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Home My WebLink About1196 MAGNOLIA AVE; ; CB122613; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 12-06-2012 Permit No: CB122613 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: 1196 MAGNOLIA AV CBAD PME 2052102200 Project Title: NAYLOR RESIDENCE ELECTRICAL SERVICE REPAIR Lot#: 0 Applicant: Owner: NAYLOR NANCY L NAYLOR NANCY L PO BOX 947 PO BOX 947 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: SOLANA BEACH CA 92075 SOLANA BEACH CA 92075 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES ISSUED 12/06/2012 MDP 12/06/2012 12/06/2012 $0.00 $154.00 $0.00 $0.00 $154.00 Total Fees: $154.00 Total Payments To Date: $154.00 Balance Due: Inspector: FINAL APPROVAL Date (Z-7/tZ.,, Clearance: $0.00 NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectiYely 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 f h' N Tl hi h f limi i r vi I THE FOLLOWING~P.,ROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: [j PLANNING D ENGINEERING □BUILDING □FIRE □HEALTH 0HAZMAT/APCD r~ ~,::1irl) Plan Check No. Est. Value ~ CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Garlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: buldllng@carlsbadca.gov www.cartsbadca.gov Plan Ck. Deposit Date SWPP JOB ADDRESS t \CU, CT/PROJECT# LOT# SUITE#/SPACE#/UNIT# # BATHROOMS APN TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING Fl YES □#_ NOD YES D NOD APPLICANT NAME (Secondary Contact) ADDRESS STATE ZIP PHONE FN< EMAIL EMAIL PROPERTY OWNER NAME CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LIC. # STATE UC.# CLASS CITY BUS. UC.# (Sec. 7031.5 Business and P_rofessions 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 fChapter 9, commending with Section 70_00 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 subiects the applicant to a c1vII penalty of not more than five hundred dollars {$500)). Workers' Compensation Declaration: I hereby afflnn under penalty of perjury one of the following declarations: □ 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, □ I have and will maintain workers' compensation. as required by SecUon 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 Date _________ _ This section need not be completed Jf 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' C.Ompensat;on 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 attomey's fees. ~ CONTRACTOR SIGNATURE □AGENT DATE I hereby affinn that I am exempt from Contractor'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 himself or through his own employees, provided that such improvements are not intended or offered fOf 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 constrl.lCI the project (Sec, 7044, Business and Prolessions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereo contracts for such projects with contractor{s) licensed pursuant to the Contractor's license Law). □ Bu iness and Professions Code for this reason: □Yes □No 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 Ac+:? □ Yes □ No Is the applicant or future building occupant required to obtain a permit Imm 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 IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES ANO THE AIR POLLUTION CONTROL DISTRICT. I certify that I have read the apJ!lication and state that the atMwe infomiation is correct and that the lnfonnation on the plans is accurate. I agree to complywlth all City ordinances and Stam laws relating ID building construction. I hereby aulllorize representa~ve of the Ci to enter ur,xin the aOOve mentioned property br ins~ purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY Of CARLSBAD AGAINST ALL LIABILITIES, JUOGM , COSTS A D EXP H MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA perm~ is requi eep and dem ion orcoostruction of structures over 3 sbries in height. EXPIRATION: Every pennit iss I under the provisb of this Code shall expire by IJTlitaUon and become null and void ithe buik:ling or 'Mlrk aulllorized by such ~rrnrt is not mmmenced 'Nithin 180 days from the date of sue ing r ',\Qfk authorized uch permit is su ime after the w::irk is mmmenced for ape 'od of 180 days (Section 106.4.4 Unrforrn Building Code) 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 www.buildinq@cartsbadca.gov or Mail the completed form to City of Cartsbad, Building Division 1635 Faraday Avenue, Cartsbad, California 92008 CO#: (Office use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY Carlsbad STATE CA PHONE FAX EMAIL OCCUPANT'S BUS. UC. No. DELIVERY OPTIONS □ PICK UP: o CONTACT (Listed above) u OCCUPANT (Listed above) r:1 CONTRACTOR (On Pg. 1) □ MAIL TO: o CONTACT (Listed above) □ OCCUPANT {Usted above) o CONTRACTOR (On Pg. 1) □MAIL/FAX TO OTHER:. ---··············· ,..S APPLICANT'S SIGNATURE o ASSOCIATEDCB#'------------- □ NO CHANGE IN USE/ NO CONSTRUCTION o CHANGE OF USE / NO CONSTRUCTION DATE ZIP ' Inspection List Permit#: CB122613 Date Inspection Item 1210612012 34 Rough Electric 12/06/2012 39 Final Electrical Thursday, December 06, 2012 Type: PME Inspector Act PB AP PB AP NAYLOR RESIDENCE ELECTRICAL SERVICE REPAIR Comments Page 1 of 1