HomeMy WebLinkAbout2218 DAVID PL; ; CB032702; Permit09-30-2003
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing Permit Permit No CB032702
Building Inspection Request Line (760) 602-2725
Job Address
Permit Type
Parcel No
Reference #
Project Title
2218DAVIDPLCBAD
PLUM
Lot#
Construction Type
MARRON RES GAS LINE REPAIR
0
NEW
Status ISSUED
Applied 09/30/2003
Entered By SB
Plan Approved 09/30/2003
Issued 09/30/2003
Inspect Area
Applicant
JEANENE MARRON
Owner
2218 DAVID PL 92008
729-3015
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
5390 09/30/03 0002 01 0?
CGP 27-00
/?
Inspectoi
FINAL APPROVAL
Date /fr-fr"^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
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1 635 Faraday Ave , Carlsbad, CA 92008
PRO JECt INFORMATION
FOR OFFICE USE ONLY
PLAN CHECK
EST VAL
ZtoZ.
Plan Ck Deposit
Validated By^
Date
dctress (include Bldg/Suite #)Business Nama (at this address)
Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units
Assessor's Parcel #Existing Use Proposed Use
Description of Work
CONfAGJiPERSONW *Mrererrt fro
SQ FT #of Stories # of Bedrooms # of Bathrooms
Name Address
J3y". 'APPUCANTv Q-Contractor Q:Agent'foriContractor^ ^
City
:AgBnt for Owner:;
State/Zip Telephone tt Fax tt
City State/Zip Telephone tt
Address City State/Zip Telephone ttName
5. CONTRACTOR-COMPANY NAME '•••. '' ' • • " ';••" ...' ••:•••'• ":: - ' .,; -.^ ••"-.••-•" :';: ;..""•->x Ti;: ••;•'; 4f •'•:".. 'Wf"
(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 subjects the applicant to a civil penalty of not more than five hundred dollars ($500))
Name
State License tt
Address
License Class
City State/Zip
City Business License tt
Telephone tt
Address City State/Zip TelephoneDesigner Name
State License #
•6 "„" WORKERS' COMPENSATION :-u „. /. -i.,..,,.,: , / ' ,?' VC : 1 "',,:'' , ,„„•':•• .**, "": ' . . „ A.
Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations
|~1 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 [$1001 OR LESS)
|~1 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
O SIGNATURE DATE
,V7 '
•J I hereby affirm that I am exempt from the Contractor's License Law for the following reason
0 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 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)
^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 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)
l~l 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 Q 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)
I will provide some of the ywtfkTbjjt I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type
if vvork) / J / /ft ^s. xxx~» >
^PROPERTY OWNER SIGNATURE t^^^^^/^ (-^\ ^(J IQ/V/Cst' ^L/ DATE /
COMPLETE THIS^SECJION FOBT5|3/i£^ MA..::.,-, .., uL.i:.;.U ,-J-,*te:: J V. :..,.,„ .1 .-. i".:L: '".. V \-~ :
Is the applicant or future buildinffoccupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention
program under Sections 25505,^5533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Q YES Q 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? O YES d 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
;B,: i;CO>JSJRUCTIQN LENDING AGENCY * ^^,^^,lt: *•]??£*'J.'£ :-* " .. '_!- ,,..-.' : . •'„;• -'•'- ...... .. ,- . " : • "
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
fc,, \APPLICANT CERTIFICATION:!;;^ Qh. .W's^.jvj*./:,™;--. W- A -vst \,™ « *- '<•, ••'•„» •-.•i- ••:>•,, , •>^"^'-: • ;k "•• :: "-;...• '••*•; •', i'k'- '•?' °: •:•:.-
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 Every permit issued-bv 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'comnjenced within 180 days fromnhe 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'commerjced for a period of 180^lejys \Sg^j)j3^l06 4 4 Uniform Building Code) _
DATE /APPLICANT'S SIGNATURE
WHITE File YELLOW Applicant PINK Finance
UNSCHEDULED BUILDING INSPECTION
DATR JO 1
PERMIT #
JOB ADDRESS
DESCRIPTION.
CODE DESCRIPTION
INSPECTOR
PLAN CHECK #
^
ACT COMMENTS