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Home My WebLink About1015 SAGEBRUSH RD; ; CB132650; Permit10-28-2013 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: CB132650 Building Inspection Request Line (760) 602-2725 1015 SAGEBRUSH RD CBAD PME 2146441000 Lot#: KUBALL: ELECT. TO BBQ & OUTSID 0 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: PLUGS//MOVE ELEC LINES UNDER STAIRS TO INSIDE WALU/CHANGE OUT WTR HTR TO ON DEMAND W/OUTLET//GAS TO FIREPIT Owner: ISSUED 10/28/2013 JMA 10/28/2013 10/28/2013 RUSS JOHNSON CONSTRUCTION, INC. KU BALL RICHARD K&KIMBERL Y L 5536 WHITNEY AVE CARMICHAEL CA 95608-3055 916-484-7109 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES 1015 SAGEBRUSH RD CARLSBAD CA 92011 $33.00 $158.00 $0.00 $0.00 $191.00 Total Fees: $191.00 Total Payments To Date: $191.00 Balance Due: Inspector: FINAL APrOVAL Date /,-• • f'; 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 IT APPLY to any f x i n f whi h I Tl E imil r i h h l'mi i n h THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH 0HAZMAT/APCD «,~ ' Building Permit Application Plan Check No. Co 13 . 20Sc> 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value f'7:Jec. c.56 ~ CITY OF Ph: 760-602-2719 Fax: 760-602-8558 CARLSBAD email: building@carlsbadca.gov Plan Ck. Deposit www.carlsbadca.gov Date ('T'>/7 r/ ,~ lswPPP JOBAJ?l.is )IJ-;J.t> 5 1:3 rvs Ii ?L£>I/ SUITEI/SPACEI/UNITI APN ~ /kl --- CT/PROJECT# I LOT# I PHA.SE # I# OF UNITS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I occ. GROUP d"'"'r p,,;;;/ ...,,., ... ~ tv ,;,,,, JJ...._ ,..,.R. 1 , "'.o 9 DESCRIPTION OF WORK, Include Squa,o Feat of,.., .... A,oa(s) /hi!;' /£ ,,,...;I-s--.,{, /hiV / ~ ,!? s-<-,vt9/t-:J t.-.::,,v p_;,;t7,r. ~ ~......_ u--ST,u,i. 5v Ju,,,'e.-,,... ";"'-',.,1\ ~~'f!.. ' EXISTING USE FIREPLACE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS {SF) YES[), IAIR CONDITIONING I FIRE SPRINKLERS "'° YESONo □ YES□No□ APPLICANT NAME (PrlmaY?vi•st:i-Ji,..,~~ L,_,.,,,. S-7-z,.,'-APPLICANT NAME (Secondary Contact) ADDRESS ADDRESS 55' ~ wh ,I,.,,,, 'fzH CITY t'~.bltl-d STATE ZIP y' CITY STATE ZIP ~ py.,:1 PH,;'/,:: IFAX PHONE IFAX '/~~ ,It>«; EMAIL EMAIL ;et,<;,$ tP /2vss Toh .... ,,.,. 1.,,.,,. j"lf'i.,.:,7,,,_., I .c,,,,.._,_ PROPERTY ,;.~ER !!'1 k ',J_ «.b-tl CONJACT0R B~ 4">< s-/ __ s-,,-.,.,T,,,,. Ill\.,<-- ADDRESS ~ /~/ )A<:.,r-4 r11s-A 1W ADDRESS w., ~~~ ').,, w,; /1,,-( CITY~Ael/ STATE ~;;;; ~ STATE ZIP 4'... 1,4. -~ ,a, ~,,Zdy PHONE IFAX PH0/4 l'AX '7 ~ 1/1.4 7 / f.l'o/ EMAIL EMA:Je L.;0,5 {? R1,,~5 ,µ;....,~ e,... .. rr ,.,,:,,,.. -~ ARCH/DESIGNER NAME & ADDRESS ISTATELIC.# STATE UC.# 'i"1/'1¥ J? 1'01 l'rrv,.;'.'.~;~•l' o _d (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or re~alr an~structure, prior to its issu:t~fi, also requires the applicant for such permit to me a sr ed statement that he Is licensed pursuant to the provisions of the Contractor's License Law C a ter , commending with Sectio 7 00 of Division 3 of the Business and Professions Code} or tat he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section to3f5 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 workers' compensation as provided by Section 3700 of the labor Code, for the perfom1ance of the work for which this pem1il is issued ~ve and will maintain workers' compensation, as required by Section 3700 of the Lal:xlr Code, for the performan~_9f the work for which this pem1it is Issued. My workers' compensation insurance carrier and policy aumb,,a~,lnsurar,ceCo fTit-7<! E~ PoUcyNo. 