HomeMy WebLinkAbout1069 GOLDENEYE VW; ; CB042955; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing Permit Permit No: CB042955
Job Address:
Permit Type:
Parcel No:
Reference #:
Project Title:
Applicant:
Building Inspection Request Line (760) 602-2725
1069 GOLDEN EYE VW CBAD
PLUM
2121801900 Lot#: 0
Construction Type: NEW
BUTZ RES -INSTALL WATER
HEATER
Owner:
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
07/30/2004
KMT
07/30/2004
07/30/2004
DRAIN PATROL BUTZ JAMES F&TRAVINO CYNTHIA Y
4807 MERCURY ST
SAN DIEGO, CA 92111
619-560-113 7
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
TOT AL PERMIT FEES
Total Fees: $27.00
Inspector:
0
0
0
0
1
0
0
1069 GOLDEN EYE VW
CARLSBAD CA 92009
Total Payments To Date: $0.00
FINAL
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
Balance Due:
Clearance:
$27.00
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
fees/exactions of which ou have reviousl been iven a NOTICE similar to this or as to which the statute of limitations has reviousl otherwise ex ired.
FOR OFFICE USE ONLY
PERMIT APPLICATION PLAN CHECK Na.CB otd ~ 95'.S-
A CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
EST.VAL.~~~~~~~~~-
Plan Ck. DeposJ
Validated By_~+-"-,...,t,"-'~:.;)f"....__ _____ _
Date -z l;o'l oY
Address (include Bldg/Suite I)/ 1 I...
{}cs, 'f 60L":J"U\
Business Name (at this address) u:.Q..,...,....)
Legal Description Subdivision Name/Number Unit No. Phase No. Total I of units
~'Z.O ~~ ~"'-~'~
Assessor's Parcel I Existing Usa Proposed Use
Description of Work ......., SQ. FT. lot Stories I of Bedrooms I of Bathrooms
t\-U> ~.....,_ ~.>--".n~
~.,.CO.t/.tAC!J'· ~1JS0N~Ufullffei9ii~)rom applfi:antl:;i; &!:l,.fi;;.;t;'!; :~ie, '.,;..~.,t-·~c -': ·,, ~--~ ··•
Name Address City State/Zip Telephone I Fax II
~ ... ' ~IJ_CANT~i!:t.comraPcta~~ .. .(, O~tien(for,Cont~ ... ~Otl, : D ·P_wner,~ .0 ~eri.t fg~ner ~ x ~~ ll~~ s -~~
Name Address City State/Zip Telephone I
~.:..,.J.1.Pl!OPERT,V,;JtW~E~ 1·,1:.t ;i;J;;\J~'<fj,,'£....",1~~~ 1. .Cl ·;.--,;.~::-• .,.rx · , .. .f,,, ... P ·· ifi. ,. '\ ;•. ~. ":..; · . ' ' t*' . .:•.
'J\""'-~v\'L l0Co \ (,-o\~ ~ J: ~ C-S\'flL-S~~
,._ ~ .. ..; !,·,
State/Zip Telephone I
(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
"'-!'<emption. Any-"iolation of Section 7031 .5 by any applicant for a permit subjects the applic~ to a civil penalty of not more than five h ed dollars ($500)).
"1> ,._, '<~\'e.C-L. '"11.\.o A-Q.' I.N..5 "5\J c.Jl--'t-Z:( 8" 5c.,O\\.~ "1 .
City State/Zip Te ephone I Address Name
Stat License I ~1."1..\,:,\o
(Vh.,._, ~
City Business License II \ I\ '\OS"L
04--
Designer Name Address City State/Zip Telephone
State License I lfl 'Z.1.. '31. ~...:..::...:::..:..<C-~~~~~
[8;~'-W9RKE8S:C0'9'1e_ENSATIO ;_,,,,.~,., • ~"-~ .... , _ : _.·;•, ,.
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
O I have end 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. ff 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 ~sur'Q.ce carrier and policy number are: ·c [
Insurance Company :;:,1"A"R..-~ <""~ Policy No. 0 D ~ 15" .J Expiration Date { c, ~CL\,
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS)
D 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
orkers' Compensation Laws of California.
WARNING: Fallur to 1
thousand dollar• $1 0 ,
workers' compensation coverage la unlawful, end shall subject an employer to criminal penalties and civil finH up to one hundred
O , In addition to the cost of compenaatlon, damage• 11 provided for In Section 3706 of the La r c de, Interest and attorney'• fffl.
DATE -, SIGNATURE-4__,.,~....e::~..:::..~--------------------~ Fl.D.Owr.l' ~:t~aAB(tJQ_ ::~~~~~"';l:.v;,.~Q-~~-.f'.:,'.!:;«;~..-,::, .. ,. :-'~\ -1";;.:"''~tf ;t .... ~ "' ::i.' .. '.~ ~r:.'! 4;.¥
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
O 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 not build or improve for the purpose of sale).
O 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 1n owner of property who builds or improves thereon, and contracts for such projects with contractor(&) licensed
pursuant to the Contractor's License Law).
O 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 number): _______________________________________________ _
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-----------------------DATE_~~~~~~~~-
,.,, t • .... ~.r,-.
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? -D 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 ,001.l teat of the outer boundary of a schc,vl sit .. ? 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 f/lEl:TING THE
REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
[t.'E ~Q.NS_T8.UQI!Qr4 L~DIN..<tMENC_Y..;;~:....~ • .'.....~ ... L~ . .:.:.:::.':!~'...:!.~:~· ... :., ... ~ ··-·· "'-'·-· ·--· , __ .. ~~ ...
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--------------LENDER'S ADDRESS--------------------------
(9j .!•·~~APPUCANT;C{lfTtflC~TION1t~:~1~,(t,~~~~~~.:"~'*· .. ,-,~iti~-·.t"°~;;:::ti":S-'~-";1;.~;;;~•-(Z.~-;;·"~~-•· :t ._.. _ :': · · ·-·""J ·t :. "'~ ,~;, ,. · ·'!';.. ~-i.a ."·rLt ~
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 6'0" deep and demolition or construction of structures over 3 stories in height.
EXPIRATION: Every pennit issu t ilding Official under the provisions of this Code shall expire by limitation and become null and void if the building or work
authorized by such pennit is not mme ithin 180 days from the date of such pennit or if the building or work authorized by uch ermit is suspended or abandoned
at any time after the work is mmen period of 180 days (Section 106.4.4 Unifonn Building Code).
APPLICANT'S SIGNA TUR DATE
WHITE: File YELLOW: Applicant PINK: Finance
City of Carlsbad Bldg Inspection Request
For: 08/02/2004
Permit# CB042955
Title: BUTZ RES-INSTALL WATER
Description: HEATER
Type: PLUM Sub Type:
Job Address: 1069 GOLDENEYE VW
Suite: Lot 0
Location:
APPLICANT DRAIN PATROL
Owner: BUTZ JAMES F&TRAVINO CYNTHIA Y
Remarks:
Total Time:
CD Description
Inspector Assignment:
Phone: 8582544145
Inspector: J~ ----
Requested By: RICHARD
Entered By: ROBIN P,;r Comment
~-------25 Water HeaterNents
Associated PCRs/CVs
Inspection History
Date Description Act lnsp Comments