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Home My WebLink About1240 PINE AVE; MULTI-PERMIT FILE; 70-337; PermitSet Back Bldg.Valuofion/ FrontP.L. ZJ_/ MainBldg. SideP.L. Garage RearP.L. Other Group Z----, I<.\.. Contractor City Bus. Lic. No. M_4 Water Meter Sewage Disposal System - - -/ Inspection Recrd CITY OF CARLSBA BUILDING DEPARTME 729-1181 - Ext. 36 AppIkalioir BUILDING Permit -, Building Permit Fee Owners N cant to Fill In APR 1t-7O cc Buildinq Dept. Use Only Mail Address Contractor Contr. Address To Consf. D To Add 0 To Alter 0 Convert El To Move From e 1f f -.- f jrwtu'-Zow Type of Const. a--- Fra etc. To Be Used For Kind of Foundation_ No. of Stories / 67 Floor Space (Sq. Ft.) Garage Floor Space (Sq. Ft.) Attached Detached All 4'5 I' Legal Description /i" _o7#_ 2' Lot _Block Subdivision 12 Section Township Range No. of Existing Building Will this construction include any plumbing installation or alter- ation? Yes No J Signature of Appl? . n t I ACKNOWLEDGE THAT HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY AND STATE LAWS REGULATING BUILDING. I CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQJ.I.ED BY CITY OF CARLSBAD AND STATE OF CALIFOIP OR THAT I AM TIsf LEGAL OWNER OF THE ABOVE DSCRBED RESIIENTILJPROPERTY. SIGNATURE OF PERMITTEE Utility Company Notified -- Date--By._._ Final IF a check is tendered for payment for the above fee and the check is not honored when presented for payment, your building permit will be immediately revoked. City of Carlsbad Building Dept. Permit void if work is not commenced within 60 days of issuance. PERMIT NO. ' TOTAL FEE $ /3 ' - Application for ELECTRICAL Permit BuiIPn% 1tti7o U * * 13.50 CITY OF CARL AD BUILDING DEPARTMENT 729-1181 -Ext. 36 For Applicant to Fill In PERMIT FEES: Each Fee BUILDING ADDRESS: Item Recpt. Sw. Lighting fixtures w/ballast for each 10 $ 1.00 /)- St. Near Elec. Ranges, Clothes Dryers, Water Heaters .50 ' '' ,j.e' OWNER \J,9nle..c Elec. Space Heaters Dishwashers, Garbage Disposers, Auto. Washers, Sta. Cooking Units .50 , ADDRESS:a 474171 a/0 a MOTORS: Per each motor H.P. CITY 0 to 1 $ .25 1 to 2 $ .50 TELEPHONE NO. J 2 to 5 $ 1.00 5 to 15 $ 1.50 State City Business License License 15 to 50 $ 2.50 50 to 200 $ 5.00 Group Zone By SIGNS: No. trans. Ea. $ 1.00 Inspection Record: No. lamps over 50 ea. $ .50 SERVICE: 0 to 150 AMPS For each additional 100 Amps. $ 10.00 $ 2.00 /6 o Temp. Power Pole, 100 AMPS or LESS $ 3.00 For Each addI Meter, over one per service $ 3.00 MISC: Approvals Date By: SUPPLEMENTARY PERMIT FEE: $ 2.00 Conduit TOTAL: $A11.9 R. Temp. Power Wiring F ixtures I ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY AND STATE LAWS REGULATING ELECTRICAL WIRING. I CERTIFY THAT I AM PROPERLY LICENSED BY THE CITY OF CARLSBAD AND THE STATE OF CALIFORNIA OR THAT I AM THE LEGA 0 NER OF THE ABOVE DESCRIBED RESe- DENTIAL PROP RTY SIGNATURE OF PERMIT TEE: __________________________________________________ S.D. G. & E. FINAL 0 . 0 2 PLUMBING PERMIT APPLICATION 51--5.1 City of CARLSBAD, CALIFORNIA OR 14-70 5!02613**f*+1 .00 App licant to complete numbered spaces on/v. JOB ADDRESS /Z'b 4-— LEGAL 1 DESCR. LOT NO. BLK TRACT (DSEE ATTACHED SHEET) OWNER MAIL ADDRESS 2 f4ni g 0 ,v PHONE CONTRACTOR MAIL ADDRESS 3 PHONE LICENSE NO. ARCHITECT OR DESIGNER MAIL ADDRESS 4 PHONE LICENSE NO. ENGINEER MAIL ADDRESS 5 PHONE LICENSE NO. LENDER MAIL ADDRESS 6 BRANCH USE OF BUILDING /UcG 8 Class of work: D NEW D ADDITION D ALTERATION 0 REPAIR 9 Describe work: 1WLB.A 7 ?Id1i_.. PERMIT FEES -- No. Type of Fixture or Item Fee SPECIAL CONDITIONS: WATER CLOSET (TOILET) BATHTUB ol 41 LAVATORY (WASH BASIN) SHOWER 2.15 KITCHEN SINK 8t5P ..4 2 DISHWASHER APPLICATION ACCEPTED BY: PLANS CHECKED BY: ____ APPROVED FOR ISSUANCE BY: LAUNDRY TRAY - - CLOTHES WASHER WATER HEATER NOTICE THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM MENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. URINAL - - DRINKING FOUNTAIN - ____________________________________ FLOOR—SINK OR DRAIN - - SLOP SINK ..