HomeMy WebLinkAbout167 MAPLE AVE; ; CB002261; PermitvfooV
r City of Carlsbad
06/13/2000 Plumbing Permit Permit No:CB002261
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
167 MAPLE AV CBAD
PLUM Status: ISSUED
06/13/2000
RMA
06/13/2000
06/13/2000
Parcel No: 2042332000 Lot #: 0 Applied:
Construction Type: NEW Entered By:
Reference #: Plan Approved:
Issued:
Project Title: SILVA RES-GAS LINE REPAIR Inspect Area:
Applicant:
CHUCK'S PLUMBING
3800 WESTHAVEN DR
CARLSBAD, CA 92008
619-729-0961
Total Fees: $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
TOTAL PERMIT FEES
Owner:
.~~,M~AAl';L J& TESSA T~63 06/lJ/OO
t " ' ,'
• 1 er ,MARL!! {..VE ,
• ~RLSS,1/>.D CA 92008"
+ ' t
• Totaf Payments To bate: $0.00
0
0
0
0
0
1
0
FINAL APPROVAL
'
eaiahce Due: ,, . t
'$20.00
" $0.00
"$0.00
$0.00
$0.00
$0.00
$7.00
$0.00
$0.00
$0.00
$0.00
$27.00
0001 01
C-PRMT
$27.00
Inspector: Date: JI-& ·Oa 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. lf 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 Ca~sbad 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 with this project NOR DOES IT APPLY to any
fees/exactions of which ou have reviousl been iven a NOTICE similar to this or as to which the statute of limitations has reviousl otherwise ex ired.
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161
02
27-00
PEl!MIT, APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
FOR OFFICE USi,9fl~
PLAN CHECK N~
EST. VAL. _________ _
Plan Ck. Deposit 4-,-
Validated BY,.:: , , lizft:::::.
Date (;,/(<JOO I 'o
Business Name lat this address)
Legal Descripti n Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units
Assessor's Parcel I Existing Use
Description of Work 1< e fll,:J-('e.-Le,,r/ ;( ;, 6. a~s.
'2,. CON'rACT.PERSC)N 1ft dlff.,_,.t from applicant}
Name
3; APPUCANT )i("contractor
Name
4. ·::ii°PERTYOWN"'l ::i£ > > > l t/,9;
Name
Address
0 Agent for Contractor
Address
S. · CONTRACTOR • COMPANY NAME
Downer
l #Q,,! Stories
(,./(:.,0
City
0 Agent for Owner
City
Proposed Use
# of Bedrooms # of Bathrooms
State/Zip Telephone#
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, altar, improve, demolish or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statement that ha is licensed pursuant to the provisions of the Contractor's License Law
(Chapter 9, commanding with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged
a r,tion. Any violation f Section.._ 7031.6 by any applicant for permit subjects the ap icant t a civil penalty of not m than five hundred dollars [$5001).
3 w" · ,.-.1 .-?J
State License # ..JC:;4-,.)L''-7-,.z;"'-'6"'-'{,,,..__
Address
License Class ,C..:~-::::.-~r...~---City State/Zip Telephone #
City Business License # ,3 ? '/ Q Q
Designer Name Address City State/Zip Telephone
State License # _________ _
8. WORKERS' COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of perjury· one of the following declarations:
0 I have and wm maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance
vhe work for which this permit is issued.
f
~ I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My worker's 79P1Pllllf8tion insurafl$-I carrier and policy number are:
Insurance Company u,., ,r~rt &c, (tc, INC, C.Z> PolicyNo.211 c2·1 s':C-120 Expiration Date /;J ~ :3/-_;)t'JOt;
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$100) OR LESS)
0 CERTIFICATE OF EXEMPTION: 1 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 .. cure workers' co pensation coverage I• unlawful, and shaH subject an employer to crtmlnal pen■ltiH and clvU fines up to one hundred
thousand dollars 0 ,0001, n addition ha coat of compansation, damage■ u provided for in Section 3706 of the Labor coda, interest and attorney's fee■.
SIGNATURE__,,~~~~:2..,_~J.,,{£:!z!!~~~'f-------------DATE b,,., J 5 _,. o o
7. 'OWNEII-BUILD£R DECLARATION
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 do the work and tha structure is not intended or offered for sale
(Sec. 7044, Business and Professions Code: The Contractor's Ucense 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).
0 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 Ucenu Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractorts) licensed
pursuant to the Contractor's License Law).
0 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. 0 YES ONO
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 parsons to provide the work indicated Onctude name / address / phone number / type of work):. ______________________________________________________ _
PROPERTY OWNER SIGNATURE ____________________ _
COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDINO PERMli'SONLY
DATE ________ _
Is the applicant or future building occupant required to submit a business plan, acutely haz.■rdous materials registration form or risk management and prevention
program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES O NO
Is the applicant or future building occupant required to obtain a permit from the air pollutlon control district or air quality management district? 0 YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES O 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 I.ENDINO 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 _____________ _
9. APPLICANT CERTIFICATION
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. l agree to comply with all
City ordinances and State laws relating to building construction. I hereby authorize representatives of the Citt 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 6'0" 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 1imitallon and become null and void if the building or work
authorized by such permit is not comme ed within 180 days f m 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 com ! for a ~riod of 180 s (Section 106.4.4 Uniform Building Code). "\
APPLICANT'S SIGNATURE ,:::'.~~~~~~!c,,;ie-1.~~~~~4----------DATE 0 -/-?---06
WHITE: File VEL OW: Applicant PINK: Finance
r
(I City of Carlsbad Bldg Inspection Request
. . For: 6/14/2000 . .
Permit# CB002261
Title: SILVA RES-GAS LINE REPAIR
Description:
Type:PLUM Sub Type:
Job Address:
Suite:
Location:
167 MAPLE AV
Lot
APPLICANT CHUCK'S PLUMBING
0
Owner: SILVA MERRILL J&TESSA TR
Remarks:
Total Time:
Act Comments
Inspector Assignment: CT'L
Phone: 7607290961
Inspector: \/l..
Requested By: CHUCK
Entered By: ROBIN
CD Description
23 GasfTest/Repairs f-)1_~-----
Associated PCRs
Inspection History
Date Description Act lnsp Comments