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Home My WebLink About1215 OAK AVE; ; CB112236; Permit.. 10-19-2011 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: CHAD COX City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB112236 Building Inspection Request Line (760) 602-2725 1215 OAK AV CBAD PME 2050204200 Lot#: 0 COX RES-REPAIR GAS LEAK FROM METER TO HOUSE Owner: CHAD COX Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 10/19/2011 RMA 10/19/2011 10/19/2011 1215 OAK AV CARLSBAD CA 92008 619 990-0579 1215 OAK AV CARLSBAD CA 92008 619 990-0579 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Total Fees: $150.00 Total Payments To Date: Inspector: $150.00 $0.00 $0.00 $0.00 $150.00 $150.00 Balance Due: 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 Goverriment 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 x i n I whi h h n iv n N Tl imil hi r i h f limi i n h r vi I «~~ ~ C I TY OF CARLSBAD JOB ADDRESS CT/PR JECT # Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 www.carlsbadca.gov # OF UNITS # BEDROOMS Plan Check No. Est. Value SWPP NAME ROUP EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES D #_ NO D YES D NO D YES D NOD APPLICANT NAME (Primary Contact) APPLICANT NAME (Seconda,y Contact) ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX CONTRACTOR BUS. NAME ADDRESS STAT~ CITY STATE ZIP FAX PHONE FAX -EMAIL STATE UC.# STATE UC.# CLASS CllY 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, 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 with Section 7000 of Division 3 of the Business and Professions CodeJ 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 a civil penalty of not more than five hundred dollars ($500)). Workers' Compensation Declaration: I hereby affirm under penalty of perjury 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 performance of the work for which this permit is issued. D I 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 carrier and policy number are: Insurance Co. Policy No. Expiration Date ---------- This section need not be completed if the permit is for one hundred dollars ($100) or less. D Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. ,,I$ CONTRACTOR SIGNATURE 0AGENT DATE I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: 0 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 Contracto(s License Law does not apply to an owner of property who builds or improves thereon, and who does such work himsett 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). 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contracto(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. Cl Yes "s No 2. ~ have not) signed an application for a building permit for the proposed worlc. 3. I have contracted with the following person (firm) to provide the proposed construction (include name address I phone I contractors' license number): N 'P Q... U l--l, <:, "il:l.l c...'i"1ot,J 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major worlc (include name I address I phone I contractors' license number): ut I ve contracted (hired) th ollowing persons to provide the worlc indicated (include name I address I phone I type of worlc): Cl AGENT DATE 'O\ \"\ \ \ Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration fonn or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 Yes O No Is the applicant or future building occupant required to obtain a penn~ from the air pollution control district or air quality management district? 0 Yes O No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 Yes O 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. I certify that I have read the applicatiion and stlte that the above informatiion is conectand that the informatiion on the plans is accurate. I agree to comply with all City ordinances and Stlte la"'5 relating to building construction. I hereby authorize reprasenlative of lhe City of Carlsbad to enter up:)11 lhe above mentoned property tir inspection !XJrposes. I .ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN AfN WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: AA OSHA perm~ is required tir excavations over 5'0' deep and demol~ or conslrucfun of structures over 3 slories in height. EXPIRATION: Every permit issued by lhe 1 • g Offcial under lhe provisions of this c.ode shafl expire by imilatiln and become nul and vcid if lhe buik1ing orv.orl< authorized by such perm~ is nol rommenced wthin 180days from lhe dale of such perm~ or lhe orv.ort< au such perm~ is suspended or abandoned at any time after the v.ol1< is rommenced for a perm of 180days (Seeton 106.4.4 Uniform Buik1ing c.ode). ,N$ APPLICANT'S SIGNATURE \\ UNSCHEDULED BUILDING INSPECTION 8-44 Development ~ervices Building Division 1635 Faraday Avenue Carlsbad CA 92008 760-602-2700 DATE: (Q-(q.(( PERMIT#: C(3 [( 2, Z,)' INSPECTOR~ CONTACT: ------- PHONE#: ------- JOB ADDRESS: ( 2-( ~ Q A:f{~ DESCRIPTION: -------------------- CODE DESCRIPT ON ACT COMMENTS i, ~~~ A-rfl-Erd kk=: Bldg Inspection Form Page 1 of 1 Rev. 06/09