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Home My WebLink About2862 RANCHO PANCHO; ; CB161705; Permit05-03-2016 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB161705 Building Inspection Request Line (760) 602-2725 2862 RANCHO PANCHO CBAD PME 2225912800 Lot#: 0 KINGS: INSTALL A/C Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 05/03/2016 SLE 05/03/2016 05/03/2016 ACTION AIR COND & HEATING-SD FISHMAN FAMILY TRUST 05-14-83 2750 S SANTA FE AV SAN MARCOS CA 92069 760 727 4152 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES 108 LISA CT SANTA CRUZ CA 95060 $0.00 $0.00 $163.00 $0.00 $163.00 Total Fees: $163.00 Total Payments To Date: $163.00 Balance Due: Inspector: FINAL APPROVAL Date: 1-Zf-/v Clearance: $0.00 l'KJTlCE: Aea;e ta<e l\OTlCE that WM ci )W" Jltject irdu:ies Ire "lrrpc:si1iori' ci fE>lS, dErlcaticns, """'1/00Cl'lS, cx ctl'er exa:licns -o:Jledivay rderredtoas 1ees'e><!rlcns." Yoo haM, OOdays fromtre-ttis pemit "85 iss.alto prctest irrpc:si1ion cithesefees'exa:licrs. If )OJ prctest lren'\ )OJ rrust fdlONlre prctest pl{XE(ires set lath in G:Marrrre:t C,exle Section E'0020(a), a'-d file Ire prctest a'-d any ctt-er recµred inforrration wth Ire Oty ~lex prooessl'lJ in l<XXl'daa>wth a.tsboo Mridpa C,exle Section 3-32.03'.l. Fal<retoimayfdlONthal r,oreclrewll ba' anysubseq.Jort lega adionto~ re.ne11, set asiOO, \Od, er anJ their irTfXEitioo. Yoo ,re heret,y FLR1l-ER l'KJTlFIED that )W" rig-I to prctest Ire sp,dfied fees'exa:Dcm OCES NOr APPLY to'Mlter a'-d '1iMef oonnecton fees a'-d capooty mrges, ncx pa'lil'lJ, 21:rirg IJ'd"ll cx ctt-er snila-wication prooessil'lJ <l" serAre fees in oonnection wth !tis Jltject. ~ OCES IT APPLY to any f wi sinilcr ·s a as t W'lch tre e ci lirri irns THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH 0HAZMAT/APCD · C City of Building Permit Application Plan Check No. (1 P., II II JI n ~ 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value Carlsbad Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit email: building@carlsbadca.gov www.carlsbadca.gov Date~-:.;_ / f n ISWPPP JOB ADDRESS\:? SUITEt/SPACEt/UNITt IAPN 2"8(,,-Z.. °'-"'c..\.~o "Pa.nc..\--o --- CT/PROJECT# ILOT# I PHASE# I# OF UNITS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME ICONSTR. TYPE I OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) hsk\l ~--, 2. s ~~A)c. ' EXISTING USE l PROPOSED USE I GARAGE (SF) PATIOS {SF) I DECKS (SF} FIREPLACE IAIR CONDITIONING I FIRE SPRINKLERS v,so,_ NoQ YES □No □ YES□No□ APPLICANT NAME <:"+.,,._,_ <. I •~PERTY O~R T.,£D I? Primary Contact . -~-· ~ ........ C!' ' . ADDRESS ADDRESS K . -)\ZZS I -1)._ .._ Y\ __ ~ 2\~ 2.~1,,2_ <>--""-he, \:> o...nc.ho CITY • STATE ZIP CITY STATE ZIP r,J .. ,~.Ho.\«-\/; \ \"' ~L.' Ci>.. qr3(c7. Co..r\,;bc,_a. C-A. C\ 2C,c,0, PHONE IFAX PHONE IFAX 81~-735-,R7<... ~51.!-LJ J")-32.~C,. EMAIL EMAIL DESIGN PROFESSIONAL Cj\NT,A~R BUS: rtME ~ ' . .i;.: <;;,.\o..r . r,,._ C... - ADDRESS ADDRESS . 27SD S. S..n-\-a-Fee_ A""- CITY STATE ZIP CITY STATE ZIP 5:'o-.."''\'<l°'-rco$ C(:I.. 92-~"l PHONE IFAX PHONE IFAX ,r.,c,-72 7-L\152- EMAIL EMAIL ISTATEUC.# STATE LIC.# I CL.ASS I CITY BUS. LIC.