HomeMy WebLinkAbout2821 CACATUA ST; ; CB040017; Permit0 I -05-2004
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Building Inspection Request Line (760) 602-2725
Plumbing Permit Permit No: CB040017
Job Address:
Permit Type: PLUM Status: ISSUED
Parcel No: 21 53901 500 Lot #: 0 Applied: 01/05/2004
Reference #: Pian Approved: 01/05/2004 Issued: 01/05/2004
Project Title: HONDA RES-REPLACE H20 HTR Inspect Area:
2821 CACATUA ST CBAD
Construction Type: NEW Entered By: MEL
Applicant: SAMARIN DANIEL&DEBBiE A
CARLSBAD CA 92009
Owner:
SAMARIN DANIELLiDEBBIE A
292 1 CACATUA ST CARLSBAD CA 92009
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
$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: $0.00 Balance Due: $27.00
FINAL APPROVAL
DATE/-(y2F
SIGNATURE
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
FOR OFFICE USE ONLY
PLAN CHECK NO.f&d "p
EST. VAL.
Plan Ck. Deposit
Validated By
Date
Business Name (at this address)
Phase No. Total # of units Legal Description Lot No. Subdivision NamelNumber Unit No.
Assessor's Parcel # Existing Use Proposed Use
Description of Work sa. FT. #of Stories I of Bedrooms # of Bathrooms u~b-rm Hm7Ee
(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 e 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 Codel or that he is exempt therefrom, and the besis for the alleged
exemption. Any violetion of Section 7031.5 by any applicant for e permit subjects the applicant to a civil penalty of not more than five hundred dollars 155001).
Name Address City Statelzip Telephone I
State License I License Class City Business License t
Designer Name Address City Statelzip Telephone
State License #
0 of the work for which this permit is issued.
0 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 IblOOl OR LESS1
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: Wlum to smn workers' compenaatlon coverage Is unlawful, and .hdl subject an employef to crlmlnal pencrlties and civil fines up to one hundred thousad dollars ($100,000). In addition to the cost of compenraion, damages as provided for In Saction 3708 of tha Labor code, Interest and attorney's fees.
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
SIGNATURE DATE
offered for sale , and who does
rofessions Code: The
contractorlsl licensed
1. I personally plan to provide the major labor and materials fo proposed property improvement. 0 YES UNO
program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES 0 NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 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.
0 YES 0 NO
LENDER'S NAME
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 permlt is required for excavations over 5'0' deep and demoliiion 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 tlme after the work is commenced for a
APPLICANT'S SIGNATURE ~ DATE 0, ]o!/oq (Section 106.4.4 Uniform Building Code).
L
WHITE: File YELLOW: Applicant PINK: Finance
.) c
City of Carlsdad Bldg Inspection Request
For: 01 /09/2004
Permit# CB040017
Title: HONDA RES-REPLACE H20 HTR
Description:
Type: PLUM Sub Type:
Job Address: 2821 CACATUA ST
Suite: Lot 0
Location:
APPLICANT SAMARIN DANIEL&DEBBIE A
Owner: HONDA TIMOTHY A
Remarks:
Total Time:
Inspector Assignment:
Phone: 7604769363
Requested By: CAROLYN
Entered By: CHRISTINE
CD Description
25 Water HeaterNents
Associated PCRs/CVs
Inspection History
Date Description Act lnsp Comments