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Home My WebLink About109 CEREZO DR; MP; CB151324; Permit04-30-2015 City of Carlsbad 1635 Faraday Av Carlsbad.CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CBI51324 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #; PC #: Project Titie: 109 CEREZO DR CBAD St: MP PME OOOOOOOOOO Lot #: TRAFFIC SIGNAL METERED PED REPLACEMENT Status; Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 04/30/2015 LSM 04/30/2015 04/30/2015 Applicant: MARK KRATZER Owner: 405 OAK CARLSBAD 92008 760-802-4752 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $0.00 Total Fees: $0.00 Total Payments To Date: $0.00 Balance Due: $0.00 FINAL APPROVAL Inspector: Date: Clearance: NOTICE: Please tal(e NOTIC^that aoproval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." \)U ha^e 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 Govemment Code Section 66020(a), and file the protest and any other required infomiation 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 ate 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 sen/ice fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previouslv othenwise expired. THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMfT ISSUANCE: OPLANNiNG nENGINEERING nBUILDING •FIRE DHEALTH OHAZMAT/APCD ^ City of Carlsbad 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. (IjS / 5" 1 '^3-^ Est. Value Plan Ck. Deposit Date SWPPP JOBADDRESS . _ _ 5UITE*/SPACEf/UNIT« APN - CT/PROJECT # LOT# PHASE* # OF UNITS # BEDROOrviS # BATHROOMS TENANT BUSINESS NAME CONSTR. TVPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet ofAtfected Areafs) EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YESr~k NOj I AIR CONDITIONING YES QNO I I FIRE SPRINKLERS YES I |NO| I 'aZTalt (MMlC ^V<T7£^ APPLICANT Prim PROPERTY OWNER ADDRESS ^Q5 cm Av^ ADDRESS CITY STATE CA ZIP CITY STATE ZIP PHONE PHONE EMAIL DESIGN PROFESSIONAL CONTRACTOR BUS. NAME ADDRESS ADDRESS STATE ZIP CITY STATE PHONE FAX PHONE EMAIL CITY BUS. LIC.# (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 appiicahtfor such permltto file a signed statement that he Is licensed pursuantto the provisions ofthe Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3 ofthe Business and Professions Code} or that he is exempttherefrom, and the basis forthe 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)). I P E N S A TI O N Workers' Compensation Declaration: I hereby affinn under penalty of perjury one ofthe following declarations: • l 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 permit is issued. I have and wiil maintain workers' compensation, as required bv Section 3700 of the Labor Code, for the performance of the woht for which this oermit Is Issued. My woriters' compensation Insurance carrier and policy number are: Insurance Co. Policy Nc. Expiration Date This sedion need not iDe completed if the permit is for one hundred dollars ($100) or less. I I Certificate of Exemption: I certify that in the performance of the work for which this pemiit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Calfomia. 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 attomey's fees. CONTRACTORSIGNATURE • AGENT DATE I hereby affinn that I am exempt from Contractors License Law for the following reason: I I 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, pravided 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 I I, as owner of the property, am exclusively contracting with licensed contractors to constmct the project (Sec. 7044, Business and Professions Code: The Contractor's Ucense 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 I I am exempt under Section Business and Professions Code for this reason: 1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement. QYes I INO 2,1 (have / have nol) signed an application for a building pennit for the proposed work. 3.1 have contracted with the following person (fimi) to provide the proposed construction (include name address / phone / contractors' license number): 4.1 plan to pravide portions of the wortt, but I have hired the following person to coordinate, supen/ise and pravide the major worit (include name / address / phone / contractors' license number): 5.1 will provide some of the worit, but I have contracted (hired) the following persons to provide the wortt indicated (include name / address / phone / type of wortt): PROPERTY OWNER SIGNATURE QAGENT DATE on NON-f7ESIDENTIAt BUILOING P E I? M I T S ONLY Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or rtsk management and prevention program under Sections 25505,25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Yes No Is the applicant or luture building occupant required to obtain a permit from the air pollution control district or air quality management distrtct? 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 CON STRUCT ION LENDING AGENCY I hereby aflirm that there is a constmction lending agency for the perfomiance of the work this pemiit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address ,At,„!P l» L'I C A M T C en T I F I CAT I 'i^H I ceitily that I have read the applk^on and state thatthe above inlbimation is conectand thatthe inlbmiation on the plans is accurate. I agiee to comply with all City oidinanoes and State laws relating to building constniction. I hereby authorize representative ofthe City of Carisbad to enter upon the above mentioned property lor inspectbn purposes. 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 PERMfT. OSHA: An OSHA pennit is required fbr excavations over 50' deep and demolitbn or constructbn of shictuies over 3 stories in height. EXPIRATION: Every permit issued by the Building Oflicial under the provisbns ofthis Code shall expire by limitatbn and become null and void if the building or wortt authorized by such peimit is not commenced within 180 days from the date of such penmit or if the building or wortt authorized by such permit is suspended or abandoned at any time after the worit is commenced fbr a period of 180 days (Sectbn 106.4.4 Unifomi Building Code). vfilfAPPLICANT'S SIGNATURE (AW '.«A. DATE 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 buildingiScarlsbadca.qov or Mail the completed fomi to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, Califomia 92008. C0#: (Office Use Only) CONTACT NAME OCCUPANT NAIVIE ADDRESS BUILDING ADDRESS CITY CITY STATE ZIP Carlsbad CA PHONE EMAIL OCCUPANT'S BUS. LIC. No. DELiVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAILTO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAIL / FAX TO OTHER: ASSOCIATED CB#- NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION ^APPLICANTS SIGNATURE DATE Inspection List Permit*: CB151324 Type: PME TRAFFIC SIGNAL METERED PED REPLACEMENT Date Inspection Item Inspector Act Comments 04/30/2015 32 Const. Service/Agricultural PY AP 04/30/2015 39 Final Electrical PY AP Friday, IVlay 01, 2015 Page 1 of 1