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Home My WebLink About2540 LA COSTA AVE; ; CB031734; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 06-25-2003 Plumbing Permit Permit No: CB031734 Job Address: Permit Type: Parcel No: Reference #: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 2540 LA COSTA AV CBAD PLUM 2163600700 Lot#: 0 Construction Type: NEW SHABA RESIDENCE WATER HEATER REPLACEMENT Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 06/25/2003 MDP 06/25/2003 06/25/2003 ARS SHABA NIZAR&NEHAIA 8202 06/25/03 0002 01 STE 100 6162 NANCY RIDGE DR 2540 LA COSTA AVE SAN DIEGO CA 92121 CARLSBAD CA 92009 CGP 858-677-5455 Plumbing Issue Fee $20.00 Fixture or Trap 0 $0.00 Building Sewer 0 $0.00 Roof Drain 0 $0.00 Install/Repair Water Line 0 $0.00 Water Heater and/or Vent 1 $7.00 Gas Piping System 0 $0.00 Vacuum Breaker 0 $0.00 Other Plumbing Fees $0.00 Master Drainage Fee $0.00 Sewer Fee $0.00 Additional Fees $0.00 TOTAL PERMIT FEES $27.00 Total Fees: $27.00 Total Payments To Date: $0.00 Balance Due: $27.00 CLEARANCE 02 21.00 PERMIT APPLICATION FOR OFFICE USE ONLY ro q PLAN CHECK NO. 6;;> -~ \ CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. __________ _ Plan Ck. Deposit ________ _ Validated By __________ _ Date. _______________ _ Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Tot.al # of units Assessor's Parcel # Proposed Use #of Stories # of Bedrooms # of Bathrooms Name Address State/Zip Telephone# Fax# (Sec. 7031 .6 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 tio . Any violation of Secfon 7031.5 by any · plicant!Q[ a permit subjects the applicant to a civil penalty of not more than five h dred doll r ($600J!.r_., . \M S . 9;;)./d.. ~$ ,Yl~ City State/Zip Telephone # City Business License # I D)Q')QO City State/Zip Telephone 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 the work for which this permit is issued. ffi., 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 co pensation nsurance carrie and policy number are: .~,9 2 O} .f /1. -Q l . . /-/ -O(o Insurance Company \JS Polley No~d;~~-+-:...>_·_ D_l.P_'1._·~~----Exp1rat1on Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100] OR LESS) 0 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: Fallure to secure workers' compensation coverage la unlawful, end shell subject en employer to crlmlnel penalties end clvll fines up to one hundred thousand dollars ($1 ,000), I ad tlon to the cost of compensation, damages •• provided for In Section 3706 of th11 Labor code, Interest end attorney's fees. SIGNATURE • DATE {R-;;l'3>-Q~ ,,..._,.,._o,,,._WNEi,= ER"':BUI DE -~no ..,..,._,,,._._,....,' ........................ _____ ~,.....- I hereby affirm that I a xempt from the Contractor's License Law for the following reason: 0 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}. 0 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. 0 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): ________________________________________________________ _ 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 26505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES O NO Is the applicant or future building occupant required to obtain. a permit from the air pollution control district or air quality management district? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site 7 0 YES O NO 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). !l.., 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 Citt 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 180 days from the date of such permit or if the building or work authorized by such permil is suspended or abandoned at any tin u after the work is com enc d for period of BO days (Section 106.4.4 Uniform Building Code). • / . / APPLICA T'S SIGNATURE --=--i--=-=~=-=---1..,,£.:....::.........:.......JL.1--...,..L.:___________ DATE w _a::>_ o 2:-> t I WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 11/19/2003 Permit# CB031734 Title: SHABA RESIDENCE Description: WATER HEATER REPLACEMENT Type: PLUM Sub Type: Job Address: Suite: Location: 2540 LACOSTAAV Lot APPLICANT ARS Owner: SHABA NIZAR&NEHAIA Remarks: Total Time: ----- 0 Inspector Assignment: PS --- Phone: ~775455 X 204 Inspect~ Requested By: YOLANDA Entered By: KAREN CD Description Act Coml}lent 25 -W-at_e_r H_e_a_te-rN-en_t_s ___ f r pJ fi<v- Associated PCRs/CVs lnsriection Histo[Y Date Description Act lnsp Comments 11/13/2003 25 Water HeaterNents CA PS BY YOLANDA 08/18/2003 19 Final Structural WC PS 08/18/2003 25 Water HeaterNents co PS FIRE WALL & P & T TO OUTSIDE 08/15/2003 25 Water HeaterNents CA JM 08/15/2003 29 Final Plumbing CA JM 08/05/2003 25 Water HeaterNents co PS NOONE HOME