-I GAS SYSTEMS: NO. OUTLETS _j WATER PIPING & TREATING EQUIP. . fr' HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT WASTE INTERCEPTOR - VACUUM BREAKERS - - LAWN SPRINKLER SYSTEM SEWER 0-0 CESSPOOL SEPTIC TANK & PIT SISAOU CONTRACTOR OR AUTHORIZED AGENT (D7TE) PERMIT $ OWN ER (IF OWN ER BU ILDERI TEl TOTAL FEE f , WHEN rMurEI1L.Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH INSPECTOR Form 100.2 9-69 REORDER FROM: INTERNATIONAL CONFERENCE OF BUILDING OFFICIALS 0 50 SO. LOS ROBLES 0 PASADENA. CALIFORNIA 91)01 INSPECTION REPORTS 'DrE 1 ITErV REMARKS INSPECTOR USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC. INTERDEPARTMENTAL INFORMATION SHEET DATE:________________ BUILDING DEPARTMENT dale?,~ Owner's Name_ Permit No.____________________ Address Lot No._______________________ (w J, Contractor Legal Description Address Approval to Issue Permit Certifica of Occupancy PLANNING DEPARTMENT '1 Parking Spaces Provided Required Setbacks Zone. REMARKS: Date 4 - -Da te Approval to Issue Permi Approval for Occupancy ENGINEERING DEPARTMENT. Easements 'ov Sewer Connectioh _P.1-12-70 Improvements- AJO 7i45. Driveway Locations7p_e9iIr ,..• - ,- e-e_, / '- ----cL - Industrial Waste______________________ Water Connection I-(f--- S,cic-g j%JS'flL. 1 -d REMARKS:- WIC & Date - /7 Date 0 : Approval ±_Issu.e I have read the above information and agree to comply with the requirements set forth. Signature • Date I . BUILDING PERMIT APPLICATION (4. -4 ('A DI cDAr% ('Al IrrDMIA /~mple~tL -y UI '..d fl L. Urt Li LII J F I II r APR 27-71 Applicant lo mbered spaces only. JOB ADDRESS E LOT NO. ELK TRACT ([:]SEE ATTACHED SHEET) 0 R MAIL ADDRESS ZIP 2 PHONE C T - MAIL ADDRESS PHONE LICENSE NO. ARCHITECT OR DESIGNER MAIL ADDRESS 4 PHONE LICENSE NO ç - - ENGINEER MAIL ADDRESS 5 PHONE LICENSE NO. LENDER MAIL ADDRESS 6 BRANCH USE OF BUILDING 7 8 Class of work: fl ADDITION fl ALTERATION D REPAIR E MOVE E REMOVE 9 Describe work: I 14.) I - C;;;;., :>::: . 10 Change of use from Change of use to 11 Valuation of work: $ I/cO PLAN CHECK FEE/UA — PERMIT FEE SPECIAL CONDITIONS: Type of Const. Occupancy Group Division Size of Bldg. (Total) Sq. Ft. No. of Stories Max. 0cc. Load Fire Zone Use Zone Fire Sprinklers Required ElVes UNo APPLICATI N ACCEPTED BY. PLANS CHECKED BY APPROVED F ISSUANCE BY No. of Dwelling Units - OFFSTREET PARKING SPACES: Covered Uncovered NOTICE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB- ING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED. - I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. Special Approvals Required Received Not Required ZONING HEALTH DEPT. FIRE DEPT. SOIL REPORT OTHER (Specify) 4fl SYdNATORE QrOONNER (11 WNER BUILDER) ( / .. WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT tLAA CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH INSPECTOR Form 100.1 9-69 REORDER FROM: INTERNATIONAL CONFERENCE OF BUILDING OFFICIALS* 50 SO. LOS RDBLES 0 PASADENA, CALIFORNIA 91101 LA cc 0 t161I**t* 00 0 0 PLUMBING PERMIT APPLICATION #7 / City of CARLSBAD, CALIFORNIA T -7-71 Applicant to comalete ~nyeryspaces on/v. 2 I I 0 0 I I JOB ADDR ESS 120 Pine St.. Carlsbad LEGAL 1DESCR. I I LOT NO. I RLK I I I TRACT I I (JSEE ATTACHED SHEET) OWNER MAIL ADDRESS 2 Scanlon, James 2955 Elm ZIP PHONE CONTRACTOR MAIL ADDRESS Bob's Plumbing 2501 State St PHONE LICENSE NO. 729-2055 25707 E ARCHITECT OR DESIGNER MAIL ADDRESS 4 PHONE LICENSE NO. ENGINEER MAIL ADDRESS 5 PHONE LICENSE NO. LENDER