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Home My WebLink About2611 VIA ECO; ; CB052944; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 08-11-2005 Plumbing Permit Permit No: CB052944 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: 2611 VIA ECO CBAD PLUM 1673004300 Status: Lot #: 0 Applied: Construction Type: NEW Entered By: Plan Approved: Issued: Project Title: CUMMINGS RES REPLACE H2O HEATE Inspect Area: Applicant: CALIFORNIA DEL TA MECHANICAL SUITE# 27 12440 OAK KNOLL RD 92064 866-898-0008 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 1 0 0 Owner: PEMBERTON LINDA G 200 BRIGHT CREEK LN OCEANSIDE CA 92056 ISSUED 08/11/2005 KG 08/11/2005 08/11/2005 $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 Total Fees: $27.00 Total Payments To Date: $0.00 Balance Due: $27.00 Inspector: EXPIRED PERMIT PERMIT HAS EXPIRED IN ACCORDANCE WITH C.B.C. SECTION 106.4.4 AS AMENDED BY C.M.C.18.04.030568 DATE '43\' lo~ s1GNATURE_~Q~Y,Q,A.A},__ __ _ FINAL APPROVAL Date: Clearance: 08/ ... 1/05 0002 01. CGP 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 f x i n f whi r vi I n iv n N Tl hi r whi h h r vi I h rwi ')2 ?.7,00 FOR OFFICE USEAN~?l)tj;/ PLAN CHECK I\JO.~,,.__~....\L..-....:~-•v/ _ __c_7 PERMIT APPLICATION EST. VAL. __________ _ CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Plan Ck. Deposit H4--------- Validated By ---.hY.'6~-l-7----,,,.::::;;,..-,,,:.:___ Date -----F----""----1-L--=-=---- 1. PROJECT INFORMATION "1&/1 VIA-e:-CIP Address (indude Bldg/Suite#) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. T otat # of units Proposed Use # of Bedrooms # of Bathrooms 2. CONTACT PERSON {If different from applicant) c: A: L , Er? RA! 16 7) a -rA ME cJ1&(J I CA-L Name Address City 3. APPLICANT rs/. Contractor □ Agent for Contractor D Owner r;;AIZ,Y ,4;1..¥V f,-,1.3.S-,f/"ANR ,IJ,VE, s:?'/!.1Nt; Name Address City Sfate/Zip Telephone# 4. PROPERTY OWNER CIJHHIAI;~ 41#'-A £ti/ 1 Address Name VIII-EaJ City ~ SM/) . cA 9o?aJJ? State/Zip' Telephone# 5. 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 ,ts issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractors License Law [Chapter 9, commending with Section 7000 of Oivision 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 or a pe'.mit subjects pplicant to a dl(il penalty ~f not more than five hundr~ dollars ~5001). J # o. , :> ,., C'l. , . ~/l.l. . ·~ ., • SGO S: • cc.,.-1,-{./0-r ,"C-i v ·/4~ ,.;>...,. C->-' c,. Address City State/Zip Telephone % ,1 j ( ] 4 License Class C , . ..-?2 b City Business License# _________ _ Designer Name State License # ---"g_.'_.1_1._.,\ _,\1-, 4::_.__ Address City State/Zip Telephone# 6. WORKER'S COMPENSATION Workers' Compensation Oedaration: I hereby affirm under penalty of perjury one of the following dedarations: □ 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. }iL. I have and will maintain worker's compensation, as required by Section 3700 of the labor Code, for the performance of the work for which t is permit is issued. My ~~ 2 fl Insurance Compan +.+'cC.l....!..3-..:'"'3«..:..:..>f,L-1..!...'e....L..::_µd.!Lll.:! Policy No. ,( "Cf 3:::8'2.. -J Expiration Date __ _,___.__,__,O'-o-C-· ---- (THIS SECTION N IT IS FOR ONE HUNDRED DOLLARS [$100) OR LESSI □ CERTIFICA rformance of the work for whieh this permit is issued, I shall not employ any person in any manner so as to become subject tot alifornia. WARNING: Failure verage is unlawful, and shall subject an employor to criminal penalties and civil fines up to one hundred thousand dollars($100,000), i , damages are provided for in Section 3706 of the Labor Code, interest and attorney's f••z· . / SIGNATURE. __ 1-71~».f-+-':::__-.\--------------------DATE r-LVl/11.S- 7, OWNER-B µ~"'-"''iA I / I hereby affirm tha the Contractor's lJcense Law for the following reason: □ I, as owne r my employees with wages as their sole compensation, will d the work and the structure is nOI intended or offered for sale (Sec. 7044, Business and Professions Code: T e Contractors 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 Contractors License Law does nol apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractors Ucense 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. □ YES □ NO 2. I (have/have no!) 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 (indude name I 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 (indude name/ address/ phone number/ /ontractors license number): ----------------------------------------------- 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (indude name I address/ phone number/ type of work): PROPERTY OWNER SIGNATURE ___________________________ DATE----~~------ WHITE: File YELLOW: Applicant PINK: Finance PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Page 2 of 2 COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a business plan, acutely hazardous matenals registration for or nsk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account A&? □ YES □ NO Is the applicant or future building occupant required to obtain a permit from the air pollution control distnct or air quality management district? □ YES □ NO Is the facility to be constructed within 1,000 feet 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 ANO THE AIR POLLUTION CONTROL DISTRICT. 8.. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a consi'ruction lending agency for the performance of the work for which this permit Is issued (Sec. 3097(1) Civil Code). LENDER'S NAME __________________ _ LENDER'S ADORES$ ___________________ _ 9 .. ·· APPLICANT CERTIFICATION I certify that I have read the application and state that the above information ,s 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 City 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, JUDGEMENTS, 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 of 5'0" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the building Officia under t~ provisions of lhis Code shall expire by hm1tation and become null and v01d if the building or work authonzed by such permit Is not commenced within 180 days fro e date of uch permit or 1f the bwlding or work authonzed by such permit Is suspended or aidoned at any time after the work ,s commenced for a period of 0 days S on 106.4.4 ,form Building Code). , APPLICANT'S SIGNATURE , DATE -~--r-----r--------- WHITE: File YELLOW: Applicant PINK: Finance