMS # BATHROOMS
GARAGE (SF) PATIOS (SF) DECKS (SF}
ZIP
ZIP
STATE UC.#
SWPPP
CONSTR. TYPE OCC. GROUP
AIR CONDITIONING
YES □No □
FIRE SPRINKLERS
YESO•oO
ZIP fz,07/
(Sec, 7031.5 Business and Professions Code: Any City or County which requires a permit to_construct, alter, improve, demolish or repair an~ structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he 1s licensed pursuant to the provisions of the Contractor's License Law {Cha'/'ter 9, commending with Section 7000 of Division 3 of the Business and Professions Code} or that he 1s exempt therefrom. and the basis for the alleged exemption. Any violation of Section 103 .5 by any applicant for a permit subjects the applicant to a civ1\ penalty of not more than five hundred dollars {$500}).
WORKERS' COMPENSATION
Workers' Compensation Declaration: / hereby affirm under penalty of pe,jury one of the following declarations: D I have and wm maintain a certificate of consent to self-Insure for wo 'rs' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued D I have and will maintain wortters' compensation, as reQuired by n 3700 f the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation i~nce ~nd policy
numberara:losuraoceCo. ~u,'., A/ArT;. / "7. PolcyNo. 2{,U(.,/0<-/2t2~9 &pi,alonDate ?i➔
~section need not be completed if the permit is for one hun doll ($ 00) less. LJ Certificate of Exemption: I certify that in the performan t r ch 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' comp e s unlawful, and shall subject an employer to criminal penaltln and civil fines up to one hundred thousand dollars (&100,000), In
addition totha cost of compensation, damage& as provid 06 of the Labor coda, Interest and attorney's fees.
_g CONTRACTOR SIGNATURE
I hereby affirm that I am exempt from Contractor's Ucense Law for the foJlowing 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 wi!I 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. 0Yes 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 (firm) to provide the proposed construction (inciude 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 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/ address I phone/ type of work):
..8$ PROPERTY OWNER SIGNATURE □AGENT DATE
' ,
COMPLETE 7HIS 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? Yes No
Is the facility to be constructed within 1,000 feel 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 IS MEETING THE REQUIREMENTS OF THE OFFICE OF
EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there 1s a construction lending agency for the performance of the work this permit 1s issued (Sec 3097 (1) Civil Code)
Lender's Name Lender's Address
APPLICANT CERTIFICATION
I certify that I have read the application and state that the alxwe lnfonnadon Is correct and that the infonnatlon on the plans Is accurate. I agiee to comply~ all Cily ordinances and State laws relating to bullclng construction.
I hereby au~orize representative oflhe City of Carlsboo to enter upo bo"' mentioned property br inspeclon pu!pOSeS. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CAALSBAD
AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXP S HICH MAY IN Af{'( WAY ACCRUE AGAJNST SAID CITY IN CONSEQUENCE OF THE ffiANTING OF THIS PERMIT.
OSHA AA OSHA permit is requred forexcavalions r ' '~pf,,,,1/fiemolitbn orcoostruction of structures over 3 stories in he,Jht.
EXPIRATION: Every J):lnnit 5Sued by the Buildi e · ions of this Code shall expire by linitation and oocome null and vokl W the building or oork authorized by such permit is not rommenced 'Mthin
180days from the date of sldl permit or if the rized by sudl pennlt is suspended or abanOOned at anytime after the oork is (X)lllmenced for a period of 180 days (Sectbn 100.4.4 Uniform Building Code) .
.JiS APPUCANT'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 Garlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008.
CO#: (Office Use Only)
CONTACT NAME OCCUPANT NAME
ADDRESS BUILDING ADDRESS
CITY STATE ZIP CITY STATE
Carlsbad CA
PHONE FAX
EMAIL OCCUPANT'S BUS. LIC. No.
DELIVERY OPTIONS
PICK UP: CONTACT (Listed above) OCCUPANT (Listed above)
CONTRACTOR (On Pg. :1.)
MAIL TO: CONTACT (Listed above)
CONTRACTOR (On Pg. :1.)
OCCUPANT (Listed above)
MAIL/FAXTOOTHER: ______________ _
,.IS APPLICANT'S SIGNATURE
ASSOCIATED CB#'-------------
NO CHANGE IN USE/ NO CONSTRUCTION
CHANGE OF USE/ NO CONSTRUCTION
DATE
ZIP
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Inspection List
Permit#: CB151523 Type: PME
Date Inspection Item
05/21/2015 19 Final Structural
05/21/2015 21 Underground/Under Floor
05/21/2015 23 GasfTesVRepairs
05/20/2015 23 GasfTest/Repairs
05/20/2015 23 GasfTesVRepairs
Friday, May 22, 2015
CHRISTIAN RES-REPAIR GAS LEAK
AT STOVE
Inspector Act Comments
MC Fl GMR CALLED IN TO DEBBIE.
MC
MC
RI
AP
RI
CA
AT RANGE
PER CONTRACTOR
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