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Home My WebLink About1361 CASSINS ST; ; CB053479; Permit105)04-2605 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB053479 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 1361CASSINSSTCBAD PLUM 2156914100 Lot* 0 Construction Type: NEW HUDSON RES NEW H20 HEATER Status: ISSUED Applied: 10/04/2005 Entered By: SB Plan Approved: 10/04/2005 Issued: 10/04/2005 Inspect Area: Applicant: MY PLUMBER STE603 5490 COMPLEX ST 92123 760 729-4326 Owner: HUDSON FAMILY TRUST 03-26-04 1361 CASSINS ST 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 0 0 0 0 1 0 0 $20.00 $0.00 $0.00 $0.00 $0,00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $27.00 Total Fees:$27.00 Total Payments To Date:$27.00 Balance Due:$0.00 EXPIRED PERMIT PERMIT HAS EXPIRED IN ACCORDANCE WITH C.B.C. SECTION 106.4.4 AS AMENDED BY C.M.C.18.04.030 NOTICE: Please take NOTICE that approval of your project includes the Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as lees/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/exactore TOES NOT APPLY to water ajxJsevwam^^ changes, nor planning, zoning, grading or otr^sMarapplicatkw processing «servk» fees in c^^ NOR DOES IT APPLY to any lees/exactions of which vou have oreviouslv been alven a NOTICE similar to this or as to which the statute of limitations has oreviouslv otherwise exoired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK EST. VAL. 79f Plan Ck. Deposit Validated Date » — 73 T Address (include Bldg/Suita #)Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total f of units Assessor's Parcel *.Existing Use Proposed Use Description of Work SQ.FT.f of Stories t of Bedrooms * of Bathrooms Name 'Addr«s City State/Zip Telephone* s&'&f^z C-^SZS wsamaaa'ftusfflfcaiffltg'^.ffiflffia}^ '"^^ ^^^ rft.Q2V2S 3^-2200 Name Address City State/Zip Telephone * \?\Q\ Name Address City State/Zip Telephone * (Sec. 7031.B 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, commanding with Section 7000 of Division 3 of the Business end Professions Code) or that he is exempt therefrom, and the besis 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 1*5001).w •fHPGS Name f State License * Address License Class City ^ State/Zip City Business License * \'2- Telephone * Designer Neme State License *. Address City State/Zip Telephone Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Q I have and will maintain a certificate of consent to self-insure for workers* compensation as provided by Section 3700 of the Labor Coda, for the performance of the work for which this permit is issued. Br I have snd 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 _fe@bl Policy No._££2^C£ Expiration Date Ai"Ql'OCp (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*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 ss to become subject to the Workers' Compensation Laws of California. WARNING: FaBura to secure workers' compensation coverage la unlawful, and anal subject an employer to criminal penalties and ehrf fines up to one hundred thousand doflars (9100.000). ta addrtfon to the cost of compensation, damages as provided for in Section 3706 of the Labor coda. Interest and attorney's fees. SIGNATURED ^H} fjj A ^Ti t^Jl f'ti& I hereby affirm that I am exempt from the Contractor's License Law for the following reason: Q 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 hot 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). Q I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business snd 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. Q YES QNO 2. I (have / have not) sighed an application for a building permit for the proposed work. 3. I have contracted with the following parson (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 NO 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 2S605, 26633 or 26S34 of the Presley-Tanner Hazardous Substance Account Act? <• Q YES Q 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 Q 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. ' 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 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. 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 S'O* deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by trie building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE ^^-^gjut-A {/^CCj^lffil DATE *_>: WHITE: File YELLOW: Applicant PINK: Finance 04/11/2005 12:29. 9512963778 BBSI PAGE 87