The URL can be used to link to this page

Home My WebLink About1040 BUENA PL; ; CB031876; Permith City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Building Inspection Request Line (760) 602-2725 07-6942063 Plumbing Permit Permit No: CB031876 Job Address: Permit Type: PLUM Status: ISSUED Parcel No: 155251 2400 Lot #: 0 Applied: 07/09/2003 Reference #: Plan Approved: 07/09/2003 Issued: 07/09/2003 Project Title: VADERMEIJ RES NEW H20 HEATER inspect Area: 1040 BUENA PL CBAD Construction Type: NEW Entered By: SB Applicant: AJACKS MAINTENANCE SERVICE 7631 LEMON AVE LEMON GROVE 91 945 61 9-589-8888 Owner: VANDERMEIJ HENDRIKUS 1040 BUENA PL CARLSBAD CA 92008 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Drain Instali/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 $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 Total Fees: $27.00 Total Payments To Date: $0.00 Balance Due: $27.00 InsDector: -’ Date: ,INAL= 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 “feedexactions.” You have 90 days from the date this permit was issued to protest imposition of these feedexactions 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 Cily 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. PERMIT APPLICATION CITY OF bARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 / FOR OFFICE USE ONLY PLAN CHECK NO. c%? @'16 EST. VAL. Plan Ck. Deposit L -- J Address (include BldglSuite XI Business Name (at this address) Legal Description Lot No. Subdivision Name/Numbdr Unit No. Phase No. Total X of units Assessor's Parcel # Existing Use Proposed Use Description of Work sa. FT. #of Stories # of Bedrooms # of Bathrooms Name Address City SSatelZip 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 Law [Chapter 9, commending with Section 7000 of Division 3 of the Business end Professions Codel or that he is exempt therefrom, and the basis for the alleged exernptlon. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil pe Name Address city StatdZip Telephone # State License I 567 933 Designer Name Address City StateIZip Telephone State License I Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 Ity of not more hen five hundred dollars 1$5001). clT&J&d& 7b-31 a-07 &dcL C, CiWW . g4b-r)' C14W 6lq-mS c gkG% License class C- Ib , P 36 City Business License # 1 2 (1 'I 70 I 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 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 rk for which this permit is issued. 20 ' aq b% 0 issued. My worker's compensation insurance carrier and policy number are: Insurance Company 7 5 r~ \ Policy No. Expiration Date (0 /I (0 3 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS I61001 OR LESS) 0 to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure wo CERTIFICATE OF EXEMPTION: I certify that In tha performance of the work for which this permit is issued, I shall not employ any person in any manner so as atlon coverage Is unlawful, and shall subject an employer to crlmlnal penalties and dvll fines up to one hundred t of compensation, damages as provlded for in Section 3706 o attomay's fees. 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 Lsw 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 w 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 contractorfsl licensed pursuant to the Contractor's License Law). 0 1. 2. 3. 4. number I contractors license number): 5. I am exempt under Section I personally pian to provide the major labor and materials for construction of the proposed property improvement. 0 YES ON0 I (have / have not) signed an application for a building permit for the proposed work. I have contract4 with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number): 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 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name I address / phone number I type Business and Professions Code for this reason: of work): 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 26634 of the Presiey-Tanner Hazardous Substance Account Act? 0 YES 0 NO Is the applicant or future building occupant required to 0btain.a permit from the air pollution control district or air quality management district? Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 NO REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 0 YES 0 NO 0 YES 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 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097lil Civil Code). LENDERS NAME LENDERS ADDRESS 9'~~~~~~~~l~ 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 U(PENSES 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 end demolition or construction of structures over 3 stories in height. EXPIRAT authorize at any tir ire by limitation and become null and void if the building or work ng or work authorized by such permit is suspended or abandoned APPLICP ' 'S SIGNAT DATE 7 ci 03 L,. City of Carlsbad Bldg Inspection Request For: 09/09/2003 Permit# CB031876 Inspector Assignment: Title: VADERMEIJ RES NEW H20 HEATER Description: Type: PLUM Sub Type: Job Address: 1040 BUENA PL Suite: Lot 0 APPLICANT AJACKS MAINTENANCE SERVICE Location: Owner: VANDERMEIJ HENDRIKUS Remarks: Phone: 7607206960 4 Inspector: JhA Total Time: Requested By: BRIDGET CD Description Entered By: CHRISTINE & Comment 25 Water HeaterNents Associated PCRs/CVs Date JnsDection History Description Act lnsp Comments