HomeMy WebLinkAbout1493 PINE AVE; MULTI-PERMIT FILE; CB033116; PermitCjd^
11-17-2003
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing Permit Permit No: CB033116
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Reference #:
Project Title:
1493 PINEAVCBAD
PLUM
Lot #: 0
Construction Type; NEW
BONGIORNI RES-REPLACE GAS LINE
TO HOUSE & REPLACE WATER HEATER
Applicant:
PEGGY BONGIORNI
Status:
Applied:
Entered By;
Plan Approved;
Issued:
Inspect Area:
Owner:
PEGGY BONGIORNI
ISSUED
11/17/2003
KMT
11/17/2003
11/17/2003
1493 PINE ST
760-729-6958
1493 PINE ST
760-729-6958
Plumbing Issue Fee $20.00
Fixture or Trap 0 $0.00
Building Sewer 0 $0.00
Roof Drain 0 $0.00
Install/Repair Water Line 0 $0.00
Water Heater and/or Vent 1 $7.00
Gas Piping System 1 $7.00
Vacuum Breaker 0 $0.00
Other Plumbing Fees $0.00
Master Drainage Fee $0.00
Sewer Fee $0.00
Additional Fees $0.00
TOTAL PERMIT FEES $34.00
Total Fees:$34.00 Total Payments To Date:$0.00 Balance Due:$34.00
8810 11/17/03 0002 01 02
34-00
\ !NSP>
CLEARANCE,
PPROVAL
ft'/'Odate.
PERMIT APPLICATIOIM
CITY OF CAf^LSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad. CA 92008
I PROJECT INFORMATION f "viu /.'w ;
FOR OFFICE USE OMLY
PLAN CHECK NO
EST. VAL.
ONLY
.QM^Lp
Plan Ck. Deposit
Validated By_Date / / / 7 ^
Address (include BIdg/Suite It)Business Name (at this address)
Legal Description Lot No.Subdivision Name/Number Unit No.^ase No.T otal # of units
Assessor's Parcel #Existing Use Proposed Use
j/ Qucrtption of Work SQ. FT. ror siories # or Deoroorris ^ »or i
<SA6 u Tb j cocti-i-T' -
,2., CONtACT PERSON (if diffeient frornaiMeantrJi . i. v'T'i v - v :
#of Stories H of Bedrooms 0 of Bathrooms
Name Address
3. /y^PLICANT ri Contractor, O Agent for Contractor
City
^Owner .Q Agent for Ownw '
State/Zip Telephone # Fax It
Name
4. ,PRlCPFfftyt>WrlER
Address City State/Zip Telephone #
City State/Zip Telephone #Name Address
;S;-V"XONTBACTOR::-COMPANYNAMB-"'-r^'''^-'''^'''<"''!''' - i-.-.r:---- rij.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 subiects the applicant to a civil penalty of not more than five hundred dollars ($500)).
Name
State License #
Address
License Class
City State/Zip
City Business License #
Telephone #
Designer Name
State License It
Address City State/Zip Telephone
e. WORKERS' COMPENSATION
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 Code, for the performance
of the work for which this permit is issued.
□ 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 (»100] 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 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 as provided for in Section 3706 of the Labor code. Interest and attorney's fees.
SIGNATURE^ DATE
7; OWNER-BUILDER DECLARATION1 hereby 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 sola 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 doessuch work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement issold 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).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The
Comractor'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).
0 I am exempt under Section Business and Professions Code for this reason:
1. Ijuugonally plan to provide the major labor and materials for construction of the proposed property improvement. Q YES
2. (1 (havOT/ have not) signed an application for a building permit for the proposed work.
3. iJlTve contracted with the following person (firm) to provide the proposed construction (include name i address / phone number / contractors license number):Vo ^vV.g^v-) :
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 ^ ^COMPLETE THIS SECTION FOR /Yd/V-Af^^TSdT^LDINQ PERMITS ONLY; J' i n ^ i i
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and preventionprogram under Sections 26505, 25533 or 25634 of the Presley-Tanner Hazardous Substance Account Act? Q 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? O 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 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 , ' . ' ' ,
1 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., .APPLICANTCERTlFiCATION-, r;
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 or ine Cit^ 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 CONSEOUENCE 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 ^-(he^COndln^^pTrrcla! under the provisions of this Code shall expire by limitation and become null and void if the building or workauthorized by such permit is not cofrimenced withinJ60 ^ys from ^e date of such permit or if the building or worit authorized by such permit is suspended or abandonedat any time after the work is comi^encedJo^^lD^i^^^SO days (Section 106.4.4 Uniform Building Code).
■—. DATE / 7 - .
