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Home My WebLink About2727 LLAMA CT; MULTI-PERMIT FILE; CB070861; PermitCity of Carlsbad .. 1635 Faraday Av Carlsbad, CA 92008 03-29-2007 Plumbing Permit Permit No: CB070861 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2727 LLAMA CT CBAD PLUM Status: Parcel No: 2154200900 Lot #: 0 Applied: Construction Type: NEW Entered By: Reference #: Project Title: Applicant: BOOMHOWER RES-REPLACE WATER HEATER FAST WATER HEATER COMPANY 12601132ND AV NE KIRKLAND WA 98034 425 814 3124 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: BOOMHOWER DEAN&APRIL 2727 LLAMA CT CARLSBAD CA 92009 ISSUED 03/29/2007 LSM 03/29/2007 03/29/2007 $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: $27.00 Balance Due: Inspector: Date: Clearance: $0.00 NOTICE: Please take NOTICE Iha approval of your project includes the 'lrnposit n" of fees Cledications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this permit was issued to pro st imposition of these fees/exactions. \f 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 wl!l 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 f exa i n of whi h ou h v r vious! e iv n N Tl E imi\ar hi as t hi h th a t limit i ns ha r I otherwise ex ired. ---------------·-·· Fron: 03/28/2007 12:2& 1292 P.II02/DD5 • PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 2727 LLAMA CT l!>dotingUN -o!Wod< SCl FT. Remove/Replace Gas Water Heater - BullnNI Nan• (et lfda addreN,) Urj!No. f'lltloNo. tot-I-of 8'1draom8 •ot- -Foxt ' I , _, 1 I i • . -• • -e .U •.. ~I'. ; ; : --City -' BOOMHOWER, APRIL blhtiib. bl Mbb& 9iji&hbs (Sec. 7031.6 6ulineu and PICZ I rw Coda: Alfi Cly or~ which requna a pmmtt to conabuat. dlr, lrnprllw, dlmOlflh or 19pa any~ ... prior to Ill laua\Ce. •1oD-tho11>pll-lorouchpmmft.,ftleaoiQ,...i-1hathllloD __ _,1llo~•oll1o---law[ChaplotB,~wlth Sdon 70DOol-I ollhll B-•nd-lono c:o«eJar 1hat he •--pt-m, and t,o _fot ... -d _,,,.,.._ Any,lolollon cl-7031.5 by any applQant'tlr • perrntt IUflflcCa U. app:llaant1D advll .,.,_n,of notmo19 flllnM hunnd dalllrS {S&00]). FAST WATER HEATER COMPANY 12601 132ND AVE NE KIRKLAND, WA 98034 425 814-3124 Noma Addrw Clly stolllZJp Jelophono# --· 877489 UcenNCluo C36 CllySUll-l./c:ona0#_1_2_22_3_0_2 ____ _ ~Name --·--------City Slate/Zip Tolephono# CJ I lw.wt and wit mantaln a Clllltlcat:I of CIH111flt ID MI-IRIU1'9 fOr walkn' comP9Jlllllgn n pmfded by Secaon. 370D or Ill Labar" CQda. for the perfo,manc::11 ol the \Wfll: for Wl'lldl UU permtt la la.ltd. Jl I h_.. Ind wll mllfflllln .-OIUl"t ~1 • r.qund by SecCkNt 3700 of the i.bor Code, for lh9 Jllll'IM"ll'lance Df H1a work 111r whloh thit perml II 111U111. My worker"■ compenlllon lnsnnoe earl'llrlftd ~ numberatr. ln11RnceComp,ny Catifqnia State Fund Polc)INo 1761660 ___ 1_2/_1_/0_7 ___ _ (THIS 911C'1"10N NllD NOT Bl! COlll'Lffllll IF IHE -IS !'OR ONI 11\JNDQI) DOLL.ARI ($1Dtl 0R t.El8) Cl CERTIPICATI. OP DIIIIPTK>N: I Clltlfy lhalt In 1he J)effonnanoa of th• work tor "1llch thlt permll II Issued, I WU not lfflQby 111Y Plf'9DJJ 1n lff/ Mlnnlf so • to ......,._., .. w_.eo.,,.-111Mwaor0ollon"lo. WARNING: Fallull lo acin wor1an,• CGfflPIMIIIIOn __,... Ill ~ w1 thall IIIIJdNt a ~to cmtllal pe-wtd alvl ftnN 11p to OM hdftdNd thouand :;:;::a>.tn 4,;;;!;.J;~P\$:t±~'rpnwldad'°'.,StoUoumeottMLnor~1mwt~ ~o7 L£t1at,am_,,p1_11111W,.-.... 