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Home My WebLink About1037 GOLDENEYE VW; ; CB061797; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 06-22-2006 •. Plumbing Permit Permit No: CB061797 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: Applicant: 1037 GOLDENEYE VW CBAD PLUM 2110911000 Lot#: 0 Construction Type: NEW COX RES-REPLACE WTR HTR Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 06/22/2006 LSM 06/22/2006 06/22/2006 CALIFORNIA DELTA MECHANICAL COX TY BRIAN&KATHRYN A SUITE# 27 12440 OAK KNOLL RD 92064 866-898-0008 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 Total Fees: Inspector: $27.00 1037 GOLDENEYE VW CARLSBAD CA 92011 0 0 0 0 1 0 0 Total Payments To Date: FINAL APPROVAL Date: $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 $27.00 Balance Due: $0.00 PERMIT HAS IN ACCOf{Dl~CE WITH C.B.C. SECTION 1t16AA AS AME\1iDED BY C.M.C.18.043)30 DATE_<.,!2..&{a_':t SIGNATUflJfjµ.J __ a="-~' 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 fees/exactions of which vou have oreviouslv been aiven a NOTICE similar to this or as to which the statute of limitations has oreviouslv otherwise exoired. FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. flR.,(Jb/ 79 ? CITY OF CAR $BAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST.VAL._~~~~~~~~~ Plan Ck. Deposit--------- Validated By __________ _ Date ______________ _ 1. PRo.JECJ ~RMATtOf<l I Q.?J7obCX9Ji ,E:-YE:: 1, i EU ) Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total I of units Assessor's Parcel I Existing Use Proposed Use I of Bedrooms I of Bathrooms Name Address City State/Zip Telephone II Fax I f..__ 3. APPLICANT O Contractor (It ~_gent for Contractor O Owner D Agent for Owner 0-7'-::f -Na-m---r-:--....,...,.~~:-.,-~,-X-!)/.)-::--~~=--A~d~d-res-s-~-:.-:-::=-T'T..'f(~[e::::-'.-:T";::-;:;n-~--;:C~ity~~r,;;-:--:-;'7'---;;:::;::,:;;:~771,~,~T~ele~p~ho~ne~~;n:;=v=;-,~~~.~~'.)fi 10,-,7 C7C'li1MeYe vtf11> corj:5l:xlci CA -Wto oc, rm~08~9a5!1 Address City S.tate/Zip Telephone I 6, (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty 51.f not more than five hundred dfl..(lars [$~~ 0 CiJieve;u>1tJ»;,J-,TA Jlla:-H . ;.,50o s.Pou ,r12 Pei. :;u,2£./.1'0 Jlle;so., .t!Z:d5:{[8 f&>·d'Y~ 'l-~ Name Address City State/Zip Telephone II State License I 8 / / //!/ License Class C-,:2 G City Business License II-------- Designer Name Address City State/Zip Telephone State License '---------- 8. .W0..8JU;f1S' @MPEN"'TIQN Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 T 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 ~ork for which this permit is issued. (lJ 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 co pen tion ins ranee carri rand policy number are: Policy No. /6 976;1..?J (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) Expiration Date 7 /tJ/ /Of; I 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 irt any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to ncure workers' compensation coverage ia unlawful, and ahal subject 1111 employer to criminal penaltlu and clvil flnu up to one hundred thousand dollara 100 01, In to the coat of compensation, damagu u provided for In Section 3706 of the Labor 'r"}e, lnterut end attorney's fees. SIGNATURE '){.,{)t) DATE fo -ri.L O 0 ' 7. OW.,IU!l,P.M OECLARATIOf,I , I hereby affirm 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 (~ec. 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 suph 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 not build or improve for the purpose of sale). 0 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(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 I 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 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 I 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 I address I phone number I type of work): ________________________________________________________ _ PROPERTY OWNER SIGNATURE _____________________ _ CO~PLQE ~IJl:CTJQfUQB N9IH!ffll)fNT/AL !WlLDINO ~ITS ONLY 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 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? O YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site7 D 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. ~m&LCTION ~QJN(l~CY . 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 NAME _____________ _ ift, -MNCM't..eEll~IlOI!I LENDER'S ADDRESS------------------------- 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 Citt 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 permit issued by the building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit Is suspended or abandoned N at any time after the work is co menced for a riod of 180 days (Section 106.4.4 Uniform Building Code). V\ APPLICANT'S SIGNATURE • DATE G. J I-DG WHITE: File YELLOW: Applicant PINK: Finance • r-' • • ... ,. -.... ., POLICYHOLDER COPY ' P.O. BOX 807, SAN FRANCISCO.CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DA"rl~: 07-01-2005 C P R C SOX 869006·' PLAINO TX 75086 NF GROUP: POLICY NUM6ER: 1697823-2005 CERTIFICATE 10: 3 CERTli=ICAfe E~IRES: 07-01-2006 -07-01•2005/07-01-2006 JOB: ,, This ls to certify that we have issued a valid Workers' Compensation insur.inci policy in a form approvtd by the California Insurance Commissioner to the employer named below for the policy period indicated.. This pol icy is not sub jeet to cancellation by the Fund except upon 30 days' advance wrinen nocice to ttie employer. We will also give you 30 d~y;;: ,i'~van~e notice should this policy be cancelled prior to its normal expiration. -..• • • • ' T ' • : • This cenific;ate 9f insuranc;e is n~f an· insurance policy and does not amend; sxtei:id _.or alter the coverage afforded by the policies listed herein: .Notwithst.nding any requirement. term. or cohditi!'n of any contract or other document with resp~ct to· which this ceFtificate of insurance may ·be. is~ued or may ~.ert1i1;1. ~e insur.inee afforded by the · policies describe~ herein is subject to all the terms.···axcl~slons and conditions:of such policies. ·' . . -. AUTHORIZED,.. REPRESENTATIVE PRESIDENT. : ... ~ ·~: ... EMP~OY}R~S ~IABILlT't Lii-iJT INCLUDING DEFENSE CO°sTSi SJ::~o:oo~;OO PER OCCUR~ENCE. ·• E_NDO~SEMENT #2065 ENTITL~D C:ERTIFICAtE HOLDERS' NOTICt l;FFECT.lVE.~07:o1:200S S AT~ACHED TO AND ' FORMS A PART OF THIS POLI·.CY. -~ •. . . r· • . . . ... , ~EV.3•031 ........ .. ' . ....... - EMPLOYER ·.'° : i ........ . "./' , . ;. _; . t h .••••• , ••• ., ·, .. .... . .. i ; . ~. . . . .: : . .. CAl ~-{O~NJ) .. ·DELTA~ MECJiA.~ l ~.A.L. I NC :· 2.500 S POWER RO f 8~120·" .... MESA AZ 85208 . ' .. . · ' .... ..... -.. ..::., ... ... .•. •' . ., :'"'' .. ._ ........... . :. ., : ... ,,/ LEGAL NAME . ...... . .. ·-. CAq(O.RNIA DELTA MECHANl.C~L, INC :. ) . . .. ; PRINTEb;" osJ 17i 2oos P0409 NF ........ ,---~-- Z:0 38\Jd SP9S81l 08P 01:s1 900l/61/90