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Home My WebLink About2390 CIPRIANO LN; ; CB042380; Permit06 15 City of Carlsbad 1635 Faraday Av Carlsbad CA 92008 Plumbing Permit Permit No CB042380 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 2390 CIPRIANO LN CBAD PLUM 1560321100 Lot# Construction Type EZELL RES NEW H20 HEATER 0 NEW Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 06/15/2004 SB 06/15/2004 06/15/2004 Applicant EZELL JOHN R 2390 CIPRIANO LN CARLSBAD CA 92008 Owner EZELL JOHN R 2390 CIPRIANO LN CARLSBAD CA 92008 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Dram Install/Repair Water Line Water Heater and/or Vent Gas Piping System Vacuum Breaker Other Plumbing Fees Master Drainage Fee Sewer Fee Additional Fees 0 0 0 0 1 0 0 $2000 $000 $000 $000 $000 $700 $000 $000 $000 $000 $000 $000 TOTAL PERMIT FEES $2700 Total Fees $2700 Total Payments To Date $000 Balance Due $2700 4399 06/15/04 0002 01 02 CGF 27 Inspector FINAL APP/ROV/ 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 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 PERMIT APPLICATION CITY OF'CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave Carlsbad CA 92008 1 "IlPROJECryNFORMATION™ *~ FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Q Plan Ck Deposit Validated By Date MlX" Address (include Bldg/Suite Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total tt of units Assessor Existing Use Proposed Use Description of Work SQ FT #of Stones # of Bedrooms # of Bathrooms 2 CONTACT PERSON (if different from applicant) Name Address City 3 APPLICANT Q Contractor Q^Agent for Contractor Q Owner D Agent for Owner State/Zip Telephone tt Fax it Name Address City State/Zip Telephone tt .PROPERTY OWNER Name Address City State/Zip Telephone tt (ha CONTRACTOR COMPANY NAMF > ^ <• i~ ~ ^ * > (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 Section 7031 5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001) Name State License tt Address License Class City State/Zip City Business License tt Telephone tt Designer Name State License tt Address City State/Zip Telephone ,i: CO~MPE¥SATION I v «, !_"*"**, Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations [3 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 n 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 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS) D CERTIFICATE OF EXEMPTION I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California WARNING Failure to secure workers compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollarS't$l)(KM>00)r-4r*addition to the cost of compensation damages as provided for in Section 3706 of the Labor code, interest and attorney s fees SIGNATURE ^—~#^ (~ 1^\^~~^> DATE ** |7 ^ ~~ I hereby affirm that I am exempt from the Contractor s License Law for the following reason Q 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) l~l 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) l~l 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 Ej 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 work but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type F work) PROPERTY OWNER SIGNATURE ^- — ) ^-y^r./3:DATE 'COMPLETE THIS SECTION FOR A/O/^fS/^ra^STJlLDINp^ERMlIS ONLY Is the applicant or future building occupanfrequireo tb""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? O YES CD NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? f~l YES f~l NO Is the facility to be~£Dnstructed within 1 000 feet of the outer boundary of a school site? fj 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 S8 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(0 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 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 authorized by such permit is not commenced within; m any time after the work is commepee'6rfi>r a Rsijod < yVp ) days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned L 106 4 4 Uniform Building Code) PPLICANT S SIGNATURE DATE YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 07/27/2004 Permit* CB042380 Title EZELL RES NEW H20 HEATER Description Inspector Assignment JM Type PLUM Sub Type Job Address 2390 CIPRIANO LN Suite Location APPLICANT EZELL JOHN R Owner EZELL JOHN R Remarks OR 533 0731 Total Time Lot CD Description 25 Water Heater/Vents Act Commej Phone 7607800732 Inspector V Requested By JOHN Entered By CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 07/20/2004 25 Water Heater/Vents CO JM NO ON E HOME 06/30/2004 25 Water Heater/Vents CO JM STRAP VENT (2) EXTEND B VENT TO ROOFTOP & T & P OUTSIDE