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Home My WebLink About2421 LA COSTA AVE; B; CB100144; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 01-22-2010 Plumbing Permit Permit No: CB100144 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 2421 LA COSTA AV CBAD St: B PLUM Status: Lot#: 0 Applied: 2162405528f Construction Type: NEW Entered By: Reference#: PC#: Project Title: JUREWITZ RES REPLACE WTR HTR Applicant: ALL STAR WATER HEATERS & PLUMBING 17886 LAKESHORE DR _92530 1-800-727 -0977 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 0 1 0 0 Plan Approved: Issued: Inspect Area: Owner: JUREWITZ ROSS A&LEE I 2421 LA COSTA AVE #C CARLSBAD CA 92009 ISSUED 01/22/2010 KG 01/22/2010 01/22/2010 $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 Total Fees: $27.00 Total Payments To Date: $27.00 Balance Due: EXPIRED PERMl'T $0.00 PERMIT HAS EXPIRED IN ACCORDANCE WITH C.8.C. St:CTION 106.4.4 AS AMENDED BY C.M.C.18.04.030 Inspector: DATE I b\\ \11 SIGMTUIIE-'@A""""~'---- FINAL APPROVAL 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 wilt 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 x i n. f . h h v r l I N Tl imil r hi hi h I limitati ns h ~. .«~~ ~ CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718/ 2719 Fax: 760-602-8558 www,carlsbadca,gov SUITE#/SPACE#/UNIT# ~ TENA Plan Check No Est. Value Plan Ck. Deposit Date Af'N M /0 EXISTING USE PROPOSED USE GARAGE [SF) PATIOS (Sf) DECKS (SF) AIR CONDITIONING FIRE SPRINKLERS YES □ NOD YES □ NO □ CONTACT NAME (ff Dllferent Fom Applicant) APPLICANT NAME ADDRESS ADDRESS CITY STATE ZIP PHONE FAX EMAIL PROPERTY OWNER NAME CONTRACTOR BUS. NAME ,n ADDRESS FAX EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LIC. # STATE UC.# (Sec. 7031.5 Business and Professions Code: Any Clty or County which requires e permit to construct alter, Improve, demolish or repair any_ structure, prior to Its Issuance, elSo requires the applicant for such permit to flle a s11,tned statement tnet he Is licensed pursuant to the provisions of the Contractor's License Law !Chapter a. commending with Section 7000 of Division 3 of the Business and Professions Code) or [hat he Is exem_1;it therefrom, end the basis for the alleged exemption. Any violatlon of Section 031.5 by any applicanffor a permit subjects the applicant to a clvll penalty of not more than five hundred dollars {$500}). WORKl!RS' COMPENSATION ' ' Workers' Compensation D1claratlon: I horsby afflrm undsr penalty of ptljury one of the following declarations: D I have end will maintain I certificate of consent to aelf-in1ur, for workers' compensa~on as provided by Section 3700 of lhe Labor Code, for the performance of Iha work ror which this permit is Issued. ~ have and wUI maintain workers',"1l!!1pen1fllon, as required by Sacllon 3700 of the Labo, Code, for the performance of the work for which this permit is issued. My worker1' compen11tion insura:: ca")·er and policy numberare:lnsuranceCo. t-2e ·-0 s :r>, c;. Polley No. '201KIZM 12..00lH 5:"Ji Expiration Dale 2t Lvt-_ LO This section need not be completed If the permll ls for one hundred dollars ($100) or less. 0 Certlflc1t1 of Examptlon: J certify that In the performance of the wotk for which this permU ls Issued, I shall not employ any p&l'fon in any manner so as to become subjOGt lo the Workers' Compensation Laws of California. WARNING: Fallure to stcure workers' compensation coverage 11 unlewful, and ,hall subject an employer to crfm!nal penaltlee and civil fin11 up to one hunclr•d thousand dollars (&100,000), in addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, lnl1r11t snd attorney's fets. / AS CONTRACTOR SIGNATURE --===----:.:::-------I b I I I hereby affirm that I am exempt from Con/rector's License Law far the fol/owing reason: □ I, as owner of lhe property·or my employees wilh wagens·their-sole compensation, will do lhe·work and the structure Is not lnlended or offered for sale (Sec. 7044, Business and Professions Cods: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who does such work hlmsetr or lhrough his own employees, provided that such Improvements aro nol intended or offered for sale, If, however, the building or improvement Is sold within one year of completion, the owner-builder will have the burden of proving the! he did not build or improve for the purpose of sale). □ I, as owner of the property, am e~clusiva!y contracting with licensed contractors lo construct 1he project (Sec. 704◄, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor{s) licensed pursuant to the Contractor's License Law). □ I am exempt under Sec~on, _____ Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. □ Yes □ No 2. I (ha~e I ha~e not) &lgned en eppllcsllon for a bu/ldlng permit fo, the prop0$ed work. 3. I have contracted with the following person (firm) to provide the proposed coostructlon (Include name address/ phone f contractors' llcense number): ◄. I plan to provlde portions of the woo., but I have hired the following person to coordinate, supervise end provide the major work (Include name I address I phone/ contractors' lcense 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 f phone/ type of work:): _,I!$ PROPERTY OWNER SIGNATURE ClAGENT DATE COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY , ,/)"" Is the appllcarit or future building occupant required to submil a business plan, acu!ely hazardous materials registratioo fo,m or risk management and prevention program under SecUons 25505, 25533 or 2553~ of the Pr8sley-Tanner Hazardous Substance Account Act? □ Yes .g.+Jo Is the applicant 01' Mure building occupant required to obtain a permit from Iha air pollutio., control dlslrict or air quality management district? □ Yes 0-.io Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ 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. CONSTRUC.Tl9N LENDING AGENCY I hereby affirm that there 1s a construclfon lendrng agency for the performance of the work this permit 1s issued (Sec 3097 (1) C1v1I Code) Lender's Name Lender's Address A P P L IC A NT c; E, R T I f I C A T I O N I certify that I have read the application and state that the above infom,atlon lscolTBCt and that the lnfonnatlon on the plans ls accurate. I agree to comply with au City on:llnancesand State laws relatlngttl buildlngconstructlon. I heraby authorize representative of the City of Car1sbad to enter upon lhe eboYe menOOned prop&ll)' for inspedi::ln purposes, I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS /WO EXPENSES WHICH MAY IN /WY WAY ACCRUE AGANST SIIJD CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations OV815'0' deep anddemaition or oonstruclion of structures over 3 sbries ii height. EXPIRATION: Ever,; permit issued by the Building Official under the provisions of Um Code shall expire by lfflilation and become null and void If lhe buidi'lg or work aulhorized by sudi pe,mil is not commenced 'Mflin 180 days fi'om lhe dale of such permit or if the b1,1iding or YAJrk autiorlzed by such permit is suspended or abandoned at anytrne after Ile v.ork is commenced for a period of 180 days(SeclM 106.4.4 Llnibm &likling Code) . ..6$ APPLICANT'S SIGNATURE DATE 0