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Home My WebLink About2716 LA GOLONDRINA ST; ; CB021261; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 04-24-2002 Plumbing Permit Permit No: CB021261 Job Address: Permit Type: Parcel No: Reference #: Project Title: Applicant: ARS STE 100 Building Inspection Request Line (760) 602-2725 2716 LA GOLONDRINA ST CBAD PLUM 2155410800 Lot#: 0 Construction Type: NEW KRALL RES-REPLACE WATER HEATER Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: KRALL EDWARD C&SOFIA ISSUED 04/24/2002 RMA 04/24/2002 04/24/2002 6162 NANCY RIDGE DR SAN DIEGO CA 92121 858-677-5455 2716 LA GOLONDRINA ST CARLSBAD CA 92009 5778 04/24/02 0002 01 CGP Total Fees: $27.00 Total Payments To Date: $0.00 Balance Due: 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 ~e Inspector: ~=--- 0 0 0 0 1 0 0 _ FINAL ft-~AJ. '"'2- Date: / [_~ Clearance: $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 $27.00 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 . , . 1,,,..,,,.. . ' .. -•-----,,-~ll"ITlf"l:-... :-a ... ,tn+i..: .. nr~c:tn .. ,l.:...h+l,,,,,.f,,t,,IA,,f. . . L--. -•L--·-'----' 02 27°00 PERMJT AP.PUCA TION FOR OFFICE USE a PLAN CHECK NOO .2 I :2 t I CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 Business Name (at this address) Legat Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Proposed Use #of Stories # of Bedrooms # of Bathrooms 2. CONTACT PERSdN;Uf diU8if8ilt·frofui8~·pj1cli11tf Name 3. Address [). 'Agent_-fofCOl'ltraOfor :~ ~ b2. City . ,. CJ AQ~l1HdHSWri~f · * Na Address City State/Zip Telephone # Fax# z_ c. kcrsTY6'c~,\ a 11 ~ · e,._ ~lrir\t\~~, &lsQ;~ City c:A. 9aoo1 Q{go-i/3 I -ssqtj State/Zip Telephone# Name Address 5. CONTRACTOR • COMPANY NAME·- Designer Name Telephone State License # __________ _ 6. WORKERS' COMPENSATION. Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: O I have and wlll 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, D I have and will maintain workers' compensation, as required by Section issued. My worker's compensation insurance carrier and nnllcy number are: Insurance Company~ tr\A-e:S;-\ l.Lf::A-. \<1~~ ___ _ ' . 3700 of the labor Code, for the performance of the work for which this permit is Pol;cy No.:..l'13w+3.-()0 Expfrat;on Date_l_· /_ij t,~ {THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS I$100I OR LESS! D 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 wo,kers' compensation coverage Is unlawful. and shall subject an employer to crlmlnal penalties and civil fines up to one hundred thousand dollars ($1 o, OJ, In dltlon t h ost of compensation, damages as provided for In Section 3706 of th~ b r code, I terest and attorney's fees. SIGNATUAE' _ __'~)Pk'.IJc.lt,,l;/..b,__S,~~~~'.=:;~rc--,---,--c---,--.,-.,.-,c---- 7. OWNER-BUILD I hereby affirm that I am exempt from the Contractor's license law for the following reason: D 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 salel. 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(sl 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 arid materials for construction of the proposed property improvement. D 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 I address/ phone number/ contractors license number): 4. I plan to provide portions of the work, but J have hired the following person to coordinate, supervise ·and provide the major work (include name/ address I 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 SIGNAT\..JRE ______________________ _ COMPLETE THIS SECTION FOR'NON-liESiDENnAl eu11:.01N(lPERMItS''c)N'tY'.'" 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 Act7 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 district7 D YES D NO ls the facility to be constructed within 1,000 feet of the outer boundary of a school site? D 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 ANO THE AIR POLLUTION CONTROL DISTRICT. 8. CONSTRUCTION LENDING AGENCY 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 _______________ _ 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 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 TH1S PERMIT. OSHA: An OSHA permit ls 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 ii the building or work authorized by such permit Is not commenced within 180 days from the date of such permit or If the bufldlng or work authorized by such permit is suspended or abandoned al any 1;me afler the work ;5 co_mmenc for a p ;od of 18 (Sec1;on 106.4.4 Uniform Bu;ldlng Code). 1 I/ / / APPLICANT'S SIGNATURE _\~f:,_~,l!~~L), _ _j..'.'...)d,.Q~c!:_'.:;:~)---------DATE f La () d\ I I PINK: Finance UNSCHEDULED BUILDING INSPECTION INSPECTOR If f ----- PERMIT # 0 -i I 2 "I . PLAN CHECK# ____ _ DESCRIPTION __________________ _ CODE DESCRIPTION ACT COMMENTS