1arlho-- c I, • owner of 1W JrOPertJ ar my efflPloya,N" .tlh .,... u their SOia ~. wll d a. WOl1t and U. 11ruetu111 18 not ~did or crMNad tar ..i. (Sao. 704t Buatna• end P1uf f m COde: The Connclm"e !.lolf'll8 Law dcea not~ 1D an owner of proptrly whQ bUn or ~ thateorl. u:t llftt> daM .uct, wortc NmNlf or through hl1 own empio,ee.. przNldld lhet IIXlh lm))rclYell\el'dl ar. not !minded or offer'lld for nlo. If, haWIIWr, the _bUlldklg or tmpn,Mnlltt II IOld wllin one year of compledon, lhl~wll l'laYI v-tiuraan ofpnMng 1hAt h• did not build orlmprow: for 11w purpo11 of..,,. C ~ u owner d ~ pn,perty, am ucluatwiiy ~ with IOllffllld CDl"llra::tliJnl to oonetruct the iro,,111 (Sac. 7044, lilualMM encl Piufun:1111 Codi,: The Contraotor'a Ucana law dQu not ■ppty to an GWMI' of Pfl)De~ who bJllcll or IEl'IJffl,MI tn.on. n ocnncll tar SUllh Jfflljecta wttt. conn:okN(a) lcanud pUl'8latl 1D 1111 ConCrlc(Or'I Uconee Law). O lameicmnptundlr Sdon ______ a...aPlollNklnsCDdaforttdsrfllOn: 1. I PfflCll!llly Plln to -1111 ml/Ol'labar ond -for-of tho pl\)IIIIOOd -Im-C Y!S C NO 2. I (h-l1QI) llfgnld M lpplltllon lora Wklila plffllltfart,o Pl"polld work. 3. I hlW comrw.aled wl'lh 11w foDawtna pellCn (flnn) ta prv.tcll the prapoNd conatrUC11on (Include nami I adlDN I phane numZMr / aonhDtCn IIPenae number}: ol. I pan ID p,owde pml'Ql'II ot the work. but I have hlra:i 1M fdlowlrQ pnon ID COQfdlnait, supervf.-and proo,Jd• the m$1work (Include name/ adchal / phoiw number/ /on!Ja::tcn;llellranumti.,: --------------------:---:------:--:--:---:---:---:-C":""-L I w111 J)RMdl 10me ot 1he ~. bUt I hive contraCIUtd {hired) the fo«owtng 410raona ta prOl'l9 u. wo,tc. Mdiellad (lncull name t lddreh / phon• ru.,nbar I \/Pe of work): PROPERTYOWNER8JGNATURE ______________________ DAT1 ________ _ 53 Fron: . PERMITAPPUCATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Page2 of 2 --.:iimsor:IS84ol1ho-T1111111' ____ DYES C NO 03/28/2007 12:27 11292 P.003/005 II ttw 9J)J)lclnl or tJture bUlldlng occupant l'ICIUnd IC abCaln a pennlt from ttl9 .... ~ contml dlalrlot or air quellly m1111agement dlllrlet? C YES C NO II lhe facllly ID be COlllbUclld wtltlln 1,000 W of the outar bounday of■ ll:lm»OI lftt? Cl YES C3 NO IF Alft 01' TH& -AIUI YU, A PINAi. ClllfflPICAff o, OCCUPANCY IIAY NOT ■I -UNl.U8 THE APPIJc:ANT HAI 1111T OR IS MRTING THE RPJQIWNTI OPTHII OJIPJCE Of IMIR•ICYfllllWICll8AND Tttl AR POUJITIDM COMTIIOL Dlll'RICT. lhnbyllfllm,ll,ol-··----t--.,lhl-lDr __ zls □-s1oma~ LENOER'SNAME I -lhat I h.,. -lhe opoll-111d -1hot ttlO •-lnfrml...., lo -ond a,11111 Eon on 1ho plaw I■ --I -to comply J .,, City _,_.,,. __ IOldngtob ___ lherwby_11p_,ta11,..0lttlOCl>"olCnbodtoenlilrupontho-m--far-"""'°"" I At.IQ AGR!E TO 8AW. IND&!NIFY ANO ICEEP HARIILE88 THI CITY DF CA11UMD AOAIHBT AU. UA81UIIES, JUD8l!MINTI, COBTI AND EXPl!NUSWHICH MAY IN NfYWAY ACCIIUI AGAINST MID CITY If CONll!QIJENCI! Of TtE GRANTING OP THII Pl!RMIT. OetfA; An OSHA permltlar11quhd b'~ICfQI• af6'0" dMp andcs.momlon orconmrudondllW0lurNl1Ylr3 lfl)rlel In hllght. E>PIM'l10N: e..,-1'0lffllllsluedbylllbulldlnGOlll,lolundortho-ol1hlsCado--b>'ftm-111d_,.,nulll1dl/OklWlll-onwllk1ilhDIIDd by u:h pennltls notcorn-""'111180 dtpflom Ill -of lllCh pennl orllho bUldlnO or---by .,.r, ponnlt II -or.-II IIIIY llm• ottar 1hoWOl1< ••-tor a pertodol180dly> (-100.4Al.inlftlom Mdln1Cado). APPUCANT'SSIGNAl\JRE __ ··~~=::~i~i=\~····~=•~•'=:=.