HomeMy WebLinkAbout2413 LA COSTA AVE; C; CB052382; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
06-27-2005 Plumbing Permit Permit No: CB052382
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Reference #:
Project Title:
Applicant:
2413 LA COSTA AV CBAD St: C
PLUM
2162405534 Lot#: 0
Construction Type: NEW
BANNISTER RES EMERGENCY DRAIN
WITH TRAP PRIMER
Owner:
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
BANNISTER KATHRYN M BANNISTER KATHRYN M
2413 LA COSTA AVE #C
CARLSBAD CA 92009
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
0
0
0
1
0
0
0
2413 LA COSTA AVE #C
CARLSBAD CA 92009
ISSUED
06/27/2005
KG
06/27/2005
06/27/2005
$20.00
$0.00
$0.00
$0.00
$7.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$27.00
Total Fees: $27.00 Total Payments To Date: $0.00 Balance Due: $27.00
r:::c~r··
Inspector: 6 J.J{J).JCJe,) FINAL APPROVAL
Date: p~~O -0', Clearance:
NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, rese1Vations, or other exactions hereafter collectively
referred to as "fees/exactions.H You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Car1sbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any
fw. h Tl imil r hi i h fl' i i h i
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad CA 92008
1. PROJECT INFORMATION
AssessoCs Parcel # ::;i ) (., ~ '-\ Q 5" S 3 Lj Existing Use
FOR OFFICE USE3N~Y I':
PLAN CHECK NcLJt)_j Z':> y
EST. VAL __________ _
Plan Ck. Deposit ZJ
Validated By _____ ~~=-~---
Date (o-,;l..J-<5"5
Total # of units
Proposed Use
Description of Work SO. FT. # of Stories # of Bedrooms # of Bathrooms
6<-po~ :J.'1 bri:,-,n ~,ne .(;-ow. \o.LLn,h·':I --¼o 3;, W':fe To e,:,._JJ_ Ro",c-;to.-+ liV'le \i'!.-4nll new
2. CONTACTPERSON(lf~lfferentfromappllcant) ~~n\;net-h-af -lo &-.>S'l'cle" JA...,.,~, e.it.pt•~ .. ,e..s. ~ ~C\,S, /
Name Address City State/Zip Telephone# Fax#
3. APPLICANT □ Conlrador □ Agont [qr~ . jll( Owner □ AQfllll for Owner (, \._
K&r•E P>5N"'l$Jkl<-,29,3-C L11-Cos+c, Av.g...(Llni± e,) 0,vlsh;_Jl Ci\-~'7k,0~479-041 'l
Name Address City State/Zip::1 Telephone#
4Kf1~=!'.Th-rt. .A 413-C. LA-U,S11't /h,.(.. (ll.,-.. ;+ C.) u, \s~.Q. cl\-'1;)al'1 C7hO )-42'/-tJJ.fl~
Name Address City State/Zip / Telephone# ?
5. CON'IRACTOR · COIIPANY N,IIIE
(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 lo 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 p..ermit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001).
1 t"ATROL 771,, Ar·onS .S~IJ bit' C/Jr 'j:;2\;;i.C., 7/pO l.f31o S'L/'/-
Name Address . / City State/Zip 'Telephone#
State License# 4 :;i;;i \ 3(o License Class (: 3(., C.. 4.;l City Business License# I I qq O Sri, •
Designer Name Address City State/Zip Telephone#
State License# ________ _ (,eel-. ~"-"' t. ~ l>,J'dl'iQ.11-A C\,..-k<" ..,;~n:b'2.A11J P~o'j
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
□ 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.
□ I have and will maintain worker's 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)
□ 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($100,000), In addition to the cost of compensation, damages are provided for in Section 3706 of the Labor Code, interest and attorney's fees.
SIGNATURE ______________________________ DATE _________ _
7. OWNER-Bll.lLOERD&QLIRATION
I hereby affirm that lam exempt from the Contractor's License Law for the following reason:
□ I, as owner of the property or my employees with wages as their sole compensation, will d 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).
la"""' 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).
□ 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. □ YES QI. NO
2. I (havefhave not) signed an application for a building permit for the proposed work.
3. I have contracted with the following person (firm) to provide the reposed construction (include name I address/ phone number I contractors license number: D fl-L ' ~r· r,S .sa.,.,· ·-1
4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide t e major work {include name I address/ pho e number I
fontractors license number}: ------------------------------------------------
5. I will provide some of the work, but I have contracted (hired) the following pars ns lo provide the work indicated (include name I address I phone number I type of work):
DATE_t.=t~:i.~1...,_l_:z~o.~~~5_-__ _ •
WHlTE: File YELLOW: Applicant PINK: Finance
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad CA 92008
Page 2 of 2
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 for or risk management and prevention program under
Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act.? D YES □ 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 □ NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES □ 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(1) 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, JUDGEMENTS, 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 of 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 180 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
the work is commenced for a period of 180 days (Section 106.4.4 · Building Code).
WHITE: File YELLOW: Applicant PINK: Finance
City of Carlsbad Bldg Inspection Request
For: 06/30/2005
Permit# CB052382
Title: BANNISTER RES EMERGENCY DRAIN
Description: WITH TRAP PRIMER
Type: PLUM Sub Type:
Job Address: 2413 LACOSTAAV
Suite: C Lot
Location:
APPLICANT BANNISTER KATHRYN M
Owner:
l&l.f7 {II
0
Remarks: LAUNDRY DRAIN INSPECTION
Total Time:
CD Description Act Comment
Inspector Assignment:
Phone: 7604790418
Inspector: /JV
Requested By: KATHRYN
Entered By: CHRISTINE
22 t.,Jk,,,., _______________ _ ~~~~-=--'------£~~~~~~~~
Associated PCRs/CVs
Inspection History
Date Description Act lnsp Comments