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Home My WebLink About2624 COLIBRI LN; ; CB040804; Permit03-10-2004 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB040804 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 2624 COLIBRI LN CBAD PLUM 2155341600 Lot# 0 Construction Type NEW KRIKES RES NEW H20 HEATER Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 03/10/2004 SB 03/10/2004 03/10/2004 Applicant A&J FOSTER, INC STEB 13706HWY8BUS EL CAJON CA 92021 619390-4477 Owner KRIKES NICHOLAS P JR&BACHMAN KRIKES MARY E FAMIL 2624 COLIBRI LN CARLSBAD CA 92009 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Dram Install/Repair Water Line Water Heater and/or Vent Gas Piping System Vacuum Breaker Other Plumbing Fees Master Drainage Fee Sewer Fee Additional Fees 0 0 0 0 1 0 0 $2000 $000 $000 $000 $000 $700 $000 $000 $000 $000 $000 $000 TOTAL PERMIT FEES $2700 Total Fees $2700 Total Payments To Date $000 Balance Due $2700 7209 03/10/04 0002 01 02 Inspector **-** u FINALA^g DatP &// C^L Clfiarancp 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 fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired PERMIT APPLICATION CITY OF'CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 1 PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date C..,nAddress (include Bldg/Suite If Business Name (at this address) Lot No Subdivision Name/Number Unit No Phase No Total # of units Ass.essor s Parcel it . i \ , Existing Use\AfcOrer--Proposed Use Description of Work SQ FT ? CONTACT PERSON,(if different from applicant)\^-K i *-cd—• <~* r-:~s-i t f •> »^-^ ,-*-~V—* S l-O""~l #of Stories # of Bedrooms # of Bathrooms 1 rgS cn m Name Address 3 APPLICANT QContractor D Agent'for ContractorV~\ \ •'; " "\ ' /• v^~]L x-> .**• —l-^^—v *' i O'^'"! *'-*/Owner City Agent for Owner'tate/Zip _Telephone #done tt Fax # 39O<4<4^4% qZQZLIName 4. . PROPERTY OWNER Address City tate/Zip elephone # Name 5 CONTRACTOR-COMPANY NAME 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 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 of Section 7031 5 by any applicant for a permit subiects_the applicant to a civil penalty of not more lhan five hundred dollars l$5QOl)- -- f KLk £\(fa\ar CJPflCSL( (oft -(\ar) 3Name State License , Address License Class City J " State/Zip City Business License # j_ 'elephone # ' Q Designer Name Address City State/Zip Telephone State License it 6 WORKERS COMPENSATION , " " " " ,""""' Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations |"1 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 ^Sj 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 c_oiripensation insurance earner and policy number are Insurance Company i_PoUcvNo M(C>O>OL30LT7I 5 Expiation Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) l~l CERTIFICATE OF EXEMPTION I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California WARNING Failure to secujgworkers compensationcoutfrage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($ 10JJ^JO") ji^bditpn tjjtrre cost oTjrornrjergatipn damages as provided for in Section 3706 of the Labor cod« jnter^st and attorney s fees DATESIGNATURE 7 OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contactor s License Law for the following reason 0 I as owner of the property or my employees with wages as their solo 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) PI 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) 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 l"~l YES I~|NO 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) PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOR NONRESIDENTIAL BUILDING PERMITS OWLY,,, ., ; s* > :: " _> 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? f~l YES |~1 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 O NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? f~] YES l~l 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 30970) Civil Code) LENDER S NAME LENDER S ADDRESS 9 APPLICANT CERTIFICATION ' " - . : , ' -_. , " r ' ' " r 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 CitV 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 EXPIRATfON 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 commencedj^taa 180,<teys from the dat^pfapch permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is comii^fTCed^f^pfliayof'tfOjiftyfSectiofBroS 4 Uniform Building Code) APPLICANT S SIGNATURE DATE i YELLOW Applicant PINK Finance 1 City of Carlsbad Bldg Inspection Request For 04/14/2004 Permit* CB040804 Inspector Assignment JM Title KRIKES RES NEW H20 HEATER Description Type PLUM Sub Type Phone 7609298523 Job Address 2624 COLIBRI LN Suite Lot 0 ~~l\/\/\ Location Inspector UWV APPLICANT A&J FOSTER, INC Owner KRIKES NICHOLAS P JR&BACHMAN-KRIKES MARY E FAMIL Remarks Total Time Requested By KRIKAS RES Entered By CHRISTINE CD Description AcJ, Comment 25 Water Heater/Vents \^\j Associated PCRs/CVs Inspection History Date Description Act Insp Comments 04/05/2004 25 Water Heater/Vents CO JM NO ONE HOME so COMPENSATION IN SUR PO POLICYHOLDER COPY 807) SAN FRANCISCO,CA 94142-08p7 FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE 04-01-2003 GROUP OO0467 POLICY NUMBER 0000713-2OO3 CERTIFICATE ID- 4 CERTIFICATE EMPIRES 04-01-2O04 ^ 04-01^2^03/04-01-2004 CONTRACTOR'S STATH LICENSE BOARD SD\ , / / *, \ LICENSE fcijMfER LICENSE #630120 /WORKERS-COMPENSATION UNIT > l< / „< *'-^ INCEFTIOI* DATE 04-O1-2003' I P o "feox 26000 = s ~ „. : •% - ^% F.O . ' 'so" v SACRAMENTO CA 95e*2& j J \ - -n / « t .. % t * f ' 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 ' \ •>.,--'^ * s This policy is not subject to cancellation by the Fund except upon 10 days' advance written notice to the employer We will also give you to'<Jays/"-a<^ance notice should this policy be cancelled prior to. <ts jnbrrnat .expiration. ** ' 4 * -I "•^*r*f » \ t , . I t! S AUTHORIZED BS»RESENT:ATIVE