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HomeMy WebLinkAbout2779 SOUTHAMPTON RD; ; CB161781; Permit05-06-2016 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: CB161781 Building Inspection Request Line (760) 602-2725 2779 SOUTHAMPTON RD CBAD PME 2081401900 Lot#: OKAMURA RES= NEW NC, COIL 40 AMP CIRCUIT// REPLACE FURNACE 0 Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 05/06/2016 LSM 05/06/2016 05/06/2016 ACTION AIR COND & HEATING-SD OKAMURA FAMILY TRUST 06-26-89 2750 S SANTA FE AV SAN MARCOS CA 92069 760 727 4152 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES 2779 SOUTHAMPTON RD CARLSBAD CA 92010 $0.00 $0.00 $163.00 $0.00 $163.00 Total Fees: $163.00 Total Payments To Date: $163.00 Balance Due: FINAL APPROVAL Inspector: Date: fl) ~/I-/~ Clearance: $0.00 I\OTICE: Rease take that~ ri :,or prtjed ird~ tte "lrTl)Cllitiai' ri 1-decicaicrs, reseivali"°" a cirer e,a;dicrs l'lere!iter cxJledivay ,..;sraci to as '1-em:!i01s." You hMl 00 days from tte date Ins pemit""" iss.ed to pn:lest in-position ri ttese-ex,dions. If you pn:lest Item you rrust fdlo.vtte pn:test prooedres set forth in GoJerrmrt Code Section 68J20(a). 1rd file tte pn:test 1rd arr; ctrer req.ired infarmlion wth tte Qty rvlmgerfa pooessrg i1, amdacewth Calstm Mndpa Code Section 3.32.030. Riluetotimfyfdloothat ~wll lB' arrysul»e<µrt lega a:liontoattoo<, re-Aew, set aside, \odd, er anJ trar inµ:stioo. You ae ~ FLRTI--ER I\OTIRBJ that :,or rig1 to pn:lest tte specified f-exa:lions OCES NOf APPLY to Wil£< 1rd se,.er cxrrection fees a-d capocity clmges, nr pmirg, zairg, ga:lrg a cther sirrila-'lliJicaion pooessrg a ,.,,,;oe lees in cx:mooion wth tlis prtjed. I\CR OCES IT APPLY to arr; f ci af'.OTICE . i . • • THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE; □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH 0HAZMAT/APCD {city of Building Permit Application Plan Check No. l ~ 17 a'\ 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 Dat61 ~/Jr~ lswPPP JOB ADDRESS SUIT£#/SPACE#/UNITI IAPN . 2.779 Sou \.-\..CL=-+ cw, ¥ ~ --- CT/PROJECT# I LOT# I PHASE# I# 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) ~s+..._\\ 1--\ e.'--.> 3-+o"' A) C.. Co', \ 4D ~=i:> Ckc_ui~ !?~.,.._\.._~ ... 7o,ooo·ITT'-' ~---n=c:-e C C\ \)-.,.,_-\-s EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE IAIR CONDITIONING I FIRE SPRINKLERS YES[),~ No[] YES □No □ YES □No□ APPLICANT NAME Primary Contact ~-\-....,e.n s:;;_ \...,,..;,e.-e< iOPERTY OWNER M o'oec-~ ~ <>....-, Ok~----ADDRESS 3\z-zs La.. \?,"'""'-b.-. ¼Z\:. ADDRESS 77,9 S.ov\-\.. "'"'"',\ 0 ,-~ d CITY STATE ZIP CITY STATE ZIP 0e,:;\ \ ..\,,. "-Vt \I o.~ e Cf:>, 913t.,-z._ C .c>..-r \,; \,. .... c:4 CA 92Dlt- PHONE IFAX PHONE I FAX is-11?-735 -7,?,~ lii:5 ~-, 2. z -35:!£_-, EMAIL EMAIL DESIGN PROFESSIONAL CONRACTOR BUS. N\'i, ll e c,.-\-hrv ' <:"'~I<.-c..\--io\o"'"'I, A C. .&, ADDRESS ADDRESS . . 2.750 -;-. <;;',,,."'"-¼°' k A~-=- CITY STATE ZIP CITY STATE ZIP l_<:"ct.n M~rc._~<:. CA. 9-i.cXoR PHONE IFAX PHONE l'AX t lcO-7'2.. 7 -£.-\I~ 2 EMAIL EMAIL ISTATELIC.# STATE LIC.# I CLASS I CITY BUS. UC.# sociBos C.2.0 L; \ 91?. CC> (Sec. 7031.5 Business and Professions Code: Any City or Coun_tywh1ch requires a permit to construct, alter, improve, demolish or repair any 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 )Chapter 9, commending with Section 7000 of D1vis1on 3 of the Business and Professions Code} or that he Is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 031.5 by any applicant for a permit subJects the applicant to a civil penalty of not more than five hundred dollars {$500}). WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penafy of perjury one of the following declarations: [:li have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. J.d,.thave and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance canier and policy numberare:lnsuranceCo,Ln$. c ... oC ·1:½,c... Uest PolicyNo.W st).,5p2,..E?4G,Sb\ Expiration Date \ ,( 3) 1 IL. ~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 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, dam~s as provided for in Section 3706 of the Labor code, interest and attorney's fees. JIS CONTRACTOR SIGNATURE ~ ~--'--- I hereby affirm that I am exempt from Contractor's License Law for the following reason: □ □ □ I, as 0W11er 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 or 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 (firm) to provide the proposed construction (include 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 I address I 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 Presley-Tanner Hazardous Substance Account Act? □ Yes □ No Is the apl)licant 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 feet of the outer boundary of a school site? 0 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. I certify that I have read the application and state that the above infonnatlon Is correct and that the infonnation on the plans Is accurate. I agree to comply'Mth all City ordinances and Strte laws relating to building construction. I hereby authorize representative of the City of Carlsbad to enterurx:in the above menb:Jned proi:erty br inspedion pul"JXlses. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEaJENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA pemitt is requi"ed for exc.avafons over 50' deep and demolioon or construction of structures over 3 stories in height. EXPIRATION: Every i:ermil issued by the Building Offtial under the provisKlns of this Code shall expire by limitation and become null and void if the building orv.ork authOOzed by sudl i:ermit is notoommenced Milin 180 days from the date of such permtt or if the building or'M)rk authorized by such permit is suspended or abanOOned at any Ume after the 'Mlrk is commenced for a period of 180 days (Sec!Klfl 100.4.4 Unifoon Building Code) ..@S°APPUCANT'SSIGNATURE ~ ~ DATE s}c,./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 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. UC. No. DELIVERY OPTIONS PICK UP: □ CONTACT (Listed above) □ OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) MAIL TO: □ CONTACT (Listed above) o OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) MAIL/FAXTOOTHER: _______________ _ A$ APPLICANT'S SIGNATURE o ASSOCIATEDCB#------------- □ NO CHANGE IN USE/ NO CONSTRUCTION o CHANGE OF USE/ NO CONSTRUCTION DATE ZIP lns.pection List Permit#: CB161781 Type: PME Date Inspection Item 10/11/2016 43 AirCond/Furnace Set 10/11/2016 43 AirCond/Furnace Set 10/11/2016 49 Final Mechanical 10/11/2016 49 Final Mechanical Wednesday, October 12, 2016 OKAMURA RES= NEW A/C, COIL 40 AMP CIRCUIT// REPLACE FURNACE Inspector Act Comments RI JW AP RI JW AP Page 1 of 1