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
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Associated PCRs
Inspection History
Date Description Act lnsp Comments