HomeMy WebLinkAbout1011 LANDS END CT; ; CB073170; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
12-21-2007 Plumbing Permit Permit No: CB073170
Building Inspection Request Line (760) 602-2725
Job Address·
Permit Type
Parcel No
1011 LANDS END CT CBAD
PLUM
2145310800 Lot#: 0
Construction Type: NEW
Status:
Applied:
Entered By:
Reference #: Plan Approved:
Project Title:
Applicant:
POZZEBON RES-REPLACE GAS LINE
@BACKYARD TO EXISTING BBQ & FIREPIT
Owner:
Issued:
Inspect Area:
KURT FORD CONSTRUCTION POZZEBON LEWIS J&ELIZABETH A
3025 DEL REY AV
CARLSBAD CA 92009
944-0529
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
1011 LANDS END CT
CARLSBAD CA 92011
ISSUED
12/21/2007
LSM
12/21/2007
12/21/2007
$20.00
$0.00
$0.00
$0.00
$0.00
$0.00
$7.00
$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: Clearance:
$0.00
NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of ees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." You have 90 days from the date this penriit 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 timety 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 fT APPLY to any
fee /exaction I whi h u hav revi u I n iven N T! E simil 1 r I which he st I limi ti n h I
City of Carlsbad Plan Check No. (!& ()7 31 t 0
1635 Faraday Ave., Garlsbad, CA 92008
760-602-2717 / 2718/ 2719
Fax, 760-602-8558
Building Permit Application
JOB ADDRESS l LD I LA'-.i'u S
CT/PROJECT# --!LOTH
DESCRIPTION OF WORK:
Est. Value
Plan Ck. Deposit
Date
SUITE#/SPACE#/UNIT# APN
OCC. GROUP
ou1\)001'2-
EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS
YES □# __ NOD YES □ NOD YES □ NO □
CONTACT NAME (ff Different Fom App/leant) .. \
tLu ~ 'FORD col-lS,12-u<-'i' ,o...., APPLICANT NAME
ADDRESS ADDRESS
'.:>ol'J.-S-~~~'E.=L~..\2-~~-v~A~v~'6-_____ ,
CITY -i§'rATE ZIP CITY CA~ LS 12, /:\ t) C-A "I z._o o q STATE ZIP
PHoff.:;;. FAX PHONE FAX
EMAll.~-0
-cJ---~4~i;-~--?,~?J~75~3~-----------"-c--l-EM-A-IL-------~-----------
PROPERTY OWNER NAM
LU\S l-1-=l O~~\!,c,N\) ADDREs~so=="-'~'-~=--_......__.___..,._ _ _.,_,cc_====--=---=c._-------j.,_~=----------------------------
\6 \ l 1..-A t-J~S \:: i-J't:>
Cifv' STATE Z{P CITY STATE ZIP
CA'<t-LS l\'u CA q '20 \ ( PHONE "'-..1.J'-'--''--"''------~~,.=x-'-_:_'-----'-----------+,-H-o-N_E _____________ F_AX _______________ _
EMAIL EMAIL
ARCH/DESIGNER NAME & ADDRESS STATE UC.# STATE UC.# CITY BUS. UC.#
'32.0-;:;.-~ AUS f3 /'ft; cA-
/5ec. 7031.5 Business and Professions Code: Any City or County which requires a permit to constroct. alrer1 improve, demolish or reP,air 311y structure1 prior to in issu311ce, also requires the applicant for such permit to file a signed statement that he is ricensed _P.11rsuant to the provisions of the Contractor's License Law {Chapter 9, commending witli Stction 000 of Otvision 3 of the Buiness 311d Prorenions Code} or that he is exempt therelrom, and the ba11S for the alleged exemption. Any •iolation of
Section 7031.5 by any applicant for a permit rnb~cts the applicant to a ci•il penalty of not more than five hundred dollan (S500}).
rs' Compensation Declaratfon: I hereby affirm under penaffy of perjury one of the following declarations:
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.
have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of lfle work for which this permit is issued. My workers' compensation insurance carrier and policy
number are: Insurance Co. ______________________ Policy No. _______________ Expiration Date __________ _
~ection need not be completed if the permit is for one hundred dollars ($100) or less. ¼\ Certificate of Exemption: I certify Iha! 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 Woriers' Compensalion Laws of
California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shalt employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In
addition to the cost of compensation, s provided for in Section 370 e L ode, Interest and attorney's fees,
.Jt5 CONTRACTOR SIGNATURE
I hereby affirm that / am exempt from Contraclor's License Law for the following reason
□ 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 sold within one year of completion. the owner-builder will have the burden of proving that he did no1 build or improve for the purpose of sale).
□ I, 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)
□ 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 improvemen1 0 Yes □ 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) to provide the proposed construction (include name address/ phone 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/ address I phone I contractors· license number)
5. I will provide some of the work, but I have contracted (hired) the following persons lo provide the work indicated (include name I address I phone I type of work)
----------------------~ -------------·
_g PROPERTY OWNER SIGNATURE DATE
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 □ No
Is the applicant or future building occupant required lo obtain a permit from the air pollution control district or air quality management district? □ Yes □ No
Is the facility lo be constructed within 1,000 feet of the ouler boundary of a school site? □ Yes □ 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.
I certify that I have read the application and 51:ate that the allt'r-A:! information Is oorrect:and that the infonnation on the plans is accurate. I agree to oomplywlth all Cllyordinances and State laws relating to building oonstruction.
khereby authorize representative of Ille City 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 demciition or constn.iclion of structures over 3 stories in height.
EXPIRATION: Every pem1it issued by the Building Official under Ille provisions of this Code shall expire by limitation and become null and void W Ille building or work authorized by such pem1it is not commenced within
180 days from Ille date of such pem1it or if Ille building or work authorized by such permit is suspended or aband ny tiiiie after the work is commenced for a period of 180 days {Section 106.4.4 Uniform Building Code).
A$ APPLICANT'S SIGNATURE _/ DATE
4\·
~
City of Carlsbad Bldg Inspection Request
For 01/03/2008
Permit# CB073170
Title: POZZEBON RES-REPLACE GAS LINE
Description: @BACKYARD TO EXISTING BBQ & FIREPIT
Type:PLUM Sub Type:
Job Address:
Suite:
1011 LANDS END CT
Lot: 0
Inspector Assignment: JM ---
Phone: 7608453383
Location: Inspector: ----
OWNER POZZEBON LEWIS J&ELIZABETH A
Owner: POZZEBON LEWIS J&ELIZABETH A
Remarks:
Total Time:
Act Comments
Requested By: KIRT
Entered By: CHRISTINE
CD Description
29 Final Plumbing (;(,. ____ _
Comments/Notices/Holds
Associated PCRs/CVs Original PC#
Inspection History
Date Description
12/24/2007 23 Gasffesl/Repairs
Act lnsp Comments
AP JM PIT/BBQ
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