HomeMy WebLinkAbout2522 NAVARRA DR; A; CB041433; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
04-2-20c!4 Plumbing Permit Permit No: CB041433
Building Inspection Request Line (760) 602-2725
Job Address: 2522 NAVARRA DR CBAD St: A
Permit Type: PLUM Status: ISSUED
Parcel No: 216170561' Lot #: 0 Applied: 04/29/2004
Construction Type: NEW Entered By: SB
Reference #: Plan Approved: 04/29/2004
Issued: 04/29/2004
Project Title: MADDOX RES NEW H20 HEATER Inspect Area:
Applicant: Owner:
ALL STAR WATER HEATERS & PLUMBING
2&2P14AVM4RATiR #B
17886 LAKESHORE DR 92530 '-7 eRtS9TtirJ9
1-800-727-0977 / ? /0)
,
Plumbing Issue Fee
Fixture or Trap
Building Sewer
Roof Drain
Install/Repair Water Line /')
Water Heater and/or, Vent
Gas Piping System / Vacuum Breaker -I Other Plumbing Fees
Master Drainage Fee
Sewer Fee I
Additional Fees
TOTAL PERMIT FEES
'
7'
7 \>4i
\ Ti
- \ $20.00
"1 J o $0.00\
r0:00 \ $7.00
\ ,$o.00
ril ç $000
c \,'$0.00
I $0.00
j $0.00
/
/ $27.00
Total Fees: $27.00 .Total Payments To Date: ORATEt$0.0,,' Balance Due: / $27.00
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' PERMIT w JRED IN ACCORDAN12141 "I.R.;4A 0001 s o SECTjiJl)o.4. 'CGP
DATErLNATL_LL=.
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 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
27.010
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
FOR OFFICE USE ONLY
.
PLAN CHECK NO.
EST. VAL.
Plan Ck. Deposit
Validated By______________________
Date Cf/'zg/tcj
Bldg/Suite #) - Business Name (at this address)
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units
Assessor's Parcel # . Existing Use Proposed Use
Description of Work SQ. FT #of Stories # of Bedrooms # of Bathrooms
iIdJ P1ñt)1 iY
Name Address City State/Zip Telephone # Fax #
317
7-7
ame Address City State/Zip Telephone # (
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish orrepair 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 therefidm, 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 l$500fl.
Name Address City State/Zip Telephone #
State License ii ') I2?'( License Class ( City Business License # IZ
Designer Name Address City State/Zip Telephone
License #
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
O 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 t e work for which this permit is issued.
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 (T"AT(! C Policy No.(") h/ çs '/t# Expiration Date r,.—('--
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100] OR LESS)
CERTIFICATE OF EXEMPTION I certif hat in the performance of the work for which this permit is issued, I shall not employ any parson in any manner so as
to become subject to the Workers omp sati n Laws of California.
WARNING: Failure to secure w rker comp atlon coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
usand dollars ($100,000), I - n to a cost of compensation, damages as provided for In Section 3706 of the or code, Interest and,pttomey'a fees.
SIGNATURE DATE
I hereby affirm the I am xempt from the Contractor's License Law for the following reason:
I, as owner f a 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).
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 tothe Contractor's License Law).
0 I am exempt under Section ______________ Business and Professions Code for this reason:
I personally plan -to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO
I (have / have not) signed an application for a building permit for the proposed work.
I have contracted with the following person (firm) to provide the proposed construction (Include name / address I phone number / contractors license number):
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 I phone number / contractors license number):
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
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 0 NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control dist,iit or air quality management district? 0 YES 0 NO
Is the facility to be bnstructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 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.
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_______________________________________________________
... . ,.
..4.....
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 tq' building construction. I hereby authorize representatives of the Citj' 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 LIABIUTIES,
JUDGMENTS, COSTS AND EXPENSES WIICH MA41NY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA permit is required for e cavatio ov 5'0 deep and demolition or construction of structures over 3 stories in height.
ç\1)
EXPIRATION: Every permit issued by th bull g Offi al 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 commen d w in 180 aye from the date of such permit or if the building or work authorized by such permit is suspended or abandoned
a any time after the work is cad r period o, 180 days (Section 106.4.4 Uniform Building Code).
PPLICANT'S SIGNATURE
- DATE
WHITE: File YELLOW: Applicant PINK: Finance
717