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HomeMy WebLinkAbout1335 CHESTNUT AVE; ; CB031662; PermitX UK' 06-17-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB031662 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 1335 CHESTNUT AV CBAD PLUM 2052108800 : ; • Lot#: Construction Type: COULTER RES-GAS TO BBQ& FIRE RINC3 . • 0 NEW Applicant: COULTER WILLIAM I J JR&ANNE E 1335 CHESTNUT AVE CARLSBAD CA 92008 Status: ISSUED Applied: 06/17/2003 Entered By: RMA Plan Approved: 06/17/2003 .Issued: 06/17/2003 Inspect Area: Owner: COULTER WILLIAM I J JR&ANNE E 1335 CHESTNUT AVE CARLSBAD CA 92008 06/17/03 02 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 Additional Fees 0 0 , 0 .0 0 • " 1 , ' 0 $20.00 $0.00 $0.00 ' $0.00 $0.00 $0.00 $7.00 , ' $0.00 $0.00 . $0.00 $0.00 $0.00 TOTAL PERMIT FEES $27.00 Total Fees:$27.00 Total Payments To Date:$0.00 Balance Due:$27.00 Inspector: FINAL APPROVAL Date: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), arid 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 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' 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. PflfiVIIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 FOR OFFICE USE ON PLAN CHECK NO.. EST. VAL. Plan Ck. Deposit Validater^By Date 1. PROJECT INFORMATION' '' Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No.Phase No.Total # of units Assessor's Parcel #Existing Use Proposed Use Description of Work SQ. FT.# of Stories # of Bedrooms # of Bathrooms 2," CONTACT PERSON (if different from applicant) Name Address City J3._ APPLICANT Q,_Cpntractor, ; D _Agent for Contractor _ M Owner. State/Zip Telephone # O Agent for.0wner __ CA- Fax* Name 14- PROPERTY OWNER Address City State/Zip Telephone # City State/Zip Telephone #Name Address 1""'CONTRACTOR-COMPANY NAME ."" J,'' ' ".' •••;-"- _ ; _: -' _,•_._. ',' ','._ , _" ^ " ,', ~~ ~J (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 State License # Designer Name State License # Address License Class Address City City State/Zip Citv Business License # State/Zip Telephone # Telephone # Ji| "WORKER'S COMPENSATION ' : '.' ' ~ ' ', ""°. " ' ' /" 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 worker's 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($100,000), in addition to the cost of compensation, damages are provided for in Section 3706 of the Labor Code, interest and attorney's fees. SIGNATURE ; DATE 7. 'OVWgR-BUItpERDEClARATION' '' '"" """'"'" ' ' '' ~ I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D I, as owner of the property or my employees with wages as their sole compensation, will d 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). j£ 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 contractors) 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 }gTNO 2. I j^javgjhave 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 / tontractors 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 WHITE: File YELLOW: Applicant PINK: Finance PERMIT APPLICATION F CARLSBAD BUILDING DEPARTMENT 1 635 Faraday Ave., Carlsbad CA 92008 Page 2 of 2 COMPLETE THIS SECTION FOR NON&ESIDENTIAL BUILDING PERMITS ONLY ....,..- Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration for 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? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D 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. 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(1) 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, JUDGEMENTS, COSTS AND OSHA: An OSHA permit is required for excavations of 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 180 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 for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE Md&SLsZrt&^-^Tl DATE ^_ WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 12/16/2003 Permit* CB031662 Title: COULTER RES-GAS TO BBQ& FIRE Description: RING, ELEC TO OUTLETS@BBQ,FRNT& SPA Inspector Assignment: JE 1335 CHESTNUT AV Lot 0 Type: PLUM Sub Type: Job Address: Suite: Location: APPLICANT COULTER WILLIAM I J JR&ANNE E Owner: COULTER WILLIAM I J JR&ANNE E Remarks: Phone: 0000000000 Inspector: * Total Time: CD Description 23 Gas/Test/Repairs 29 Final Plumbing 39 Final Electrical Act Comment Requested By: WILLIAM COULTER Entered By: CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 06/23/2003 31 Underground/Conduit-Wiring AP JE CONDUIT ONLY 06/19/2003 23 Gas/Test/Repairs AP JE 06/19/2003 31 Underground/Conduit-Wiring CO JE NEED TO ADD MISC ELEC AND FUTURE SPA TO PERMIT AND HAVE CONDUIT INSPECTED