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Home My WebLink About2289 MASTERS RD; ; CB120422; Permit, 03-09-2012 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: HANNA PLUMBING 643 S. SANTA FE VISTA CA 92083 760-726-2002 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB120422 Building Inspection Request Line (760) 602-2725 2289 MASTERS RD CBAD PME 2121401500 Lot#: Status: 0 Applied: Entered By: Plan Approved: Issued: SLOVAK RES-ELIMINATE GAS LINE Inspect Area: TO KITCHEN TO MAKE REPAIRS TO GAS LINE UNDER SLAB Owner: SLOVAK JEFF 2289 MASTERS RD CARLSBAD CA 92008 ISSUED 03/09/2012 LSM 03/09/2012 03/09/2012 $150.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $150.00 Total Fees: $150.00 Total Payments To Date: $150.00 Balance Due: Inspector: Clearance: $0.00 at approval of your project includes the "lmpos~ion" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." ou have 90 days from the date this pennit was issued to protest imposition of these tees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), ard 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 wiH 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 f f i h h Tl imil r hi hi h II -\ 0 Building Permit Application 1635 Faraday Ave., Garlsbad, CA 92008 760-602-2717 I 2718 / 2719 Fax: 760-602-8558 www.carlsbadca.gov #BEDROOMS I, (\e SUITE#/SPACE#/UNIT# # BATHR I r1 Plan Check No. Est. Value Plan Ck. Deposit Date .3/'i { 12-SWPP APN I ES NAME GROUP I b EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIRE SPRINKLERS YES □ NO □ CONTACT NAME (If Dm.rent Fom Applicant) APPLICANT NAME ADDRESS CITY STATE ZIP ZQ -2 PHONE FAX EMAIL EMAIL PROPERTY OWNER NAM ADDRESS --. ]_ '2 'c, l-) FAX EMAIL ARCH/DESIGNER NAME & ADDRESS STATE UC.# (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 ltS Issuance, also requires the applieant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law {ChaDter 9, commending with Section 7000 of Division 3 of the Business and Professions Code} or that he IS exemf:!t therefrom, and the basis for the alleged exemption. Any violation of Section 1031.5 by any applicant for a permit subjects the appllcant to a civll penalty of not more than five hundred dollars li500}). WORKERS' COMPENSATION Workan' Compen1ttlon Ded111t1on: / hereby afflnn under penalty of peljury one of the following declarations: n 3700 of the Labor Code, for the performance of the work for 'Mllch this permit is issued. ~}hi"O ~ ■nd wl!I maintain w ance th 'Mll'k for whk:h this permit Is Issued. My workers' compensation ipsura! carrier and policy number n: Insurance Co . ..l....-""'----lLJ.---'-'--'-:C..::;.JL.,:~f---1-"'-""-..L----Polley No. ,. ~ -i.... Expiration Date \ I-I t I ·3, ThlS section need not be completed If the permit hoodred dollars ($100) or less. D Certificate of Exemption: I · the performance of the work for which this permit Is Issued, I shall not employ any person in any mooner so as to become ect to the Workers' Compensation Laws of California WARNING: Fall 1ecure workers' compM11■tlon coverag■ 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 cOlt pens■tlon, d ag dad for In Section 3706 of the Labor code, lnterett 1nd attorney's fees. Cc-..-Ce✓1A- I hereby affinn that I wri exempt from Contracta-'s License Law fa' the following reason: □ I, as owner of the J:roperly 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 Lkense lAw does not apply to c11 owner of J:roperty 'MIO buikis 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 bulldlng or Improvement Is sokl 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 scie). □ I, as owner of the property, am exclusively contracting with licensed contractors ID construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of J:roperly who builds or improves thereon, and contracts for such pr0tects with con~s) licensed pursuant to the Contractor's License Law). □ I am exempt under Section ____ ,Business and Professions Code for this reason: 1. I personally pan to provide the major labor and materials for construction of the proposed property Improvement □ Yes □ No 2. t (have I have not} signed an application for a buUdlng permit for the proposed work. 3. I hM contracted with the fol!O'Mng person (firm) ID J:rovlde the proposed construction (Include name address I phone/ contractors' license number): 4. I plan kl provide portions of the work, but I have hired the klllowlng person to coordinate, supervise and provide the major work (include name I address I phone/ contractors' license number): 5. I will provide some of the won(, but I have contracted (hired) the following persons to J:IOVide the work indicated Qnclude name/ address/ phone/ type of work): _85 PROPERTY OWNER SIGNATURE □AGENT DATE •. COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required b submit a business plan, a::utely hazardous materials registration