The URL can be used to link to this page

Home My WebLink About2353 LA COSTA AVE; ; CB032469; Permit1-..~l\Y: ~J \ 09-08-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB032469 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2353 LA COSTA BLVD CBAD PLUM Status: ISSUED 09/08/2003 MDP 09/08/2003 09/08/2003 Parcel No: Reference #: Project Title: Applicant: 2141705400 Lot#: 0 Construction Type: NEW TABATA ORIGINAL HOUSE CHANGE FROM SEPTIC TO SEWER Owner: Applied: Entered By: Plan Approved: Issued: Inspect Area: STANDARD PACIFIC CORP STE 200 TABATA FAMILY TRUST 01-14-83 5750 FLEET ST CARLSBAD CA 92008 619 292-2200 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: $3,187.00 PO BOX943 CARLSBAD CA 92018 0 1 0 0 0 0 0 Total Payments To Date: $0.00 $20.00 $0.00 $15.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $3,152.00 $0.00 $3,187.00 Balance Due: $3,187.00 3566 09/08/03 0002 01 02 CGP 3187.00 APPROVAL ,.,..__"""---DATE t'. ~ 2 2 ~ o 3 CLEARANCE j FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. 0:1-l,_ t{_GJ\ CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. __________ _ Plan Ck. Deposit ________ _ Validated By __________ _ Date ----------------- Business Name (at this address) l,. Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Asses r\' Parcel # V 5 -\7 -.. e Propes~~ '/ Descrip~;,;ork Fr ~ f-S'e.f)i:f l ,t- #of Stories # of Bedrooms # of Bathrooms 2. CONTACT PERsoN (if different from applicant) ~ St-\J.Jif 3 3 Name City State/Zip Telephone# Fax# ~ Contractor Address Telephone# e.o Bbl( <14"; Name Address City State/Zip Telephone# \ Js. 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 Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any vi lation of Section 7031.5 by any applicant for a permit subjects the applic nt to a civil penalty of not more than five hundred dollars ($500)). ~ ,· ~f • S t-. ~ rtsbt1. CA-7~J-o -lo Name State License # ~"~Y-)~{,~(,~5""~--- Address City State/Zip Telephone # License Class S City Business License # 12 I \ \ \ 5" Designer Name Address City State/Zip Telephone 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: XState License # _________ _ ~ 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 !nsuran~ carrier and policy number are: I \ Insurance Company~'() 2"-e,,,h'\-~. Co . Policy No. lS03 ~\lo 7 Expiration Date "' -I -o'-1 (THIS 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 civil fines up to one hundred Xthousand dollar $100,0 I, in ad ition to the cost of compensation, damages as provided for in Section 3706 of the bo code, interest and attorney's fees. SIGNATURE.~;;:J#,'4--l---l~·~·i~'t..~~~---------------------DATE _...,__"t-4-.=.b""'------ 7. OWNER ILDER 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). 0 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 / 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): ________________________________________________________ _ PROPERTY OWNER SIGNATURE _______________________ _ DATE -----------COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING 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 Account Act? 0 YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 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. 8. CONSTRUCTION LENDING 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(il Civil Code). LENDER'S NAME ______________ _ 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 Cit,-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 authorized by such permit is not commenced within 1 BO days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned Jany time after the work is comm ed for a P. d of 1 0 days (Section 106.4.4 Uniform Building Code). ! I PPLICANT'S SIGNATURE ---:::--F""""'-fc-::;j,...,..'.:...f-""'1~--------------DATE ___,fe.f~Y ...... __ 0_1~------- YELLOW: Applicant PINK: Finance ,I I) . . City of Carlsbad Bldg Inspection Request For: 09/22/2003 . Permit# CB032469 Title: TABATA ORIGINAL HOUSE Description: CHANGE FROM SEPTIC TO SEWER Type: PLUM Sub Type: Job Address: 2353 LA COST A BLVD Suite: Lot 0 Location: APPLICANT STANDARD PACIFIC CORP Owner: Remarks: PM PLEASE Total Time: Act Comment Inspector Assignment: PD --- Phone: 61 14~ Inspect~ Req uested By: CURTIS Entered By: CHRISTINE CD 22 Description Sewer/Water Service !J&--,1----------4&-=----(A!'-lrl--____ _ Associated PCRs/CVs Inspection History Date Description Act lnsp Comments