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Home My WebLink About2719 YORK DR; ; CB022631; Permit\v C;. ,J City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 06-1 8-2003 Plumbing Permit Permit No: CB022631 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 2719 YORK RD CBAD PLUM 1673924200 Lot#: 0 Construction Type: NEW Status: ISSUED Applied: 09/05/2002 Entered By: RMA Reference #: Plan Approved: 09/05/2002 Project Title: HASAN RES-REPAIR GAS LINE-REAR YARD-ELECT FOR FUTURE SPA Applicant: HASAN SAMIR&DONNA 2719 YORK RD CARLSBAD CA 92008 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 0 1 0 Issued: 09/05/2002 Inspect Area: JM Owner: HASAN SAMIR&DONNA 2719 YORK RD CARLSBAD CA 92008 n14 06110103 0002 01 CGP $20.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $43.50 $0.00 $0.00 $0.00 $70.50 Total Fees: $70.50 Total Payments To Date: $47.00 Balance Due: $23.50 Inspector: 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 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 02 23-50 • FOR OFFICE USE ONLY PERMIT APPLICATION ' . . PLAN CHECK NO. C,6 () .2 2IJ> ! CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. __________ _ 1. PROJECT INFORMATION :z_ :1 \ °' ~ I~ C '6--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 # Existing Use Proposed Use Description of Work SO. FT. #of Stories # of Bedrooms # of Bathrooms ~~ -.t:> ~ "\. -f' . ~ CL s. L :i.. ""-~ 2. CONTAcT PERSON (If dlfferl!Jt from appllcantl Name Address 3. APPLICANT O Contractor 0 Agent for Contractor O Owner Name Address City 0 Agent for Owner City State/Zip State/Zip Telephone# Fax# Telephone# 4. PROPERTY OWNER ~'!Y'-. ½0-..~o._,\A 2 '"\ \ <\ 1 L-5.-s s-6 b Name Address City State/Zip Telephone# 5. CONTRACTOR -COMPANY NAME (Sec. 7031.5 Business and Professions Code: Any City or County w hich 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 Codel 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 ($50011. Name Address City State/Zip Telephone# State License # _________ _ License Class _________ _ City Business License # _______ _ Designer Name State License # 6. WORKERS' COMPENSATION Address City Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: State/Zip Telephone 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. O 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 ______________________ Policy No. ____________ _ Expiration Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 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 ls 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. _______________________________ _ DATE _-:-::========-- 7. OWNER-BUILDER DECLARATION I hereby effirm that I am exempt from the Contractor's License Law for the following reason: 0 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 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 sc:~in 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) . ....--c'.f-.i..s 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: ~ ~ally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES~ C_)./ ~ I have not) signed an application for a building permit for the proposed work. 3. I ~ave contracted with the following person (firml to provide the proposed constr.uction (include name I address I phone number I 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 I address I phone number / contractors license numberl: _________________________________________________ _ 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address I phone number / type of work): ___________ ..,..--------.----------------------------------------- PROPERTY OWNER SIGNATURE s~ \ ~ DA TE -~.e......-1\_,_S:.J.....\.\..., _,.,\Jc_J...._...__ COMPLETE THIS SECTION FOR NON-RESIDENnAL BUILDING PERMITS ~ 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 ADDRESS __________________________ _ APPLICANT CERTIFICATION I 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 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 5'0" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permil issued by lhe building Official under lhe provisions of lhis Code shall expire by limitation and become null and void if the building or work aulhorized by such permit Is not commenced wilhin 180 days from lhe dale of such permil or if lhe building or work aulhorized by such permil is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE ~ A:--->:::>, u ,______ --..= DATE WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 06/19/2003 Permit# CB022631 Title: HASAN RES-REPAIR GAS LINE-REAR Description: YARD-ELECT FOR FUTURE SPA Type: PLUM Sub Type: Job Address: 2719 YORK RD Suite: Lot 0 Location: APPLICANT HASAN SAMIR&DONNA Owner: HASAN SAMIR&DONNA Remarks: AM PLEASE Total Time: CD Description 29 Final Plumbing 39 Final Electrical ~ Comment ------------ Associated PCRs/CVs lns(2ection Histo!}'. Date Description Act lnsp Comments Inspector Assignment: JM --- Phone: 7607293576 Inspector: J'V'f\- Requested By: SAM Entered By: ROBIN 02/27/2003 29 Final Plumbing NR JM NOONE HOME 02/27/2003 39 Final Electrical NR JM 10/04/2002 31 Underground/Conduit-Wiring AP JM CONDUIT ONLY-OK TO BACKFILL 10/04/2002 39 Final Electrical WC JM 09/09/2002 23 Gas/Test/Repairs AP JM OK TO BACKFILL TO TWO OUTLETS ONE FUTURE USE 09/06/2002 23 Gas/Test/Repairs NR JM