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Home My WebLink About2710 UNICORNIO ST; ; CB023154; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 10-21-2002 Plumbing Permit Permit No: CB023154 Job Address: Permit Type: Parcel No: Reference #: Project Title: Building Inspection Request Line (760) 602-2725 2710 UNICORNIO ST CBAD PLUM 2153505300 Lot#: 0 Construction Type: NEW JOHNSTON RES REPAIR GAS LEAK Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 10/21/2002 SB 10/2 1/2002 10/21/2002 Applicant: JOHNSTON MARTIN P&ANDREA J JOHNSTON MARTIN P&ANDRW}-:3 .10/2l /02 0002 0l 02 2710 UNICORNIO ST CARLSBAD CA 92009 Total Fees: Plumbing Issue Fee Fixture or Trap Building Sewer Roof Drain $27.00 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 2710 UNICORNIO ST f"GP Tr .oo CARLSBAD CA 92009 - Total Payments To Date: 0 0 0 0 0 1 0 $0.00 Balance Due: $20.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 $27.00 r PERMIT APPLICATION FOR OFFICE USE ONLY PLAN CHECK No.C~o1-3 ~~ CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. _________ _ Plan Ck. Deposit....,,,,.,77...,.. _______ _ Validated B-<,~S::::.....,,;;;D'--------- Date (DI Z I l 61 b 1. PR9.,IECT INFORMATION , I 9--71 o L)vJ ;c..orr'-' ,o s;T, Address (include Bldg/Suite #) Cj1Do9 Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Existing Use Proposed Use ct V. Description of Work SO. FT. #of Stories # of Bedrooms # of Bathrooms 2. CONTACT PERSQl':,I (lLd!fterent fJom lll!Pllc11ntl Name 3. APPLICANT O Contractor ~ ame . PROPERTY OWNER °'-../-f I ',A) Address ame Address 6. CONTRACTOR • COMPANYNAM~ City 0 Owner O Agent for Owner City City State/Zip Telephone# Fax# State/Zip Telephone# S.tate/Zip (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 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 ($5001). Name Address City State/Zip Telephone# State License # _________ _ License Class _________ _ City Business License # _______ _ Designer Name Address City State/Zip Telephone State License # _________ _ 6. WORKERS' COMPENSATION 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' compensation 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 [$1001 OR LESS) 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 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 ($100,000), 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 7. OWNER-BUILDER DECLARATION ·=====::::===::;;::=;:;;;;=. _____ ~--- < I h~by affirm that I am exempt from the Contractor's License Law for the following reason: )gJ 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 improverwents 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 ofsproving 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. 0 YES ONO 2. I (have / have notl 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 I phone number / contractors license number): 4. I plan to provide portions of the work, but I have hired the folio person to coordinate, supervise and provide the major work (include name / address I phone number/ contractors license numberl=-----.,..---,,--,:,.....,--+,p-=--------------------------------- 5. I will provide some of the work, but I have ons to provide the work, indicated (include name / address / phone number / type of work!: ;(J. PROPERT,_Y_O_W_N_E_R_S-IG_N_A_T_U_R_E -:;.,,,,.:,_ 7,;/t,TJ.Qep~t:::::::-"""'::::::::=--__::,,,."'" _____ D_A_T_E===/~0~~~:~:1~ro_:__-;-'2--~==------- rcoMPLETE THIS SECTION FOR NON-RESIDENTIAL B Is the applicant or future building occupant required to ubmit a busi ess plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Pre -Tanna Hazardous Substance Account Act7 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 site7 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 ANO THE AIR POLLUTION CONTROL DISTRICT. 8. CONSTRUCTION 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. ________________________ _ 9. APPLICANT CERTIFICATION I certify that 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 Cit\' 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 LIABILITIES, JUDGMENTS, COSTS ANO 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 5'0" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the b 'ldi g Official under t e R ions of lhis Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenc it n 1 0 elate of such permit or it the building or work authorized by such permit is suspended or abandoned I\ ft any time after the work is comma~ d o 180 ction 106.4.4 Uniform Building Code). { { l tx APPLICANT'S SIGNATURE _..cz..y.~=--~~::::::::::::-:;;;?4::::=).~::::--::;::.,.,.----:-------DATE O t 1._.( _ Q 1,..-- PINK: Finance