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Home My WebLink About2855 RANCHO GANADERO; ; CB151068; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 04-10-2015 Permit No: CB151068 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2855 RANCHO GANADERO CBAD PME Status: Parcel No: 2225911100 Lot#: 0 Applied: Reference #: PC#: Project Title: DENTON: GAS LEAK REPAIR Applicant: PROACTIVE PLUMBING, INC SPC 25 500 RANCHEROS DR SAN MARCOS CA 92069-2905 760-798-1167 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Entered By: Plan Approved: Issued: Inspect Area: Owner: DENTON SCOTT D 2855 RANCHO GANADERO CARLSBAD CA 92009 ISSUED 04/09/2015 JMA 04/09/2015 04/09/2015 $160.00 $0.00 $0.00 $0.00 $160.00 Total Fees: $160.00 Total Payments To Date: $160.00 Balance Due: Inspector: FINAL APPROVAL Date t-f~@-tS" 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 fol!ow 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 hi h NTI hi THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH 0HAZMATIAPCO Ccityof 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_ GB lS--: t008 Est. Value Plan Ck. Deposit Date SUITEI/SPACEI/UNITI # OF UNITS # BEDROOMS # BATHROOMS DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) l\~'?'JLOX. EXISTING USE APPLICANT NAME Primary Contact CITY PHONE EMAIL Jl SCs-:f'T" 1<.t:. ?LACE:"" 'PPr-tL£b c.o f\"T£1) 1,; l..J:\ ND c.oo~ p ~ ? \ ~ l ~ /-r-~ LA(___,--1-\: ) 1 A),;.-r"'k--(._ e_o r,.::, ~ \A.-\\, PROPOSED USE PATIOS (SF) DECKS (SF) PROPERTY OWNER ZIP FAX STATE LIC. # FAX SWPPP CONSTR. TYPE OCC. GROUP FIRE SPRINKLERS YES □No□ (Sec. 7031.5 Business and Professions Code: Any City or Coun_ty which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance. also reciuires the applicant for such per_m1t to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law {Chapter 9, commending with Section 7000 of D1v1s1on 3 of the B_usiness and Professions Code} or that he is exemP.t therefrom, and the basis for the alleged exemption. Any violation of Section 1031.5 by any applicanffor a permrt subjects the applicant to a civil penalty of not more than five hundred dollars {iS00}). WORKERS' COMPENSATION Wor1un' Compensation Declaration: I hereby affirm under penalty of perjury one of the foJ/owing declarations: □ I 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 perfonnance of the walk for which this permit ~ issued. ~ have and will maintain work 'compensation, as reQ 'red Section 37 the Labor Code, for the perform~ 9J.l!).e \JZtr which~issued. My workers' compensa02urance irrier and policy number are: Insurance Co, ~ • • Policy No. ~ ~ ~ 2Je3piration Date f 7 L S: I ; J:bj§.section need not be completed if the pe tis 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: Fallure to secure workers' compensation coverage Is unlawful, and shall subject an employer to crlmlnal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, dam a H a provldedJ°r In Section 3706 of the Labor code, Interest and attomey's fees, .Ji5 CONTRACTOR SIGNATURE ~ ,_,-1::::,,~--□AGENT I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: □ □ □ /, 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 alld Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. Oves 0No 2. I (have I have not) signed an application for a bllilding permit for the proposed work. 3. I have contracted with the followirig person (firm) to provide the proposed construction {include name address I phone I contractors' license number): 4. ! plan to provide portions of the won(, 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 I address I phone I type of work): ,.8S PROPERTY OWNER SIGNATURE □AGENT DATE COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future buikling occupant required to submit a business plan, acutely hazan:lous materials registration form or risk management al'ld prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Acrf Yes No Is the applicant or future building occupant required to obtain a permit from the air pollution C011trol district or air Quality management dlStricl? Yes No Is the facility to be conslructed 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 IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES ANO THE AIR POLLUTION CONTROL DISTRICT. I certify that I have 181d the application and state that the aboYe infolffl8tion Is conectand that the lnfonnatlon on the plans Is accurate. I agree ID comply'Mth all City on:llnances and State laws relatlngm building oonstructlon. I hereby auttiorize representative of the City of Cartsbad lo enter upon the alxlve rnenlioned property br inspectkln ~rposes. I ALSO AGREE TO SAVE, INDEMNIFY .AND KEEP HARMLESS THE CITY OF CAALSBAD ACAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE ACAINST S<\ID CITY IN CONSEQUENCE OF THE GRAITTING OF THIS PERMIT. OSHA: NI OSHA permk is requred for excavations OIA:!f 5'0' deep and demolitkJn or coostructkJn of structures over 3 stories fl hek;Jht. EXPIRATION: Every permit issued by the Buik:ling Offk:ial uncle!" the proviskJns of this Code shall expire by !imitation and become null and VOO if the buik:ling or V()rk authorized by such pennlt is not rommenced Yiilhin 180 days from the date of such permit or if the buik::lflg or v.ork authorized by such permit is suspended or abandoned at any time after the 'Mlrk is rommenced t>r a period of 100 days (SectkJn 106.4.4 Unit:>nn Buik::ling Code). ;@S'APPLICANT'SSIGNATURE hr-~~ 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 buildinq@cal1sbadca.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 Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. L1C. 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/ FAX TO OTHER: _______________ _ ,.65 APPLICANT'S SIGNATURE ASSOCIATEDCB#------------- NO CHANGE IN USE/ NO CONSTRUCTION CHANGE OF USE/ NO CONSTRUCTION DATE ZIP Inspection List Pennit#: CB151068 Type: PME Date Inspection Item . 04/09/2015 23 GasrresVRepairs 04/09/2015 29 Final Plumbing Friday, April 10, 2015 DENTON: GAS LEAK REPAIR Inspector Act Comments PB AP PB AP Page 1 of 1