MAIL ADDRESS 6 BRANCH USE OF BUILDING 7 8 Class otwork: LINEW El ADDITION 11 ALTERATION REPAIR 1• 9 Describe work: water beater chargeout . > - -- PERMIT FEES No. Type of Fixture or Item Fee SPECIAL CONDITIONS: WATER CLOSET (TOILET) $ BATHTUB LAVATORY (WASH BASIN) - - SHOWER - - KITCHEN SINK & DISP. DISHWASHER APP2CCEPTEOBY: PLANSCHECKED BY: APPRMtD_k0R ISSUANCE BY: 017 LAUNDRY TRAY - - CLOTHES WASHER WATER HEATER 1 _ NOTICE THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 9-29-71 URINAL DRINKING FOUNTAIN CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A FLOOR--SINK OR DRAIN - - SLOP SINK GAS SYSTEMS: NO. OUTLETS - - ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS - WATER PIPING & TREATING EQUIP. - - HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT WASTE INTERCEPTOR PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING VACUUM BREAKERS - LAWN SPRINKLER SYSTEM - SEWER CESSPOOL SEPTIC TANK & PIT SIGNATURE OF CONTRACTOR OR AUTHORIZED(GENT (DATE) - PERMIT $ 3 55 5 100 TOTAL FEE $ SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) WHEN PROPERLY VALIDATED ON THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH INSPECTOR Form 100.2 9-69 REORDER FROM: INTERNATIONAL CONFERENCE OF BUILDING OFFICIALS S 50 50. LOS ROBLES *PASADENA, CALIFORNIA 91101 BUILDING PERMIT Permit No: Project No: Development No: CB980240 A9800312 01/28/98 07:54 Page 1 of 1 Job Address: 1240 PINE AV Suite: Permit Type: MISCELLANEOUS Parcel No: 205-020-36-00 Lot#: Valuation: 0 Occupancy Group: Reference#: Description: RESIDE GARAGE, HANG DRYWALL ON INTERIOR WALLS AND ADD WINDOWS & ELEC Appl/Ownr : LEFROIS, HOLLY 760 1240 PINE AVE CARLSBAD, CA. 92008 *** Fees Required *** 3462 01/28/99 0001 01 C-PRMT Construction Type: Status: Applied: Apr/Issue: Entered By: 720-0758 02 70-00 VN ISSUED 01/28/98 01/28/98 MDP .00 .00 70.00 it Ext fee Data ------------------- 20.00 ELECTRIC 50.00 PERMIT 70.00 s Collected & Credits - --------------------------- ----- --V.:- Fees: 70.00 •. . • N. Adjustments: /.00 ).,Totl,Credits: Total Fees: /70.00 Thtàl/Payments: / BaIncé.-Due.: Fee description / V •UhItsi'F&e/U ------------- Miscellaneous Fee #1 . >' 20.00\-- Miscellaneous Feef#2-.... > VV so.o6 \ '' * MISCELLANEOUS TOTAL \ INCORPORATED N t• (Jj FINAL APPROVAL INSP , DATE_______ CLEARA:CE CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 FOR OFFICE USE ONLY PLAN CHECK NO.B EST. VAL. Plan Ck. Deposit Validated By__________________________ Date 1 PROJECT INFORMATION 2-M0 10E \JE;fJU) C - s MOLA 92ccQ Address (include Bldg/Suite #) Lok • Business Name (at this adJress) 7 Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Asse or's Parcel # Existing Use Proposed Use e— v- ' ' 4(0 I Description of Work .._) SQ. FT. #of Stories # of Bedrooms # of Bathrooms o- c WAU -et 2 CONTACT PERSOt(pf dffferent from apphcant) Name Address City State/Zip Telephone # Fax# 3 APPLICANT 0 Contractor 0 Agent for Contractor CK6wner 0 Agent for owner #tj LeFoI..s Qi CISbc4 2009 7l,o -72..ocY7$ Name I -iHress City slit Zip Telephori? # PROPERTY OWNER LFx*s Y1L Y'4PYUk 54-Q- C Name Address J . Address City State/Zip Telephone # CONTRACTOR - COMPANYNAME:.. (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 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 a civil penalty of not more than five hundred dollars ($50011. Name Address City State/Zip Telephone # State License # License Class City Business License # Designer Name Address City State/Zip Telephone State License # 6 WORKERS COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 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 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company Policy No. Expiration Date__________________ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) C] 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. SIGNATURE DATE 7 OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License 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 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 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). 