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Home My WebLink About2162 VISTA LA NISA; ; CB110841; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 04-22-2011 Plumbing Permit Permit No: CB110841 Building Inspection Request Line (760) 602-2725 Job Address: 2162 VISTA LA NISA CBAD PLUM Status: Permit Type: parcel No: 2552621600 Lot ~ 0 Applied: Construction Type: NEW Entered By: Reference #: Plan Approved: Issued: PC#: -Project Title: YAGI RES-REPLACE WATER HTR Inspect Area: Applicant: AFFORDABLE WATER HEATER 24707 SAN FRANANDO RD SANTA CLARITA, CA 91321 661 259-7131 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: YAGI KEISUKE&MICHIKO 2162 VISTA LA NISA CARLSBAD CA 92009 ISSUED 04/22/201 1 LSM 04/22/201 1 04/22/201 1 $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: $27 .00 Balance Due: Inspector: FINA L Date: --'--------/ / Clearance: $0.00 at approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." ou 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 JOBAOORESS JI <,J_ 8~1-iding Permit ippli~a~fon • 1635 Faraday Ave., Carlsbad, CA·92008 760-602-27i7 / 2718 / 2719 Fax: 760-602-8558 www;carlsbadca.gov SUll(#/SPACE#/UNll # Plan Check N~. de>·· :1 Est. Value Plan Ck. Deposit Oate q CT/PROJECT• PHASE# I OF UNITS I BEOOOOMS # BATHR TENANT BUSINESS NAME CONSTR. TYPE OCC. GROU DESCRIPTION OF WORK: Include Squate Feet of Alfected Alea(s) t; 4.Mt.. EXISTING USE PROPOSED USE GARAGE (SF) PATIOS(SF) DECKS(SF) FIREPLACE YES □#_ NOD AIR CONDITIONING YES D NOD FIRE SPRINKLER YES D NO[ CONTACT NAME (If D1rr-t Fom Appl/cant) APPUCAICT NAME Sc.ott L-i t-t e_fle.leJ. ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL PROPERTY OWNER NAME ADDRESS PHONE 1~0 3r 7-,, EMAIL ARCIVOESIGNER NAME & AOORESS STATE UC.• CITY BUS. UC.I ,~,1~,1 (Sec. 7031.5 Business and Prot'essions Code: All'f City or County wtllch requires a pennit to oonstruct. alte<, Improve, demolish or repair any sttucture, prior to Its issuance, also requires the applicant for such pennit to file a sil!ned statement that he is licensed l)IMSU8nt to the provisions of the Conllactof"s License Law !Chapter 9, commending with Sectlon 7000 of Division 3 of the Business and Professions Code} or !hat he is exempt therefrom, and the basis for the alleged exemption. Any Yk>latlon ot Section 7031.5 by any applicant for a pennit subjects the applicant to a civil penalty of not more than five hundred dollars ($500!~ WORKERS ' COMPENSATION -. Wori<ers' Compensation Declaration:/ hereby alf11rr1 under penalty d perjury one d Ille folowing dedarations: D I have and will malnlal • certificate or consent lo self-Insure lo< wonceis' compensation as provided by Section 3700 or lhe Labor Code, for 1he pelfonnance ol lhe '11011( to,-which 1his pennij is issued. ~ have and will malnlal workers' compegsati<V', as required by Seclion 3700 ol lhe Labo< Code, lo,-the pe<fonnance or the !0.11\ ~~tis ::nnij is issued. My wonceis' oompensalion instxance carrier and poli, numberare:lnsuranceCo. "tt.h,:\: h PolicyNo. "t.t>1,1¥9'\Y-70 f2. Expiration Dale ( -f • 11:,. This section need not be oompleted Wlhe pennil is for one hundred dollars ($100) or less. D Certificate or Exemplion: I certify thal in 1he pelformance d 1he wor1( lo< which this pennil is issued, I shall not empk)y any person in a,ry nmner so as to be<:x>me subject to 1he Wmers' Compensation Laws of California. WARNING: Flilu,. to secure wori<en;' compensatlon·coverage Is unlawfu~ and shall subject an tmployer to criminal penalties and civil fines up to one hundred thousand dohrs (&100,000), in addttion to lhe cost or e0411pensation, damages as . ed for r Section 3706 ol lhe Labor code, interest and attorney's lees. _I$ CONTRACTOR SIGU.TURE e.