HomeMy WebLinkAbout1348 SHOREBIRD LN; ; CB152953; Permit09-10-2015
Job Address:
Permit Type:
Parcel No:
Reference #:
PC#:
Project Title:
Applicant:
ASI HASTINGS
STE 200
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing/Mechanical/Electrical (PME) Permit
Permit No: CB152953
Building Inspection Request Line (760) 602-2725
1348 SHOREBIRD LN CBAD
PME
2157912300
LIPPARD: REPLACE 2 FURNACE
ADD 2 NC W/ELECTRIC
Status:
Lot#: 0 Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
Owner:
CZAJKOWSKI ROBERT&BARBARA A
ISSUED
09/10/2015
JMA
09/10/2015
09/10/2015
4870 VIEWRIDGE AV
SAN DIEGO CA 92123
619-590-9300
1348 SHOREBIRD LN
CARLSBAD CA 92011
Plumbing Fees
Electrical Fees
Mechanical Fees
Other PME Fees
TOTAL PERMIT FEES
Total Fees: $201.00 Total Payments To Date:
Inspector:
$0.00
$38.00
$163.00
$0.00
$201.00
$201.00 Balance Due: $0.00
NCJTICE Please ta<e NCJTICE that _,,.,,. ct )OOr prtject irdooas tre "lrrpc,aitiori' ct fees, declcatio-s, reservoocns, c, ctrer exoctio-s -rolectively
r,terred toas 'fee,,'exoctio-s" Yoo t.Ml OOdays franlhl-ths pemit v.as issuad to pretest irrpc,aition ctttosefeeslexoctio-s. If )00 pretest ltel\ )00 rrust
fcJloott-eprciest prooedres set forth in 0:Nerrmrt OJde Section 68'.l20(a), a-dfilelhl prclest a-d 111yctrer reqjred infCJTl'Bion 1/Jth lhl atyMmgerfor
i:,oc,,ssng in occadan,\Mlh Ga1slm M.rid!B OJde Section 3.32.!ro. FaluetotimJyfcJloothat ;:ro,,d.re\/Jll ta-111ysutJsecµ,nt leg,j a:tion toattoo<,
revieN, set aside, \Od, er a-nJ th3ir irrµ:Eitioo.
Yoo ane taet>; FLRTlffi NCJTIFlED that yo..r rigt to pretest th, spedfie:1 fee,,'exoctio-s DCES NOr APPLY tov.aa-a-d se,,,er ocrn,djon fees a-d ~
dmges, ra pmng, ming ga:lng c, ctrer sinila-,wiaation i:,oc,,ssng """"oefees in oonnection wth ths prtject. ~ DCES IT APPLY to "'Y
f Wldl a 'rrila-ast wi hestEtU: linitai .
THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE; □PLANNING D ENGINEERING I }BUILDING □FIRE □HEALTH [] H.A.ZMATIAPCD
~ Building Permit Application Plan Check No. 1P, ( ~ · '2.'l ) °5
<-_(•·''i> 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value ._,,.
~ CITY OF Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit
CARLSBAD email: building@carlsbadca.gov
Date q: 10. I 5 lsWPPP www.carlsbadca.gov
JOB ADDRESS SUITE#/SPACE#/UNIT# rPN 1348 SHOREBIRD LN ---
CT/PROJECT# I LOT# I PHASE# T# OF UNITS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I OCC. GROUP
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s)
REPLACE (2) FURNACE. ADD (2) AC & (2)COIL. WITH ELECTRICAL.
EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE \AIR CONDITIONING I FIRE SPRINKLERS
v,so N<L] YES □No □ YES0N00
APPLICANT NAME JERMAINE MAEWEATHER PROPERTY OWNER NAME MARK LIPPARD '---·-----
ADDRESS ADDRESS
4540 KEARNY VILLA RD #213 1348 SHOREBIRD LN
CITY STATE ZIP CITY STATE ZIP
san dieqo ca 92123 CARLSBAD CA 92011
PHONE I FAX PHONE I FAX
619-590-9337 4256149365
EMAIL EMAIL
JERMAINE@WEGREENINC.COM
DESIGN PROFESSIONAL CONTRACTOR BUS. NAME asi hastinas
ADDRESS ADDRESS 4870 viewridge ave
CITY STATE ZIP CITY STATE ZIP
san dieqo ca 92131
PHONE rFAX PHONE TFAX 619-590-9337
EMAIL EMAIL
I STATE LIC. # STATE UC.# I CLASS I cnv aus uc.1200804 513115 c20
(Sec,. 7031.5 Business and P_rofess1ons Code: Any City or Coun_ty which requires a permit to c_onstruct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a s1.E(ned statement that he Is licensed pursuant to the provisions of the Contractor's License LawJChapter 9, commending with Section 7000 of D1v1s1on 3 of the Business and Professions Code) or that he Is exemP.t therefrom, and the basis for tho alleged exemption. Any violation of Section 031.5 tj"j any applicant for a permit subJects the applicant to a
cIvII penalty of not more than five hundred dollars {$500)).
