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HomeMy WebLinkAbout1121 SCRUB JAY CT; ; CBR2019-1406; Permit(city of Carlsbad Residential Permit Print Date: 09/18/2019 Permit No: CBR2019-1406 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: 1121 Scrub Jay Ct BLDG-Residential 2145800610 $0.00 Work Class: P/M/E Lot#: Reference#: Construction Type: Bathrooms: Orig. Plan Check#: Status: Applied: Issued: Permit Finated: Inspector: Closed -Finaled 06/05/2019 06/05/2019 Plan Check#: Final Inspection: 9/18/2019 10:44:43AM Project Title: Description: DAILEY: REPLACE A/C AND FAU Owner: Contractor: TRUST DAILEY ANITA J FAMILY 1121 Scrub Jay Ct ACTION AIR CONDITIONING HEATING AND SOLAR CARLSBAD, CA 92011 PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT Total Fees: $175.00 Total Payments To Date: $175.00 2750 S Santa Fe Ave San Marcos, CA 92069-5928 760-727--4152 Balance Due: 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 sim!lar 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. $0.00 1635 Faraday Avenue, Carlsbad, CA 92008-7314 I 760~602-2700 I 760-602-8560 f I www.carlsbadca.gov $175.00 • (_ City of Carlsbad RESIDENTIAL BUILDING PERMIT APPLICATION 8-1 Plan Checkce£.")ofj -Jt//Ya Est. Value PC Deposit -~------- Date ~6~-~s_-~L~? __ Job Address__._\_..\ ..,2c.1.l __ S ...... c..1.r_,,y,..b-..l.J,C......,J--(---=·.:...\-___ ---'Suite: ____ APN: ________ _ CT /Project#: __________ Lot#:. ____ Fire Sprinklers: yes/ no Air Conditioning: yes / no BRIEF DESCRIPTION OF WORK: ½~\~c. E,.. fl, Jc r,..,..J tW □ Addition/New: _____ Living SF, ____ Deck SF, ____ Patio SF, ____ Garage SF Is this to create an Accessory Dwelling Unit? Yes/ No New Fireplace? Yes/ No, if yes how many? __ D Remodel: _____ SF of affected area Is the area a conversion or change of use? Yes/ No 0 Pool/Spa: ____ SF Additional Gas or Electrical Features? ---------~--- □ Solar: ___ KW, ___ Modules, Mounted: Roof/ Ground , Tilt: Yes/ No, RMA: Yes/ N_o, Battery: Yes/ No Panel Upgrade: Yes/ No D Reroof: ------------------------------------- □ Plumbing/Mechanical/Electrical Only: _________________________ _ D Other: ___________________________________ _ APPLICANT (PRIMARY CONTACT) PROPERTY OWNER Name: ['! A:c,,\.. E',\,,,,....,,,...._ Name: k,'t"' QlJ\.; l~;:t Address: ':)H,Z.'i W-~t""J"" 0< · j"z~~ Address: 711,<> 'll"{ · C..-7~(., City: W~')\-1,..,1,<.e State: U,.. Zip: ;\f-;L;l..,. City: (, .... .rl',1:>Q..4 State: C..f> Zip: 9 7 o c1 Phone: )l"5---,;i;-·1i71,-Phone: lloO -115( ·· C,,]')l, Email: __________________ Email: ____________________ _ DESIGN PROFESSIONAL Name: _________________ _ Address: ________________ _ City: _______ State: __ --'Zip: ___ _ Phone: _________________ _ Email: _________________ _ Architect State License: ___________ _ CONTRACTOR BUSINESS Name: l::.ct-""" S,. k • Address: 2-"'l')O S. s ..... ,.,.. City: 5 ...... !"\,,-«. "'':. State: Phone: "11,,0-1'2-1-'11;, Email: f'e \'-,..,_ U' Zip: _,9,._.'2=0.ui'i~"l __ _ mo~ oo39tJ9- State License: Soci ~O'S sus. License: ______ _ (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 the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's license Law {Chapter 9, commending with Section 7000 of Division 3 ofi:he Business and Professions Code} or that he/she 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 {$500}). 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov B-1 Page 1 of 2 Rev. 06/18 ( OPTION A): WORKERS'COMPENSATION DECLARATION: I hearby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain a certificate of consent to self•insure for workers' compensation provided by Section 3700 of the labor Code, for the performance of the work which this permit is issued. r;fit,,ve and will maintain worke(s compensation, as required by Section 3700 of the Labor Code, for th~erformance of the work for which lh!s permit is issued. My workers' comp~_§ati,qn l11surance carrier and policy number are: Insurance fJ:fflpany Name: -::r .. ,$. (_ ,o c,{ -:l\v vJ~~ \~ Polley No. VSv"..,(J lit ,IP c., Expiration Date: _.\-z,"1"/l"4+'-~.._ ____ _ 0 Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to be come subject to the workers' 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 $100,000.00, In addition the to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. !~-✓,;- CONTRACTOR SIGNATUR~ ~GENT DATE: ~/~,I '!i ( OPTION B ): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt from Contractor's License Law for the following reason: □ 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'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, 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. D Yes D No 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/ 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/ address/ phone/ contractors' license number): 5. I 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): OWNER SIGNATURE: _________________ □AGENT DATE: _____ _ CONSTRUCTION LENDING AGENCY, IF ANY: I hereby affirm that there is a construction lending agency for the performance of the work this permit Is issued (Sec. 3097 {I) CMI Code}. Lender's Name: ___________________ _ Lender's Address: ___________________ _ ONLY COMPLETE THE FOLLOWING 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 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 occupant 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 ~et 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. APPLICANT CERTIFICATION: I certify that I have read the application a11d state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representative of the Qty of Carlsbad 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 UABlllllES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.OSHA: An OSHA permit is required for excavations over S'O' deep and demolition or construction of structures over 3 stories in height EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is not oommenced within 180 da~ the date of such pennit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a peri of da~ ection 106.4.4 Uniform Building Code). ::;___ __________ DATE= /p/ s( h 1635 Faraday Ave Carlsbad, CA 92008 8-1 Ph: 760-602-2719 Fax: 760-602-8558 Page 2 of2 Email: Building@carlsbadca.gov Rev. 06/18 Pcrrru! Type: BLDG-Residential Application Date: 06/05/2019 Work Cla!;s; P/M/E Issue Date: 06/05/2019 Status: Closed -Finaled Expiration Date: 03/16/2020 Scheduled Date Actual Start Date 09/18/2019 09/18/2019 September 18, 2019 IVR Number: 19521 Inspection Type Inspection No. BLDG-43 Air Cond./Furnace Set 104499-2019 BLDG-Final Inspection Checklist Item BLDG-Building Deficiency 104498-2019 Checklist Item BLDG-Plumbing Final BLDG-Mechanical Final BLDG-Electrical Final Inspection Status Passed COMMENTS Passed COMMENTS Owner: Subdivision: Address: Primary Inspector Peter Dreibelbis Peter Dreibelbis TRUST DAILEY ANITA J FAMILY CARLSBAD TCT#92-02(8) PARKSIDE 1121 Scrub Jay Ct Carlsbad, CA 92011-2526 Re inspection Passed Yes Passed Yes Yes Yes Complete Complete Complete Page 1 of1