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Home My WebLink About2128 SUBIDA TER; ; CB120885; Permit05-11-2012 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: CB 120885 Building Inspection Request Line (760) 602-2725 2128 SUBIDA TERRACE CBAD PME 2164811600 Lot#: 0 BOXCO RES-REPLACE GAS LINE BEHIND STOVE-REPLACE 6 FT SECTION OF PIPE TO Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 05/11/2012 RMA 05/11/2012 05/11/2012 BOXCO FAMILY SURVIVORS TRUST 06-11-98 BOXCO FAMILY SURVIVORS TRUST 06-11-98 2128 SUBIDA TER CARLSBAD CA 92009 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES 2128 SUBIDA TER CARLSBAD CA 92009 $150.00 $0.00 $0.00 $0.00 $150.00 Total Fees: $150.00 Total Payments To Date: $150.00 Balance Due: Inspector: f1t\ · /',o!.J,u,s FINAL AiPROVAL Date: 0 5 l4J I-Z-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 pennit 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 10 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 I xinf I nivnNIEimilrhi hi ____ , ____ _ «~> ~ CITY OF CARLSBAD JOB ADDRESS '2.( Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 www.carlsbadca.gov . C. Plan Check No. Est. Value Plan Ck. Deposit SWPP CT/PROJECT# LOT# PHASE# # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE CCC. GROUP EXISTING USE PROPOSED USE APPLICANT NAME (Primary Contact) ADDRESS CITY STATE ZIP PHONE FAX EMAIL STATE ZIP c..,A , FAX -"lo O ARCH/DESIGNER NAME & ADDRESS STATE UC.# -.,:,, ' AIR CONDITIONING YES □# __ NOD YES O NO □ APPLICANT NAME (Secondary Contact) ADDRESS CITY STATE ZIP PHONE FAX AIL CONTRACTOR BUS. NAME ADDRESS CITY STATE ZIP PHONE FAX EMAIL STATE LIC.# CLASS CITY BUS. UC.# - FIRE SPRINKLERS YES □ NOD (Sec. 7031.5 Business and P_rofessions Code: Any City or Coun_ty which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to frle a signed statement that he is licensed pursuant to the provisions of the Contractor's License LawjChapter 9, commending with Section 70_00 of Division 3 of the Business and Professions Code} or fuat he 1s exem.et 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 Declaratron: / hereby affinn under penalty of perjury one of the following declarations: 0 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 performance of the work for which this permit is issued D I have 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 carrier and policy number are: Insurance Co. ______________________ Policy No. _______________ Expiration Dale __________ _ This section need not be completed if the permit is for one hundred dollars ($100) or less. □ 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. ,l!5 CONTRACTOR SIGNATURE !l!!IIE □AGENT DATE I hereby affinn that I am exempt from Contractor's License Law for the following reason: ..t..._ I, as awrier 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 ot 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 provirig 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 construe\ 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 conlractor(s) licensed pursuant to the Contractor's License Law). I am exempt under Section _____ ,Business and Professions Code for this reason: / 1.1 p~sonally plan to provide the major labor and materials for construction of the proposed property improvement. V Yes □ No 2. I av have not) signed an application for a building permit for the proposed work. 3. I ha e 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 worll, 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): ,lf5 PROPERTY OWNER SIGNATURE~ 1'4-GENT DATE ~ ({ -/ "2- 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 applicant 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? □ Yes □ No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE lSSUEO 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 infonnatlon on the plans is accurate. I agree to comply with all City ordinances and State laws relating to btllldlng construction. I hereby authorize representative of U,e City of Caflsbad to enter upon U,e above meotioned property for inspection purposes. 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 CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over 5'0' deep and demolition or construction of structures over 3 stories in he":jht EXPIRATION: Every permit issued by U,e Building Official under U,e provisions of U,is Code shall expire by Imitation and become nul and void if the building or work authorized by such permit is not commenced within 180 days from the date of such permit or if the bu~ding or work authorized by such permit is suspended or abandoned at any time after the work. is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). ~ APPLICANT'S SIGNATURE DATE /11 (/ -, .,_ 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 www.building@carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CONTACT NAME ADDRESS CITY STATE PHONE FAX EMAIL DELIVERY OPTIONS □ PICK UP: o CONTACT (listed above) o OCCUPANT (Listed above) □ CONTRACTOR (On Pg. 1) □ MAIL TO: o CONTACT (Listed above) □ OCCUPANT (Listed above) □ CONTRACTOR (On Pg. 1) ZIP D MAIL/ FAX TO OTHER: ________________ _ _.es'APPLICANT'S SIGNATURE CO#: (Office Use Only) OCCUPANT NAME BUILDING ADDRESS CITY STATE ZIP Carlsbad CA OCCUPANT'S BUS. LIC. No. o ASSOCIATED CB#·-----------~ o NO CHANGE IN USE/ NO CONSTRUCTION o CHANGE OF USE/ NO CONSTRUCTION DATE 4\ w City of Carlsbad Bldg Inspection Request For: 05/14/2012 Permit# CB120885 Inspector Assignment: Title: BOXCO RES· REPLACE GAS LINE Description: BEHIND STOVE-REPLACE 6 FT SECTION OF PIPE TO BYPASS LEAKY FITTING Type:PME Sub Type: Job Address: 2128 SUBIDA TERRACE Suite: Lot 0 Location: OWNER BOXCO FAMILY SURVIVORS TRUST 06-11-98 Owner: BOXCO FAMILY SURVIVORS TRUST 06-11-98 Remarks: AM PLEASE -GAS IS LOCKED OFF Total Time: CD Description Act Comments Phone: 7607268093 Inspector: ---- Requested By: BOB Entered By: CHRISTINE 23 Gas/Test/Repairs H_ ____________ _ ~---------'Ft Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act lnsp Comments