~~;~·-'·=J='.l~~•:-=,~j~:_, _______ DATe_0_3/2_8_/2_0_0_7 _____ _ ~-w City of Carlsbad Bldg Inspection Request For: 02/27/2008 Permit# CB070861 Title: BOOMHOWER RES-REPLACE Description: WATER HEATER Type: PLUM Sub Type: Job Address: Suite: Location: 2727 LLAMA CT Lot 0 APPLICANT FAST WATER HEATER COMPANY Owner: BOOMHOWER DEAN&APRIL Remarks: LEFT SIDE/HOUSE IN CLOSET NO ONE HM. Total Time: Inspector Assignment: a_ \ ) Phone: 6195078092 Inspector: ----- Requested By: APRIL Entered By: JANEAN CD Description 25 Water HeaterNents ~Commen~J ---------------------------- ---------------- Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act lnsp Comments City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 01-2i~2003 Plumbing Permit Permit No: CB030204 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2727 LLAMA CT CBAD PLUM Status: ISSUED 01/22/2003 SB 01/22/2003 01/22/2003 Parcel No: 2154200900 Lot#: 0 Applied: Construction Type: NEW Entered By: Reference #: Plan Approved: Issued: Project Title: DOOMBOWER RES NEW H20 HEATER Inspect Area: Applicant: A&J FOSTER, INC. STEB 13706 HWY 8 BUS EL CAJON CA 92021 619-390-44 77 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 Total Fees: $27.00 Inspector: 0 0 0 0 1 0 0 Owner: OKADA LINDA L 2727 LLAMA CT CARLSBAD CA 92009 Total Payments To Date: $0.00 6303 ')1/22/03 0002 01 02 $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 Balance Due: CGP· 17 .. )0 $27.00 PER''· Hf\S EXPIRED IN ACCORDANCE WITH U.B.C. SECfiON ·106.4.4 OATF 'J k • I !ts SIGNATURE a£lu: t FINAL APPROVAL 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. lf 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 setVice fees in connection with this project. NOR DOES IT APPLY to any PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 ~1-i1ie1t-~lti!:lNEOR.MAill.QNij~~:iil!~~im~111.111irui~t~~ii"lw1!~1/E~~jW~lt~~ru~tJJ~;[IJlllJiir~~~lilll L Ct FOR OFFICE USE ONLY PLAN CHECK NO.C i?o 3c. 2.D'{ EST. VAL.----------~ Plan Ck. Deposit ________ _ Validated By~",:?"'=,_.D=~----- Date / -~ '2. -c::,,') Business Name lat this address) Legal Description Assessor's Parcel # 215 420-09-00 Lot No. Subdivision Name/Number SFR Existing Use Unit No. Phase No. Total # of units Proposed Use Description of Work SO. FT. #of Stories # of Bedrooms # of Bathrooms lg,~ll~:(iqfli't!ri~~~i~,~,m'1allla~ll,.l!ioo~,,1~~-ij~i,i~1f!!,~!fil,~J!i!!, Name Address City State/Zip Telephone # Fax # @'.~l!'/1!~~~~,~=~,~~~~j]i]i~!~~Wl~~~f~•[~R!Jl~l~J!i~~ri~~~rj~~~~,tl~,~!;, Name Address City State/Zip Telephone # lj~i~rJ~P,Jjgij~Q~~W~l~lOO.~~iii!!~fiii!il~rnrnw.~m:il~itliilm~~ifflll~~~,1--,.:m1~~Wi!llf.li~~,-~¥lllm111•1111m&Eitmll~I.ITTWl~lii!!ITTilIB~~~f:!m~1~.~i!ifJlr1,~i~-~i Doomhown Apri J 2727 r,J ama ct earl sbad Ca. 92009 760-930-1305 Name Address City S.tate/Zlp Telephone # ti\!l'~lll:.ONJ]iji\'!fltl!i!;1e.!!Mlfillii~i!iiMi!frilii1iilf.!.!ti:ij!liil!li!lll!!ililif,ill!IWl!l!llli-i[~-!l'i!11iii~-·i!fflili!ll!l!!~!~i!l!l~1l%\'imii~li (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 ot 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 subjects the applicant to a civil penalty of not more than five hundred dollars ($5001) . .". & J Fost;oi: Plll!llbii:i.g 13706 B Hwy 8 Bus EJ Cajon CA 92021 (619)390 4477 Name Address City State/Zip Telephone # State License# 63Q] 2Q License Class C-36 City Business License# 1210836 Designer Name Address City State/Zip Telephone State License # ---4'1H'\----- r~~l!.'