# 5Dq3(£ c2-o '-1198CO (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 signed statement that he is licensed pursuant to the provIsIons of the Contractor's License Law /Chapter 9, commending with Section 7000 of Division 3 of the B_usiness 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 cIvII penalty of not more than five hundred dollars ($500)). WORKERS' COMPENSATION WO!'kers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: D have and will maintain a certificate of consent to self-Insure for iYOrkers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ave and will maintain workers' compensation, as required by Secti 3700 of the Labor Code, for the performance of the work for which this permit is issued, My workers' compensation · sura ce carrier and policy number are: Insurance Co. Tn'S . Cc o..C. r.--~ ~ Policy No.W SD .SQ:z-8::( C:,.S O l Expiration Date _,_/,c,Z+~"''+'""----- p:!§,secUon need not be completed if the permit 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 provided for in Section 3706 of the Labor code, interest and attorney's fees, ,85 CONTRACTOR SIGNATURE ~z_...C::-::: • I hereby affirm that I am exempt from Contractor's License Law for the fol/owing reason: □ □ □ I, as owner of the property or my employees with wages as their sole compensation, will do the work and 1he structure is not intended or offered for sale (Sec. 7044, Business and Professkms 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 buiid 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/ 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 (include name address/ 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/ contractors' license number): 5. \ will 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): N$ 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 Pres.lay-Tanner Hazardous Substance Account Act? □ Yes □ No Is the applicant or future building occupant required to obtain a pennil 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 IS 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 lnfonnation Is conectand that the lnbrmation on the plans Is accurate. I agree to comply with all Cify ordinances and State lcM5 relating to bulldlng construction. I hereby authorize representative of the City of Carlsbad to enterul))fl the alx>ve mentioned property br inspection pul'!XJses. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST AlL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CrTY IN CON SE OJ ENCE OF THE GRANTING OF THIS PERMIT OSHA: An OSHA perm~ is required for excavations over 5'0' deep and demdition or OJ11struction of structures over 3 stories in he'Jht EXPIRATION: Every parrn~ issued by the 0.Jilding Offcial under the provisions of this Ox1e shall expire by lrTiitation and berome null and voKI W the building or 'MXk authorized by sud1 parrnit is not commenced 'Mlhin 180 days from the date of such penn~or if the building orv.or'K authorized by sud7 pennit is suspended or abandoned at any time after the v.or'K is commenced bra period of 180 days (Section 106.4.4 Uniform Building Oxle) . ..@S'APPLICANT'SSIGNATURE ~~ ~ DATE 5 JI<., • 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. CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LtC. No. DELIVERY OPTIONS PICK UP: □ CONTACT (Listed above) □ OCCUPANT (Listed above) □ CONTRACTOR (On Pg. :1.) MAIL TO: □ CONTACT (Listed above) □ OCCUPANT (Listed above) □ CONTRACTOR (On Pg. :1.) MAIL/ FAX TO OTHER: ________________ _ A5 APPLICANT'S SIGNATURE □ ASSOCIATED CB#------------- □ NO CHANGE IN USE/ NO CONSTRUCTION □ CHANGE OF USE/ NO CONSTRUCTION DATE ZIP Inspection List Penni!#: CB161705 Type: PME Date lnspecti_on Item 09/28/2016 43 AirCond/Furnace Set 09/28/2016 43 AirCond/Furnace Set 09/28/2016 49 Final Mechanical 09/28/2016 49 Final Mechanical Thursday, September 29, 2016 Inspector PB PB KINGS: INSTALL A/C Act Comments RI LATE PM PLEASE AP RI LATE PM PLEASE AP Page 1 of 1