foITT1 or risk m111agement and prevention program under Sections 25505, 25533 or 25534 Of the Presley-Tanner Haurdous Substance Account Ad? □ Yes O No ls the applicjnt or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ Yes □ No Is the facility to be constru:ted within 1,000 feet of the outer boundary of a school site? 0 Yes □ No 1F 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. CONSTRUCTION LENDING AGENCY I hereby affirm lhat lhera • a cooslructioo lending agency for lhe performance of lhe wOll< lhis penmt is issued (Se~ 3097 0) Civil Code). Lender's Name Lenders Address APPLICANT CERTIFICATION I oertlfythatl have mad theappllcatlon and state that the above lnfonnation Is conectand that the lnfonnatbn on the plans Is accurate. I ag,eeto complyNth all CHyordlnanoas and State laws l9latlng to bljl<lng construclion. I hereby auUiome represenlatlve of lhe Cltyof catba:11> eni,rupoo lheabc>A! rr,nlilr,d i,uperty lrilspediJn pufPOS"S. I />I.SO AGREE TO SAVE. INDEMNIFY AND KEEP HAAMLESS THE CITY OF CARLSBAD AG/'JNST ALL UABILJTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUEAG/'JNST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: ,., OSHA perml • ""l(lh'ed Ir excavations ..,, sa deep and demofb or conslrudlon of structiJres""' 3 stires in height • EXPIRATION: i;.,,ry perm! issued by 1he Burding Olli:ia1 under lhe provisoos of~-Code shal expire by linlaoon and become nul and void ff lhe l>Ji~U1g or l',00( -by such pennl • not a,mmena,d wlhn 1110 days lool lhe dai> of such penniorff Ile butf orV<llk aultloraed by such pennl • suspended or abandoned at any tine alllrlhem • commenced Ira period of 1IIO days (Sediln 100.4.4 Unitllrn Bul:lng Code). ¥ _6 APPLICANT'S SIGNATURE DATE 3-CJ • • (~f~A" '\", .. >WJt/ ~ CITY OF CARLSBAD JOB ADDRESS CT/PROJECT# LOT# Buildjng Permit Application 1635 Faraday Ave., Garlsbad, CA 92008 760-602-2717 / 2718/ 2719 Fax: 760-602-8558 www.carlsbadca.gov Plan Check No . Est. Value Plan Ck. Deposit Date SUITE#/SPACE# /UNIT# APN PHASE# # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YES □# __ NO □ APPLICANT NAME (Primary Contact) APPLICANT NAME (Secondary Contact) ADDRESS ADDRESS CITY STATE ZIP CITY STATE PHONE FAX PHONE FAX E All EMAIL PROPERTY OWNER NAME ADDRESS CITY STATE ZIP PHONE FAX EMAIL A ELI . # SWPP CONSTR. TYPE OCC. GROUP AIR CONDITIONING YES □ NO □ ZIP F1RE SPRINKLERS YES D NOD (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 iss n , also requi est e 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 Sect n 000 of Division 3 of the B I ess 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 vii penalty of not more than five hundred dollars {$500)) . • Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: D I have and wlll 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. D I have and wlll 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 workers' compensation insurance carrier and policy number are: Insurance Co. ______________________ Policy No. _______________ Expiration Date __________ _ Th ction need not be completed if the permit is for one hundred dollars ($100) or less. ertlflcate 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 nia. WARNING: Failure to secure workers' ompensatlon coverage Is unlawful, and shall subject an employer to criminal penalties and ctvll fines up to one hundred thousand dollars (&100,000), in addition to tha cost of compansation, damaga fo Section 3706 of the Labor code, interest and attorney's fees. NS CONTRACTOR SIGNATURE I hereby affirm that I am exempt from Contractor's License Law for the following reason: □ 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). □ 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 Secfion _____ ,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 I have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (finn) to provide the proposed construction (include name address I phone I 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 I 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/ type of work): NS PROPERTY OWNER SIGNATURE □AGENT DATE m City of Carlsbad Bldg Inspection Request . For: 03/14/2012 . Permit# CB120422 Inspector Assignment: MC --- Title: SLOVAK RES-ELIMINATE GAS LINE Description: TO KITCHEN TO MAKE REPAIRS TO GAS LINE UNDER SLAB Type:PME Sub Type: Job Address: 2289 MASTERS RD Lot: Suite: Location: OWNER SLOVAKJEFF Owner: SLOVAK JEFF Remarks: NEEDS GAS RELEASED Total Time: CD Description 23 Gas/Test/Repairs 0 Act Comments Phone: 9517570575 Inspector: _ _._ • ..:.-it, __ Requested By: ROBERT Entered By: CHRISTINE ·-----------····-------------------- ___ ------·-------------------------- Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description 03/12/2012 23 Gas/TesVRepairs 03/12/2012 29 Final Plumbing 03/12/2012 29 Final Plumbing Act lnsp Comments PA MC TEST EXCLUDES LINE TO KITCHEN ISLAND WC MC WC MC