HomeMy WebLinkAbout1986 HIGH RIDGE AVE; ; CB054141; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
12-08-2005 Plumbing Permit Permit No: CB054141
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
1986 HIGH RIDGE AV CBAD
PLUM Status:
Parcel No: 2073851000 Lot#: 0 Applied:
ISSUED
12/06/2005
LSM
12/08/2005
12/08/2005
Construction Type: NEW Entered By:
Reference #: Plan Approved:
Issued:
Project Title: GRODANZ RES~ REPLACE H20 HTR Inspect Area:
Applicant:
ALL STAR WATER HEATERS & PLUMBING
17886 LAKESHORE DR 92530
1-800-727-0977
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
TOTAL PERMIT FEES
0
0
0
0
1
0
0
Owner:
GRODANZ ELLIS B&JULIE E INTERVIVOS TRUST
1986 HIGH RIDGE AVE
CARLSBAD CA 92008
$20.00
$0.00
$0.00
$0.00
$0.00
$7.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$27.00
Total Fees: $27.00 Total Payments To Date: $27.00 Balance Due:
Inspector:
EXPIRED PERMIT
PERMIT HAS EXPIRED IN ACCORDANCE Wl:H C.B.C.
SECTION 106A4 AS A~4ENOED BY C.M.C.~8.04.030
DATE_jAl}dQ/Q SIGNATURE oA11 -··
FINAL APPROVAL
Date: Clearance:
$0.00
NOTICE: Please take NOTICE that approval of your project includes the 'Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as ·tees/exactions." You have 90 days from the date this permit was issued lo 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 infonnalion with the City Manager for
processing in accordance with Cartsbad 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 lo 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
f x i n f whi I I imil r hi r hi h f limi i h r vi I .
.
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad CA 92008
1.
Address (indude Bldg/Suite#) Business Name (at this address)
Legal Description Lot No. Subdivision Name/Number Unit No.
Assessor's Parcel # Existing Use
Description of Work SQ. FT. # of Stories
FOR OFFICE USE ONLY
PLAN CHECK NO. <1605 4 J4f
EST. VAL. __________ _
Plan Ck. Deposit Ll:\
Validated By __ ~~~~------
Date I.J./ b / 05'
Phase No. Total # of units
Proposed Use
# of Bedrooms # of Bathrooms
=---cV/.=:~oi~~) _______________________ _
Name
Name
Address
C C<,ntrac:IIDr
Address
Name Address
City
City
S~€
City
State/Zip Telephone# Fax#
State/Zip Telephone#
State/Zip Telephone#
(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 ? applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$5001). 8w 71:., 7
f!j.L~ w":ff§Z-----. H~S 1 .?o;eo f>v c.'Z-'"t"o V A~ , µ,,N, ~f:-qz.my o:n,
Name Address City 7 State/Zip Telephone #
State License# 812,8 '1'-( License Class (__,J G City Business License# A P (' L'rf,O
Designer Name Address City State/Zip Telephone#
State License # _______ _
6.
Workers' Compensation Declaration: I 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 worker's 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 S:,A:rf: fil..JC Policy No. /JI:,/ I. ',(/<.1✓ Expiration Date __ C/_-_/-_CJ_co _____ _
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100) OR LESS)
□ 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
lifomia.
WARNING: Failure to secure worke
dollars($100,000), In addition to the c
n erage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand
tlon, damages are provided for In Section 3706 of the Labor Code, Interest and atto'J"')''s fees.
DATE t'r ~Z...-of SIGNATURE iUimER-
1 hereby affirm that I am em
□ I, as owner of the property or my employees with wages as their sole compensation, will d 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).
□ 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).
□ 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. □ YES □ NO
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 I 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 I address / phone number I
/ontractors license number): -----------------------------------------------
6. 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 ___________ _
WHITE: File YELLOW: Applicant PINK: Finance