7t-/ --oo l')Z.!,O --Zb/~Ex,;ratoaOat, ~ol'(,//o ~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 performance of the work for which this pem1it is issued, I shall not employ any person in any manner so as to become sub_iect to the Workers' Compensation Laws of California. WARNING: Failure to secure woril;ers' compensation coverage is unlawful, and shall subject an employer to crlmlnal penalties and civil finu up to one hundred thousand dollars (&100,000), In addition to the cost of compensation, dama.0115;111 provided ~~n 06 of the Labor code, lntereat and attorney's fees. _g CONTRACTORSIGNATURE ; -)}/M,:}_/,1,,,_. I hereby affirm that I am exempt from Contractor's Ucense 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 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 svch 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 !hat 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 I have not) signed an application for a building permit for the proposed work. 3, I have contracted with the following person (finTI) to provide the proposed construction (include name address/ phone I contractors' license number): 4. I plan lo provide portions of the work, bl/I I have hired the following person to coordinate, supervise and provide the major worl( (include name/ address/ 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): _g PROPERTY OWNER SIGNATURE AGENT DATE COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or Mure building occupant required to submit a business ~ly hazardous materials registration form or nsk management and prevention prografT1 under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Ac!? Yes No ~"'\. ls the applicant or future building occupant required to obtain a permit from e air pollution control district or air q~anagement district? Yes ~) ls the facility to be constructed within 1,000 feet of the outer bouAdary of a school site? Yes ~ 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. I certtrythat I have read the applk:atlon and state that the abcMI lnfonnalion Is correct and that the lnblmatlon on the plans Is accurate. I agree to oomplywlth all Cltyon:tlnanc:es and State lav.s relating 1D bullclng construction. I hereby aulhorize represenlati"" of Ire Cifyof Carlsbad to enter upan fue alio1,o menooned property !Jr inspedioo f'Jrposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL UAfllLITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: AA OSHA permit is required for excavations over 5'0' deep and demolioon or CXlllslructbn of structures owr 3 stories il heght. EXPIRlfflON: Every ~rmit issued by the Buik:ling Offcial under the provisbns of this Cooe shall expire by limitation and beaJme null and void n the buik:ling or oork authorized by such permit is not rommenced 'Mttlin 180 days from the daE of sLK:h J:ermil or iflhe buik:li"lg arm authorized by such permit is suspend8j or abandoned at any time after the WJrk is commenced for a pericxl of 100 days (Secoon 106.4.4 Unifonn Building Cooe). ,15 APPLICANT'S SIGNATU :1 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 bulldinq@carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CO#: (Office Uae Onty) 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 (Ltsted above) CONTRACTOR (On Pg . .1) OCCUPANT (listed above) MAIL/ FAX TO OTHER: _______________ _ A$ APPLICANT'S SIGNATURE ASSOCIATED CB#~------------ NO CHANGE IN USE/ NO CONSTRUCTION CHANGE OF USE/ NO CONSTRUCTION DATE ZIP Inspection List Permit#: CB132650 Type: PME Date lnspec_tion Item 12/03/2013 29 Final Plumbing 12/03/2013 39 Final Electrical 12/03/2013 89 Final Combo 11/06/2013 25 Water HeaterNents 10/31/2013 14 Frame/Steel/Bolting/Weldin 10/31/2013 23 Gas/Test/Repairs Thursday, December 05, 2013 Inspector Act PD PD PD PD RI RI AP AP AP AP KUBALL: ELECT. TO BBQ & OUTSID PLUGS//MOVE ELEC LINES UNDER STAI Comments Page 1 of 1