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1656 CORTE ORCHIDIA; ; CB042696; Permit
o \ 07*12-^(504 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB042696 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 1656 CORTE ORCHIDIA CBAD PLUM 2159501400 Lot# Construction Type HSIA RES-REPAIR GAS LINE-BBQ 0 NEW Status Applied Entered By P;an Approved Issued Inspect Area ISSUED 07/12/2004 RMA 07/12/2004 07/12/2004 Applicant DRAIN PATROL 4807 MERCURY ST SAN DIEGO, CA 92111 619-560-1137 Owner HSIA SONG LING&LINA 1656 CORTE ORCHIDIA CARLSBAD CA 92009 6384 07/12/04 0002 01 CGR 27-00 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Dram 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 $2000 $000 $000 $000 $000 $000 $700 $000 $000 $000 $000 $000 TOTAL PERMIT FEES $2700 Total Fees $2700 Total Payments To Date $000 Balance Due $2700 Inspector FINAL AR 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;l 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 capacity changes nor planning zoning, grading or other similar application processing or service fees in connection wrh 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 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 T1-/cJtvQT"<g.»tnr^'iafV. FOR OFFICE USE O PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date "7 fa(pl!M- Business Nam» (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total » of units Assessor's Parcel #Existing Use Proposed Use i.CONTACT PERSONJIfWeronVfrdm a Name /APPLICANT s Address Contractor,-? .' Q Agent for Contractor;:. •;• City | Owner D Agent for Owner State/Zip Telephone tt Fax tt Name Address City State/Zip Telephone tt if PROPERTY?>OWNER " IName <, OY[ (y f/f Address City State/Zip Telephone tt (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/bf Section 7031 5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hqpd/ed dollars [$500]) L- s> . ^ i r *> \ Crt V Name L\y*)\State License tt *—l £• t— ' I Address ^ £<9 ft 0 O *^ License Class *~ City State/Zip City Business License tt P? Telephone tt ' ' ~" ' Designer Name State License tt Address City State/Zip Telephone 6;, .WORKERS'COMPENSATION , ,.;-..; , , „ .. Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations [~1 | 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 n 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 « —- t— , Insurance Company Policy No \ f (*) O / / 0 Expiration Date [ C/ — GJ 1 "~ C (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) n 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 searfe workers' compeniradmrWverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($1000000), in ad^mo/Uothe^bst of compensation, damages as provided for in Section 3706 of the Labor code interest and attorney a fees SIGNATURE ff _/lfo/fyrr&'*^- **" DATE "7 — V <- — & ^ tefiipytfNEijiSfiiii^^ '•••••• <--:-fv>r- ..-»> :—:. ,-v ,;; :,., *•'•'. -,-, ,r- I hereby affirm that I am exempt from the Contractor's License Law for the following reason [~| |, 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) Q 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) Q 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 f~l 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 tha work indicated (include name / address / phone number / type of work) PROPERTY OWNER SIGNATURE DATE COMPLEmTHIS SECTION f OK NON-RESIDENTIAL BUILDING PERMITS ONLYiai.iU.;1;,^ « :, ',- ;. B.J;,., >...,, ^ ,. _i i ; 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? Q 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 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(0 Civil Code) LENDER'S NAME _ LENDER'S ADDRESS _______ !,v^<^^ ..... • .••• • >> - -i. .,,....,:• 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 CitV 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 5'0* deep and demolition or construction of structures over 3 stories in height EXPIRATION Even/ 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 ___ DATE _ WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 07/13/2004 O "^ v;Permit* CB042696 Inspector Assignment Title HSIA RES-REPAIR GAS LINE-BBQ Description Type PLUM Sub Type Phone 7607176714 Job Address 1656 CORTE ORCHIDIA Suite Lot 0 Location Inspector APPLICANT DRAIN PATROL Owner HSIA SONG LING&LINA Remarks Total Time Requested By ALAN Entered By CHRISTINE CD Description Act Commer 23 Gas/Test/Repairs Associated PCRs/CVs Inspection History Date Description Act Insp Comments License Detail Page 1 of2 /California Home Monday. July 12, 2004 j Welcome tot-.'>-.' License Detail Contractor License # 422136 CALIFORNIA.CQNTRACTQRS STATE LICENSE BOARD DISCLAIMER A license status check provides information taken from the CSLB license data base Before relying on this information, you should be aware of the following limitations • CSLB complaint disclosure is restricted by law (B&P 7124 6) If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below Click on the link or button to obtain complaint and/or legal action information • Per B&P 7071 _1_7, only construction related civil judgments known to the CSLB are disclosed • Arbitrations are not listed unless the contractor fails 1o comply with the terms of the arbitration • Due to workload, there may be relevant information lhat has not yet been entered onto the Board's license data base Extract Date 07/12/2004 * * *Business Information * * * AMERICAN ALLIANCE ALWAYS AVAILABLE dba DRAIN PATROL 2400 LINDBERGH STREET AUBURN, CA 95602 Business Phone Number (530) 888-8114 Entity Corporation Issue Date 05/10/1982 Expire Date 05/31/2006 * * *License Status * * * This license is current and active All information below should be reviewed. * * * Additional Status Information * * * Click here for Complaint Disclosure information * * *Classifications * * * |Class | Description I II I http //www2 cslb ca gov/CSLB_LIBRARY/License+Detail asp 07/12/2004 License Detail Page 2 of 2 C36 JPLUMBING J C42 SANITATION SYSTEM * * * Bonding Information * * * CONTRACTOR'S BOND: This license filed Contractor's Bond number 877268C in the amount of $10,000 with the bonding company INDEMNITY COMPANY OF CALIFORNIA. Effective Date 6i/01/2004 Contractor's Bonding History BOND OF QUALIFYING INDIVIDUAL(I). The Responsible Managing Officer (RMO) BRYAN ALEC GRAVES certified that he/she owns 10 percent or more of the voting stock/equity of the corporation A bond of qualifying individual is not required Effective Date 05/01/2001 BQI's Bonding History * * * Workers Compensation Information * * * This license has workers compensation insurance with the STATE COMPENSATION INSURANCE FUND Policy Number 1706755 Effective Date 10/01/2002 Expire Date 10/01/2004 Workers Compensation_History_ Personnel listed on this license (current or disassociated) are listed on other licenses. Personnel List Salesperson List Other Licenses Complaint Disclosure Licejise_Numbe_r_Re_que_st Con tractor Name Request Personnel Name Request Salesperson Request Salesperson Name Request © 2004 State of California Conditions of Use Privacy Policy http //www2 cslb ca gov/CSLB_LIBRARY/License+Detail asp 07/12/2004