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Home My WebLink About2723 SOUTHAMPTON RD; ; CBR2017-0265; PermitPrint Date: 03/23/2017 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: 2723 Southampton Rd BLDG-Residential 2553012900 $0.00 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Residential Permit www .carlsbadca.gov Work Class: P/M/E Lot#: Reference#: Construction Type: Bathrooms: Orig. Plan Check#: Plan Check#: Description: HARTLEY: REPLACE WATER HEATER PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT Total Fees: $98.00 Owner: TRUST HARTLEY RENATA A REVOCABLE TRUST 12-12-91 2723 Southampton Rd CARLSBAD, CA 92010 Total Payments To Date: $98.00 Status: Applied: Issued: Finaled: Inspector: Contractor: RESCUE ROOTER 965 Ridge Lake Blvd Memphis, TN 38120-9401 858-457-6572 Balance Due: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." 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 FURTH ER 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 fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitation has previously otherwise expired. Permit No: CBR2017-0265 Closed -Finaled 02/08/2017 02/08/2017 $0.00 $98.00 CSR t= 1LE THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERM!T ISSUANCE □PLANNING []ENGINEERING 0BU!LDlNG OF!RE □HEALTH 0HAZMAT,APCD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov Plan Check No. Est. Value 2.011-02.U'J CARLSBAD JOB ADDRESS a CT/PROJECT# LOT# PHASE# # f UNITS # BEDROOMS DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) Plan Ck. Deposit Date SWPPP SUITE#/SPACEI/UNITI -oc.- # BATHROOMS TENANT BUSINESS NAME CONSTR rvPE EXISTING USE PROPOSED USE GARAGE {SF) PATIOS (SF) DECKS (SF) FIREPLACE YES[}, AIR CONDITIONING NO□ YES □No □ FIRE SPRINKLERS I YES□No□, APPLICANT NAME (Secondary Contact) PHONE lfAX EMAIL SL\ ARCH/DESIGNER NAME & ADDRESS STATE UC.# CITY BUS. UC.# \ "2.0i lo'-\ 0 (Sec,. 7031.5 Business and Professions Code: Any City or County 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 file a signed statement that he IS licensed pursuant to the provIsIons of the Contractor's License Law /Chapter 9, commending wrth Sectron 7000 of DIvIsIon 3 of the Business and Professions Code] or that he is exempt therefrom. and the basis for the alleged exemption. Any violation of Section 1031.5 by any applicant for a permit subJects the applicant to a cIvII penalty of not more than five hundred dollars ($500)). ~ rr," -~ ~ s ~, WOltKl'IU" COlllll'l'NSATION Worker5' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations· ave 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 !tie work for which this permit is issued ave and will maintain worke ' com nsation. as quired by Section 3700 of the Labor Code, for the performance of the work for which this oermIt is issued. My workers' compensation insuran carrier and policy number are· Insurance Co, Policy No. '7 (D 2, \ 5(1i< to'o \ 0 \'4,:xp1ration Date _._,__.,_,µc...J,-L '1 This section need not be completed if the permit is for one hundred liars ($100) or less D 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 worker5' 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 compensati~mages as provided for in Secti 3706 the Labor c de, int d attorney's fees. 85 CONTRACTOR SIGNATURE l_) -~ I hereby affirm thaf I am exempf from Confractor·s Ucense Law for the following 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 such work himse~ 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 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 / have not) signed an application for a building permit for the proposed work 3 I have contracted with the following person (firm) to pro~ide the proposed construction (include name address I phone I contractors· license number) 4.1 plan to provide portions of the work, but I have hired the following person to coordinate. supervise and provide the major work {include name/ address/ phone/ 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 I type of work} ,a$ PROPERTY OWNER SIGNATURE □AGENT DATE ~"'=-"1""'""""r'" ~-~rr>-71":~ ~ ---><c --~ .,. ~---------""" ~-, -"'""--''"""" --~~~~--~7-"~' = , :;;., ..... .,,. ·ntn 11'.CTIOM 1'011 IIION:•l!IUOIIMJ'JAI. l!OU.Dlllll ,. .... , ... , OIIJ.Y ,,¥~1---• 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 1 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 ISSUED UNLESS THE APPLICANT HAS MET OR rs MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. ! I hereby affirm that there 1s a construction lending agency for the performance of the work this permit 1s issued (Sec. 3097 (1) C1v1I Code). 1 Lender's Name lender's Address " ~ = -~-' - ·"Pf!UCA,11'1' Clll'l'tf'ICA'l'IOII I certify that I have read the applk:ation and state that the above infonnation is correct and that the infonnation on the plans is accurate. I agree to comply 'Mth all City ordinances and State laws relating to building construction. I hereby autllorize representative of the City of Carlsbad to enter upon tile above mentioned property for inspection puf)Xlses. 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 PERM~ OSHA: M OSHA perm~ is required for excavations over 5'0' deep and demolition or construction of structures over 3 stories in height EXPIRATION: Every i:ermit issued by tile &Jilding Official under lhe provisions of tllis Code shall expire by limitation and beo::ime null and void if the building orWJri<; authorized by suet, i:ermit is not commenced 'Nithin 180 days Imm the date of such ~rm1t or 1fthe building or IMlrk authorized by such permit 1s suspended or abandoned at any time after lhe IMlri<; IS commenced for a rood of 180[ays (Seeton 106 4 4 Urnbrm Building Code) ~PPLICANT'SSIGNATU~-~~~ ~~~ DATE _a.-_ _d-3 I -'~-- 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 bui!ding@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 EMAIL DELMRY OPTIONS PICK UP: MAIL TO: CONTACT (Listed above) CONTRACTOR (On Pg_ 1) CONTACT (Listed above) CONTRACTOR (On Pg. 1J ZIP FAX OCCUPANT (Listed above) OCCUPANT (Llste!I above) MAIL/ FAX TO OTHER:----------------~ A$ APPLICANT'S SIGNATURE CO#: (Office Use Only) OCCUPANT NAME BUILDING ADDRESS CITY STATE Carlsbad CA OCCUPANT'S BUS. LIC. No. ASSOCIATED CB#----- NO CHANGE IN USE/ NO CONSTRUCTION CHANGE OF USE/ NO CONSTRUCTION DATE ZIP f\crr1,1t ·(ype. \No:"°¥ Class: Si:dU'J Scheduled Date BLDG-Residential P/M/E Closed -Finaled Actual Start Date Inspection Type Application Dato: 02/08/2017 Issue Dc1te: 02/08/2017 Expiration Date: 09/19/2017 IVR Number: 1862 Inspection No. Inspection Status 03/23/2017 03123/2017 BLDG-25 Water HeaterNents 017451-2017 Passed March 23, 2017 BLDG-Final Inspection ChPckl!st !tern BLDG-Building Deficiency 017452-2017 C hcck!ist !tern BLDG-Plumbing Final COMMENTS Passed COMMENTS Ownor: TRUST HARTLEY RENATA A REVOCABLE TRUST 12-12-91 Subdivision: Address: 2723 Southampton Rd Carlsbad, CA 92010-2896 Primary Inspector Reinspection Complete Peter Dreibelbis Complete Yes Peter Dreibelbis Complete P<1ssec1 Yes Page 1 of 1