HomeMy WebLinkAbout1308 CASSINS ST; ; CB991347; Permit04/07/1999
City of Carlsbad
Plumbing Permit Permit No:CB991347
Building Inspection Request Line (760) 438-3101
Job Address:
Permit Type:
Parcel No:
Reference #:
Project Title:
1308CASSINSSTCBAD
PLUM
2156904200 Lot#:
Construction Type:
GAS LINE FOR BBQ W/ELEC
0
NEW
Status: ISSUED
Applied: 04/07/1999
Entered By: DT
Plan Approved: 04/07/1999
Issued: 04/07/1999
Inspect Area:
Applicant:
SECRET GARDENS
STE153
422 W SAN MARCOS BL
SAN MARCOS CA 92069
760-591-0231
H JR&JEANNE B
Total Fees:$47.00 e Due:$47.00
\s~
Plumbing Issue Fee ~ > **.
Fixture or Trap T «- 1
Building Sewer ! f ,-J- '• -
Roof Drain ; ' \- '-
Install/Repair Water Line
Water Heater and/or Vent ~_
Gas Piping System " :
Vacuum Breaker :
Other Plumbing Fees -
Master Drainage Fee "-'"**
Sewer Fee
0
0
V - , 0
g
o • •1
-. 0
**• •.''-" « -4i "•*'--' i- - 5i,' .;,>3^r *
'-' * L4' ' **•»
4-
,1 •*
?^rt>- ^5 i< ^i?
S-l
, $ *,. ?•»' , , ss-Vr^^* ,- ^-'* S--s^-^- ^- -- ^4"*-r ' - > f
„ , L •? * T ' " *~r
, ^$^~; ^^ v "
11%"--*:, 'j-'
%^ ', -»-^4~-4~
*L
$20.00
WO.OO
^ $0.00
V $7.00
$0.00
$20.00
$0.00
$0.00
TOTAL PERMIT FEES $47.00
SECTION 106.4.4
Inspector:
FINAL APPROVAL
SIDate:
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 wfth this project NOR DOES IT APPLY to any
fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired.
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. PROJECT INFORMATION ,
FOR OFFICE USE ONLY
PLAN CHECK
EST. VAL.
Plan Ck. Deposit
Validated By.
Date
Address (include Bldg/Suite *)Sf-.usiness Name (at this address)
Legal Description Lot No.Name/Unit No.Phase No.Total # of units
Assessor's Parcel tt
Description of Work
2. CONTACT PERSON (tf drfferent from applicant)
Existing Use Proposed Use
Name State/Zip Telephone *Fax #Address
Contractor Q Agent for
Name Address
6. CONTRACTOR - COMPANY NAME
(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. Anu^uiolation of S/clion 7031.5i>y arm,applicant for a permiusubjects the applicant to a civil penalty of not more than five hundred dollars ($5001)." fit
Name
State License #
Address
License Class
City State/Zip
City Business License *
Telephone #
Designer Name Address City State/Zip Telephone
State License #
6. WORKERS'COMPENSATION ,1
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
G 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.
l£\ 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 cc/npensation insurance carrier and policy number are: ,>—^» ...._* s\{3 A
'II Expiration Date 4" ' *Insurance Company Policy No.
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100) OR LESS)
G 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 worhefs^jeomnenaation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars (jJjUu.BJWl. juM3Hwi to thfc cost of compensation, damages as provided for in Section 3706 of the Le,bof code, interest and attorney's fees.
SIGNATURE ^"-^S'^i^r'Vai .V^"""*?"' DATE
7. OWNER-BUILDER DECLARATION ' ( L
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
G 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).
G 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).
l~l 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):
4. I plan 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 I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type
of work):
PROPERTY OWNER SIGNATURE DATE
COMPLETE THIS SECTION FOR WO/V-fifS/OeVTMi BUILDING PERMITS ONLY , , . , ,
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? 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? 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 RNAL 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. CONSTRUCTION LENDING AGENCY
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
9. APPLICANT CERTIFICATION ___ ..
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 City 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.
