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Home My WebLink About2605 COLIBRI LN; ; CB980803; Permitn<af™nce# TO BUILDING PERMIT Permit No CB980803 B U I L u i Project No A9801058 03/18/98 13 41 Development No Page 1 of 1 Job Address 2605 COLIBRI LN ^te Permit Type PLUMBING Parcel No 215-535-12-00 Lot* Congtructlon Type NEW Valuation 0 M Status ISSUED 03/18/98 03/18/98 Entered By JM Appl/Ownr CHUCK'S PLUMBING 760 729-0961 3800 WESTHAVEN DRIVE CARLSBAD CA 92008 ....- -. ^ edit*- *** *** Fees Required *** ,,, '" ***„_-, !^!!!:§__!-_! - -- F^es 27X'00 ., \C: \.^/^\/O} , N nn Artnijc-tments -' 00:-":.' -"Total. Credit^ 03/1B/98 0001 Oi°°02^:TTeli /«<*:•:•/.„ To.^ificTS5.%. c-p??- 27'°° ---/,., c\UhitV "'-'^e'eVuhit Ext fee DataFee description / Enter "Y" for Gas Piping System/1 •, ;x'7_00\ 20 00 Y 7 00 I FINAL APPROVAL CLEARANCE. CITY OF CARLSBAD 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr, Carlsbad CA 92009 (760)438-1161 1 PROJECT INFORMATION FOR OFFICE USE ON PLAN CHECK NO . EST VAL Plan Ck Deposit Validated By Date 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 s Parcel #Existing Use Proposed Use Description of Work CONTACT PERSON (If different from applicant) * of Bedrooms it of Bathrooms Name 3 APPLICANT Contractor Address City Agent for Contractor Q Owner Q Agent for Owner State/Zip Telephone tt Fax # Name 4 PROPERTY OWNER Address City State/Zip Telephone # Address City State/Zip Telephone *Name S CONTRACTOR COMPANY NAME " " "" " -™^™- ~-y-— - -~— —^ — ~r (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 oUSection 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 t> Address License Class City State/Zip City Business License # Telephone * Designer Name Address City State/Zip Telephone State License # 6 WORKERS COMPENSATION " " " ''"' "' "~~ Workers Compensation Declaration I hereby affirm under penelty of perjury one of the following declarations Q 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 Q 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^T^^ jptJ 4/& Policy No /S^f fl/£>^ ^7/5 Expiration Date / -" /— ^ ^ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*100) OR LESS) Q 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) hi addition lo the'co'st of enmpenMtlon. rinmnpm as provided for hi Section 3706 of the Labor code interast-atid attorney a fees /yA j/y Jr /S c. j, •Sy I f7^ /ZPl*? SIGNATURE .^^>/%A^L£^i /(___ C,!^f^t^(^^f>^7 DATE«g — J fi—7 X 7 OWNER BUILDER DECLARATION ' -">.-,-%-„ , , p-r I hereby affirm that I am exempt from the Contractor s License Law for the following reason n 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 end 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 em 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 contractorls) 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 Q 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 / phona 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) PROPERTY OWNER SIGNATURE DATE_ -fl—'T-COMPLETE THIS SECTION FOR NON-ftESlDENTlM. BUILDING PERMITS ONLY" 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? Q YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES Q NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? Q 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 !8 CONSTRUCTION LENDING AGENCY " " """"" """' *"*r "" "~" " " 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 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 365 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 thewprk is commenced for a period/of 180 days (Section 106 4 4 Uniform Building Code) APPLICANT S SIGNATURE WHITE File YELLOW Applicant PINK Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB980803 FOR 03/19/98 DESCRIPTION: REPLACE GAS LINE TO POOL EQUIP TYPE: PLUM JOB ADDRESS: 2605 COLIBRI LN APPLICANT: CHUCK'S PLUMBING CONTRACTOR: OWNER: REMARKS: C/CHUCK/729-0961 SPECIAL INSTRUCT- INSPECTOR AREA PLANCK# CB980803 OCC GRP CONSTR. TYPE NEW STE: LOT: PHONE: 760 729-0961 PHONE: PHONE: INSPECTOR TOTAL TIME: CD LVL DESCRIPTION 23 PL Gas/Test/Repairs ACT COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS 07/22/98 INSPECTION HISTORY LISTING FOR PERMIT* CB980803 DATE INSPECTION TYPE 03/19/98 Gas/Test/Repairs 03/19/98 Gas/Test/Repairs INSP ACT COMMENTS RI TP RI AP C/CHUCK/729-0961 HIT <RETURN> TO CONTINUE... so COMPENSATION INSURANCE FUND PO BOX 807 SAN FRANCISCO,CA 94101-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE 01-01-98 POLICY NUMBER 1398465 - 98 CERTIFICATE EXPIRES 01-01-99 STATE CONTRACTORS LICENSE BOARD-WORKER'S COMP. BOX 26000 SACRAMENTO CA 95826 JOB LIC 287308 EXP 2-29-96 INCEPTION DATE 01-01-98 D 0 SAN DIEGO This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated This policy is not subject to cancellation by the Fund except upon todays advance written notice to the employer We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance police and does not amend extend or alter the coverage afforded by the policies listed herein Notwithstanding any requirement term or condition of any contract or other document with respect to which this certificate of insurance may be issued or may pertain the insurance afforded by the policies described herein is subject to all the terms exclusions and condition; of such policies PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS $1,OOO,OOO 00 PER OCCURRENCE STANDARD EXCLUSION INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY EMPLOYER LEGAL NAME CHUCK'S PLUMBING 3800 WESTHAVEN OR CARLSBAD CA 92008 ARMSTRONG, CHARLES RAY PRINTED- 12-18-97 PQ409 THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND SCIF 102S5 (REV. 2-95