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Home My WebLink About2628 COLIBRI LN; ; CB031504; Permit05-28-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB031504 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 2628 COLIBRI LN CBAD PLUM 2155341800 Lot# 0 Construction Type UN MCGREW RESIDENCE WATER HEATER REPLACEMENT Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 05/28/2003 MDP 05/28/2003 05/28/2003 Applicant MY PLUMBER STE 603 5490 COMPLEX ST 92123 760 729-4326 Owner MCGREW DONALD L&LEE A TRS 6069 05/28/03 2628 COLIBRI LN CARLSBAD CA 92009 0002 01 p ;gp 02 2700 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 0 0 0 0 1 0 0 $2000 $000 $000 $000 $000 $700 $0 00 $000 $000 $0 00 $000 $000 TOTAL PERMIT FEES $2700 Total Fees $2700 Total Payments To Date $000 Balance Due $2700 Inspector FINAL 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 6602Q(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 ljUSw^.'Jy^^&:^*s4'-^^AlQAr-\ FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date Address (include Bldg/Suite tt)Business Name (at this address) Lot No Subdivision Name/Number Unit No Phase No Total # of units Proposed Use Hot Stories # of Bedrooms tf of Bathrooms yjji^ Fax # Address (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 Codel or that he is exempt therefrom and the basis ^or the alleged exemptioorp^ny violaton of Seaion 70315,jpy^riyjpplicant fa City State/Zi City Business License #State License tt Designer Name State License # Address City State/Zip Telephone Workers Compensation Declaration I hereby affirm under penalty 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 O/l have and will maintain workers compensation as required by Section 3700 of the Labor Code for the performance of the work for which It hisi permit is issued My worker s conjfi^ns^fioi^ ipsurarcCTarrier and e^licy number areJcWt i (A. _Insurance Company Policy No Expiration Date wnicnnnisi permit is -fifr/of- (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$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 Failule tdjsecure workers ,corrjpensatlon coverage Is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (BMMTOOJ hiAddition t&tbaf ccfstot compensation damages aa provided for In Section 3706 of theUebor nbdajaterest and attorney a fees SIGNATURE /M/)[/(/|/L-"y| / |/{/fyL/l DATE ^jfj^jlt^J I hereby affirm that/I am exerrlpl-from the Contractor s License Law for the following reason Q I as ownSTof 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) Q 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) Q 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 QlMO 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 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? C] YES fj NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? l~1 YES l~l NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? O YES Cl 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 !8:3S§!liMC^ ^r^iij&i^&e *3£.,-*'&* - & - 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 ti'Oti't^J- ***• :"* -5?.T',3"'*Ll?l»~"<, •.1v".*E~.f.-'ifr3.Si-,-:.l»W'i-»-«».,SK{~- ,t.l.f If,:, .. >.„;?> ."'tt •: 4iS-.Hj. ,•;'.•>,.-. ;"M.:ir~ ->,,,"V>-1IIV™:-!t-jt.-,.:-j,.. -teisj..,' v>^~-l'V.i '>„:;,- j -• J'..-.i.-si* .-,-- jJi;»j!.Jc»rv'J' ..•...!•.«.i". :•":../.Vi-.-. .; '•.„'* -:.. ... ,. -.-isj.!'. • 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 comrtfenced within 180 days fromjhe date of such permit or if the building or work authorized by silch permit is suspended or abandoned at any tine after the work is con^iiexjfi^fo/ a pej^od of lp6\l%ysj(Sfcc\fon.AQ6 4 4 Uniform Building Code) " "~ " APPLIC£ r S SIGNATURE DATE WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 06/03/2003 Permit* CB031504 Title MCGREW RESIDENCE Description WATER HEATER REPLACEMENT Inspector Assignment 2628 COLIBRI LN Lot Type PLUM Sub Type Job Address Suite Location APPLICANT MY PLUMBER Owner MCGREW DONALD L&LEE A TRS Remarks Phone 7609180782 Inspector Total Time CD Description 25 Water Heater/Vents Act Comment Requested By DON Entered By CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments POLICYHOLDER COPY P O BOX 420807, SAN FRANCISCO, CA 94142-0807 FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE COMPENSATION INSURANCE APRIL 22, 2003 CONTRACTORS STATE LICENSE BOARD WORKERS' COMPENSATION UNIT P 0 BOX 26000 SACRAMENTO CA 95826 GROUP 000046 POLICY NUMBER 13176-2003 CERTIFICATE ID 1 CERTIFICATE EXPIRES 04-01-2004 04-01-2003/04-01-2004 LICENSE #779636 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 10 days 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 policy 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 conditions of such policies AUTHORIZED REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS $1,000,000 PER OCCURRENCE EMPLOYER MY PLUMBER OF SAN DIEGO LP 5490 COMPLEX ST STE 603 SAN DIEGO CA 92123 SCIF 10262E IEPFUI B01