~ir{W,QM"eiJSj£tiMfiffl J>;ttlQ'lll~~iT!~ill/4wiJl1il~i'ift((IBlimW1\ilmiHfiBj¥.11f&ifliillml,'Jf'~-!ti~IttilJV8l!ill1~fii~ij~~Ri~1~!li!f1~il!H~t~,~~r.ti!li!~!~l~! 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. 0 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 issll&J. My worker's eompensatlon Insurance carrier and policy number are: Insurance Company State Comp. Inc, Policy No. 467 QJ QQQQ7] 3 Expiration Date 04 01 03 (THIS SECTION NEED NOT BE COMPLETEDlf THE 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 11&cure war thousand dollars ($100,000) · addl SIGNATURES====~==~~~~::::C~d~;;;?'.~~~~========== ii~!l1~1~W~e!il1iJ~p~ij!~~g~lfflfilliiFl!!l~~i~lill~~'n' : .. ,IIDi~~~lt~~-Jl~~~~lilim~-Ji~lL:Eil~IfflF:ffi.Rmrn~i!~½~~~!ffif~~!]~1~11!~!1~:mtmli!\& I hei"eby affirm thet I am exempt from the Contractor' License La~ 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 Colitractor'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). 0 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. l 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 hava contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work).,_------------------------------------------------------ PROPERTY OWNER SIGNATURE_______________________ DATE======--=- t!11).!Jijj~~j'~tf.i[itl§§li![[!im!,ijiffl,ij!,ll'../jl/~JiifflJlf~iii!li!!!il@l!Ji§i!/ialifi!!,,iij\\jm§R!iR/fi,ili!lil~--ijlll1l!l!lil!j":;filJlj!IM!.U-.i.!11!®11)j~il)i!i\]l~i\i!~!\ijli;~j\;jjll,\jm Is the applicant or future bulldlng 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 Hazardoi.Js 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? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site 7 O YES O 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. ~l~fftl~.BiDi;W!lijDNl'-J[~.l~iN§.m~t,1t1l+IE-Ei~lle-l--•1•~~~1~1~t!!l!~~lilITTl'i(~l-lr111&11u~~~~rnr~:1!l~!~1i~1il]!il;.1mii1~~~rl~\).ili!i:11\m:ii 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 -----=---4l8i>,Br------LENDER'S ADDRESS tt~irn:fillWp;111f.JJ1U:~D~iJ;l;aJ;Jfit,AJli!Qll!l . r1~:§ "~\911Ji~filr~m~~~-~PJ~~~·--.-, -.-,.-~-:ffiffif.-\-.. ~-,-.. -.-.-. -!!---.-.-, -, -.-.-lt!-.",-1-uR_'_!ll_lll_mm-~-!OO!-.I--!~-. -.ij1~-,\illlfill-.1n1-~1-"-clr-,vN-.i\-mr;-~ir-Jm-u~~~J~ 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 relatlng 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 A9AINST 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 Offlclal under the provisions of this Code shall expire by Hmllation and become null and void If the bulldlng or work authorized by such permit Is not commenced within 180 days from the date of such permit or If the buildlng or work authorized by such permit Is suspended or abandoned at any time after the work is commenced for a o 180 days ( ctlon Uniform Bulldlng Code). YELLOW: Applicant PINK: Finance ----·--····-------- City of Carlsbad I 1635 Faraday Av Carlsbad, CA 92008 10-03-2002 Plumbing Permit Permit No: CB022997 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 2727 LLAMA CT CBAD PLUM 2154200900 Lot #: 0 Construction Type: NEW Status: Applied: Entered By: Reference #: Plan Approved: ISSUED 10/03/2002 MDP 10/03/2002 10/03/2002 Project Title: BONNELL RESIDENCE WATER HEATER REPLACEMENT Applicant: WATER HEATERS ONLY INC. 400S EL CAMINO REAL SAN MATEO, CA 94402 415-375-8751 Owner: DONNELL SHERRY R 2727 LLAMA CT CARLSBAD CA 92009 Issued: Inspect Area: 7936 10/03/02 0002 01 CGf::• Total Fees: $27,00 Total Payments To Date: $0,00 Balance Due: $27,00 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 0 1 0 $20.