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Home My WebLink About2332 CAMINO ROBLEDO; ; CB000642; Permit* 02/25/2000 City of Carlsbad Plumbing Permit Permit No:CB000642 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 2332 CAMINO ROBLEDO CBAD PLUM 2552721400 Lot#: Construction Type: INSTALL GAS LINE 75 FT 0 NEW Status: ISSUED Applied: 02/25/2000 Entered By: GMF Plan Approved: 02/25/2000 Issued: 02/25/2000 Inspect Area: Applicant: SHULDBERG KIRTW&LISAA 2332 CAMINO ROBLEDO CARLSBAD CA 92009 W&LISAA 02/25/00 0001 01 02 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 0.00 .00 0.00 0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $27.00 FINAL Inspector: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 ttiis 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. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 Address (include Bids/Suite FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated Bv Date - Business Name {at tills address} Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total t of units Assessor's Parcel #Existing Use Proposed Use Description of Work *&( SQ.FT.tot Stories # of Bedrooms # of Bathrooms Name Address City State/Zip Telephone #Fax IT Address Telephone # (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, sher, improve, demolish or repair any structure, prior to its issuance, elso 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 IS5001). Name Address State License # License Class City State/Zip Telephone # City Business License f Designer Name Address State License # City State/Zip Telephone 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. G 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 [9100] 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 shaft subject an employer to criminal penalties end civil fines up to one hundred thousand dolara (*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 I hereby affirm that I am exempt from the Contractor's License Lew for the following reeson: GH 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 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, and contracts for such projects with contractor(s) licensed pursusnt to the Contractor's License Law). D I em 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. £ YES QNO 2. IrfFjaT^f have not) signed an application for a building permit for the proposed work. 3. I hsve 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 end 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): PROPERTY OWNER SIGNATURE 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 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? Q 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. 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 NAME LENDER'S ADDRESS I certify that I have reed the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with ell 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 building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work at any time after the work is commenced for a period of 160 days (Section 106.4.4 Uniform Building Code). 'APPLICANT'S SIGNATURE ^ (j • 5>WlJ?jj i^g DATE WHITE: File YELLOV alicant PINK: Finance City of Carlsbad Bldg Inspection Request For 3/1/2000 Permits CBOO0642 Title: INSTALL GAS LINE 75 FT Description: Sub Type: 2332 CAMINO ROBLEDO Lot 0 Type: PLUM Job Address: Suite: Location: APPLICANT SHULDBERG KIRT W&LISA A Owner: SHULDBERG KIRT W&LISA A Remarks: Inspector Assignment: Phone: 7609421875 Inspector: Total Time: CD Description 21 Underground/Under Floor 31 Undergrour/d/ConduitfWirlng f AcU Comments Requested By: LISA Entered By: CHRISTINE Associated PCRs Inspection History Date Description Act Insp Comments