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Home My WebLink About2382 OUTLOOK CT; ; CB031071; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 ' -c~ G~~ 04-15-2003 Plumbing Permit Permit No: CB031071 Job Address: Permit Type: Parcel No: Reference #: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 2382 OUTLOOK CT CBAD PLUM 1675900700 Lot#: 0 Construction Type: IIN GRIMM RESIDENCE GAS LINE FOR FIRE PIT Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: T LANGSTON CONSTRUCTION GRIMM EDWARD A&IRIS J M ISSUED 04/15/2003 MDP 04/15/2003 04/15/2003 701 POMELO DR 2382 OUTLOOK CT CARLSBAD CA 92008 2758 04/15/03 0002 01 02 VISTA CA 92083-6308 760 855-9583 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 Inspector: 0 0 0 0 0 1 0 Total Payments To Date: $0.00 $20.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 Balance Due: Clearance: CGP 27-00 $27.00 NOTICE: Please take NOTIC ect includes the "Imposition' of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." rom the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures rth in Gov ent Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with rlsbad 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 f f whi h I n i n N T ii r h. whi h f Ii vi PERMIT APPLICATION FOR OFFICE USE ONLY PLAN CHECK No.c:5s -lOt ~ CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. __________ _ Plan Ck. Deposit _________ _ Validated By __________ _ Date ______________ _ 1. PRojE~ Jt.lFORMATION t I_ z.. 3 )I L Dv. I<# 0 ,.._ Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total , ot units Assessor's Parcel # Existing Use Proposed Use Description of Work + SO. FT. #of Stories # of Bedrooms # of Bathrooms G~~ l.'11e -F:-rt-f.J,' · ~Ofi!~CT PERSON (If dlfferent.Jrom applicant) State/Zip Telephone# Fax# cA Name Address City State/Zip Telephone# ;4. PROPERTY OWNER ga r.;c.""'""' c,_,4 160 VJ<f-lS-1& Name City State/Zip Telephone# ij. CONTRACTOR • COMP~Y t'AMJ: (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 violation of action 7031.5 by anx, applic1nt for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($50011. 7 "' Co111 7"-' t. t\' ""' • <:.. .+ 61'1 &f 't ~ 'l > "3 .:> Name Address "1 City State/Zip Telephone # 1:;, City Blli'iness License # j "l... I '-f I~~ L/1 1' Ci4 1, ~,; Z. Designer Name State License # 8. WOl\l(.ERS' CQMPEN$ATION City Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: State/Zip Telephone D 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. D 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 _______ _ (TH~TION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS) '2(' 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 w raga la unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), of com nsation. damages as provided for in Section 3706 of the Labor d~in rest and attorney's fees. SIGNATURE DATE '( / J tJ OWNER-BUiLDER p O 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). D 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. D 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 __________ _ C0'1'PL~TE THIS SECTION FOR IION-RESIDENnAL 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 25606, 25633 or 26634 of the Presley-Tanner Hazardous 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 D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D 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. · ·-~ON$TRUCTION LENDING A.GENCY 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 ________________________ _ fg , 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 buil · g 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 commence the date of such permit or if the building or wor.k authorized by such permit is suspended or abandoned at arw time alter the work is commenced f ection 106.4.4 Uniform Building Code). APf ANT'S SIGNATURE DATE YELLOW: Applicant PINK: Finance T I City of Carlsbad Bldg Inspection Request Permit# CB031071 Title: GRIMM RESIDENCE Description: GAS LINE FOR FIRE PIT For: 04/21/2003 Type: PLUM Sub Type: Job Address: 2382 OUTLOOK CT Suite: .Lot 0 Location: APPLICANT T LANGSTON CONSTRUCTION Owner: Remarks: Total Time: CD Description Act Comment Inspector Assignment: .:J1l--- Phone: 6198559583 Inspector: ---- Requested By: PETE Entered By: ROBIN • 21 Underground/Under Floor _/}f_ r,1 ~1/J.B 121tTS I?,,~/ Associated PCRs/CVs Inspection History Date Description Act lnsp Comments 1-1(