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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. 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