0 I am exempt under Section Business and Professions Code for this reason: I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES []NO ((have / have not) signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number): I 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 number / contractors license number(: I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work(: PROPERTY OWNER SIGNATURE tr4'tL. DATE COMPLETE THIS SECTION FOR NON-RESIthlTIAL BUILDING PERMITS ONLY 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? 0 YES 0 NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES 0 NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 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. 8 CN'tRUCTTON LEN AGENC I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME LENDER'S ADDRESS__________________________________________________________ 9 APPLICANT CERTIFICATiON I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Cit' of Carlsbad to enter upon the 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 OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is comma ed for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE /fr1tL1 (,Je )fS DATE 1/252/9 WHITE: File YELLOW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERNIT# CB980240 FOR 03/02/98 INSPECTOR AREA PY DESCRIPTION: RESIDE GARAGE, HANG DRYWALL ON PLANCK# CB980240 INTERIOR WALLS AND ADD WINDOWS & ELEC. 0CC GRP TYPE: MISC CONSTR. TYPE VN JOB ADDRESS: 1240 PINE AV STE: LOT: APPLICANT: LEFROIS, HOLLY PHONE: 760 720-0758 CONTRACTOR: PHONE: OWNER: PHONE: REMARKS: C/DICK/720-0758 INSPECTOR SPECIAL INSTRUCT: PAUL, PLEASE CALL DICK - HE IS AWAITEN9'fOUR CALL. TOTAL TIME: CD LVL DESCRIPTION ACT COMMENTS 19 ST Final Structural A,40 ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP COMMENTS 022698 Rough Electric AP PY 022498 Rough Electric PA PY City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 02-20-2014 Permit No: CB140386 Building Inspection Request Line (760) 602-2725 Job Address: 1240 PINE AVCBAD Permit Type: PME Status: ISSUED Parcel No: 2050203600 Lot #: 0 Applied: 02/20/2014 Entered By: RMA Reference #: Plan Approved: 02/20/2014 PC #: Issued: 02/20/2014 Inspect Area: Project Title: RICHIERI RES- REPLACE 100 AMP ZINSCO SUB-PANEL IN SAME LOCATION- 100 AMP - W/ NEW 100 AMP PANEL Applicant: Owner: RICH IERI VIVIAN RICH IERI VIVIAN 1240 PINE AVE 1240 PINE AVE CARLSBAD CA 92008 CARLSBAD CA 92008 Plumbing Fees $0.00 Electrical Fees $158.00 Mechanical Fees $0.00 Other PME Fees $0.00 TOTAL PERMIT FEES $158.00 Total Fees: $158.00 Total Payments To Date: $158.00 Balance Due: $000 InsDector: FINAL APPROVAL Date: ____________ Clearance: 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 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 dght 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 ITH00W1NG APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: PLANNING ENGINEERING DBUILDING DFIRE DHEALTH DHAZMAIiAPCDI '1 C I T Y 0 F C/\RLSBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov ().4- www.carlsbadca.gov Plan Check NoL2fLf3f Est. Value Plan Ck. peposit -Date J,2,, /151 SWPPP JOB ADDRESS --kD ( -'t t.t 12 oI SUITE#/SPACE#/UNIT# APN I I - - CT/PROJECT# LOT 41 PHASE # #OFUNITS #BEDR0OMS #BATHROOMS TENANT BUSINESS NAME CONSTR.TYPE OCC.GROIJP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) RepIo-e, -i'r 'nco it w,s..VZ40 tbo /c' w-t 0(a.L *- 'jt bc y —os. EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) I FIREPLACE IYES [D# NOD I AIR CONDITIONING YES DNOEl I FIRE SPRINKLERS YES[::] NO[—] APPLICANT NAME (Primary Contact) APPLICANT NAME (Secondary Contact) ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL PROPERTY OWNER NAME CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY STATE ZIP 16 CITY STATE ZIP PHONE --1 32414 ' FAX PHONE IFAX EMAIL v EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LIC.