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HomeMy WebLinkAbout1097 BUENA VISTA WAY; TP; CB111955; Permit09-12-2011 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB111955 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: POWER PLUS 436 N QUINCE ST 92025 760 839-9430 1097 BUENA VISTA WY CBAD St: TP PME 1552510200 Lot#: 100 AMP TEMPORARY POWER POLE FOR CONSTRUCTION OF NEW HOME Status: ISSUED Applied: 09/12/2011 Entered By: RMA Plan Approved: 09/12/2011 Issued: 09/12/2011 Inspect Area: Owner: SMERUD FAMILY TRUST 03-27-97 3667 CAMINO MARGLESA ESCONDIDO CA 92025 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees $0.00 $150.00 $0.00 $0.00 TOTAL PERMIT FEES $150.00 Total Fees:$150.00 Total Payments To Date:$150.00 Balance Due:$0.00 J_ Inspector: FINAL APROAL Date:Clearance: NOTICE: Please take NOTICWiat approval of your project includes the Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. '« +0$• «g» CARLSBAD CITY OF s y- Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718/2719 Fax: 760-602-8558 www.carlsbadca.eov Plan Check No. Est. Value Plan Ck. Deposit JOB ADDRESS /O 97 SUITE#/SPACE#/UNT CT/PROJECT #toTi # BATHROOMS I TENANT BUSINESS NAME CONSTR. TYPE I OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Aroafs) 1l)0& JM Qpkjfj/ tx- f^~ *• J EXISTING USE PROPOSED USE GARAGE (SF)PATIOS (SF)DECKS (SF)FIREPLACE YES D # NO D AIR CONDITIONING YES D NOD FIRE SPRINKLERS YES D NOD CONTACT NAME (If Different Fam Applicant)APPLICANT NAME ADDRESS ADDRESS CITY STATE ZIP EMAIL EMAIL PROPERTY OWNER NAME CONTRACTOR BUS. NAME ADDRESS ADDRESS K/6- It- STAT ZIP PHONE /7QV FAX PHONE FAX EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LIC. #STATE LIO.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 theapplicant 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 with Section 7000 of Division 3 of theBusiness and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to acivil penalty of not more than five hundred dollars ($500)). Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of (he following declarations: O 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. Oxf 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 earner and policy ' number are: Insurance Co. Ql^. tU. V A. b \ t~L &- txwv ~&^£\A -f- Policy No. /? !?- C (^3 ~J V f // 0 V Expiration Date 3 - 3 > ~ / "I- - This section need not be completed if the permit is for one hundred dollars ($100) or less. O 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 (4100,000), in addition to the cost of compensation, damages as provided for in Section 3706of the La£or code, interest and attorney's fees. OAGENT DATE ^'_ /— / /CONTRACTOR SIGNATURE / hereby affirm that / am exempf from Contractor's License Law lor 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 properly who builds or improves thereon, and who does such work himself or through his own employees, provided thai 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). D 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^) licensed pursuant to the Contractor's License Law). D 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. D Yes D No 2.1 (have / have not) signed an application for a building permit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / 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): 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): x£5"pROPERTY OWNER SIGNATURE dAGENT DATE 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? O Yes D No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D Yes O No Is the facility to be constructed within 1,0.00 feet of the outer boundary of a school site? D Yes O No IF ANY OF THE ANSWERS ARE YES, / EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address I certify that I have read the application and state thattte above information is correct and that the(information on the plans is acoirate-lagree to romprywitti all Gityoiriinances and State laws relating to building construction. I hereby authorize representative of the City of Carlsbad to enter upon Die above mentioned 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 ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OFTHE GRANTING OFTHIS PERMIT. OSHA: An OSHA permit is required for excavations over 5'0r deep and demolition or construction of structures over 3 stories in height 180 days from (he date of such permit or if (he buldiig 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 l/l/l . J/T, //t /faJ/njf~ DATE A-// City of Carlsbad Bldg Inspection Request For: 09/15/2011 Permits CB111955 Title: 100 AMP TEMPORARY POWER POLE Description: FOR CONSTRUCTION OF NEW HOME Sub Type: 1097 BUENAVISTAWY TP Lot: 0 Type: PME Job Address: Suite: Location: APPLICANT POWER PLUS Owner: Remarks: GATE CODE 1942 Inspector Assignment: Phone: 8589975866 Inspector: Total Time: CD Description 32 Const. Service/Agricultural Act Comments Requested By: MARTIN Entered By: BINSPECT 7 Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act Insp Comments ServicSeContainedirst Bill $4s- •a ©<=>and permanentappear on firstschedule a crecompleted.labelonth'oncea iaco a t I o 51 32 L.o 259 s*< *, t/)"Omo 52 O trtto Io3 mrmo oo m 3 -J* mr? 50 inB 55m oo O Z rn