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Home My WebLink About1145 CARLSBAD VILLAGE DR; ; CB043227; Permit08-16-2004 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB043227 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 1145 CARLSBAD VILLAGE DR CBAD PLUM 1561802600 Lot# Construction Type 0 NEW SHELL CAR WASH-CONNECT TO EXISTING LINE-STRIP DRAIN TO CLARIFIER Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 08/16/2004 RMA 08/16/2004 08/16/2004 Applicant ENVIRONMENTAL PROJECT SERVICES STE 203 1585 SOUTH DST 92408 909 889-7799 Owner HELTIBRIDLE FAMILYTRUST 11-13-95 P O BOX 3663 TUSTINCA 92781 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Dram Install/Repair Water Line Water Heater and/or Vent Gas Piping System Vacuum Breaker Other Plumbing Fees Master Drainage Fee Sewer Fee Additional Fees 0 1 0 0 ' 0 0 0 • $2000 $000 $1500 $000 $000 $000 $000 $000 $000 $000 $000 $000 TOTAL PERMIT FEES $3500 Total Fees $3500 Total Payments To Date $000 Balance Due $3500 S9S3 08/16/04 0002 CG Inspector FINAL APPROVAL Date 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 you have previously beenjiven a NOTICE similar to this, or as lo which the statute of limitations has previously otherwise expired PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date 3 SLL 7 Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No Subdivision Nsma/Number Unit No Phase No Total # of units Assessor's Parcel #Existing Use Proposed Use Address City (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 iJSction 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 J31»¥J»ny applicewfe* a peon it subjects the applicant to a civiljpenattywt nca more than«(jve hundred dollars JS 50011 Name Q^ AJdress-^ j_^ State License # I**-* 7 V~T^\ License Class V\ XV Designer Name Address State License ff City State/Zip Telephone # CT 9 l / ;> City Business License ff \2-iX_EuOVO 1 A 1 ' CffiQ GO& 7*7 City State/Zip Telephone1 l O Cl I Srs' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations 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 [5r 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 carn«.and policy number are A Insurance Company ^"^"C Bft^T^^-, ^^.f^t^STr^ Policy No \*—-A^/l ^* *-^,.c.J ^-* Expiration (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) Q 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 WfirKeiV Compensation Laws of California WARNING \Failure to\tecurfe worlmrs' compensation coverage Is unlawful, and shall subject on employer to criminal penalties and civil fines up to one hundred thousand dollaMi jilfifLOOO), (B addition to the coat of conjbensation, damages as provided for in Section 3706 of the Labor code, irUeust and attorney's feet SIGNATURE V-3j^ ^"'^V^-^ _ DATE I hereby affirm that I am exempt from thoGemfactor's License Law for the following reason Q 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 ha did not build or improve for the purpose of sale) [^1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec 7044, Business end 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 contractorfs) licensed pursuant to the Contractor's License Law) Q 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 Q YES QNO 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 number / contractors license number) _ s 4 I plan to provide portions of the work, but t have hired the following person to coordinate, supervise and provide the major work (include name / address / phone number / 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 / address / phone number / type of work) _ ___ _ _ _ _ PROPERTY OWNER SIGNATURE DATE fwumri-cusrinia OC^MVII rurvy*w*Y-ncoivc/»(*«t DuiLuinu.rcnifli 10 ui»uia;^ j^iBiu,; Hi_y>^£™ -j.B^i , ^U s.Lr^.-.y ,. ,. __Z' i f s > i' ' ,*„ >„. : 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? Q YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES Q NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MA> 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 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 W iffegrff ,f*Kt!&4«ii4^ias!l"iit^irS;f:Ss,"1i <-i,A --,_ jj jjsr"1 "•".'•ijw ',.1 ft'1*! »4^"*T|^( *5"»j" *--"£> «su ) D — '.^' — i « '.., v < i 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 CitV 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 fofTTafiflvations over 5'0" deep and demolition or construction of structures over 3 stories in height EXPIRATION Every pejaujsgued by the buittimg Official under the provisions of this Code shall expire by limitation and become null and void it the building or worfc authorized by such permit is no7corttrReV;ed witmn 180 days from^he date of such permit or if the building or work authonzed by such permit is suspended or abandoned at any time after the work is comrBenceoNor a peViod of 180 days (Section 106 4 4 Uniform Building Code)y / . i ^ c\ 8 DATEAPPLICANT'S SIGNATURE YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 09/09/2004 Permit* CB043227 Title SHELL CAR WASH-CONNECT TO Description EXISTING LINE-STRIP DRAIN TO CLARIFIER Inspector Assignment TP 1145 CARLSBAD VILLAGE DR Lot 0 Type PLUM Sub Type Job Address Suite Location OWNER HELT1BR1DLE FAMILY TRUST 11 -13-95 Owner HELTIBRIDLE FAMILY TRUST 11-13-95 Remarks STRIP DRAIN INSPECTION Phone 7148157709 Inspector Total Time CD Description 22 Sewer/Water Service Act Comment Requested By BOB Entered By CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 09/02/2004 21 Underground/Under Floor AP TP