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HomeMy WebLinkAbout2758 LA COSTA AVE; ; CB011456; Permit• City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 V/OV/J 04/18/2001 Plumbing Permit Permit No:CB011456 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 2758 LA COSTA AV CBAD PLUM 2162802200 Lot #: 0 Construction Type: NEW Status: Applied: Entered By: Reference #: Plan Approved: ISSUED 04/18/2001 MDP 04/18/2001 04/18/2001 Project Title: Applicant: NOBLE RESIDENCE GAS LINE REPAIR PALOMAR PLUMBING 1367 VIA BELLEZA SAN MARCOS CA 92069 760 986-0630 Issued: Inspect Area: Owner: NOBLE RANDOLPH H&ALIC,i,~ 04/lS/0l 4529 GLORIA AVE ENCINO CA 91436 0002 01 CGP 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 Inspector: 0 0 0 0 0 1 0 FINAL APPROVAL Date: <J,/4t./a I $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 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 capactiy 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 vou have nreviouslv been niven a NOTICE similar to this or as to which the statute of limitations has oreviouslv otherwise exoired. 02 27-00 PERMIT APPLICATION FOR OFFICE USE ONLY · PLAN CHECK NO.()\ ~ \ '---( ~"fo CITY OF CARLSBAD BUILDING DEPARTMENT EST. VAL. _________ _ 1635 Faraday Ave., Carlsbad, CA 92008 Plan Ck. Deposit ________ _ Validated By _______ .....,...,__ __ Date. _______ ....;:...lo'l-+++,-:'---- r Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total If of units ·Existing Use Proposed Use SO. FT. #of Storie~ # of Bedrooms # of Bathrooms Designer Name Address City State License # _________ _ e""' WQBK~~eJ.ltlA.n<ffl.--, ·J ~. .. ~~,U.i.t-A~~!':ftE~Bm~,\f~JW-i -;a~ Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the fo)lowing declarations: O 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 Cqde, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company_____________________ Policy No. Expiration Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) , J!f: 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 o coverage 11 unlawful, and ahaN subject an employer to criminal penalties and clvll fines up to one hundred thousand dollars ($100,0 , In of com en111tjon, damages es provided for In Section 3706 of tha Labor co~. lntere1t and attorney's fees. SIGNATURE DATE 0--/~-0/ 11 W.~ . PECLAH,AJI ___ ,; ~~w. •-. -. <D:J:· I he;eby affirm that I am exempt from t Contractor's License Law for the following reason: O I, as owner of the property or my employees with wagei;. 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, 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). 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 fo~ a buildi~g permit for tt,e 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 numberl=---~--.---~-------------------------------------- 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 t~i.ilC,1t~Wililf1qi«~J(l?.lrtBft8.Mrtb>.m-,· 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? O YES O NO 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 ADDRESS 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 Cltt 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. EXPl~ATION: Every pe_r~it issued by the bui~dl~g Offlclal unde~!)t-t . ovlslons of this ?od~ shall ex~lre by limitation a~d become null and void If the building or work autt,orized by such permit 1s not commenced 18 ays rom t date of such permit or ,t the building or work authorized by such permit Is suspended or abandoned at any time after the work is commenced a P. · f d y (Section 106.4.4 Uniform Building Code). y APPLICANT'S SIGNATURE --y<:.~_.:;;~--_,,e.:._;.~:::::;;;:;::...._____________ DATE C/'-/$-0/ YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request Permit# CB011456 Title: NOBLE RESIDENCE Description: GAS LINE REPAIR For: 04/24/2001 Type:PLUM Sub Type: Job Address: Suite: Location: 2758 LACOSTAAV Lot APPLICANT PALOMAR PLUMBING 0 Owner: NOBLE RANDOLPH H&ALICE S Remarks: PM PLEASE Total Time: Description Act Comments Inspector Assignment: Phone: 0000000000 ....--: Inspector: J n '>, ' '-- Requested By: ADAM Entered By: CHRISTINE CD 21 23 Underground/Under Floor t boRa?~oo ~ Gas/Test/Repairs ------~---------------------- Associated PCRs Inspection History Date Description Act lnsp Comments