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Home My WebLink About130 HEMLOCK AVE; ; CB992075; PermitCity of Carlsbad 05/28/1999 Plumbing Permit Permit No:CB992075 Building Inspection Request Line (760) 438-3101 Job Address: Permit Type: 130 HEMLOCK AV CBAD PLUM Status: ISSUED Parcel No: 2042510600 Lot#: 0 Construction Type: NEW Reference #: Project Title: GAS LINE TO FIRE PIT-FRONT Applicant: RONALD KAGEL 130 HEMLOCK AV CARLSBAD CA 92008 760 729-2400 Applied: 05/28/1999 Entered By: RMA Plan Approved: 05/28/1999 Issued: 05/28/1999 Inspect Ar.ea; Ol::,;6 05/28/99 0001 01 02 C-PRHT 27 -00 Total Fees: $27.00 ~ :Payments To Date; · · $0.00 '.l:lil111ce Due: $27.00 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 TOTAL PERMIT FEES . ' ' .. 0 p . 0 ,o 0 1 .a FINAL APPROVAL Date: f ·(f ·f f $~0.00 ·$0.00 ;$0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $27.00 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 capactiy 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. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 " PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 1. A:IIE FOR OFFICE USE ONL V O -"?r C PLAN CHECK NO. q9<?'---U .J EST. VAL. _________ _ Address (include Bldg/Suite #) Business Name (at this address) Lot No. Subdivision Name/Number Existing Use Description of Work SO. FT. G-c,.s-/, 11 e To Fr iJ2. ~-~ '2?-: ,.A,,,,- • CQl{L~C~IW)NJ!! 4iffffln.UJ9rn eppllc;antl Name 3. Address #of Stories 61Mwt l 7c,~✓ 4 ~~ City 0 ..hllent f.s>! Owner City Unit No. Phase No. Total # of units Proposed Use I of Bedrooms I of Bathrooms State/Zip Telephone# Fax# State/Zip Telephone# (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 ($500)). Name Address City State/Zip Telephone # State license # _________ _ License Class _________ _ City Business License # _______ _ Designer Name Address City State/Zip Telephone State License # _________ _ " I hereby affirm under penalty of perjury ona 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: Ins ranee Company______________________ Policy No. Expiration 0~te ______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS) 0 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 ia unlawful, and shall subject en employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of compen111tion, damages as provided for In Section 3706 of the Labor code, Interest and attorney's fees. () SIGNATURE.____________________________ DATE --::;;=:;::;::::===-~ 7. OWNER-JUILDeR DECLARATION I h~by affirm that I am exempt from the Contractor's License Law for the following reason: _if 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 sol~ithin 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). ~ 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: I personally plan to provide the major labor and materials for construction of the proposed property improvement. ~ES O NO 2. ~/have not) signed an application for a building permit for the proposed work. 1. 3. I h e contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number): a.. 4. to provide portions of the work, but I 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 ve ontracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work): ___________ .....t.....L--':::..L-------------------------------7""----------- PROPERTY OWNER SIGNATURE ~ .. <2 /'YI.=: _,:::,~ ~ co~~E THI$ S{CTJON FOR IION~ESIDEN~L B!,llLj)lf\lQ PE!J~~y _, -- Is the applicant or future bull<fing occupar.! required to s· •"mit a businoH p!an, ~cutely hazardo1•; materials registration form or risk management and prevention program under Sections 25505, 25633 or 25534 of the Presley-Tanner Hazardous Substance Account Act7 0 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 1,000 feet of the outer boundary of a school site7 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 MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 8. _g).lfllB!,&.'IIM L1fml!'!IGAG~CY ·------•--------,,, 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 ______________ _ !i. Al!PIJ,CAN ~Tlfl~JIQf{ 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 permit Issued by the Building Official under the pro·IAsions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced or a period of 180 days [Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE ~ ~ ~ DATE~~, ... 5:......,..h.='-2=.,8:;""--/4:.......L....,.7'----- WHITE: File YELLOW: Applicant PINK : Finance City of Carlsbad Inspection Request For: 6/2/99 Permit# CB992075 Title: GAS LINE TO FIRE PIT-FRONT Description: Type:PLUM Sub Type: Job Address: Suite: Location: 130 HEMLOCK AV Lot APPLICANT RONALD KAGEL 0 Owner: EBLOWITZ FAMILY TRUST B 09-16-81 Remarks: Total Time: Act Comments Inspector Assignment: Phone: 7607292400 lnspectod.L Requested By: RON Entered By: CHRISTINE CD Description 21 Underground/Under Floor 23 Gas/Test/Repairs f_ __ _ Inspection History Date Description Act lnsp Comments