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Home My WebLink About1255 MARIPOSA RD; ; CB033297; PermitCity of Carlsbad • 1635 Faraday Av Carlsbad, CA 92008 11-26-2003 Plumbing Permit Permit No: CB033297 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 1255 MARIPOSA RD CBAD PLUM 2122204200 Lot#: 0 Construction Type: NEW Status: Applied: Entered By: Reference #: Plan Approved: ISSUED 11/26/2003 SB 11/26/2003 11/26/2003 Issued: Project Title: NEELEMAN RES GAS FOR FIRE PIT Inspect Area: Applicant: NEELEMAN FAMILY TRUST 04-09-93 1255 MARIPOSA RD CARLSBAD CA 92009 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: $27.00 Owner: NEELEMAN FAMILY TRUST 04-09-93 0 0 0 0 0 1 0 1255 MARIPOSA RD CARLSBAD CA 92009 Total Payments To Date: $0.00 9695 11/26/03 ~ijp)l $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 Balance Due: $27.00 02 , •. .:.7 .,.,JO Flt~AL APPROVAL SIGNATURE FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NOk%~32 7 7 CITY' OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. _________ _ Plan Ck. Deposit Business Name (at this address) Lot No. Subdivision Name/Number Unit No. Phase Total # of units Proposed Use # of Bedrooms # of Bathrooms Name Address City State/Zip Telephone# Fax# --l1iil;lfiiiiill~RMIAIIIIB!iBl!~l<,io■!l'Dlliillil11:!~i:ioii:i,~Mli<•••,1', ::\ci,". • :,:. ·,:\,!ll'-/c;,:1:,i:)'.jlj\;j;e,:~",'·,.'·f :. ::p:, ,· ::::: E'l'' · . Address City State/Zip Telephone# Name Address City S.tate/Zip Telephone # --■---■aiiii!lli .... ilfii!l!Mf!~!~ltit'~f,iAf~J::1:;i~~;i!~d~fit:1~!~)~:qbt;;';'.~-,i;il•?i.,;:~;~i;,t;-z~;;~}4~;;)?i~~iEt~~;t~lit.l~~' i~lid:;1,!~tli!ll:l1:~~i;;l:8~:~t (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 of not more than five hundred dollars ($5001). Name Address City State/Zip Telephone# State license # _________ _ License Class _________ _ City Business License # _______ _ Designer Name Address City State/Zip Telephone State License # _________ _ 1:1:~l/:,%'WjmJ{1Jis.ldb:MNNU:rtON~~~%' '.)i;,ii i:£<k'.l:i'YL ., c,-:".C:L:>';!J,', , , ';;;i;> ;:1"::\f>±,';);'i' Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 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 of the work for which this permit is issued. 0 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 carrier and policy number are: Insurance Company______________________ Policy No._____________ Expiration Date _______ _ (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 to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars 1$100,000), In addition to the cost of compensation, damaga, as provided for In Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE,______________________________ DATE _________ _ iMdldliM1.jliji:ffC«C~TiONlit~~X&*l,k'i,tiffififr'~~jWffig;\Yfi.~jti0i#;H:gqtf,¥:00J-S;'>\G'¥t+$f&>,'.,,:;~;'.1f<:':'.;a:;µi,::j~;<i1f25!itld~#xlJ:iiii1hli~ii'.t>;if~$:;;;;;,,ly[_;111fi2'~,i;°i;'.,/¥H;fiP'.';;?'i1!·-t I hei"eby affirm that I am exempt from the Contractor'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 not build or improve for the purpose of sale). D 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). 