# STATELIC.# CLASS CI BUS .LIC.# (Sec. 051.b business and Proressions 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 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 a civil penalty of not more than five hundred dollars ($500)). Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: [1 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. Eli 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. EliCertificate 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. CONTRACTOR SIGNATURE [-]AGENT DATE / hereby affirm that/am exempt from Contractor's License Law for the following reason: Elli 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 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). El 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. IIYes 59No C' _'I 2, QVI I have not) signed an application for a building permit for the proposed work. I) 0 contracted with the following person (firm) to provide the proposed construction (include name address / phone I contractors' license number): — A55.e e-',Is d-, , c'- I 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 I phone /contractors' license number): I will provide some of the work, bull have contracted (hired) the following persons to provide the work indicated (include name I address / phone / type of work): ..PROPERTY OWNER SIGNATURE DAGENT DATE >'j 9)) Is the applicant or future building occupant required to su tely hazardous materials registration form or risk management p 'gram under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Yes No Is the applicant or future building occupant required to obtain a permit from me 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 AND THE AIR POLLUTION CONTROL DISTRICT. -Jx I hereby affirm that there is 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 thatthe above information is comnsctand that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating te building construction. I hereby authorize representative of the City of Carlsbad to enter upon the 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 INCONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over 50' deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void itlhe building or work authorized by such permit is not commenced within 180 days from the date of such permit or if the building orwork authorized by such permit is suspended orabandoned at any time afterthe work is commenced fora period of 180days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE \_ 'CJA_L DATE t '2-0 / STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. C E R T I FICATE Fax (760) 602-8560, Email buildincl(CarisbadCa.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) ASSOCIATED CB# MAIL TO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) NO CHANGE IN USE/ NO CONSTRUCTION MAIL /FAX TO OTHER: CHANGE OF USE/ NO CONSTRUCTION APPLICANT'S SIGNATURE DATE 'c_ Inspection List Permit#: CB140386 Type: PME RICHIERI RES- REPLACE 100 AMP ZINSCO SUB-PANEL IN SAME LOCATION. Date Inspection Item Inspector Act Comments 02/21/2014 33 Service Change/Upgrade - RI 02/21/2014 33 Service Change/Upgrade PB AP 02/21/201439 Final Electrical - RI 02/21/2014 39 Final Electrical PB AP Monday, February 24, 2014 Page 1 of 1 b 01 ' U' p plD ; I VIM q1,34III