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Home My WebLink About2645 LUCIERNAGA ST; ; CB030567; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 ' 02-26-2003 Plumbing Permit Permit No: CB030567 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2645 LUCIERNAGA ST CBAD PLUM Status: ISSUED 02/26/2003 CB 02/26/2003 02/26/2003 Parcel No: 2153104601 Lot#: 0 Applied: Construction Type: NEW Entered By: Reference #: Project Title: Applicant: SEENER RES/ WATER HEATER REPLACEMENT WATER HEATERS ONLY INC. 400S EL CAMINO REAL SAN MATEO, CA 94402 415-375-8751 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 TOTAL PERMIT FEES 0 0 0 0 1 0 0 Plan Approved: Issued: Inspect Area: Owner: SEENER SHAWN&THERESA 2645 LUCIERNAGA ST CARLSBAD CA 92009 $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 Total Fees: $27.00 Total Payments To Date: $0.00 Balance Due: $27.00 EXP;RED PERMIT PERM! f HAS EXPIRED IN ACCORDANCE WITH U.B.C. SECTION 106.4.4 DATE )3 \3rs;io::s SIGNATURE ec:.k=---- PERMIT APPLICATION ·c1Tv·oF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NoC,f;:03()5{()7 EST. VAL. _________ _ Plan Ck. Deposit ________ _ Validated Bv~C'-'7 fJ;?_""':...._ ______ _ Date Z · Z..(e-Q?:, Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Numbe"r Unit No. Phase No. Total # of units h t_'""'~ Proposed Use #of Stories # of Bedrooms # of Bathrooms -N-,-m-.----./-...L--/-..L-"l-!C'-:J'-~"--'='--""-'A=dd-,~.~,L,-'---"'...L..L......I.----------C~;,-y------·-,;-:-!'.C-:'.-:-:z~·•?5°~:~·· -~··::~:>~\\j=;}fh_i:-··'.:n=.1~e~:~:o-nLe-"#::.:,~c..,-'F~a~x•#.>e~/ ~i!'ii!A"e.t~!~Al\lt,v~l!J.;¢:QD1iati>riJi!:1 ~,~ij£;q~~/ra!li~inf,.;l!J~iil,r&lill1i~l,,.r' .; :11\t . Name Address Citv State/Zip Telephone# (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 exempfon. Any viola ion of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penaltv. of not more than five hundred dollars 1$500]). o.~12. .,-,:;:hrz. On/ ~ c m"'--"-s~ 612.-i:;:.s '95 <t -7:30.-27~3=/ Name City St e/Zip Telephone # State License # -~--~~~-License Class C 3' I.fl C City Business License # c;:cJ J CClOO~ / 6aj / Designer Name Address City State/Zip Telephone State License # _________ _ ij,.:,,,_l1i\lQIOO!ll$"l!Cti.MPlllSlli'IO~ ~,,;, ,w.,., · iii( /iii Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 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. ~ l have and will maintain workers' co.mpensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is ued. My worker's compensatiop insurance carrier end policy number are: urance Company ~ ~ PoUcy No. /0 $ >"4 z3-Cc_ Exp;rat;on Date 5° -/ --(J ";> !THIS SECTION NEED NOT BE COMPLETED ™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: 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 ($100,0001, In add the coat of compensation, damages as provided for In Section 3706 of the Labor code, interest end attorney's fees. SIGNATURE DATE 'ti:i~WllJ!lillli;lj~'tflill~'t reason: D l, es 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 Lew 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). D 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). D 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 end 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 D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site7 0 YES D 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. s:tt,~~il~TRUCTIQNL~lliDING·AG~Ne'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 .,,,,.,---:c-,.,---,---,---,-----,-------, •~:.;,8'1\'.l'Ll!rAN'!!QaMtlFICAJiON I certify that I have reed the application and state that the abo\l'e 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. t 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 demo.lition 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 1 BO 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 the work is commenced for a p iod I 1 O ays ~Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE YELLOW: Applicant PINK: Finance