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HomeMy WebLinkAbout1771 Blackbird Cir; ; CBR2017-0325; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Print Date: 03/02/2017 Residential Permit Permit No: CBR2017-0325 www.carlsbadca.gov Job Address:1771 Blackbird Cir Permit Type:BLDG-Residential Work Class:P/M/E Status:Closed -Finaled Parcel No:2156023700 Lot #:Applied:02/16/2017 Valuation:$0.00 Reference #:Issued:02/16/2017 Occupancy Group:Construction Type:Finaled: # Dwelling Units:Bathrooms:Inspector:MColl Bedrooms:Orig. Plan Check #: Plan Check #: Project Title: Description:KHILL: REPLACE 50 GAL WATER HEATER IN SAME LOCATION Owner:Contractor: DENNIS KHILL AFFORDABLE WATER HEATERS AND 1771 Blackbird Cir PLUMBING INC 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 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. THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE:0 PLANNING .CL1 ENGINEERING 0 BUILDING 0 FIRE 0 HEALTH El HAZMATIAPCD Building Permit Application Plan Check No.Cte201-7 —0325(City of 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value Ph: 760-602-2719 Fax: 760-602-8558Carlsbademail: building@carlsbadca.gov Plan ClreprItwww.carlsbadca.gov Date 9.14ill SWPPP JOB ADDRESS I m • 1r C i SUITE!/SPACE!/UNIT!AP I 1 1 a cK.10d-r.--- CT/PROJECT#LOT #PHASE ##OF UNITS #BEDROOMS #BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP 1 I I DESCRIPTION OF WORK:Include Square Feet of Affected Area(s)—I R.e?\Ok C e..6 D ,Q l\0 r1 W 6)\-t--'2. \--\r-\-e at -tr . SOornt \Oco -±\tr\:-_garar -- . EXISTING USE PROPOSED USE GARAGE (SF)PATIOS (SF)DECKS (SF)FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES0#NOE YES ONO 0 YES0 NOE APPLICANT NAME • prixa PROPERTY OWNER NAME Y0_ASh 1 t h .1_0 a -p en nis ki-. i 1 I ADDRESS -ADDRESS 2cg'35 Cn&-t\\ak \o.rt Rd .#-tpc‘8'ill I b I ac(<_loir at cir• CITY . 'STATE ZIP CITY STATE ZIP \I ©\\e-rN C \ ()-C-A 61 \55 ca Kid-be i ct-c4 q20// PHONE,FAX :ONE ‘FAX L'?55 31.6 -9.t)r lot o\)25671 -955 -2S671 -955 -L9 -I o).31 -26q I --- 1EMAILAILPermI -I-- (Ss P a t}3 hap -C o)-.-1 'DESIGN PROFESSIONAL . 'CONTRACTOR BUS. NAME A " /.I—0 v (.0\ . 0 \e.\NI o\-cQr \-\tort ADDRESS ADDRESS -.••'21SZ nCD -'re H o-flort Rd ---7—1p018› CITY STATE ZIP CITY STATE ZIPV.(9f)'en CI a-C iCt I C S' PHONE FAX PHONE, i„FAX3.416 -°1 8:1 Ouk) 269 -'I SE Le EMAIL EMaAILS1Peyrni+S 0 otuuhar -0 rin STATE LIC. #STATE LIC.#CLASS CITY BUS. LIC.# 1f2 -1:3_LPZ`C9, LP 12 \ 1)-1 \ (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 ($500D• WORKERS'COMPENSATION 'Workers' Compensation Declaration:r hereby affirm under penaltyof perjury oneofthe following declarations: ahave 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 5rier and policy number are: Insurance Co.V1S1).Y 71v-vc.e..(•..c.... -.\Y\e.V\l e StPolicy No..0 .) 2.A 41 1 D'O Expiration Date 1 •1 -1 ‘. Usection need not be completed if the permit is for one hundred dollars ($100) or less. Certificate of Exemption:Icertify 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: Failureto 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. .re CONTRACTOR SIGNATURE 0`..`..0.en7L I2‘GENT DATE 2.•I D /7 OWNER -BUILDER DECLARATION ' I hereby affirm that I am exempt from Contractor's License Law for the following reason: E1I,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).0 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 ON° 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 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 / contractors' license number): 5.Iwill provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name I address I phone / type of work): JECPROPERTY OWNER SIGNATURE DAGENT DATE 1 easemareamilllialMil COMPLETE THIS SECTION FOR NON -RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form orrisk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act?0 Yes 0 No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?0 Yes 0 No Is the facility to be constiucted within 1,000 feet of the outer boundary of a school site?0 Yes 0 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address APPLICANT CERTIFICATION Icedifylhatl hoeread the applcation and state thatthe above information is correct andtetteirdonnation on the plans is accurate.Iagreeto comply with all City ordinances and Stabs lays relalingto buildingconsbudIon. I hereby authorize representativeofthe CityofCarlsbad to enter upon the above motioned property for inspection purposes.I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY CF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY INANY WAY ACCRUE AGAINST SAID CITYIN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over 50' deep and demolition or construction of structures over 3 stories in height EXPIRATION: Every permit issued by the Building Official under the provisionsofthis Code shall expire by limitation and become nut and void if the building orvat authorized by such permit is not commenced within 180 days from the dateofsuchpentoriel the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced fora period of 180 days (Section 106.4.4 Uniform Building Code). ISAPPLICANT'SSIGNATURE DATE 2I \ PERMIT INSPECTION HISTORY REPORT (CBR2017-0325) Permit Type:BLDG-Residential Application Date:02/16/2017 Owner:DENNIS KHILL Work Class:P/M/E Issue Date:02/16/2017 Subdivision: Status:Closed -Finaled Expiration Date:08/29/2017 Address:1771 Blackbird Cir Carlsbad, CA 92011-5010 IVR Number:1993 Scheduled Actual Date Start Date Inspection Type Inspection No.Inspection Status Primary Inspector Reinspection Complete 02/27/2017 02/27/2017 BLDG-25 Water 014747-2017 Failed Michael Collins Reinspection Complete HeaterNents Checklist item COMMENTS Passed BLDG-Building Deficiency No BLDG-Final 014746-2017 Failed Michael Collins Reinspection Complete Inspection Checklist Item COMMENTS Passed BLDG-Plumbing Final See back of card.No 03/02/2017 03/02/2017 BLDG-25 Water 015310-2017 Passed Michael Collins Complete HeaterNents Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes BLDG-Final 015311-2017 Passed Michael Collins Complete Inspection Checklist Item COMMENTS Passed BLDG-Plumbing Final Yes BLDG-Plumbing Final See back of card.No March OZ 2017 Page 1 of 1