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HomeMy WebLinkAbout2225 DAVID PL; ; CB012501; Permit07/25/2001 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB012501 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 2225 DAVID PL CBAD PLUM 1675802200 Lot# Construction Type ROBBINS RES/GAS & ELEC- BBQ 0 NEW Status ISSUED Applied 07/25/2001 Entered By CB Plan Approved 07/25/2001 Issued 07/25/2001 Inspect Area Applicant COX 947 SHEFFIELD VISTA.CA 92083 Owner L B/L-CONCORDIA CARLSBAD-25 L L C 7130AVENIDAENCINAS CARLSBAD CA 92009 5664 07/25/01 0002 01 02 CGP 47.00 Total Fees $4700 Total Payments To Date $000 Balance Due $47 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 $2000 $000 $000 $000 TOTAL PERMIT FEES $4700 Inspector FINAL APPROVAL 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" 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 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 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 PROJECT INFORMATI)JECT FOR OFFICE USE ONLY PLAN CHECK NOxIgQf ^0 EST VAL Plan Ck Deposit Validated By_ Date Address (include Bldg/Suite #)Business NameTat this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units X Assessor's Parcel #Proposed Use Descnp3J0fi of Work 2 CONTACT PERSON (if different from applicant) SO FT #of Stones # of Bathrooms Name Address 3 APPLICANT Cybontractor Q Agent for Contractor-i ?/ City | Owner O Agent for Owner State/Zip Telephone » Fax # Name 7^ 4 PROPERTY OWNER Address City State/Zip 'Telephoned Address City State/Zip Telephone #Name 5 CONTRACTOR - COMPANY NAME (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 Codel 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 mpre than five hundred dollars [$500])- - - - ~ Name State License ff dress License Class City State/Zip "^ Cltv Business License # Telephone # Designer Name V~?-£\ Address City State/Zip Telephone State License tt - v.".^7' 6 WORKERS' COMPENSATION Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations l~l 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 CD 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 ^~~J fi&if* f f )/\fr^J Policy No Expiration Date_ / i / (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) / Q 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 js unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100 OOOU& addition to the cost of comperfsation,d0rnages as provided for in Section 3706 of the Labor code interest arid attorney s fees SIGNATURE _ C-^V^-f-^^ ^ . ^^X^ ^"X^ __ *ft DATE ~^7/ £2. ^>/ fl C 7 OWNER-BUILDEE^E^LARATIOnT / I hereby affirm that I fm exempt from the Contractor s License Law for the following reason [H 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) l~l 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) • 0 ' 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 [~1 YES PlNO 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 the work indicated (include name / address / phone number / type of work) DATEPROPERTY OWNER SIGNATURE ^-T i __^ COMPLETE THIS SECTION FOR NON-RESIDENTiXrtiu\LD\NQ PERMITS ONLY 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 Accoun-; Act? CD YES CD NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? CD YES f~l NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? CD 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 8 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a constutetipn lending agency for the performance of the work for which this permit is issued (Sec 3097(i) Civil Code) LENDER'S NAME «" ( ) —s LENDER'S ADDRESS 9 APPLICANT CERTIFICATION 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 City 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 by the buildifig 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 vvjrffm 180 days from the date of such permit or if the building or work authorized by such permitjs suspended o/ abandoned at any time after the work is commenced for^ieriod of 180 days (Section 106 4 *<5niform Building Code) LJZ*'^'^ DATEAPPLICANT'S SIGNATURE JLJL •*-^ WHITE File YELLOW .PINK Finance City of Carlsbad Bldg Inspection Request For 10/15/2001 PermiW CB012501 Title ROBBINS RES/GAS & ELEC- BBQ Description Type PLUM Sub Type Job Address 2225 DAVID PL Suite Lot 0 Location APPLICANT COX Owner ROBBINS PAUL A&MARGARET A Remarks Inspector Assignment PY Phone 7605983636 Inspector Total Time CD Description 29 Final Plumbing 39 Final Electrical Requested By N/A Entered By ROBIN Act Comments Associated PCRs Inspection History Date Description Act Insp Comments 07/27/2001 21 Underground/Under Floor AP PY 07/27/2001 23 Gas^est/Repairs AP PY 07/27/2001 31 Underground/Conduit-Wiring WC PY so COMPENSATION INSURANCE PO BOX 807, SAN FRANCISCO,CA 94101-C307 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE 06-01-00 CONTRACTORS STATE LICENSE BOARD ATTN: WORKERS' COMP. UNIT BOX 26000 SACRAMENTO CA 95826 POLICY NUiyfBER 1350197 - 00 CERTIFICATE E) UOS- CONTR LIC #4i!4542 INCFPTION D\VE OS-O1-00 D 0 SAM OX EGO This is to certify that we have issued a vaiid Workers' Compensation insurance ,>oticy m a form approved by the California Insurance Commissioner to the employer named below for the policy period ir dicated This policy is not subject to cancellation by the Fund except upon 10 days' advance wi itt^ii notice to the employer We will also give you 10 days' advance notice should this policy be cancelled pr^or to its normal expiration This certificate of insurance is not an insurance policv end does, not amend, extend or alter the coverage affo'ded by the policies listed herein Notwithstanding an/ requirement term or condition of any contract or other document with respect to which this certificate of insurance Ttay be issued or may pertain t e insurance affordeo by the policies described herein is subject to all the terms, exclusions and conditions of such policies PRESIDE^' '•' EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS $1,000,OOO.OO PER OCCURRENCE STANDARD EXCLUSION INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY EMPLOYER LHGAL NAtac COX LAND'.APE 9' / SHEFFIELD u. J VfSTA CA S.2033 COX, FREDERICK W THIS DOCUMENT HAS^A BLUE PATTERNED BACKGROUND^ PRINTED. 05-17-00 P0409 SCIF 162S5;(REV: ,2-95).