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 authorized by such permit is not commenced within^2Q5 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 \ygfiris~gpmiijjQi-n/^pr a Period of 180 days (Section 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE
WHITE: File YELLOW: Applicant PINK: Finance
DATE
City of Carlsbad Inspection Request
For: 4/26/99
Permit* CB991347 Inspector Assignment: SP
Title: GAS LINE FOR BBQ W/ELEC
Description:
Type: PLUM Sub Type:
Phone: 7605910231
Job Address: 1308 CASSINSST
Suite: Lot 0 p
Location: Inspector: >\
APPLICANT : SECRET GARDENS
Owner: WELLS KENNETH H JR&JEANNE B
Remarks:
Total Time: Requested By: ALAN
Entered By: CHRISTINE
CD Description Act Comments
21 Underground/Under Floor
23 Gas/Test/Repairs
Inspection History
Date Description Act Insp Comments
4/19/99 21 Underground/Under Floor CO SP SEE NOTICE ATTACHED
4/19/99 31 Underground/Conduit-Wiring AP SP
4/15/99 21 Underground/Under Floor WC SP
4/15/99 23 Gas/Test/Repairs CO SP
4/15/99 31 Underground/Conduit-Wiring AP SP
City of Carlsbad Inspection Request
For: 4/19/99
Permit* CB991347
Title: GAS LINE FOR BBQ W/ELEC
Description:
Inspector Assignment: SP
1308 CASSINSST
Lot
Type: PLUM Sub Type:
Job Address:
Suite:
Location:
APPLICANT : SECRET GARDENS
Owner: WELLS KENNETH H JR&JEANNE B
Remarks: 591-0231 613-3200
Phone: 7609189949 HOMEO
Inspector:
Total Time:
CD Description
21 Underground/Under Floor
31 Underground/Conduit-Wiring
Requested By: ALAN
Entered By: CHRISTINE
Act Comments
CD
Inspection History
Date Description Act Insp Comments
4/15/99 21 Underground/Under Floor WC SP
4/15/99 23 Gas/Test/Repairs CO SP
4/15/99 31 Underground/Conduit-Wiring AP SP
NOTICECITY OF CARLSBAD " ^ ^^ " " ^^ ^^ (760)438-3550
BUILDING DEPARTMENT 2075 LAS PALMAS DRIVE
DATE - TIME
LOCATION ( 3 O %
PERMIT NO.
f/re
FOR INSPECTION CALL (760) 438-3101. RE-INSPECTION FEE DUE?YES
FOR FURTHER INFORMATION, CONTACT •57^t/£ F)^^/A/> 7-9
PHONE
BUILDING INSPECTOR CODE ENFORCEMENT OFFICER
City of Carlsbad Inspection Request
For: 4/15/99
Permit^ CB991347
Title: GAS LINE FOR BBQ W/ELEC
Description:
Inspector Assignment:
Type: PLUM Sub Type:
Job Address: 1308 CASSINS ST
Suite: Lot 0
Location:
APPLICANT : SECRET GARDENS
Owner: WELLS KENNETH H JR&JEANNE B
Remarks:
Phone: 7609189949 HOMEO
Inspector:
Total Time:
CD Description Act Comments
21 Underground/Under Floor \jjC-
31 Underground/Conduit-Wiring
Requested By: ALAN
Entered By: CHRISTINE
Inspection History
Date Description Act Insp Comments
NOTICECITY OF CARLSBAD " ^ ^^ " • ^^ ™~ (760)438-3550
BUILDING DEPARTMENT 2075 LAS PALMAS DRIVE
DATE T " ' ^> ' y 7 TIME_
LOCATION / ^ £> % C ASS / A/ 3
PERMIT NO.
FOR INSPECTION CALL (760) 438-3101. RE-INSPECTION FEE DUE?
FOR FURTHER INFORMATION, CONTACT
YES
PHONE
BUILDING INSPECTOR CODE ENFORCEMENT OFFICER
COMPENSATION
INSURANCE
FUND
r'H V.
r :<):
! i" t1'»'
1 ' li u
P.O. BOX 420807. SAN FRANCISCO, CA 94142-0807
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
POLICY NUMBER:
CERTIFICATE EXPIRES:
L
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the CalifOrflja
Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer.
We will also give you TEN days' advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the
policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document wftfi
respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the poHcies
described herein is subject to all the terms, exclusions and conditions of such policies.
AUTHORIZED REPRESENTATIVE PRESIDENT
EMPLOYER
r
THIS DOCUM lfiM!FiK»iw:TllIa»iiM3slJlaMs»»wii5fiH-iwi