, W.QRKJ!l!S' COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D 1 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 performance of the work for which this permit IS issued.
[Z] I have and will maintain workers' compensation, as required by Section 3700 of the labor Code, for the perfonnance of the work for which this permit is issued, My workers' compensation insurar.ce carrier and policy
number are: Insurance Co. CYPRESS INSURANCE COMPANY Policy No. ASWC605204 Expiration Date 911/2016
~section need oot 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 forwhieh th IS permit is issued, I shall r,ot employ any person In any manr.er so as to t>ecome subject to the Workers' Compensation Laws of
California. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penaltles and civil fines up to one hundred thousand dollars (&100,000), in
addition to the cost of compensation, damages as pro,~ for i1t Section 3706 of the Labor code, Interest and attorney's fees.
fES CONTRACTOR SIGNATURE /;
I hereby affirm that I am exempt from Contractors License Law for the following raason: 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 emp!oyees, provided that six:h improvements are not intended 0< offered f0<
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 pro,ect (Sec, 7044, Business and Professions Code: The Contractor's License Law does not apply lo an owner of
property who builds or Improves thereon, and contracts for such pro,ects 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 ma,Or labor and materials for construcUon 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 (include name address I phone/ 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 mapr work (include name I address/ phone/ contractors' lieense number)
s. I will provide some of the work, butt have contracted (hired) the fol owing persons to provide the work Indicated (include name I address/ phone I type of work):
_g PROPERTY OWNER SIGNATURE □AGENT DATE
Is the applicant or future building occupant required to submit a business plan, acutely hazaldous materials reglstraUon fonn or risk ma:iagement and prevention progra-n under Sections 25505, 25533 or 25534 of the
Presley-T anoer Hazardous Substance Account Act? □ Yes D No
Is !he applicant or future building occupant required lo obtain a pennlt from !he air pollution control district or air quality management district? □ Yes D No
Is !he facility to be constructed within 1,000 feet of the outer boundcl'Y of a school site? D Yes D 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.
I certify that I have read the application and state that the above infonnatlon is oorrect and that the infonnation on the plans is accurate. I agree to oomptywith an City ordinances and State laws relating 1D building oonstructlon.
I hereby authorize representative of the City of Carlsbad to enter UIXJO !he atove rnentOned property br inspectbn PJrp:>SeS. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD
AGb.lNST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA pennlt is f8:lUired for excavatioos over 5'0' deep and demolition or construction of structures over 3 stories fl hei;)ht.
EXRRA TION: Every permit issued by the Building CXl'cial under the p~bnsofthis Ccx:le shall expire by imltatbn ood become nuB and '.4:>d W the building orwoOI aulhorizoo by sldl penllt is not corrmencecl within
180 days from the dale of sudl J):lmit or W the bui ·ng or WOO( authorized by sudl J;emllt is suspended or abanOOned at any lime after the work is commerced for a i;erro of 180 days (Sectk:Jn 106.4.4 Unib'm Building Ccx:le).
A$ APPLICANT'S SIGNATURE DATE
Inspection List
Permit#: CB152953 Type: PME
Date Inspection Item ~~~~
10/22/2015 43 AirCond/Furnace Set
1012212015 43 AirCond/Furnace Set
10122/2015 49 Final Mechanical
1012212015 49 Final Mechanical
Thursday, October 22, 2015
Inspector Act
AEK
AEK
RI
AP
RI
Fl
LIPPARD: REPLACE 2 FURNACE
ADD 2 A/C W/ELECTRIC
Comments
GC #0081 AM PLEASE
GC #0081 AM PLEASE
Page 1 of 1