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Home My WebLink About2683 WATERBURY WAY; ; CB990185; PermitCity of Carlsbad 01/18/1999 Plumbing Permit Permit No:CB990185 Building Inspection Request Line (760) 438-3101 Job Address: Permit Type: 2683 WATERBURY WY CBAD PLUM Status: ISSUED 01 /18/1999 DT 01 /18/1999 01 /18/1999 Parcel No: 1674412100 Lot #: 0 Applied: Construction Type: NEW Entered By: Reference #: Plan Approved : Issued: Project Title : REPLACE SHOWER PAN W/TILE Inspect Area: Applicant: CAMBELL, TIM 2683 WATERBURY WY 92008 760-434-07 48 Total Fees: $27.00 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 Owner: CAMPBELL LIVING TRUST 11-25-92 2683 WATERBURY WAY CARLSBAD CA '92008 Total Payments To Date: $0.00 Balance Due: $20.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 $27.00 Inspector: FINAL APPROVAL Date: J_.~22-71 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 permij 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 Ca~sbad 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 otherwise ex ired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 'PERMlT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 Legal Description Lot No. Subdivision Name/Number Name ~~~CAif'!:7.lll.~~o;, '?it:r . Name Address City ~-.. _. ~Ot!Elirt~bwNER'%~:l'~:f'5!§'g1!.., >->'I Name AddrllSS City [&.:;1.b_d~ctb)l:~cbM"PANV,W"'AMR'.~,m:.&l!a~~ • ""' ...., FOR OFFICE USE ONLY PLAN CHECK NO. (0 '3 90 l85 EST. VAL. _________ _ Plan Ck. Deposit ________ _ Validated Bv ___ , _____ ... 3JT ........... _ Date ___ __.\/ ___ ) 8 ........... /_4 _____ 4 __ _ Unit No. Phase No. Total I of units Proposed Use State/Zip Telephone I S.tate/Zip Telephone I (Sec. 7031.6 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 Lew [Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he Is exempt therefrom, end the basis for the alleged exemption. Any violation of Section 7031.6 by any applicant for a_permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500)). Neme Address City State/Zip Telephone I State License I _________ _ License Cl■ss _________ _ City Business License I _______ _ Designer Name Address City State/Zip Telephone State License I _________ _ :e>:~':J/i0RKERS'•.COMP£NsATION,7T~m,1Ii~~~Jffi7.;;.~m~~~~~3l~~~t,r~~!•t~i-,:::1~;-~:}~;;~:',!~l;f,:'.~ 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 compensati!)n 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 ($100) 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: Falluni to aecure wo,11.,.' compensation coverage le unlawful, and ahan subject ., employer to criminal penaltlea and civil flnH up to one hl.wldred thousand doOars ($100,000), In addition to the coat of compenaatlon, damages u provided for In Section 3706 of the labor coda, Interest and ■ttomay's fHI. SIGNATURE ______________________________ DATE _________ _ ·1..-:~U>WNER:iiuiL:ou'tii!cU:liA'noli~~sl:~~~,~;;;:,;~~~{t&~~;t~~is,z-;t~~E~;J,.;{~~-m~~:.P~"!1l~'#t~: I hereby effirm that I ■m exempt from the Contractor's License Law for the following reason: 0 I, as owner of the property or my employHS with wages IS 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 en owner of property who builds or improves thereon, and who do■a such work himself or through his own employees, provided that such improvements are not intended or offered for sele. 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 excl1111ively 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 f01' such projects with contractor(sl 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 ■n 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 end provide the major work (include name / address / phone number / contractors license number): _______________________________________________ _ 5. I will provide some of the work, but I ns to provide the work indicated (include name / address / phone number / type of workl: __________ ,...::;_,,.i::.,-,,y ~-lr--+---,'---r-;__-?'ifL..~----------------=,-----,.-,.---------c;::;;:~~E~;;:;~RfWCIA~;~~j,t[i~aij~r►,j~ifl~~~;j~~~~. ~ .. i.irn~•ii•~,.,it~'t"'i.:,~-~~~i::i•r:t'~~~~:;;:~,.'.''.::fZ~'1:;;~~~~t:.,;: Is the applicant or future building occupant required to submit a busines1 plan, acutely hazardous materials registration form or risk management and prevention program under Sections 26605, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Actr D •-¥S--9-NO . Is the applicant or future building occupant required to obtain a permit from th■ air pollution control district or air quality management district? O YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site 7 0 YES D 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. fs~tP.N$:i11µq'fibij'[e~pJN:ci~A-~3'~~~~fflJl!~f.~~~~~1.F>~~Ti/±1;r::.-:-~;i-~~t-~,; .. ~'.i/,;,'E~.~6'.' I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Coda). ~~~=-~-cami:rfA:no~~~=;,~~-•~J'ffl!~emi~P"~.:r.!~.,t-~"'l;~-:"'ff~~~•:-;.~z.,..c1 ..4,.~~;ar,:.~_..____ -"4 ~ '·-~....W......,,.' _......,'WI,;.;.,._...,...,.. ... ,,,., I ~•rtify _that I have read the application end state that the above information is correct and that the information on the plans is accurate. I agree to comply with ell City ordrnances end Stat■ laws relating to building construction. I hereby authorize representatives of the Citt of Cer1sbad to enter upon the above mentioned property for in1pection 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 6'0" deep and demolition or construction of structures over 3 stories in height. EXPIRATIO~: Every permit issu.ed by the Buil ·ng O~ic' I und the provisions of this Code shall expire by limitation end become null and void if the building or work authorrzed by such permrt 1s no ced w 36 days om the da h permit or if the building or work authorized by such permit is suspended or abandoned at ■ny time after th for f 180 ecti n 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE PINK: Finance l , / UN~CftEDUX,ED BWPTNG INSPECTION DATE 2:--[ l PERMIT# {j 9 0/4~ INSPECTOR __ ~~-~s ____ _ PLAN orECK# ____ _ DESCRIPTION ___________________ _ TIME ARRIVE: ____ _ TIME ____ _ CODE DESCRIPTION ACT COMMENTS ------'2-fz/l«c:e,;f2