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Home My WebLink About1817 COTTONWOOD AVE; ; CB101671; Permit- - City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 09-13-2010 Plumbing Permit Permit No: CB101671 Building Inspection Request Line (760) 602-2725 Job Address: 1817 COTTONWOOD AV CBAD Permit Type: PLUM Status: ISSUED Parcel No: 2155033731 Lot#: 0 Applied: 09/13/2010 Construction Type: 5B Entered By: JMA Reference #: Plan Approved: 09/13/2010 PC#: Issued: 09/13/2010 Project Title: SEAPORT VILL: REPAIR GAS LEAK Inspect Area: Applicant: Owner: ACG PLUMBING FERGUSON SCOTT T 1817 COTTONWOOD AVE 3568 9TH ST 92078 CARLSBAD CA 92011 760 295-3346 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 0 $0.00 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 $27.00 Total Fees: $27.00 Total Payments To Date: $27.00 Balance Due: $0.00 FINAL APPROVAL Inspector: /•>L-*g> Date: £?//3//t} 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), 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 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. ,i'^k Building Permit Appli x»<£5^ 1635 Faraday Ave., Carlsbad, CA N^ CITY OF . 760-602-2717/2718/27 fARI ^RAD Fax:760-602-8558 V-rVlYl— OD/"\L/ www.carlsbadca.gov JOB ADDRESS y #~) ,._,/) )J ^ 1 S\ »si/B/7 uo~rron UJOOd A-V&- CT/PROJECT* LOT* PHASE # # OF UNITS # BEDROOMS ^. Plan Check No. 4^4*4^5^ 'cotton JET^--^— 92008 Est. ValuelaPlan Ck. Deposit Date tyf/Z^f fd swpp SUITE#/SPACE#/UNIT# APN # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(sJ £j?£ls u2j&Jz— f~'£]Ptf i f~ i f^^wC&ryULrt'j of ^^-^ /"/ <^fz~f SifDW arowd -ho /rz^Ar EXISTING USE PROPOSED USE GARAGE (SF) CONTACT NAME (If Different Fom Applicant) ADDRESS CITY STATE ZIP PHONE FAX EMAIL PROPERTY OWNER NAME ADDRESS CITY STATE ZIP PHONE FAX EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LJC.# PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES D # NO D YES D NO D YES D NO D APPLICANT NAME ADDRESS CITY STATE ZIP PHONE FAX EMAIL CONTRACTOR BUS. NAME *->..,. JLf/f 1^)) L » R !\s ADDRESS 1 ^/S^fV'Ck CJZY i t jt STATE ZIP PHONE FAX EMAIL STATCUC.* CLASS CITY BUS. LIC.# (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 theapplicant 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 theBusiness 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 acivil penalty of not more than five hundred dollars ($500)). WORKERS' COMPENSATION Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: 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 3X00 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compen Expiration Date • I have and will maintain workers' compensation. as required by Section 3X00 of the Labor Code, for the performance of th number are: Insurance CoOQU^Ka/n Tfatf&KJl . C*>n\fl6A\J Policy NaV^S and policy This section need not be completed if the permit is for one hundred dollars ($100) or less. O 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 (4100,000), in addition to the cost of compensation, dnmiges as provided for in SectjM 3706 of the Labor code, interest and attorney's fees. ^CONTRACTOR SIGNATURE ([ Sfll j/,'r/7*? / y/ QAGENT /3y /£) I hereby affirm that I am exempt from 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 the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's 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). a 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). I am exempt under Section Business and Professions Code for this reason: a No1 . 1 personally plan to provide the major labor and materials for construction of the proposed property improvement. O Yes 2. 1 (have / have not) signed an application for a building permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): 4. 1 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 / contractors' license number): 5. 1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): >£?PROPERTY OWNER SIGNATURE OAGENT DATE C O M P, L E T E THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form qr risk management and prevention program under Sections 25505,25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? a Yes a 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 O No Is the fadlity to be constructed within 1,000 feet of the outer boundary of a school site? GYes ONo IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPAN EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address APPLICANT CERTIFICATION OSHA: An OSHA permit is required for excavations ow 180 toys from Ihe date of such perrnrt or if^buM^ ^APPLICANTS SIGNATURE / ]ln,, J 177 / W_r^ DATE UNSCHEDULED Develoameat services BUILDING Building Division \/ CITY OF INQPFPTinM 1635 Faraday Avenue PAR! <SRAD INbHEOTIONv_/-\r\L3D/-\L/ B-44 Carlsbad CA 92008760-502-2700 DATE: cuVS^xfo INSPECTOR: PERMIT #: \O\U-LX CONTACT: ---------------- PHONE #:- JOB ADDRESS: DESCRIPTION: CODE DESCRIPTION ACT COMMENTS Go /j /\ *>L Q-AJL. VtL^cs£>M/v_-' A'/... ...... __^!|IMiK»^vfr^^-«>^^jMMB^3^-^B*—^94vU|B9B^^£J&. ^^^^ . * / — :—.... ~-• "Y "•• • "jm-r" Bldg Inspection Form Page 1 of 1 Rev. 06/09