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Home My WebLink About2253 VISTA LA NISA; ; CB001202; PermitCity of Carlsbad 03/30/2000 Plumbing Permit Permit No:CB001202 Job Address: Permit Type: Parcel No: Reference #: Project Title: Applicant: SIERRA MESA Building Inspection Request Line (760) 602-2725 2253 VISTA LA NISA CBAD PLUM 2552701800 Lot#: 0 Construction Type: NEW GAS LINE TO BBQ & FIRE PIT ELEC LINE TO FUTURE SPA Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: LEBLANC ROCKY ISSUED 03/30/2000 JM 03/30/2000 03/30/2000 917 HAWTHORNE CARLSBAD CA 92009 760-632-6211 2253 VISTA LA NISA CARLSBAD CA 92009 2856 03/30/00 0001 01 02 Total Fees: $47.00 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 TOTAL PERMIT FEES In spector Total Payments To Date: Date: Balance Due: Clearance: $20.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $20.00 $0.00 $0.00 $47.00 C-PRMT 47-00 $47.00 NOTICE: Please take NO E that approval of your project includes the 'Imposition' of fee , 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 capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which ou have reviousl been iven a NOTICE similar to this or as to which the statute of limitations has reviousl otheiwise ex ired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 PERMIT #APPLICATION FOR OFFICE USE ONLY, PLAN CHECK NO. ())--(WV CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. __________ _ Validated By_;:-~~---=-+=--:-t'-:-- Date. __________ -'-"_,_.~ ....... .....,.~- 1. PROJECT INFORMATION ci,;i_ 53 Vt S-TA Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Proposed Use S . FT. #of Stories # of Bedrooms # of Bathrooms ~ L.1.J~ E.Lt:: 110 1/ol.,,T .,_ a.:io 2. CONTACT PERSON (If different from applicant) P-6~ :;'o f\..,~ ~· Name Address City State/Zip Telephone# Fax# 3. APPLICANT 1ZJ Contra.ctor O Agent for Contractor O Owner . 0 Agent for Owner ,3JGR.,Jt-A-M £S ~ l.t>r-J , 911 /J-AWW6i4,J€.. IJ.J~. CQ{l+.-,W,.oi) Name Address City I State/Zip Telephone# 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 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). S!,,,Gk(k@-f-.-11! >f?1 9 1 ] J..JQ,,J[ J.Jbt.l{ JW~ $ , 19: 8 # 3. ½ 3 '--<.. 2...U Name Address /1 City State/Zip Telephone # State License # S9 0 ~ S: g License Class '----)_ 7 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: ~ I have and w ill 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 ..;y-,,tY'Cc P,hv ;) Policy No. /2.3 s -q " Expiration Date Co,-.111,-(r>-J':) (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100) OR LESS) O 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. _______________________________ _ 7. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: O I, as owner of the property or my employees with wages as their sole compensation, will do the work and the struct ure 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 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). O 1, 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 O NO 2. I (have / have not) signed an application for a building permit for the proposed work. 3. 1 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-RESIDENnAL 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 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, 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 1 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 ANO 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 permil issued by the building Official under the provisions of this Code shall expire by limitation and become null and void ii the building or work authorized by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is comme for a perio 80 d s (Section 106.4.4 Uniform Building Code). DA TE M r>1\. YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 9/7/2000 Permit# CB001202 Title: GAS LINE TO BBQ & FIRE PIT Description: ELEC LINE TO FUTURE SPA Type:PLUM Sub Type: Job Address: Suite: 2253 VISTA LA NISA Lot 0 Location: APPLICANT SIERRA MESA Owner: LEBLANC ROCKY Remarks: Total Time: Inspector Assignment: PY --- Phone: 7606326211 Inspector: ----- Requested By: N/A Entered By: ROBIN CD Description Act Comments 29 Final Plumbing ~----- Associated PCRs Inspection History Date Description Act lnsp Comments 8/3/2000 29 Final Plumbing co PY NEED SHUT OFF VALVE@ BBQ 4/4/2000 21 Underground/Under Floor WC PY 4/4/2000 23 Gas/Test/Repairs AP PY OK TO COVER 3/31/2000 21 Underground/Under Floor co TL SEE ATTACHED NOTICE 3/31/2000 23 Gas/Test/Repairs co TL NEEDS AT LEAST 10 PSI 3/31/2000 31 Underground/Conduit-Wiring AP TL CONDUIT ONLY