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Home My WebLink About1766 BLACKBIRD CIR; ; CB142414; Permit09-18-2014 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No:CB142414 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC #: Project Title: 1766 BLACKBIRD CR CBAD PME 2156020600 Lot#: STANLEY RES-REPLACE A/C UNIT Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 09/18/2014 RMA 09/18/2014 09/18/2014 Applicant: ASI HASTINGS STE 200 4870 VIEWRIDGE AV SAN DIEGO CA 92123 619-590-9300 Owner: STANLEY JACK S&PAMELA J 1766 BLACKBIRD CIR CARLSBADCA 92011 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees $0.00 $0.00 $160.00 $0.00 TOTAL PERMIT FEES $160.00 Total Fees: $160.00 Total Payments To Date: $160.00 Balance Due: $0.00 Inspector: FINAL Date Clearance: NOTICE; Please take NOTICE that approval of your project includes the "Imposiftin" of fees, dedications, reservations, or other exactions hereafter collectively refen'ed to as "fees/exactions." You have 90 days from the date this pennit 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 Carisbad 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/exadions 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 vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previouslv othenwise expired. jYHE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: PPLANNING DENGINEERING IZlBUILDING DFIRE ;ALTH D HAZMAT/APCD C City of Carlsbad Buildmg Permit Appiication 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax:760-602-8558 email: building@carlsbadca.gov A www.carisbadca.gov Plan Check No, Est. Value PI9J1 Ck. Deposit Date SWPPP JOBADDRESS t i i SUITE#/SPACE#/UNrT» - CT/PROJECT tt LOT # PHASE tt tt OF UNITS « BEDROOMS tt BATHROOMS TENANT BUSINESS NAME CONSTR.TYPE OCC. GROUP DESCRIPTION OF WORK: /ncfude Square Feet of Affected Area(s) EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE N0| I AIR CONDITIONING YES I |NO| I FIRE SPRINKLERS YES I |NO| I APPLICANT NAIVIE Primary Contact ADDRESS PROPERTYOWNER STA'K 2 ADDRES; PHONE .-—M • . - r.n. I EAX CITY 5\0 FAX EMAIL EMAIL DESIGN PROFESSIONAL CONTRACTOR BUS. NAiVIE ADDRESS ADDRESS CITY STATE ZIP CITY PHONE FAX PHONE (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permitto construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicantfor such permitto file a signed statement that he is licensed pursuantto the provisions ofthe Contractor's License Law (Chapter 9, commendingwlth Section 7000 of Division 3 ofthe 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 ofpeijuiy one ofthe following declarations: 11 have and will maintain a certificate of consent to self-Insure for vnorkers' compensation as provided by Section 3700 of the Labor Code, for the perfonnance of the work for which this pemiit is issued, [iave and will maintain workers' cprnDensatigUi as reooited bv Section 3700 of the Labor Code, for the perfomiapce of the work for which t(js oermit is issued. My workers' compensation insurance cajier and poiicy number are: Insurance Co. ( Q ^ |v 1 V, O Cl^ PolicvNo. 3^*^^ 3^1 Expiraiion Date ^^If Thjs section need not be completed if the permit is for one hundred dollars ($100) or less. I I Certificate of Exemption: I certify that in the performance oTIie 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' compe^ayon coverage is uniawful, 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 provij)ed J^r in Secdon 3706 ofthe Labor code. Interest and attomey's fees. i I. CONTRACTOR SIGNATURE GENT DATE IWNER-BUILDER DECLA»ATIO M| / teretiy affirm that I am exempt from Contractor's Uceifyslaw for the foiiowing reason^__-^^ I I I, as owner of the property or my employees wm wages as their sole compensation, will do the work and the stnicture 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 empkiyees, provided that such improvements are not intended or offered for sale, if, however, the building or improvement is sold within one year of compietion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). I I I, as owner of the property, am exclusively contracting with licensed contractors to constmct the project (Sec. 7044, Business and Professions Code; The Contractor's Ucense 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 I I am exempt under Section Business and Professions Code for this reason; 1,1 personally plan to provide the major labor and materials for construction of the proposed property improvement. QYes I iNo 2,1 (have / have not) signed an application for a building permit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number); 4.1 plan to provide portions of the work, but I have hired the following person to coordinate, supen/ise and provide the major work (include name / address / phone / contractors' license number); 5.1 will provide some of the work, but I have contracted (hi»d) the following persons to provide the work indicated (include name / address / phone / type of work): ygS'pROPERTY OWNER SIGNATURE ENT DATE COMPLETE THIS SECTION FOR N O N - R E S t D S U Jf^t:! B^VttM Is the applicant or future building oaupant 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 No Is the applicant or future building oaupant required to obtain a permit from the 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. STRUCTION LEN01Nf AGENCY I hereby affirm that there is a construction lending agency for the performance of the wort this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address I certify that I have read the appllcatkin and state thatthe above infoimation is conect and that the Intbimation on the plans is accurate. I agree to complywith all City oidinances and State laws relating to building constniction, I hereby authoree representative of the City of Carlsbad to enter upon the above mentk)ned property for inspeclion purposes. I ALSO AGREE TO SAVE, INDEIVINIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WfilCH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA; An OSHA pernio is required for excavations over 5'0' deep anMemolitbn or constmction of stnjctures over 3 stories in heght, EXPIRATION; Every pennit issued by the Building Official under the jwfvisbns of this Code shall expire by limitatbn and become null and void if the building or vwrk authorized by such pemiit is not commenced within 180 days from the date of such pemiil or ifthe building or vwjri^ autjiq^ed by such pennit is suspended or abandoned at any time after the vwrk is commenced for a period of 180 days (Section 106.4,4 Unifomi Building Code), APPLICANT'S SIGNATURE DATE 1^ "-^ STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERIVIIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. Fax (760) 602-8560, Email buildinq(a>carlsbadca.qOV or Mall the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, Califomia 92008. C0#: (Office Use Only) CONTACT NAIVIE OCCUPANT NAiVIE ADDRESS BUiLDING ADDRESS CITY STATE ZiP CITY STATE ZiP Carlsbad CA PHONE FAX OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICKUP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) IVIAIL TO MAIL / FAX TO OTHER: CONTACT (Listed above) CONTRACTOR (On Pg. 1) OCCUPANT (Listed above) ASSOCIATED CB#_ NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION JtSAPPLICANT'S SIGNATURE DATE Inspection List Permit*: CB142414 Type: PME STANLEY RES-REPLACE A/C UNIT Date Inspection Item Inspector Act Comments 11/03/2014 43 AirCond/Furnace Set - Rl STANLEY RES 11/03/2014 43 AirCond/Furnace Set SP AP 11/03/2014 49 Final Mechanical - Rl 11/03/2014 49 Final Mechanical SP Fl Monday, November 03, 2014 Page 1 of 1