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HomeMy WebLinkAbout2090 WESTWOOD DR; ; CB112506; Permit..... ... City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 11-29-2011 Permit No: CB1 12506 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 2090 WESTWOOD DR CBAD PME 1671801100 Lot#: Status: 0 Applied: Entered By: Reference #: Plan Approved: ISSUED 11/29/2011 RMA 11/29/2011 11/29/2011 PC#: Project Title: Applicant: ECONOAIR CURRY RES-REPLACE WATER HEATER AT SAME LOCATION 3366 LA PALMA AV 92806 800 503-2666 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Owner: CURRY DOROTHY M 2090 WESTWOOD DR CARLSBAD CA 92008 Issued: Inspect Area: $150.00 $0.00 $0.00 $0.00 $150.00 Total Fees: $150.00 Total Payments To Date: $150.00 Balance Due: FINAL APPROVAL Date: / 2-~ CZ-, If Clearance: _____ _ $0.00 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 h v r vi iv n N Tl imil r hi r whi h f Ii i i n r vi I «~~ ~ CITY OF CARLSBAD JOB ADDRESS Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 J 2718/ 2719 Fax: 760-602-8558 www.carlsbadca.gov Plan Check No. Est. Value SWPP NAME UP EXISTING USE PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES O # __ NO O YES O NO O YES O NO 0 APPLICANT NAME (Primary Contact) ADDRESS CITY PROPERTY OWNER NAME ADDRESS z..ucyo Cln I ~s/r-e.-,{ PHONE 7 <.,, o A ARCH/DESIGNER NAME & ADDRESS STATE FAX LJ rbf3 FAX APPLICANT NAME (Secondary Contact} ADDRESS ZIP CITY STATE ZIP PHONE FAX ~. STATE LIC. # STATE LICJ ~ .rz-~ CLASS C..~(.. (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 {Cha'f.ter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or f.hat he is exemQt therefrom, and the basis for the alleged exemption. Any violation of Section 703 .5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)). Worl<ers' Compensation Declaration: I he,eby affirm under penalty of petjury one of the following declarations: 0 I ~nd will maintain a certificate of consent to self-insure !or workers' compensation as provided by Section 3700 of the Labor Code, (or the performance o( the work for which this permit is issued. i;:;yj"'have and will maintain workers' m ensatl~, required by Section 3700 o( the Labor , for the performance o( the work (or which this permtt is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. • Policy No. I i,x w I' I Expiration Date I c) -t!) ,/ , / -z...,. This section need not be completed if the permit is for one ndred dollars ($100) or less. 0 Certificate of Exemption: I certify lhat 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 worl<ers' compens • 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 rovid for in Section 370 f the ~ode, Interest and attorney's fees. / _15 CONTRACTOR SIGNATURE _..,_,,c..-~~--~--~~ ~ENT DATE //-~ _.// I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: D I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered tor 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 himseff 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 btxden of proving that he did not build or improve for the purpose of sale). D I, as owner of the property, am exciusively 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 lo 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. O Yes D No 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) lo provide the proposed construction (include name address I phone I contractors' license number): 4. I plan lo provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work Onclude name I address I phone / 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 / type of work): ,"5 PROPERTY OWNER SIGNATURE □AGENT DATE City of Carlsbad Bldg Inspection Request For: 12/09/2011 Permit# CB1 12506 Title: CURRY RES-REPLACE WATER Description: HEATER AT SAME LOCATION Type: PME Sub Type: Job Address : Suite: Location: 2090 WESTWOOD DR Lot: OWNER CURRY DOROTHY M Owner: CURRY DOROTHY M Remarks: Total Time: 0 Inspector Assignment: Phone: 7147206908 lnspectorcG~ Requested By: DON Entered By: JANEAN CD _D_e_s_c-ri-pt-io_n _______ M-Comm~::s, _ r f_ 29 Final Plumbing _/)_ = ti Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act lnsp Comments