DATE
APPLICANT'S SIGNATURE
C /MITE: Fits YELLOW: Applicant PINK: Finance
1
City of Carlsbad BIdg Inspection Request
For: 11/26/2003
Permit# CB033116
Title: BONGIORNI RES-REPLACE GAS LINE
Description: TO HOUSE & REPLACE WATER HEATER
Inspector Assignment: PD
Type: PLUM Sub Type:
Job Address: 1493 PINEAV
Suite: Lot (
Location:
APPLICANT PEGGY BONGIORNI
Owner:
Remarks: EARLY AS POSSIBLE
Phone: 7607296958
Inspectj^f:
Total Time:
CD Description
23 Gasnrest/Repairs
25 Water HeaterA/ents
Act Comment
L
Requested By: PEGGY
Entered By: CHRISTINE
Tftr
Associated PCRs/CVs
Inspection History
Date Description Act Insp Comments
11/24/2003 23 Gas/Test/Repairs CO PD
11/24/2003 25 Water Heater/Vents CO PD
11/21/2003 23 Gas/test/Repairs CA BY PEGGY
USE BALL POINT PEN ONLY & PRESS HARD
Q ' that I am llcanaad under
provisions of Chapter 9 (commencing with
Section 70(X)) of Division 3 of the Business
ar>d Professions Code, and my license is In
full force and effect.
lie. No Class
I hereby allirm tnai I am exampi from the Contrac
tor's Ltcensa Law lor the loilowing reason (Sec. 7031.S
Business and Protessions Code: Any city or county which re
quires a oermit to constnicl. alter, improve, demolish, or
repair ariy structure, prior to Its issuance also r^uires the ^
pJIcani tor such permit to file a signed statement that he Is
licensed pursuant to the provisions of the Contractor's
License Law [Chapter 9 commenclno with Section 7000 olDivision 3 ol the Business and Prolssibns Code) or that is ei-
anpt iheretrom and the basis for the alleged exemption. Anyviolation of Section 7031.S by an appilcani icra pormlt sub
jects the appilcani to a eWll penalty o) not more than live hun
dred dtflars ($900).
□ I, asowner ol the property, or my employees with wagesas their Ms compensation, will do the work, and the structure is not intended or ottered for sale (Sec. 7044, Businessand Professions Code: The Contractor's License Law doesnot apply to an owner ol properly who bulWs or improvesthereon and who does such work himsetl or through his ownemployees, provided that such improvements are not intended or oHered for sale. If. however, the building or improve-mem is siAt within one year ol completion, the owner-builderwill have Ihe burden of proving that he did not build or Improve for the purpose of sale)
□ I. as owner of the property, am exclusively contractingwl0i llcen^ contractors to construct the projeci (Sec. 7044,
Business and Professions Code: The Contractor's LicenseLaw does not apply to an owner ot property who builds or Improves thereon, and who contracts lor each projects with a^traclor(s) license pursuant to the Contractor's License
□ As 8 homeowner lam Improving my home, and Ihe following conditions exist:1. The work is being pertormed prior to sale.2. I have lived In my home for twelve monthsprior to completion cri this wortr.3. i have not claimed Hits exemption during Ihelest three years.
□ lamexemptunderSec.
lor this reason
..B&P.C
Q I herebyalfirm that I haveacerlificateol c
10 self-insure, or a certificate of W<Compensation Insurance, or a certified copy(Sec 3B00. Labor Code) y /
POLICY NO
^^^fopy IS liled with the city
O Certified copy >s fiereby lumisried
CERTIFICATt OF EXEMPTION FROMWORKERS' COMPENSATION INSURANCE
(This section need not be completed if trie permitIS lor one hundred dollars |$100) or less)
□ I certify thai m the performance of ihe worir forwhich this permit is issued. I shall not employ anyperson m any manner so as lo become subject to
the Woritets Compensation Laws of Caiilorma
NOTICE TO APPLICANT If, alter making Ihis Certiiicaie of Exemption, you should become subieci to
the WoiKers' Compensation provisions of the LaixxCode, you musf lonhwilli comply with suchprovisions or this permit shall be deemed revoked
Q I fverebv affirm that ihere is a consiruciionlending agency fO' the performance of the work forwhich this permit is issued iSec 3097. Civii Codel
Lender S Name
Lender s Address .
CARLSBAD ^&DING DEPARTMENT
1200 Elm. Carlsbad, California 92008-1989 (714) 438-5525
APPLICANT TOy£LLL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.SSk.•raiAPPnCATlON & PERMIT
fLf^3 Pi'f^e. n'AV. ST.
RO.
VIS«'S ^ OWNER'S PHONE
r. ^ /ne A) r 7Z9-
iNEH'S MAILING ADDRESS
S/f77)e^
LOT BLOCK SUBDl VISION ASSeSSOI=t PARCEL NO.