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 EXPIRED PERMIT 02 PERM!T HAS EXPIRED IN ACCORDANCE Wl1H U.B.C. SECTION 106.4.4 Inspector: DATE ½-) ~pJ, SIGNATURE ,e,{;:..:i.M~---- FINAL APPROVAL 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 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 i n I wh· i I N Tl i ·1 hi r i h tu e I limi i I h i 27-00 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. ()?_,...?.__? \.{ . ' CITY OF CARLSBAD BUILDING DEPARTMENT EST. VAL. __________ _ 1635 Faraday Ave., Carlsbad, CA 92008 Plan Ck. Deposit _________ _ Validated By __________ _ Date ______________ _ M~!:.I INFOIU'4A TIOt,I . -;).,7 ~7 L[a,m0z ct Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use Proposed Use Description of Work # of Bedrooms # of Bathrooms Fax# (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 exempti n. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of no~ flore than five hundred dollars ($5001). o,t'~ I . ~70 f >-'Jl14 .:--. 5-t-R-e;S'S V,:,/J.,, O,, 2'00 573q_r- Add ess License Class _L~7~(.._J-f __ f_C __ State License # --3"'--7'--£./-'-'-S7_,__,_-"';>_ City State/Zir:z Telep~# City Business License # ~ \ Y ~ Address City State/Zip Telephone 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 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 l he work for which this permit is issued. ued. My worker's compensati0insNrance carrier and policy number are: / ,-- Insurance Company ~~ Policy No. _ hK 5=lf Z. '3,,-CR_ Expiration Date 5 -{ -C3 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) O 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 en employer to criminal penalties and civil fines up to one hundred thousand dollar■ ($100,000) n a n to the cost of compensation, damages aa provided for In Section 3706 of the Labor code, Interest and attorney's fees. SIGNATURE DATE /0 ,.. ) .. 0 ~ 0 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 improvervents 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). 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the 11roject (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). · -.. , . ._, 0 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 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): ________________________________________________________ _ DATE _________ _ PROPERTY OWNER SIGNATURE ,--,-,--,---,--,,--,--,--,---,--,-:---:--:----- [COMPLllU.tllS SECJlQJ!fO.li NQ{idlf°SJQf!iI/.d~J'!!,/Jl,Q!ft(lfiftM.!ll.QN~,-.......... __, ___ ----------•- 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? 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 O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O 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. !..9..l'tURU~TIQl'!l,!;NDING A,GENCY 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). 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 Cit\' 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 180 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 eriod of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance