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HomeMy WebLinkAbout1352 MAGNOLIA AVE; ; CB112309; Permit10-27-2011 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: EMPIRE PIPELINE SUITE E City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB112309 Building Inspection Request Line (760) 602-2725 1352 MAGNOLIA AV CBAD PME 2052104600 Lot#: 0 GREER RES-REPLACE GAS LINE FROM METER TO HOUSE Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: GREER BARBARA J FAMILY TRUST ISSUED 10/27/2011 RMA 10/27/2011 10/27/2011 1945 CAMINO VIDA ROBLE CARLSBAD, CA 92008 760-603-8088 1352 MAGNOLIA AVE CARLSBAD CA 92008 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 collectivefy" 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 wllh Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aslde, 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 NOA DOES IT APPLY to any f whi hv NTI whih hrwl J «1~ ~ CITY OF CARLSBAD JOB ADDRESS CT/PROJECT# LOT# Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718/ 2719 Fax: 760-602-8558 www.carlsbadca.gov # OF UNITS # BEDROOMS SUITE#/SPACE#/ # BATHROOMS DESCRIPTION OF WORK: Include Square Feet of Aftected Area(s) \ce: Plan Check No. (., Est. Value Plan Ck. Deposit Date SWPP TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP EXISTINP.J.1..SE PROPOSED USE GARAGE (Sf) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS l<...9::S YES □#_ NO □ YES □ NOD YES □ NO □ APPLICANT NAME (Secondary Contact) ADDRESS CITY STATE ZIP FAX ZIP CITY STATE ZIP PHONE FAX EMAIL ARCH/DESIGNER NAME & ADDRESS STATE 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 re_quires t e applicant for such permrt to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License LawjChapter 9, commending with Section 70_00 of DIvIsIon 3 of the B_usmess and Professions Code} or that he Is exem_P.t therefrom, and the basis for the alleged exemption. Any violation of Section 031.5 by any applicant for a permit subiects the applicant to a civil penalty of not more than five hundred dollars [$500)). Workers' Compensation Declaration: I hereby affirm under penalty of pe,jury 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 wor1< for which this permit is issued. ~ I have and will maintain wo~·e:: COIJ!_pensatlon, as requi_red by Section 3700 of the Labor Code, for the performance of the work for whk:11 this permit is issued. My workers' compensation i7urance carrier and policy number are lasurance Co. W'tl \ \;,,~ !It l:;, <, C.. 0 Policy No. Y f, 0 I\ /o 3 .l.So 2 0 1 &pIra1;on Date le / / I t ~ I This section need not be completed if the permit is for one hundred dollars ($100) or less, D Certificate of Exemption: I certify that in the pelformance of the wor1< for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Wor1<ers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to crimlnat penalties and civil fines up to one hundred thousand dollars (&100,000), In addition to the cost of compensation, damages as provided for Se on 3706 of the Labor code, interest and attorney's fees. _,1$ CONTRACTOR SIGNATURE I hereby affirm that I am exempt "1)/11 Contractor's Ucense Law for the following reason: □ \, 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 1101 apply to an owner of property who builds or improves thereon, and who does such wor1< himseH or through his own employees, provided that such improvements are 110t intended or offered for sale, If, however, the building or improvement is sok:l wilhifl one year of completion, the owner-builder will have the burdef\ of proving that he did not buik:l 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 af\d 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 Ucense Law). □ I am exempt under Section _____ ,Business and Professions Code for this reasof\: 1. I personally plafl to provide the major labor and materials for cof\structiof\ of the proposed property improvement □ Yes □ No 2, I (have/ have 1101) signed an application for a building permit for the proposed wor1< 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 I phone I contracfors' license number): 5. I will provide some of \he wor1<, but I have contracted (hired) the following persons to provide the work indicated (include name I address I phone/ type of wor1<): _65 PROPERTY OWNER SIGNATURE c:IAGENT 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? □ Yes ~o Is !he applicant or future building occupant required to obtain a permit from !he air pollubon control district or air quality management district? □ Yes erffo Is !he 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 certifytt,at I have r&ad the application and state that the above lnfonnation is correct and that the infonnation on ttie plans is accurate. I agree to oomplywlth all City ordinances and State laws relating to building construction. I hereby authorize representative of the Crty of Cartsbad to enler upon the aOOve mentioned property tir inspection purp:ises. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA Ml OSHA pennlt is required br excavatKJns over 5'0' deep and demoHOOn or construction of structures over 3 stories in heght. EXPIRATION: Every pennit issued by the Buik:ling Offi::ial under e p · ions of lhis C.ode shall expire by limitatk)n and become null and void if the building orv.orl<. authorized by such pennrt is not oommenced Wthin 180 days from the date of such permit or if · g tho · by such pennlt is suspended or abandoned at any time after the 'Mlrk is oommenced for a ood of 180 (Seeton 100.4.4 Unifonn Building Code). AS APPLICANT'S SIGNATURE DATE JI J.li f m . . City of Carlsbad Bldg Inspection Request . . Permit# CB112309 For: 1 0/28/2011 Title: GREER RES-REPLACE GAS LINE Description: FROM METER TO HOUSE Type:PME Sub Type: Job Address: Suite: 1352 MAGNOLIAAV Lot: 0 Inspector Assignment: SVV\/ Phone: Location: Inspector: OWNER GREER BARBARA J FAMILY TRUST Owner: GREER BARBARA J FAMILY TRUST Remarks: EARLY AM PLEASE Total Time: CD Description Act Comments ----- Requested By: NA Entered By: CHRISTINE 23 ~s/T11stlfepairs AL_ _________________ _ L,,,1 ~f-~1-~~0"'-'L--------t'9-___________________ _ Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act lnsp Comments