TO TO . hM±bij OJy%n^
DATE OF APPLICATION . ^SINESS LICENSE tt
SCONTRACTjaR 1 7/ j I CONTRACTORS PHONE «ufJ£/)//f7Z ^wdad'-;SNTRACTDp'S ^OSESS
DESIGNER'S ADDRESS
LICENSE NO.
23
DESIGNER'S PHONE
VALUATION
ZONE
PLAN I.D. #
STANDARD PLAN #
PERMIT NUMBER
BLOG USE CODE
BUILDING SO. EOOTAOE
OCC GP
VM nQ
REDEVELOPMENT
AREA
TYPE OCC LOADCENSUS TRAC1 GP LAND USE RES UNITS GRADING PERMIT ISSUED
Y □ N □
FIRE SPRPARKING SPACE
Not Valid Unless Machine CertifiedvH nQ vO nD
SUMMARY/ACCOUNT NUMBERMECHANICAL PERMIT - ISSUEPLUMBING PERMIT - ISSUE
BUILDING PERMIT 01-00-00-8220NSTALl FURN. DUCTS UP TO lOO.ODO BTUEACH FIXTURETRAP
OVER 100.000 BTU SIGN PERMIT 01-00-00-8221EACHBUILDINGSEWER
BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01-00-00-8806EACH WATER HEATER AND/OR VENT
/O.QOBOILER/COMPRESSOR 3 15 HP TOTAL PLUMBINGEACH GAS SYSTEM 1 TO 4 OUTLETS 01-00-00-8222
METAL FIREPLACEEACH GAS SYSTEM 5 OR MORE
EACH INSTAL.. ALTER. REPAIR WATER PIPE
ELECTRICAL 01-00-00-8223
VENT FAN SINGLE DUCT MECHANICAL 01-00-00-8224
MECH EXHAUST - HOOO(OUCTSEACH VACUUM BREAKER MOBILEHOME 01-00-00-8225
RELOCATION OF EA FURNACE/HEATERWATER SQFTNER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE)SOLAR Q1-Qn-Qfl-ftP?R
TOTAL MECHANICAL STRONG MOTION 80-92-33-0519
TQTALPLUMBING FIRE SPRINKLERS 01-00-00-8227
PUBLIC FACILITIES FEE 32-00-00-e923SOLAR - ISSUEELECTRICAL PERMIT • ISSUE BRIDGE FEE
COLLECTORSNEW CONST EA AMP/SWT/BKR SCHOOL FEE - DISTRICT
STORAGE TANKS Carlsbad 80-92-21-0519
EXIST BLOG EA AMP/SWT/BKR HOCK STORAGE Encinilas 80-92-22-0519
PUMP San Dieguilo 80-92-23-0519
REMODEL/ALTER PER CIRCUIT PLAN CHECK FEE San Marcos 80-92-24-0519
TEMP POLE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY (30 DAYS)
TOTAL ELECTRICAL total solar TOTAL FEES PAYABLE
1 HAVE CAREFULLY EXAMINED THE COMPLETED •APPLICATION AND PERMIT ' AND DO HEREBYCERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT ISISSUED TO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND
KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS ANDEXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE
GRANTING OF THIS PERMIT.
Expiration Every permit issued by lf>e Building Official under Ihe provisions of thisCode shall expire by iimitstion and become null and void If the building or workaulhonaed by such permit is not commenced wilhm 180 days from the date ol suchpermit, or if the building or work authorized by such permit is suspiended or
abandoned at any time aner the work is commenced for a period ot 180 davs
APPLICAI^T'S SIGNATUR OWNER n CONTRACTOR D
BY PHONE □
* AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
5' 0 " DEEP AND DEMOLITION OR CONSTRUCTION OF
STRUCTURES OVER 3 STORIES IN HEIGHT
APPROVED BY
INSPECTION TYPE DATE INSPECTOR
BUILDING
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME
SHEATHING
FRAME
EXTERIOR LATH INSULATION
INTERIOR LATH & DRYWALL
PLUMBING
SEWER AND BL/CO
PLUMBING UNDERGROUND
PLUMBING TOP OUT
TUB AND SHOWER PAN
GAS TEST
ELECTRICAL
TEMPORARY POWER
ELECTRIC UNDERGROUND
ROUGH ELECTRIC
ELECTRIC SERVICE
BONDING
G. F. 1. - SMOKE DETECTOR
MECHANICAL
DUCT & PLEM., REF. PIPING
heat — AIR COND. — SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
JOB SITE FINAL
PLUMBING
ELECTRICAL
MECHANICAL
BUILDING
SPECIAL CONDITIONS
ANCY ISSUEDCERT OF DC
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REG IF
CHECKED
INSPECTORS
APPROVAL DATE
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES CAISSONS
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