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HomeMy WebLinkAbout2778 CARLSBAD BLVD; 200; CB111809; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 08-18-2011 Plumbing Permit Permit No: CB111809 Building Inspection Request Line (760) 602-2725 Job Address: 2778 CARLSBAD BL CBAD St: 200 Permit Type: PLUM Status: ISSUED Parcel No: 2031722501 Lot#: 0 Applied: 08/18/2011 Construction Type: NEW Entered By: LSM Reference*: Plan Approved: 08/18/2011 PC#: Issued: 08/18/2011 Project Title: KIRKHAM RES- REPLACE WRT HTR Inspect Area: EXTERIOR CLOSET Applicant: Owner: AFFORDABLE WATER HEATER KIRKHAM REMY 24707 SAN FRANANDO RD 351 ACACIA AVE #35 SANTA CLARITA, CA 91321 CARLSBAD CA 92008 661 259-7131 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 0 0 0 0 1 0 0 $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $27.00 Total Fees: $27.00 Total Payments To Date: $27.00 Balance Due: $0.00 FINAL APPROVAL Inspector: \ HEKU—- Date: ,Y/£*-/3^ Clearance: NOTICE: Please take NOTICE traat 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 fees/exactions of which vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. €Building Permit Application £\?/ 1635 Faraday Ave., Carlsbad, CA 92008 "^7" CITY OF 760-602-2717/2718/2719 /^ A H 1 CD A r\ Fax:760-602-85581 /Ar\i SHAI J www.carlsbadca.aovV-./TI \ L.«JL//»I—/ JOB ADDRESS 311% (WlsVxxA &L- CT/PROJECT# LOT* PHASE* # OF UNITS # BEDROOMS SUITE#/SPACE#/UNIT* * BATHROOMS TENANT Plan Check No.<2& / j / <%Q^ Est. Value Plan Ck. Deposit Date y% %/i ^j i i APN BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Incluae Square Feet of Affected Area(s) SA.I^€- loC.tX'Vi OA s G yV-G.pi' Of" d I <s S •C.lr EXISTING USE PROPOSED USE GARAGE (SF) CONTACT NAME (If Different Font Applicant) ADDRESS CITY STATE ZIP PHONE FAX EMAIL PROPERTY OWNER NAME . Kj£,faU ICC /*(<Cl\<N/VN ADDRESS 1 ^~ &11% Ck-r>£^0"() fe1-- "2-00 CITY STATE ZIP PHONE FAX EMAIL ARCH/DESIGNER NAMES ADDRESS STATE LJC. # PATIOS (SF) DECKS (SF APPLICANT NAME S«.e •) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES D # NO D YES D NO D YES D NO D >tt LittleFTelci ADDRESS B<-!BUJ CITY PHONE EMAIL Pet STATE ZIP FAX mi*S ©jAtJUAP. Cftlr, CONTRACTOR BUS. NAME . . ./iFFora^blt utate.r Heaters ADDRESS CITY AJetoKftJ PHONE EMAIL PfcrMiTS { STATE LJC.# *\to*k flve STATE ZIP IFAX ? 4WhA.P'Com CLASS CITY BUS. UC.# Dusineaa anu rruicssiuns V/UUBJ ur Liiai iiu is exempt mmecivil penalty of not more than five hundred dollars {$500}). Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: G 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. PI I have and will maintain workers' compegsaticui, as required by Section 3700 of the Labor Code, for the performance of the wod!j9rJtfhj£b this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. TfctM'frK ' Policy No. <tt>W7*^« ' & £. Expiration Date t " t * ifro This section need not be completed if the permit is for one hundred dollars ($100) or less. O Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (8,100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. JS$ CONTRACTOR SIGNATURE AQO^t • SJAGENT DATE &'/*•/- 'I / hereby affirm that I am exempt from Contractor's License Law for the following reason: D I, as owner of the property or-my employees with wages asteir 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). 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 contractors) licensed pursuant to the Contractor's License Law). D I am exempt under Section Business and Professions Code for this reason: 1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement, a Yes d No 2.1 (have / have not) signed an application for a building permit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): 4.1 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 / contractors' license number): 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): >eTpROPERTY OWNER SIGNATURE BAGENT 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 Act? n Yes D 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 a No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D Yes a No EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name 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 representative of the City of Carlsbad to enter upon the above mentioned properly 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 OSHA: An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height 180 days from the date of such permit or if the buidraor work authorized by sutfipemft is susper^ or abandmed at any tm ate te ^APPLICANT'S SIGNATURE (QOP'l. DATE $ ' I */~ /I Inspection List Permit*: CB111809 Type: PLUM KIRKHAM RES- REPLACE WRT HTR EXTERIOR CLOSET Date Inspection Item Inspector Act Comments 09/22/2011 25 Water Heater/Vents - Rl gate & elevator code #1859 09/22/2011 25 Water Heater/Vents PY AP 09/22/2011 29 Final Plumbing PY AP Thursday, September 22, 2011 Page 1 of 1