The URL can be used to link to this page

Home My WebLink About1281 CARLSBAD VILLAGE DR; ; CB164072; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 11-01 -2016 Permit No: CB164072 Building Inspection Request Line (760) 602-2725 Job Address:1281 CARLSBAD VILLAGE DR CBAD Permit Type:PME Status:ISSUED Parcel No:1561907010 Lot #:0 Applied:11/01/2016 Entered By:JMA Reference #:Plan Approved:11/01/2016 PC #:Issued:11/01/2016 Inspect Area: Project Title:PACKARD: UNDERGROUND PLUMB IN PREP ON CB164072 Applicant:Owner: PACKARD CONSTRUCTION, GARTH CARLSBAD MEDICAL VILLAGE L P C/O RUSS RIES 2057 CHESTNUT AV P 0 BOX 1422 CARLSBAD, CA 92008 LA JOLLA CA 92038 619-729-7447 Plumbing Fees $163.00 Electrical Fees $0.00 Mechanical Fees $0.00 Other PME Fees $0.00 TOTAL PERMIT FEES $163.00 Total Fees:$163.00 Total Payments To Date:$163.00 Balance Due:$0.00 '42—FINAL APPROVAL Inspector:(e Date:/2 1 6.4'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 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 aiven a NOTICE similar to this. or as to which the statute of limitations has Previously otherwise expired. .........................01011111101011111111111.11 MINIIIIIIIIIIIIMIIII THE F LOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE:EPLANNING DENGINEERING EIBUILDING EIFIRE EHEALTH ElHAZMATIAPCD_t'''Building Permit Application Plan Check No.Ca 1 L3—(-1012..k_ City of 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value -,Ph: 760-602-2719 Fax: 760-602-8558Carlsbademail: building@carlsbadca.gov Plan Ck. Depositii www.carlsbadca.gov Date 1/.1.7 6 SWPPP JOB ADD/RE.2-SS.,/i.e Dr..... SUITEVSPACEVUNIT#APN S7-- CT/PROJECT #LOT #PHASE #*MOP UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME /5:6 -/90 CONSTR. TYPE OCC. GROUP pa ckarce ...0-AAP o;-,.v-13 DESCRIP ION OF WOR Include Square Feet ffecte rea(s)........,....•_ 1 EXISTING USE PROPOSED USE GARAGE (SF)PATIOS (SF)DECKS (SF)FIREPLACE AIR CONDITIONING FIRE SPRINKLERS .YES 0#___ NOM YES roONO E3 YESgi NoD APPLICANT NAME 0.zi...4 PROPEWOWNEI3 ...//3...zigitzrctePrimary Contact at-- ....._,Vi--"ia?-k- ADDRESS n60o/.7r/Lp STATE ZIP 07.74 ADDREEj/Sgs.' 7 a CITY de--/iy -e owt.44..eca -4- .2-625-g CITY t-f-A I—STATEC-19 ZIP C 9 90)-00 0 PHONE FAX PHONE ...,FAX 76a ----gd --5 - /a 7 vo -5-) 7 -9 9.0-i4 76o —7.2-9—c7)-‘467 EMAIL tVLA-C7.1 C.-4. EMAIL 1"• DESIGN BOOF SSIONAL CONTRACTOR3D BUS. NAME ADDRESS ADDRESS 131.0.9 it/ezeeva AA..&Pe ieb:cpv/-7 4-ki CITY STATE ZIP CITY A.•-)SIATE ZIPf-etZitit-7 9r. 6. cce„....„4 .0„ PHONE FAX PHONE..,FAXxge---ge)--gio7 7‘a --5;2.9-99q EMAIL EMAIL ./.24_.C4141 nt --a; STATE LIC. #STATE .V 1 /CLASS CITY BUS. LIC.# /450 r3/46 3 calf(eA4- (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 fora permit subjects the applicant to acivil penalty of not more than five hundred dollars ($500)). WORKERS'COMPENSATION Workers' Compensation Declaration:I hereby affirm under penalty of perjury one ofthe 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 permitis issued. I have and will maintain workers' compensation,as required1:22n 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insur ce carrier and policy number are: Insurance Co...1 fe.Ft?....Policy No./..30/1/GI Expiration Date O /7 This section need not be completed if the permit is for one hundred dollars ($100) or less. ElCertificate 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 (6100,000), in addition to the costofcompensation, damages as pridr d forin Section 3706 of the Laborc.j•e, interest and attorney's fees. .°:,i..le CONTRACTOR SIGNATURE IMF /--/er ,,et 0 AGENT DATE /6 79 4 OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from Contractor's License 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 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). ElI 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.[Yes EINo 2.I (have / 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 / phone / contractors' license number): 4.I plan to provide portions of the work, butI have hired the following person to coordinate, supervise and provide the major work (include name / 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 IaddresI phone I type of work): ..4KPROPERTY OWNER SIGNATURE DAGENT DATE PERMIT INSPECTION HISTORY REPORT (CB164072) Permit Type:BLDG-Commercial Application Date:11/01/2016 Owner:CARLSBAD MEDICAL VILLAGE LP Work Class:P/M/E Issue Date:11/01/2016 Subdivision: Status:Closed -Finaled Expiration Date:05/01/2017 Address:1281 Carlsbad Village Dr Carlsbad, CA IVR Number:718068 Scheduled Actual Date Start Date Inspection Type Inspection No.Inspection Status Primary Inspector Reinspection Complete 12/20/2016 BLDG-Final 009612-2017 Passed Paul Burnette Complete Inspection Checklist Item COMMENTS Passed BLDG-Building Deficiency No BLDG-Plumbing Final No BLDG-Mechanical Final No BLDG-Structural Final No BLDG-Electrical Final No 11/02/2016 11/02/2016 BLDG-21 002198-2016 Passed Paul Burnette Complete Underground/Underf loor Plumbing Checklist Item COMMENTS Passed BLDG-Building Deficiency No Page 1 of 1