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Home My WebLink About1422 TURQUOISE DR; ; CB033016; Permitc~ City of Carlsbad • ~ )~ ~ 1635 Faraday Av Carlsbad, CA 92008 05-0'6~2004 ~DN--.c.f.O\_CA.,, Plumbing Permit Permit No: CB033016 f \' ' Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 1422 TURQUOISE DR CBAD PLUM Status: Parcel No: 2121902900 Lot#: 0 Applied: Construction Type: NEW Entered By: Reference #: Project Title: ARREOLA RES-GAS TO BBQ & FIRE PIT/ ELEC FOR LIGHTING AN D BBQ Applicant: ARREOLA RUBEN S&DIANNA L 1422 TURQUOISE DR CARLSBAD CA 92009 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Drain Install/Repair Water Line Water Heater and/or Vent Gas Piping System Vacuum Breaker Other Plumbing Fees Master Drainage Fee Sewer Fee Additional Fees TOTAL PERMIT FEES 0 0 0 0 0 1 0 Plan Approved: Issued: Inspect Area: Owner: ARREOLA RUBEN S&DIANNA L 1422 TURQUOISE DR CARLSBAD CA 92009 ISSUED 11/03/2003 RMA 11/03/2003 11/03/2003 JM $20.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $43.50 $0.00 $0.00 $0.00 $70.50 Total Fees: $70.50 Total Payments To Date: $47.00 Balance Due: Inspector: Fl NAL APPROVAL Date: Clearance: $23.50 NOTICE: Please take NOTICE that approval of your project includes the "Imposition' of fees, dedications, reservations, or other exactions hereafter collectively referred 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 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 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK No.QI/J J Cd b CIT-Y OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. __________ _ Plan Ck. Depos.it ,?r Validated By_,__ ------''--L""/'--~.,__,t--__ _ Date Jr{]/@ rJ 1. PROJECT 1"-'FORMATION lA Address (include Blog/Suit ac1 (_ Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units 2. CONTACT PERSON (If different from.applicant) " Name Address 3. ~PPLICANT .0 Contractor O Agent for Contractor O Owner Address ame Address 6. CO_NTRACTOR • COMPANY NAME City 0 Agent for Ow ner City State/Zip Telephone # Fax # State/Zip Telephone# State/Zip Telephone # (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 t o its issuance, also requires the applicant 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 the 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)). Name Address City State/Zip Telephone# State License # __________ _ License Class ----------City Business License # _______ _ Designer Name Address City State/Zip Telephone State License # __________ _ 6 . WORKERS' COMPENSATIOI"{ Workers' Compensation Declaration: I hereby 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' compensat ion as provided by Section 3700 of the labor Code, for the performance of the work for which this permit is issued. 0 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 worker's compensation insurance carrier and policy number are: Insurance Company ______________________ Policy No._____________ Expiration Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100] OR LESS) 0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which t his 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' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,0001, In addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE______________________________ DATE OWNEfl0 BUILDER DECLARATION --::::=:-==::::::;:;;:;;::=:;::;;-: hereby affirm t hat I am exempt from the Contractor"s License l aw for the following reason: 151:1 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 @c. 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). D 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 O 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 number / contractors license number): 4. =--..:· 1,,.....,rnv"'(lired the following person to coordinate, supervise and provide the major work (include name / address / phone number / contractors license n I will provide some of the e following persons to provide the work indicat ed (include name / address / phone number / type f work): _________ +---7''----->~'-----.....:;11.r--------------------------------------- ROPERTY OWNER SIGNATURE _::~i:==~-,'ll\--:,_,.._o:::::, __ +-----------DATE 11-03=03 COMPLEJE THIS SECTION FOR NON-RESIDE. 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 25634 of the Presley-Tanner Hazardous Substance Account Act? 0 YES O 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 O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O 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. (8. QO~STRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME ______________ _ LENDER'S ADDRESS ________________________ _ t9. APPLICANT CERTIFICATION I certify t hat I have read the application and 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 representatives of the Citt of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST All LIABILITIES, JUDGMENTS, COSTS AND E S WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEOl!ENCE OF THE GRANTING OF THIS PERMIT. EXPIRATION: Every aulhorized by such pe at any time after the w and demolition or construction of struct ures over 3 stories in height. provisions of this Code shall expire by limitation and become null and void if the building or work ate of such permit or if the building or work authorized by such permit is suspended or abandoned lion 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE -~~-.;::,::=-+-~===-----:-f--------------DATE //-03 -03 YELLOW: Applicant PINK: Finance