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. 6il YES ONO 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): 4. I plan to provide portions of the work, but l have hired the following person to coordinate, supervise and provide the major work (include name / address / 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 / address / phone number / type work): ________ ~-~------=------------------------~---------------- PROPERTY OWNER SIGNATUR~ ~a.A~ DATE it I a:tl /f)3 :crii.lll'11-:C'ycf!Fi.&la'.'ScCTIQ' il.i'i:!:l'lnYaiii•li~,:B~o-,h'J:'Uff.ii1i,[a'lill:'.riJi1q'"fync8M'"' ~IT, 'a,.,.,.;,·tlf~',1&J,·)i;)i!<'1ti.Ngi:v,·.,_:,;,:\id'i:-:-·;'.'if0t:w:10/;_·,-:~:,1';,i.fC:{j"1'.,20&jlfuiLl-:c1;1[,}f(i~;;+_:,,,i, _ _;.: '· ·::. 0:;,,\ .·i'.\,'~1:C'.:.l ''s,.i/'.','.)0;i.•.-c,,.:;if-'_",,;k. '-• -"'""'~' ,Jliil!J! H .. ..-,1~ ...... .,~. J,i)--"¥!'1'\t•,v,!l)"Jl'J11;;J•HV6" .. _lµ:,l'!o!, ... M!~ , .... J.ir:!l!i ' .. .,@'~ .. 'i~Th. u "''""'~"'"'' :~i!!'.k&"=.,-,,_ /,:-;.'.,di6,;1¼-,il,.V,~,,;;;u;;n>'.;J,!J ~,t;:j),daj/\j,,:;,,.ii~,;,fr::ir,:ob:-L,/ , ... . .. . . , ,--"· ..... . 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 26505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES O NO Is the facility to be con5tructed within 1,000 feet of the outer boundary of a school site? 0 YES D 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. r1~trA11tB!nld.QlliJ:: ,_ .. .Cl!Mil(~~1¢X:;;~t:!¥l22£,:)!,-.J;j:,~~i;: ·t?.fHrJ::::~~:;:;'~f.~~1~::'.::~~;:},;,:\l ';;,_::,:/:;;:-al{::;:_·,;,:: ',_,'y:,:tI~ZL ':;,.;;;;; :~ ·- 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, ________________________ _ ,iiljlilAISliirlllllil!llll!lil:.:n,uii111Wl~iii~1i1lil~iiilli~.l~W~£~,:;:.;/~:·:'.:!ii1l~i:f;•::),P~~~Mii~~ilt:i'.i:!~!":!l!;•~l,;.~~fiitiJ1,:i:s;;!f.~~ial~&i.lii'.".i:~:-!it:;;:'..2,df;;;;j;;b!i1t~~;!~\:'!:?~-.::::1.i;;.!~f:i\..'ii1tl~l~\-ii:S:· I certify that I have read the application and state that the above information is correct end that the information on the plans is accurate. l 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 aulhorized 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 jt{any time after the work· mane d for a peri , of 180 days (Section 106.4.4 Uniform Building Code). A' APPLICANT'S SIGNATURE s:;~~n}.~_<:a_A~~_l~~U..dl~k>---------- \) WHITE: File YELLOW: Applicant PINK: Finance DATE _.,_lf.._./c.o?'.v'-"'-4'1.o",3.;>----- m . . City of Carlsbad Bldg Inspection Request For: 04/05/2004 . Permit# CB033297 Title; NEELEMAN RES GAS FOR FIRE PIT Description: Type: PLUM Sub Type: Job Address: Suite; Location: 1255 MARIPOSA RD Lot 0 APPLICANT NEELEMAN FAMILY TRUST 04-09-93 Owner: NEELEMAN FAMILY TRUST 04-09-93 Remarks: CARDS WILL BE OUTSIDE Total Time: CD _D_e_s_c-rip-t-io_n _______ p/) Comment 29 Final Plumbing E- Associated PCRs/CVs Inspection History Date Description 01/08/2004 23 GasfTest/Repairs 12/31/2003 23 GasfTest/Repairs Act lnsp Comments AP PD AP PD Inspector Assignment: PD --- Phone: 858]67~ lnspectdL__ Requested By: JIM Entered By: CHRISTINE