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Home My WebLink About2309 CAMINO ROBLEDO; ; CB994100; Permit11/02/1999 City of Carlsbad Plumbing Permit Permit No:CB994100 Building Inspection Request Line (760) 438-3101 Job Address: Permit Type: Parcel No: Reference #: Project Title: 2309 CAMINO ROBLEDO CBAD PLUM 2552726200 Lot #: Construction Type: INSTALL GAS LINE 0 NEW Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 11/02/1999 GMF 11/02/1999 11/02/1999 Applicant: JACKSON, JOHN R. 2309 CAMINO ROBLEDO CARLSBAD ,CA 92009 760-942-9699 Total Fees:$27.00 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 0001 tt 02 C-PRKT 27-00 $27.00 0.00 0.00 0.00 0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $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 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. CITY OF CARLSBAD 2075 Las Paimas Dr., Carlsbad, CA 92009 (760) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad ~CA 92009 (760)438-1161 T. RROdECTINFORMATION FOR OFFICE USE ONLY PLAN CHECK N0._ EST. VAL. Plan Ck. Deposit Validated Bv Date ofr* Address (include BIdg/Suite #1 Business Name (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 SO. FT.#of Stories # of Bedrooms # of Bathrooms CONTACT PERSON (if dHfe. " W-, - 'froiftivfiiteent} Name Address D Agent for Contractor City State/Zip Telephone #Fax # Name Address City State/Zip Telephone Name Address City State/Zip Telephone# ^gswtittOTi^^^ ". '".".-.... (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 700O of Division 3 of the Business and Professions Code] or that he is exempt therefrom, and the basts for the alleged exemption. Any violation of Section 7031.5 by any applicant for » permit subject* the applicant to a civil penalty of not more than five hundred dollars'1*5001). ' Name State License # Address License Class City State/Zip City Business License # Telephone # Designer Name Address City State/Zip Telephone State License * a. WORKERS'COMPENSATION j'," "i; ;j/j-v,:^::::';-^^ -• . ' .'.-• . - Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Q 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. Q I have and will maintain workers' compensation, es 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 ($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 is unlawful, and she! subject en employer to criminal penaJtia* end crvQ fines up to one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages u provided for In Section 3706 of the Labor code. Interest and attorney's fees. SIGNATURED DATE 7. OWNER-BUILDER DECLARATION ; ' 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 weges 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 Lew 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). Q 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, end contracts for such projects with contractors} licensed pursuant to the Contractor's License Lew). Q 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): 5. I will provide some of the worl of work): I heve contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type DATE \\PROPERTY OWNER SIGNATURE _^_^ __ COMPLETE THIS SECTION FOR Noty-flCSiDENTlAL BU1UHNQ PtRWTS ONLY Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management end prevention progrem under Sections 25505, 25533 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 fecility to be constructed within 1,000 feet of the outer boundary of a school site? D 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. COjBtHUCtTOH IS4D1MG AGENCY ; I 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 ADDRESSLENDER'S NAME it. APPMCAIIT CERTIFICATION .>-.:. - ;< •-> ,•> .' -. • > ',"'/•:& :/.'7.v <,. •'•'-•!' '-• • , •. : '^'^ ^^- < " •'•••; - 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 isfcuedtby 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 commenced within 365 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\|rp|work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Inspection Request For: 11/10/99 Permit# CB994100 Title: INSTALL GAS LINE Description: Sub Type: 2309 CAMINO ROBLEDO Lot 0 Type: PLUM Job Address: Suite: Location: APPLICANT JACKSON, JOHN R. Owner: JACKSON JOHN K&JANICE K Remarks: AM PLEASE Inspector Assignment: Phone: 7609429699 Inspector: Total Time: CD Description 23 Gas/Test/Repairs Act Comments Requested By: JOHN Entered By: CHRISTINE Date Inspection History Description Act Insp Comments