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Home My WebLink About1684 Fisherman Dr; ; CBR2016-0462; PermitCity of Carlsbad• 1635 Faraday Av Carlsbad, CA 92008 Print Date: 01/19/2017 Residential Permit Permit No: CBR2016-0462 www.carlsbadca.gov Job Address:1684 Fisherman Dr Permit Type:BLDG-Residential Work Class:P/M/E Status:Closed -Finaled Parcel No:2150810100 Lot #:Applied:12/27/2016 Valuation:$0.00 Reference #:Issued:12/27/2016 Occupancy Group:Construction Type:Finaled: # Dwelling Units:Bathrooms:Inspector: Bedrooms:Orig. Plan Check #: Plan Check #: Project Title: Description:PETRIC: REPLACE 75 GAL WATER HEATER IN GARAGE Owner:Contractor: TRUST PETRIC ALEXANDER TRUST 12-30-03 AFFORDABLE WATER HEATER 1684 Fisherman Dr CARLSBAD, CA 92011 28358 Constellation Rd, 698 Valencia,CA 91355-5044 661-259-7131 PLUMBING, ELECTRICAL AND MECHANICAL PERMIT $98.00 Total Fees:$98.00 Total Payments To Date:$98.00 Balance Due:$0.00 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 APPLYto 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. THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE:0 PLANNING .0 ENGINEERING 0 BUILDING 0 FIRE 0 HEALTH 0 HAZIAAT/APCD Building Permit Application Plan Check No.C6Pa0 1(9 -0116/c2.(City of 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value Carlsbad Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Depositemail: building@carlsbadca.gov vwr.carlsbadca.gov Date I ajd47/1/2 SWPPP JOB ADDRESS ....,.•.SUITEVSPACEB/UNITB APN \ \0 '4‘r\3\n -e\-m an ')I-- --- CT/PROJECT #LOT #PHASE##OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP 1 DESCRIPTION OF WORK:Include Square Feet of Affected Area(s)II ..Z.e.?\ace.--lb (0.\\oym v..)0\--\--e_\--v- A -eat -ey-- • •; Same I '0 C (.1 ---- 1 `'(-\=G or ck.e.• , EXISTING USE PROPOSED USE GARAGE (SF)PATIOS (SF)DECKS (SF)FIREPLACE IR CONDITIONING FIRE SPRINKLERS i YESoONNOO YES DNO E YESEj NO1 . --- . i APPLICANT NAME . .ks ..t -.PROPERTY OWNER NAME _ PrInag......c.A hl I h /\.(1k)h.)./Ilex_f_e.t_r-.)C I ADDRESS -ADDRESS . Iqq95'.con -‘•.t-\\ c4-\oa.Rci •#L.Qct'?"-1U2c1 riShel-nnarL.Drive ___I CITY —STATE ZIP CITY STATE ZIP\(6\\.eyNc\o-c'A (i1155 Cetr)..19cAol.Ci ciloll iPHONE,AX ,PHONE FAX 'C5.316 '•°1 0 ?1 `) Z -95 s u9 0(g105 -04ZO ---4EMAIL ' n EmAIL Yer..ry-ll -f -S P 0.w 1--1 a p -c o r-r-I DESIGN PROFESSIONAL CONTRACTOR BUS.n nNAMEA ADDRESS ADDRESS 23`..._.Z Con s*e ti ovtl on_Rd.--4-1.pois)- CITY STATE ZIP CITY ,f STATE ZIP\/01 -enCla C7r q 1355 PHONE FAX PHONE FAX —- t.;Sl3A 5 -°I(0 8'1 Lpu0 .scl -a) 6-5 Le.k..EMAIL .AIL Pe y rr)I -f.S 0)ot liuh a.-Gores ' STATE LIC.it STATE LIC.#CI ASS CITY BUS. LIC.#—HP21LPg`.c) L.;12\1)-11 (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 for a 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 oneofthe following declarations: 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 workers' compensation insurance carrier and policy number are: Insurance Co.\ V}S V.r a... --NC .e..rt •Tr -\-\(-\Q..\N e S-rpolicy No..''o ',3-.)7....41 011 D'O Expiration Date 1 •\•k 1 Illsection need not be completed if the permit is for one hundred dollars ($100) or less. Certificate of Exemption:I certify that in the performance of the work for which this permit is issued,`hall 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 a.provided for in Section 3706 of the Labor code, interest and attorney's fees. .ES CONTRACTOR SIGNATURE 04....1.4 ______41—A.--..A i Q/en - 1 --[AGENT DATE 1 1 22 R.p OWNER -BUILDER DECLARATION I hereby affinn 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'siLicense 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). 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.Dyes ONo 2.I (have I have not) signed an application fora 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, butI have hired the following person to coordinate, supervise and provide the major work (include name I address / phone / contractors' license number): 5.twill provide some of the work, but Ihave contracted (hired) the following persons to provide the work indicated (include name / address / phone I type of work): AcPROPERTYOWNER SIGNATURE DAGENT DATE PERMIT INSPECTION HISTORY REPORT (CBR2016-0462) Permit Type:BLDG-Residential Application Date:12/27/2016 Owner:TRUST PETRIC ALEXANDER TRUST 12-30-03 Work Class:P/M/E Issue Date:12/27/2016 Subdivision: Status:Closed -Finaled Expiration Date:06/26/2017 Address:1684 Fisherman Dr Carlsbad, CA 92011-2647 IVR Number:1070 Scheduled Actual Date Start Date Inspection Type Inspection No.Inspection Status Primary Inspector Reinspection Complete 01/19/2017 01/19/2017 BLDG-25 Water 009961-2017 Passed Jonathan West Complete HeaterNents BLDG-Final 009960-2017 Passed Jonathan West Complete Inspection Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes BLDG-Plumbing Final Yes January 19, 2017 Page 1 of 1