HomeMy WebLinkAbout1262 MARIPOSA RD; ; CB030465; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
02-18-2003 Plumbing Permit Permit No: CB030465
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
1262 MARIPOSA RD CBAD
PLUM
2122200900 Lot#: 0
Construction Type: NEW
Status:
Applied:
Entered By:
Reference #: Plan Approved:
Project Title: PROVO RES GAS/ELEC TO BBQ GAS
TO FIRE PIT FOOTINGS FOR FUT. PATIO CVR
Applicant:
PROVO MARK
1262 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
TOT AL PERMIT FEES
0
0
0
0
0
1
0
Owner:
PROVO MARK
1262 MARIPOSA RD
CARLSBAD CA 92009
Issued:
Inspect Area:
ISSUED
02/18/2003
SB
02/18/2003
02/18/2003
$20.00
$0.00
$0.00
$0.00
$0.00
$0.00
$7.00
$0.00
$20.00
$0.00
$0.00
$0.00
$47.00
Total Fees: $47.00 Total Payments To Date: $0.00 Balance Due: $47.00
FINAL APPROVAb.
Inspector: Date: Clearance:
NOTICE: Please take N ova of your project includes the "Imposition• of fees, ications, reservations, or other exactions hereafter collectively
referred to as "fees/exacti ns." You 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 Cartsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure wm 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
f'h I \ii 'hh fiinh ix·
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
FOR OFFICE USE ONLY
PLAN CHECK NO.C \5t:, 3c:i'-( ~
EST.;V,AL. ___________ _
Plan Ck. Deposit=--------
Validated By_.?£...JV«--------
Date Z-(6-oJ
Business Name (at this address)
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units
Existing Use Proposed Use Assessor's Parcel #
l('oescriptlon of Work # of Bedrooms # of Bathrooms ~~. 'f[Nb-
, ---
Address City S.tate/Zip Telep one #
llllmll llioiii1iK&L2&1lllll!!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
exemption. Any violation of Section 7031.6 by any applicant for a permit subjects the applicant to a civil penalty of not more than fJve hundred dollars ($600)1.
Name Address City State/Zip Telephone#
State License # _________ _ License Class _________ _ City Business License # _______ _
Designer Name
State License #
Address City State/Zip Telephone
-·~J!lillf[fiiU.1-i-,ll!~,,~~!i~ll!iii"J'i;l1il\JJ00fiii'[iil'ilr0iaili?-
workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
D 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.
D 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 ($1001 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 la unlawful, and shall subject an employer to criminal penaltlaa and clvll fines up to one hundred
thousand dollars ($100,0001, In addition to the coat of companaatlon, damages as provided for In Section 3708 of the Labor coda, Interest and attorney's fea1.
}
SIGNATURE DATE
111111\illlnllll._llll!IBl!l!II 11111 .. lllll!H.I~ .1111-:lllllill I I a Y ! 1~-fflli!,!lll.ll:4111B!!ll.!il
I 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 sate. If, however, the building or ifflprovement 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).
D 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. D YES ONO
2. I (have I have not) signed an application for a bullding 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 I have hired the following person to coordinate, supervise end provide the major work (include name I 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 I address I phone number I type
tworkl: ~
PROPERTY OWNER SIGNATURE_ j ~~a~~~~ DATE i~~~-..,_.,....__, __ ..,_,. . _ _; ~ ------=·-,,--·-·· . ·--. --,--.,---L~~l;l!IR~Mm, ' ,,m ~ll1-.wim'lfil!f~~ • W,;c " AJ!e.~~/rei
Is the applicant or future building occupant required to submit e 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? 0 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? 0 YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site 7 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.
I hereby affirm that there Is a constructlon lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Coda).
LENDER'S NAME _____________ _ LENDER'S ADDRESS, ________________________ _
RM&1CMLBMINl1illllltll~~-~r,1m#~1,~~~fu?;1mf%8fi~iv:~~r;;'fil[~§~~~~M
I certify that I have reed the applicatlon and state that the above Information is correct and that the information on the plans is accurate. I egree to comply with all
City ordinances and State laws relating to building construction. I hereby authorize representatives of the Cltt of Carlsbad to enter upon the above mentioned
property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO 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 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
horize, by such permit Is not commenced within 180 d s from the date of such permit or If the building or work authorized by such permit is suspended or abandoned
ny tin after the work is om n d f eri of 80 s (Section 106.4.4 Uniform Building Code). J i t/ ! nJ
PLIC/. JT•s SIGNATURE ""sJ.Jl..iM--\-\-.,...,--",!A-1,,LI..-"'"""=-----------DATE ~a .... +~-'---=o-lL-t.D=~-----
PINK: Finance
8-10
City of Carlsbad Bldg Inspection Request
For: 03/27/2003
Permit# CB030465 Inspector Assignment: JE ---
Title: PROVO RES GAS/ELEC TO BBQ GAS
Description: TO FIRE PIT FOOTINGS FOR FUT. PATIO CVR
Type: PLUM Sub Type:
Job Address: 1262 MARIPOSA RD
Lot Suite:
Location:
APPLICANT PROVO MARK
Owner: PROVO MARK
Remarks: AM PLEASE
Total Time:
CD Description
23
39
Gas/Test/Repairs
Final Electrical
0
Act Comment
Phone: 7602718021
Inspector: -----
Requested By: DARREN
Entered By: CHRISTINE
M__ ___ cc__----,,---1---------
Jrt_ ---'-t,;"---+-1-+'~.__.,:~-------
Associated PCRs/CVs
lnsgection Histoty
Date Description Act lnsp Comments
03/26/2003 29 Final Plumbing AP JE
03/26/2003 39 Final Electrical co JE HOT & NUTRALS CROSSED ON B B Q OUTLETS
03/21/2003 23 Gas/Test/Repairs co JE NOT COMPLETED 10:20 AM
03/21/2003 31 Underground/Conduit-Wiring WC JE
02/21/2003 11 Fig/Foundation/Piers AP JE ON 2/20/03
02/21/2003 23 Gas/Test/Repairs AP JE
02/20/2003 11 Ftg/Foundation/Piers AP JE
02/20/2003 23 Gas/TesVRepairs NR JE
02/20/2003 31 Underground/Conduit-Wiring AP JE
02/19/2003 11 Ftg/Foundation/Piers co JE NOT READY
02/19/2003 23 Gas/fesVRepairs co JE GAS LINE MAY NOT BE RUN UNDER ANY STRUCTURE. UBC 1211·3
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