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Home My WebLink About2740 HOSP WAY; ; CB051590; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 C lL Ctlv I 1orcJJl 05-04-2005 Plumbing Permit Permit No: CB051590 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2740 HOSP WY CBAD PLUM Parcel No: 0000000000 Lot #: 0 Construction Type: NEW Reference #: Project Title: CASCADE FALLS-REPLACE WATER HEATER FOR BUILDING Applicant: DRAIN PATROL 4807 MERCURY ST SAN DIEGO, CA 92111 619-560-1137 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 Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 05/04/2005 LSM 05/04/2005 05/04/2005 $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: EXPIRED PERMIT $27.00 PERMIT HAS EXPIRED IN ACCORDANCE WITH C.B.C. SECTION 106.4.4 AS AMENDED BY C.M.C.18.~.(lj!Oo5;04;os DATE s:\-.,,\~ SIGNATURE4{)~U_.....1. • .._l ___ _ 0002 01 CGF" Inspector: FINAL APPROVAL Date: Clearance: NOTICE: Please take NOTICE that approval of your project includes the "lmpositionn of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this pennit 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 service fees in connection with this project. NOA DOES IT APPLY to any f fhih ~ I ' NTI . . I'' 02 27-00 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO .. ____ _ CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. _________ _ 1, PROJECT INfORl.!l<TION Address l.ifl,,clude Bid / ui, #):;J ~2.7Lf.0 ;,r Plan Ck. Deposi~ Validated Bv ~ _ Date ~ Fn2:. lat this address) Legal Description rY\d.., ._J e, L.{) c.,..J,ot No. Unit No. Phase No. Total # of units Assessor's Parcel II Existing Use Proposed Use Description of Work 'v{v. e( f/e1t fer SQ. FT, #of Stories # of Bedrooms # of Bathrooms ,a~ _..CQl4;-(ACT' PERSON c(tf .. clfferent.fmm.'aP.pUcant) Name Address City State/Zip Telephone# Fax# ,3; Afl!tlCANT Cantra,atar, ' 0-:Agen~-for Contractor O Owner D Agent for Owner Name City State/Zip Telephone# ,~. -~El!:11'1'•,0WNER pe1fl 5 Name Address City S.tate/Zip Telephone I •J, · CON~l!AC1-0R "C!>MRANV'l'IAl.!li' (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 end Professions Code) or that ha is exempt therefrom, and the basis for the alleged axem ion. Any viola~ of Section 7031.5 by any e+~orLermit subjects the applicant to a civil nalty of not more than five h1t~t;~s 1$5001). Name Address City State/Zip .,J;elephone # 0 State License • 4 '2 '2. 13' b License Class _:::::____::__...:::_-'---.:"2... Oty Business License • I °' '--1 Os.;l.. ~ Ii ) 11./- Designer Name State License # I... { .:<) 2 \ 7 /.o ,a. -WliftllliRSl· 00Ml!ENJA:tlON Address "J tr tJ i,~ Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Telephone e A q :i 6 o -Z D 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 issued. My worker's compensatio lnsuran e,£!rrier nd ol:cy ~umbeSJ!riv':s' tJifi&t1 l 7 (9 I ~7 f;"' ~ lnaurance Company I( e Co1mrE POiiey No. ---l9 ./ ./ Expiration Date I /9 / 0 I /l!J 7 (THIS SECTION NEED NOT BE COMPLETED IF 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 Warters' Compen11tion Laws of California. WARNING: Failure to secure worlcera' compenaatlon coverage Is unlawful, and ahan aubject an emptoyer to criminal penalties and civil fines up to one hundred ~::u:t'"} 00,0001, In add~ to the coat of compensation, damage• u provided for~ Se-n 3~~T:f the~ ti::_ ln:;,rea£ attorney's fees. '1, ' 0'.VII _-i.li!J•lii:IIAIIA:m>N . I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 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 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, es owner of the property, am exclusively contracting with licensed contractors to construct tha 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), 0 I am exempt under Section ______ Business and Professions Code for this reason: 1. I personally plan to provide the major tabor and 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. 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 l have hired the following person to coordinate, supervise and provide the major work (include name/ address / phone number/ contractors license number): ________________________________________________ _ 6. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated linclude name / address / phone number / type of work):, ______________________________________________________ _ PROPERTY OWNER SIGNATURE ______________________ _ DATE __________ _ COMM.life"if('.H,1,:secnoN! F.OR:'NON-RESIDENTIAL BUILDING ,PERMITS ONLY 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? D YES D NO ' Is the facility to be constructed within 1,000 feet of the outer boundary of e school site? 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. i8, . CQNSTIII/C1'10N,~ENl:>ING -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 _____________ _ LENDER'S ADDRESS, ________________________ _ ill, i i ;A1!Pl,leAN11' il~IQ:li;lCATION 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 ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS ~ERMIT. OSHA: An OSHA permit is required for excavations over 6'0" deep and demolition or construction of structure& over 3 stories In height. EXPIRATION: Every permit issued by the building Offlclal 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 from the date of such permit or If the bulldlng or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a period o, days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE ----------J"--""---'~c:::_ _____ -_________ _ DATE __ 5"~_-_L-_l_-_tJ?_~--- WHITE: File YELLOW: Applicant PINK: Finance