(}Jf t , [iµGENT I hereby alfinn Iha/ I am exempt from Conl/llctor's License Law for the following reason: □ I, as owner or the property or my employees with wages as lheir sole compensation. will do 1he wor1( and the SNcilft is no1 inlended or offered for sale (Sec. 70«, Business and Professions Code: The Contractor's License Law does not apply lo IM1 owner ol property who builds or improws thereon, and who does such wonc himsef or lhrough his own en-c,loyees, provided flat such improYemenls are not intended or ottered for sale. If, however, 1he building or improvemenl is sold withil one ye;y: or completion. the owner-ooidef wil have the ix.den d proving flal he cfd not build or improve b-lhe J>l.ll)OS8 of sale}. □ I, as owner or the property, am exclusively conlradng wilh licensed coniattors lo construct 1he projed (Sec. 7044, ll<Jsiness and Prolessions Code: The Conlraclor's License Law does not apply lo an owner of property who builds or improves thereon, and con1racts lor such projects with contactor(s) licensed l)(J'Suant lo 1he Conlraclor's Uoense law!- □ I am exempl under Section ____ .Business and Protessions Code b this reason: 1. I personally plan lo provide the major labor and malerials for conslndon ol Ile proposed property improvement □ Yes D No 2. I (have/ have nol) signed an application for a building pe,mil for the proposed wonc. 3. I have conlraded with 1he following person (inn) lo prOYide lhe proposed construction (include Mme address/ phone/ contradors' lioense number): 4. I plan to provide portions ol lhe wori<, bul I have hi<ed 1he following person lo coordinale, supe,vise and provide the major wort< [include name I address/ phone/ contractors' license n..-nber): 5. I will provide some of the wori<, but I have contracted (hired) the following perwns to provide 1he work indicated ~ndude name I address I phone/ type of '11011(): _I$ PROPERTY OWNER SIGNATURE liJAGENT DATE • Is Ille applicant. or Mure b,.lding ~pant required 'to submit a business plan, acvtely haz.ardous materials registratioo'fonn or risk management and prevention program.undec Seciions 25505, 25533 or 25534 of Ille Presley-Tanner Hazardous Substance Account Ad? □ Yes . D No • · Is the applicant or future buildiog occupant required to obtain a pe,mij from the air pollution contol dislrict or air quality management dis~icl? D Yes D No ts Ille facility to be constructed within 1,000 feet of the outer booodary of. a school site? D Yes D No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUEO UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES ANO THE AIR POLLUTION CONTROL DISTRICT. I certify that I haw read the application and state that the aba;elllbmation lsWtTeetand lhattlle Information on the plans ls accwalie. I agreetD~wlth al CilyORlinanoesand Slate laws ,eiaoogk> buikfingconslrudion. I hereby auflorize represeolawe oC Ile at,oCCal1sbad kl ri!r"°' Ile abcMl menliJned ~b'ilspedi:Jn p.rposes. I Al.SO AGREE TO SAVE, NlEMNIFY »ID KEEP HAAMLESS THE CfTY OF CAR1.S8AO AGAINST Al.l LIABILITIES, .rJOGMENTS, COSTS NO EXPENSES WHICH MAY IN f>NiWAY /ICCRUE H3AINST SADCITYIN CONSEQWCE Of TIE GRmTNGOF THIS PERMIT. OSHA: kl OSK6. poonil is required b'mavations over5'0' deep and demoliiJn or WlSlrudiln o(~ OYef 3 sbies i'l hei<jt EXPIRATION: EYef)' pem-lt issued by Ile luldrg OCli:ial lllderlle prcNismso( tis Cole shaleicpie by liniab1 and become rd and Yoi! llle tudi1g orY«Xk a.mired bysu:h permt is nolconmenc:ed v.ti1 180 days tom Ile date of SI.di poonil or r Ile or Y«Xk d10rized by SI.di pemi is suspeMed or abandoned al atrt lire alw Ile Y«Xk is amnena!d b' a peood oC 180 days (Secfun 100.4.4 U1ibm Buiklilg Code). ~ APPLICANT'S SIGNATURE ~l. DATE ' / G, -{