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Home My WebLink About2649 VANCOUVER ST; ; CB043770; PermitCL . \ L \ YV~ C;!,!~.y~! ~~;!.~.~!~2008 10-05-2004 Plumbing Permit Perm it No: CB043770 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 2649 VANCOUVER ST CBAD PLUM 167 4420800 Lot #: 0 Construction Type: NEW Status: Applied: Entered By: Reference #: Plan Approved: Project Title: Applicant: CRESS RES-COPPER RE-PIPE & MAI N WATER SERVICE UL Tl MATE PLUMBIN G 12746 QUAIL LN 90650 562-462-9228 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 1 0 0 0 Owner: CRESS DONNA L 2649 VANCOUVER ST CARLSBAD CA 92008 Issued: Inspect Area: ISSUED 10/05/2004 RMA 10/05/2004 10/05/2004 $20.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $33.00 $0.00 $0.00 $0.00 $60.00 Total Fees: $60.00 Total Payments To Date: $0.00 Balance Due: $60.00 2548 10/05/04 0002 01 CGp Inspector: ~ FINAL APPROVAL Date: JI-pf-otj Clearance: 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 E similar to this r as to which he ired. 02 60 .. 00 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1. PROJECT INFORMATION 1 / 16 L/'t /rt4tJ caver-r-1. Address (include Bldg/Suite II) Business Name (at this address) B, Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total II of units Assessor's Parcel II Existing Use Proposed Use Description of Work .. SQ. FT. II of Bedrooms 'I' II of Bathrooms 2. CONTACT PER9aNe;,ee~m a~f,/ f ~ ':I All\.~ J4,eu/ML- Name Address City State/Zip Telephone II Fax II 3. Agent for Contractor O Owner O Agent for Owner Name Address City State/Zip Telephone II 4. PROPERTY OWNER ;t;..n on 4 CC< ,rf State/Zip -'76o. 1 :JO ~oo1< Telephone II Name Address City 6. CONTRACTOR • COMPANY NAME (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 Any violation of Section 703,1 .5 by any applican for a permit subjects the applicant to a civil penalty of not more than five hundred dollars I $5001). ·>4-$ L r..£,L ~ ~ I~ ,r:.. oJ'2-- City JI'->-Id I "1~tate/Zip Tele'Jone II l!K' License Class (!_ 13 b City Business Lfoens~0i-C/ I 601 ;;_j (J ..7 ;{_ '-f Designer Name Address City State/Zip Telephone State License II _________ _ 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 f th work for which this permit is issued. I have and will maintain "".ork~rs' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is d. My worker's c~"?"ensatton insurance carrier and pohcy number are: Insurance Company VLf1tlJ tA ½l'-L--f':z_ PolicyNo.Qo.£ Ooo/4 'f..f:: Expiration Date "'lo~ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS foR ONE HUNDRED DOLLARS [$1001 OR LESS! ~ 1 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' Compensati ws of California. WARNING: Failure to secure worker • thousand dollars ($100,000). in a SIGNATURE. _____ -,,L,.L-, ion coverage is unlawful, and shall subject. an employer to criminal penalties and civil fines up to one hundred o~t of compensation, damages as provided for in Section 3706 of the Labor c9de, in~ and attorney's fees. DATE Siip-/LJ • , C "7 7. m the Contractor's License Law for the following reason: D such work him sold within on ty or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale rofessions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does ough his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is ar 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 ow er 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 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. 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 number/ 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 number / type of work):. ____________________________________________________________ _ PROPERTY OWNER SIGNATURE ______________________ _ DATE __________ _ COMPLETE THIS 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 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 site 7 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. 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 Citt 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 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 5'0" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the building O nder 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 commenced within ays from the date ol such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a pe • of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE __ ;_o_·_r_· _c--4Y'------ WHITE: File YELLOW: Applicant PINK: Finance ~· '17 City of Carlsbad Bldg Inspection Request For: 11/24/2004 Permit# CB043770 Title: CRESS RES-COPPER RE-PIPE & Description: MAIN WATER SERVICE Type: PLUM Sub Type: Job Address: 2649 VANCOUVER ST Suite: Lot O Location: APPLICANT ULTIMATE PLUMBING Owner: CRESS DONNA L Remarks: am please Total Time: ""' 5' .1 CD Description Act Comment 24 Rough/Topout i!/_ f'twn-~- Associated PCRs/CVs Inspection History Date Description Act lnsp Comments oFf Inspector Assignment: Phone: 8185058032 Inspector: t3AJ • Requested By: UL TIM ATE PLUMBING Entered By: CHRISTINE e-o u. i.J