eTRAKiT Permit

CITY OF OCEANSIDE
DEVELOPMENT SERVICES
300 N COAST HIGHWAY, City of Oceanside CA 92054
BUILDING INSPECTIONS (760) 435-3925

Applied Date:	7/18/2018
Expiration Date:
Permit No:	BLDG18-2319
Permit Type:	BLD RESIDENTIAL PME

Site Address:

4191 ARCHWAY LN 24 OCEANSIDE

Site APN:

1580701700

Subdivision:

Site Block:

Site Lot:

Valuation:

$500.00

Site Tract:

Permit Status:

FINALED

Description of Work:

INSTALL 3/4" GAS LINE FOR FIRE PIT, INSTALL U/G 1" ELECTRICA


Contractor:	CREATIVE CONSTRUCTION GROUP
Address:	209 THIRD AVE, STE 6 CHULA VISTA CA 91910
Phone:	(619) 520-4348

Technical Information:

Caption	Value
PLAN ID #
PERMIT #
BIN #
SPRINKLER
REDEV AREA
HOT WATER CONSERVATION
FLOOD ZONE	X
COASTAL ZONE
OCC GROUP	R3
TYPE CONST	VB
USE CODE	025
EXISTING BLDG SF
OCC LOAD
UNITS	0
STATE CODE EDITION	2016
BLDG SF	0
NO STORIES	0
ELECTRIC RELEASED BY
NOTIFIED SDGE BY
DATE ELECTRIC RELEASED	12:00:00 AM
ELECTRIC RELEASE TYPE
TYPE OF BUILDING
GAS RELEASED BY
NOTIFIED SDGE BY
DATE GAS RELEASED	12:00:00 AM
GAS RELEASE TYPE
WDID #


Owner:	SLV CA 1, LLC
Address:	310 COMMERCE, SUITE 150 IRVINE CA 92602
Phone:	(714) 782-4271

WORKERS COMPENSATION DECLARATION

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 AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
____ I have and will maintain a certificate of consent to self-insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
Policy No.
____ I have and will maintain workers' compensation insurance, 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:
Carrier: Policy Number: Expiration Date:
____ 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 become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.

LICENSED CONTRACTOR'S DECLARATION

I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.
License No: Expiration Date: Contractor: Class:

Inspections:

Type	Result	Date	Inspector
**920F FINAL	PASS	8/9/2018	CHRIS BABCOCK
415 PLB UNDERGROUND	NO INSPECTION	7/20/2018	CHRIS BABCOCK

Fees:

Description	Amount	Receipt #	Paid Date
RETURNED CHECK	$1.00	PR1406	07/30/2018
RETURNED CHECK	$31.84	PR1406	07/30/2018
RETURNED CHECK	$183.61	PR1406	07/30/2018
RETURNED CHECK	$18.36	PR1406	07/30/2018
RETURNED CHECK	$3.67	PR1406	07/30/2018
RETURNED CHECK	$8.00	PR1406	07/30/2018
RESIDENTIALSIMPLE MPE PLAN CHECK	$31.84	874506	08/08/2018
RESIDENTIAL SIMPLE MPE PERMIT	$183.61	874506	08/08/2018
MPE GEN PLAN UPDATE-SIMPLE	$18.36	874506	08/08/2018
PERMIT TECHNOLOGY SURCHARGE- SIMPLE	$3.67	874506	08/08/2018
PERMIT IMAGING SURCHARGE	$5.00	874506	08/08/2018
PLAN IMAGING SURCHARGE	$3.00	874506	08/08/2018
BLD-SB 1473 GREEN TAX	$1.00	874506	08/08/2018
RETURNED CHECK FEE	$25.00	874506	08/08/2018
BLD-SB 1473 GREEN TAX	$1.00	856649	07/18/2018
RESIDENTIALSIMPLE MPE PLAN CHECK	$31.84	856649	07/18/2018
RESIDENTIAL SIMPLE MPE PERMIT	$183.61	856649	07/18/2018
MPE GEN PLAN UPDATE-SIMPLE	$18.36	856649	07/18/2018
PERMIT TECHNOLOGY SURCHARGE- SIMPLE	$3.67	856649	07/18/2018
PERMIT IMAGING SURCHARGE	$5.00	856649	07/18/2018
PLAN IMAGING SURCHARGE	$3.00	856649	07/18/2018

TOTAL FEES:	$271.48
TOTAL FEES PAID:	$271.48
TOTAL FEES DUE:	$0.00

*BLDG18-2319*