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HomeMy WebLinkAbout1241 Carlsbad Village Dr; C; CBR2017-2720; PermitPrint Date: 11/16/2017 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: Description: 1241 Carlsbad Village Dr, C BLDG-Residential 1561802000 $0.00 PURDY: GAS LEAK REPAIR Owner: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Residential Permit www.carlsbadca.gov Work Class: P/M/E Lot#: Reference #: Construction Type: Bathrooms: Orig. Plan Check#: Plan Check#: Status: Applied: Issued: Fina led: Inspector: Contractor: Permit No: CBR2017-2720 Closed -Finaled 11/13/2017 11/13/2017 TFraz TRUST PURDY MARGARET L TRUST & PURDY WILLIAM G Ill YOGIS PLUMBING AND DRAIN SERVICE PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT Total Fees: $170.00 1241 Carlsbad Village Dr CARLSBAD, CA 92008 Total Payments To Date: $170.00 810 Bonita Dr Encinitas, CA 92024-3803 760-672-0999 Balance Due: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." 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 limitation has previously otherwise expired. $170.00 $0.00 ·. { City of Building Permit Application Plan Check No.0 P-D ... ?'u l 1-?_'12.. () 1635 Faraday Ave., Garlsbad, CA 92008 Est. Value Carlsbad Ph: 760-602-271.9 Fax: 760-602-8558 email: buildlng@carlsbadca.gov Plan Ck. Deposit www.1;;s;Jrl~Qs!Q!;;s;J.gQv \3-,-, Date l \ - JOB ADDRESS c.. "Oi I l; h °' di v :r,~ ~ e o .v. SUITE#/SPACE#/UNIT# IAPN .WC ---/ 2-J..t J CT/PROJECT# 'LOT# I PHASE# I # OF UNITS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I occ. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) Q n c, { ~" }< J ren~ • EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) I FIREPLACE I AIR CONDITIONING I FIRE SPRINKLERS YES D #_ NO D YES D NO D YES D NO D APPLICANT NAME (Primary Contact) PROPERTY OWNER NAME F vY~v 1t .p /if )7 ADDRESS ADDRESS I CITY STATE ZIP CITY STATE ZIP PHONE I FAX PHONE tAX EMAIL EMAIL DESIGN PROFESSIONAL NAME CONTRACTOR BUS. NAME Y 49 ;} /) I I) J1. b ,. /\II, f p y'li\ ~ N ADDRESS ADDRESS I D' .(J ,tJ f t~ I .,, <; D CITY STATE ZIP CITY ti STATE c/ll !) '(_ Lj eAicltvf ~> c..q PHONE 'FAX PHONE r6o/5bD,. 8515: h '«)-to'12 -CR q Cf EMAIL EMAIL J y O 9 i ;, p ( a. 5 N? © G -11 tl,. . C, IJ ./-1 'STATE LIC. # STATELIC.#\ 0 \ O\ 2-1-IC-)6, ICITYBUS.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 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 [hat 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 amrm under penalty of perjury one of the following declarations: '{J 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. gJ I have and will maintain workers· compensali~requi! by Section 3700 of the Labor Code, for the performance of the work !=hich this PNmjjs j*u,eg.? workers' compensation insu~nce carrier and policy number are: Insurance Co. {fo Y t: t:...J!. Y r;JJ.. Policy No. 7 C. \}I ,:;;;;,_ (,. 0, · l '1_"'/ 0(:) Expiration Date/[ tl'O: t1 11 ? 0 1 fl 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 ecli n 3706 of the Labor code, interest and attorney's fees . ..@S°CONTRACTOR~S~IG~N~A;T~UR;E~~~~~~~~~~~~~~~~~~r,;:~~i'.'°';"7.i~~~~::--:~~~~~~~~~~~ I hereby affirm that I am exempt from Contiactor's License Law for 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 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). 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(s) licensed pursuant to the Contractor's License Law). D I am exempt under Section Business and Professions Code for this reason: 1. I personally plan lo provide the major labor and materials for construction of the proposed property improvement. 0 Yes a No 2. I (have I have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (include name address I phone I contractors' license number): 4. 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 I address/ phone I contractors' license number): 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name I address / phone I type of work): ..@S° PROPERTY OWNER SIGNATURE Cl AGENT 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? D 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 D No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D Yes D 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 CONTROt:DJSTRICT. I certify that I have read the application and state that the above lnfonnation is correct and that the infonnation on the plans is accurate. I agree to comply with all Ci1yordinances and State Jaws relating to 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 SA VE, INDEMNIFY AND KEEP HARWLESS 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: Ari OSHA penm~ is requined for excavations <:Ner s·o· deep and demolition or construction of strucb.Jres CNe< 3 stories in height. EXPIRATION: Every penm~ issued by the Building Official unde< the provisions of this Code shall expire by imitation and become nul and void if the building or won< authorized by such ~ is not coovnenoed withil 180 days from the date of such pem,itor if the building orwon< authorized by such ~ · suspended or abandoned at any time afte< the won< is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). r[) _6$ APPLICANT'S SIGNATURE DATE I Permit Type: BLDG-Residen1ial Application Date: 11/13/2017 Owner: TRUST PURDY MARGARET L TRUST & PURDY WILLIAM G Ill Work Class. P/M/E Issue Date: 11/13/2017 Subdivision: TOWN OF CARLSBAD AMENDED Status Closed -Finaled Expiration Date: 05/14/2018 Address: 1241 Carlsbad Village Dr, C Carlsbad, CA 92008-1960 IVR Number: 7682 Scheduled Actual Date Start Date Inspection Type Inspection No. Inspection Status Primary Inspector Reinspection Complete 11/15/2017 11/15/2017 BLDG-23 040535-2017 Passed Tim Frazee Complete Gas/Test/Repairs Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes November 16, 2017 Page 1 of 1