HomeMy WebLinkAbout2275 HOSP WAY; ; CB050277; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing Permit Permit No: CB050277
Job Address:
Permit Type:
Parcel No:
Reference #:
Project Title:
Building Inspection Request Line (760) 602-2725
2275 HOSP WY CBAD
PLUM
1672503600 Lot #: 0
Construction Type: NEW
CASCADE FALLS APTS
WATER HEATER REPLACEMENT
Owner:
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
01/28/2005
MDP
01/28/2005
01/28/2005
Applicant:
DRAIN PATROL UNIVERSE INSTITUTIONAL VENTURES ILL C
4807 MERCURY ST
SAN DIEGO, CA 92111
619-560-1137
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
Total Fees: $27.00
0
0
0
0
1
0
0
9478 W OLYMPIC BLVD #300
BEVERLY HILLS CA 90212
$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 Payments To Date: $0.00 Balance Due:
EXPIRED PERMIT
PERMIT HAS EXPIRED IN ACCORDANCE WITH C.B.C.
$27.00
SECTION 106.4.4 AS AMENDED BY C.M.C,1~/2B/OS 0002 01 02
DATE h\61[~s: SIGNP.TLiRE __ M____ CGP 27,00
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 !hat 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 tees 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 "OU have "reviouslv been niven a NOTICE similar to this or as to which the statute of limitations has oreviousl11 otherwise exr ired.
FOR OFFICE USE ONLY
PERMIT APPLICATION PLAN CHECK NO. (!) ~~ ,Z. 17
,
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
EST. VAL. _________ _
Plan Ck. Deposit ________ _
Validated By __________ _
Date _____________ _
1, PROJECT"IIIIFORMATION.
Business~ame (at this address) i. (!7(!) 'lf
Lot No. Subdivision Name/Number Unit No. Phase No, Total # of units
Assessor's Parcel # Existing Use Proposed Use
....i_o. esc.ripti~-. of W. orj. f , 1 .L SO. FT. f Kcfllet.& Wa <'I" h,e,:,,.1ey
#of Stories # of Bedrooms # of Bathrooms
2; . ,.CQl\lTA~-ftPi'.RSON"flf:dlff•reNUri)m ,applicant)
Name Address City State/Zip Telephone# Fax#
~~~~:f1c::;
Name
Address City State/Zip Telephone#
Address City State/Zip Telephone#
'lice·-"(IOl!IJ8AQ11'0R-•·COl\!l!ANY"l!IAME,
(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
'\,ex mption. _Any viola~n of ~action 7031.5 by any applicant tpr ,i;iern;,i] su~ects t~ applican t · ii r,n lY,.o/ not moreJ¥,an five hundred do ars LA,500)). ; ~7Vl!JL. qJ:{tPo L/rlct oe. r 11 ,s..,--(,I. rv 11 ,... oz.
Name /
Stata License # _LJ.L_.=2c.'7..=-l~?_:t,"'----Address City . State/Zip Tel~e #
License Class__________ City Business License# \ \°lC\. 0 ~-c.,_-
Designer Name Address City State/Zip Telephone
State License # _________ _
li; <W!!l!!IE.RS!"COMPU/$'ATIPN
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
0 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.
0 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, _______ _
ITHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100] OR LESS)
0 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 clvll fines up to one hundred
thousand dollars C$100,000), In addition to the cost of compensation, damages es provided for In Section 3706 of the Labor code, interest and attorney's fees.
SIGNATURE,______________________________ DATE _________ _
'7, • ,lW/.il!ii,il~/cqti\,il~ilt.!UiA:ill>N
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).
D 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).
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 I 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 / address I 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).:_------------------------------------------------------
PROPERTY OWNER SIGNATURE ______________________ _ DATE ________ _
<(:OMl!ti,:T~'("IS:SECTlON<,fOR.•NONJ/£S/QENT/IIL BUllQINGsPERMITS-ON~ Y
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 Hazardoi.Js Substance Account Act? D YES D NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site 7 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.
~; )¢!i.~$'(1!1.!c:r1ol!l(lE.NDING-AGENCY
1 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 _______________ _ LENDER'S ADDRESS, ________________________ _
"lJ.,,,-~Jl!;IQANT,<GERTIF,:CATiQN•·
1 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 Citt of Carlsbad to enter upon the above mentioned
property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES,
JUDGMENTS, COSTS ANO 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 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 com enced within 180 days from 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 comma ed for a period of 180 days (Section 106.4.4 Uniform Building Code).
~APPLICANT'S SIGNATURE
' WHITE: File YELLOW: Applicant PINK: Finance
DATE ____________ _