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Home My WebLink About1784 BLACKBIRD CiR; ; CB140516; Permit03-06-2014 City of Carlsbad 1635 Faraday Av Carlsbad.CA 92008 Piumbing/MechanlGai/Eiectrlcai (PME) Permit Permit No:CB140516 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC #: Project Title: 1784 BLACKBIRD CR CBAD PME 2156029000 Lot#: SCAGLIONE RES- REPLACE FAU Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 03/06/2014 RMA 03/06/2014 03/06/2014 Applicant: EXCEL AIR CORP STE B 530 OPPER ST ESCONDIDO CA 92029 760-741-5550 Owner: SCAGLIONE FAMILYTRUST 12-18-07 1784 BLACKBIRD CIR CARLSBADCA 92011 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees $0.00 $0.00 $158.00 $0.00 TOTAL PERMIT FEES $158.00 Total Fees: $158.00 Total Payments To Date: $158.00 Balance Due: $0.00 Inspector: FINAL APPROVAL Date:^^/04 Clearance: NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively refen'ed 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 infonnation 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 vou have oreviouslv been given a NOTICE similar to this, or as to which the statute of limitations has oreviouslv othenwise expired. THE FOLIJWING APPROVALS REQUIRED PRIOR TO PERMrr ISSUANCE: QPLANNING •ENGINEERING nBUILDING QFIRE nHEALTH •HAZMAT/APCD PlanCheckNo. CMl^DSfL Est. Value ^ CITY OF r ARI SBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax:760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov I Plan Ck. Deposjt SWPPP JOB ADDRESS ' L6T# ^ TPHASE# SUITE#/SPACE#/UNIT# CT/PROJECT # # OF UNITS I # BEDROOMS # BATHROOMS TENANT BUSINESS NAIVIE CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: /nc/ude Square Feet of Affected Area(s) ^J^?]x^•^vdrm<:& 4 \\Y/^ EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YESi~|# NOj I AIR CONDITIONING YES I INO I I FIRE SPRINKLERS YES I |NO| I APPLICANT NAIVIE (Primary ContactX APPLICANT NAME (Secondary Contact) ADDRESS ADDRESS CITY STATE ZIP FAX EMAIL PROPERTYOWNER NAME CONTRACTOR BUS. NAME CITY^ ^ ADDRESS >f> qg^- ^-90 EMAir cirri '"7/fi-i'-ll-S>faO ARCH/DESIGNER NAME & ADDRESS (Sec. 7031.5 Business and Professions Code: Any City or County wiilcii requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicantfor such permit to file a signed statement that he is licensed pursuantto the provisions ofthe Contractor's License Law (Criapter 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 applicantfor a permitsubjects the applicant to a civil penalty of not more than five hundred dollars ($500)). Woriters' Compensation Declaration: / hereby affimi under penalt/ o! perjury one ofthe foilowing deciarations: I have and will maintain a certificate of consent to self-insure for woriters' compensation as provided by Section 3700 of the Labor Code, for tlie perfomiance of the work for which this permit is issued. Have and will maintain wodters' comiif nsation, as required bisection 3700 of the Labor Code, for ttie perfonnance of the worit for which this permil ifgsued. My woriters' compensationjnsjiance catjier jndj number are: Insurance Co Expiration Date _ vvuiners CJl Ha ion insurance earner and policy This section need not be completed if the permit is for one hundred dollars ($100) or less. I I Certificateof Exemption: I certify that in the performance ofthe worit for which this permitis issued, I shall not employ any person in any manner so as to become subjectto the Woriters' Compensation Laws of Califomia. 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 compensa}ioai (lynag^ as provided for in Section 3706 of the Labor code, interest and attomey's fees. /fiT CONTRACTORS AGENT DATE i hereby affirm that i am exempt fmm Contractor's Ucense Law for the following reason: I I I, as owner of Ihe property or my employees with wages as their sole compensation, will do the worit and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: Tiie Conlractor'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). I I 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 properfy who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). • 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 improvemenl •Yes 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 (fimi) to provide the proposed constaiction (include name address / phone / contrxtors' license number): 4.1 plan to provide portions of the work but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone / contractors' license number): 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): PROPERTY OWNER SIGNATURE QAGENT DATE Is the applicant or future building occupant required to submit a business pian, 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 (he applicant or future building occupant required lo obtain a permit from the air pollution control district or air quality management districf? Yes No Is the facility to be constrocted within 1,000 feet of the outer boundary ot 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. 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 I certify that I have read the appllcatkin and state thatthe above intbmiation is conect and that the intbmiation on the plans is accurate. I agree to complywith all Cily oidinances and State laws relating to building construction. I hereby authorize representative of the City of Cailsbad to enter upon the above mentioned property for inspection purposes, I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CffY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSH A: An OSHA pemiit is requined for excavations over 5'0' deep and demolitbn or constmctton of structures over 3 stories in height. EXPIRATION: Every pemiit issued by the Buiiding Ofiicial under the provistons ofthis Code shall expire by limitatton and become null and void ifthe building or v/oik authorized by such permit is not commenoed within 180 days from the date of such pemiit or if the building or wortt authorized by such pernilt Is suspended or abandoned at any time after the woilt is commenoed for a period of 180 days (Sectton 106.4.4 Unifomi Building Code). vfiS"APPLICANT'S SIGNATURE DATE STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. Fax (760) 602-8560, Email buildina®carlsbadca.QOV or Mail the completed fonn to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, Califomia 92008. C0#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAILTO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAIL / FAX TO OTHER: ASSOCIATED CB#- NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION ^APPLICANT'S SIGNATURE DATE Inspection List Permit*: CB140516 Type: PME SCAGLIONE RES- REPLACE FAU Date Inspection Item 09/15/2014 43 AirCond/Furnace Set 09/15/2014 43 AirCond/Furnace Set 09/15/2014 49 Final Mechanical 09/15/2014 49 Final IVIechanicai Inspector Act Rl MC MC AP Rl Fl Comments 2-4 (PLS HAND DELIVER INSPECTION RECORD CARD 2-4 (PLS DELIVER INSPECTION RECORD CARD) Tuesday, September 16, 2014 Page 1 of 1