HomeMy WebLinkAbout2380 SUMMERWIND PL; ; CB151495; Permit05-15-2015
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing/Mechanical/Electrical (PME) Permit
Permit No: CB151495
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
2380 SUMMERWIND PL CBAD
PME Status: ISSUED
05/15/2015
JMA
05/15/2015
05/15/2015
Parcel No: 2081703500 Lot #: 0 Applied:
Reference #:
PC#:
Project Title: NOGHLABADI: GAS LEAK REPAIR
Applicant:
NOGHLABADI ZARRINTAJ V
2380 SUMMERWIND PL
CARLSBAD CA 92008
760-580-1232
Plumbing Fees
Electrical Fees
Mechanical Fees
Other PME Fees
TOTAL PERMIT FEES
Entered By:
Plan Approved:
Issued:
Inspect Area:
Owner:
NOGHLABADI ZARRINTAJ V
2380 SUMMERWIND PL
CARLSBAD CA 92008
$160.00
$0.00
$0.00
$0.00
$160.00
Total Fees: $160.00 Total Payments To Date: $160.00 Balance Due:
Inspector:
FINAL APPROVAL
Date: S-f9,t$" 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 es/exa i n f whi h have r vio I N TICE similar this or as which the I I f limit i n ha r viousl h r..vise ex ir
•
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"THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING OENG1NEERING □BUILDING □FIRE □HEALTH OHAZMAT/APCD . .
Ccityof
Building Permit Application Plan Check No. Cf-Jl s;:. I t.JiqS
1635 Faraday Ave., Carlsbad, CA 92008 Est. Value
Carlsbad Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Depo!'lt email: building@carlsbadca.gov
www.carlsbadca.gov Date '5/ I-. It< lswPPP
JOB ADDRESS '3 u..-,w, ?.'\ e ✓ t,J • • "'-,/I VJ SUITEt/SPACEI/UNITt IAPN
:i. ?~0 ---
' CT/PROJECT# ILOT# l PHASE# '# OF UNITS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I occ. GROUP
DESCRIPTION OF WORK: Include Squant Feet of Affected Atea(s)
c) J-1-7;'d 12~[5'' ~~ L•,,,,_e.. • -fk Hov>e..... :b'2.L .... ,. _,.. I /V {) ,,
frobo I, 17 ~
EXISTING USE FIREPLACE I PROPOSED USE !GARAGE (SF) PATIOS (SF) TDECKS (SF)
YESO
IA(R CONDITIONING I FIRE SPRINKLERS "'° YES □No □ YES□No□
APPLICANT NAME -E!IOPER_l! OWNER , ~5So ~ l,. }JD ... I,, ( 0-. b -..I . Primary Contact I'/-,<.,<. , ,,,
ADDRESS ADDRESS J (J
CITY STATE ZIP CITY STATE ZIP
PHONE l'AX ~~NE -71"' 5"%0 /23? l'AX
EMAIL EMAIL
DESIGN PROFESSIONAL CONTRACTOR BUS. NAME
ADDRESS ADDRESS
CITY STATE ZIP CITY STATE ZIP
PHONE l'AX PHONE l'AX
EMAIL EMAIL
STATE UC.# STATE UC.# I CLASS I CITY BUS. UC.#
(Sec. 7031.5 Business and Professions Code. Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, p_nor 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 Business and Professions Code} or fhat he is exemP.t 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
civil penalty of not more than five hundred dollars {$500)).
WORKERS" COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of pe,jury 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 perfonnance of the work for which this pennil is issued. D I have and will maintain workers' compensation, as reQUired bv Section 3700 of the Labor Code, for the performance of the work for which this oennit is issued. My wori<ers' compensation insurance carrier and policy
number are: Insurance Co ______________________ Policy No. ______________ Expiration Date _________ _
~section need not be completed if the permit is for one hundred dollars ($100) or less. LJ Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Wori<ers' Compensation Laws of
California. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to crimlnal penalties and clvil fines up to one hundred thousand dollars (&100,000), In
addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees .
.8$ CONTRACTOR SIGNATURE □AGENT DATE
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: 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 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),
rv1 1, as owner of the property, am exclusively COfllracting 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 Liceflse Law).
□ I am exam pt Uflder Section _____ ,Business and Professions Code for this reason:
1. I persoflally plan to provide the major labor and materials for construction of the proposed property improvement. Oves
2. I (have I have flOt) signed afl application for a building pemiit 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 coordiflate, 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 COfltracted (hired) the following persons to provide the worl\ indicated (include name I address I phofle / type of work):
~ IS PROPERTY OWNER SIGNATURE □AGENT DATE
COMPLET~ 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 applicant or future building occupant required to obtain a permit from the air pollution cootrol 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 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
I hereby affirm that there 1s a construction lending agency for the performance of the work this pennit as issued (Sec 3097 (i) Civil Code)
Lender's Name Lender's Address
APPLICANT CERTIFICATION
I certtfythatl have read the appllcallon and sta1B that the above lnfonnatlon Is ool1'8Cl:and that the infonnatlon on the plans Is ao:urate. I agree tD comply~ all City ordinances and State laws relatingt, buMdlng oonstructlon.
I hereby authorize representative of the City of Carlsboo ID enter ui:xm the alxlve menOOned property br insp:dion purJX)SeS. 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 CONSEQUENCE OF THE GRANTING OF THIS PERMIT
OSHA: 1¥1 OSHA perml is requred for excavations over 50' deep and demolitbn or constructk)n of structures over 3 slories in h8ght.
EXPIRATION: Every pennil issued by the Buik::ling Offcial under the provisbns of this Code shall expire by lrnilaOOn and bewne null and vok:I ~ the buik::ling or'Mlrk authorized by sudl permit is notoornmenced 'Mlhin
1&'.l days from the date of such pennlt or if the l:xlilding or'Mlrk authorized ,t 71t is suspended or abandoned at any time after the 'Mlrk is commenced for a period of 180days (Section 106.4.4 Unifoon Buik::ling Code).
,l!SAPPLICANT'SSIGNATURE i-~-/,/ <.,--L--DATE ~ ) d_ ,0 ,---
• 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. LIC. No.
DELIVERY OPTIONS
PICK UP: CONTACT (Listed above) OCCUPANT (Listed above)
CONTRACTOR (On Pg. 1)
MAIL TO: CONTACT (Listed above)
CONTRACTOR (On Pg. 1)
OCCUPANT (Listed above)
MAIL/ FAX TO OTHER: _______________ _
A$ APPLICANT'S SIGNATURE
ASSOCIATEDCB#-------------
NO CHANGE IN USE/ NO CONSTRUCTION
CHANGE OF USE/ NO CONSTRUCTION
DATE
ZIP
• •
Inspection List
Penni!#: CB151495 Type: PME NOGHLABADI: GAS LEAK REPAIR
Date Inspection Item Inspector Act Comments
05/15/2015 23 Gas/TesVRepairs PB AP
Monday, May 18, 2015 Page 1 of 1