The URL can be used to link to this page

Home My WebLink About2848 CAMINO SERBAL; ; CB031425; Permit05-14-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB031425 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: Applicant: HERBERTJOHN 5460 EL ARBOL CARLSBAD 92008 2848 CAMINO SERBAL CBAD PLUM 2552812400 Lot#: Construction Type: MURRAY RESIDENCE GAS &NELECTRIC FOR FIRE PIT 0 NEW Status: ISSUED Applied: 05/14/2003 Entered By: MDP Plan Approved: 05/14/2003 Issued: 05/14/2003 Inspect Area: Owner: MURRAY ROBERT M 2848 CAMINO SERBAL 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 0 0 0 0 0 1 0 $20,00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $20.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $47.00 Total Fees:$47.00 Total Payments To Date:$0.00 Balance Due:$47.00 5165 05/14/03 0002 01 02 CGP 4? = 00 Inspector: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 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 you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. PERMIT APPLICATION CITY O*F CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO.gS^ *[ EST. VAL. Plan Ck. Deposit Validated By Date Address (include Bldg/Suite Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total * of units Assessor's Parcel tt Proposed Use /"") Yi *T~tt of Stories # of Bedrooms # of Bathrooms Name Address City fO 0*few - 0 Agent for Owner State/Zip Telephone #Fax* C"? Name **.'*an/nervOwliEB^ A Address City State/Zip Telephone # Qaouitoor>> Name Address City State/Zip Telephone # (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 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 and Professions Code] or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031 .5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]). Of Name State License # 0 1 £ «P "7 Designer Name State License # Address 3>jn^73rS~ License Class A/ C ~ 2 ~[ Address City State/Zip City Business License # [ ^ City State/Zip Telephone # ,0^^l P Telephone Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: ^B 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. l~l 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 compensation insurance carrier and policy number are: Insurance Company fS^JJ-fc^ ~^R->V<^'C-L Policy No. / / 75"o?C# <* QO /31- Expiration Date (<3. - £> I - £> ~ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) (~l 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 dollar* (&JOO.OOO), In addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE AP?-Cjv ^ • y «gj^>-^t^^-' DATE .T^'V^- O ~S I hereby affirm that I am exempt from the Contractor's License Law for the following reason: Q 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). Q 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). C] 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. Q YES QNO 2. I (have / have not) signed an application for a building permit for the 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 number): _^_^_^_____________^____^^^_______ 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 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? Q YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES D NO Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? D YES O 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. 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^ 9. AW»UCANt CERTIFICATION ' ' .- 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 CitV 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. 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 time afi-r the work is commence^for a period of IjfO days (Section 106.4.4 Uniform Building Code). APPLICANT'S IGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 03/31/2004 Permit* CB031425 Title: MURRAY RESIDENCE Description: GAS &NELECTRIC FOR FIRE PIT Inspector Assignment: JM 2848 CAMINO SERBAL Lot 0 Type: PLUM Sub Type: Job Address: Suite: Location: APPLICANT HERBERT JOHN Owner: MURRAY ROBERT M Remarks: Phone: 6192612608 Inspector: Total Time: CD Description 29 Final Plumbing Requested By: ROB MURRAY Entered By: CHRISTINE Act Comment Associated PCRs/CVs Inspection History Date Description Act Insp Comments 10/15/2003 29 Final Plumbing CO JM SPA INSTALLED - GATES SWING OUT, SELF CLOSE 05/16/2003 23 GasAest/Repairs AP JM BBQ & FIREPIT 05/16/2003 31 Underground/Conduit-Wiring PA JM CONDUIT ONLY 05/-14/2003 08:2? STflTE COMPENSfiTION •» 917608049029 NO.230 0002 CERTIFICATE HOLDER COPY P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807 INSUMANCB PUN D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE MAY 13, 2003 GROUP: POLICY NUMBER: 1175208-2002 CERTIFICATE ID: 13 CERTIFICATE EXPIRES: 12-01-2003 12-01-2002/12-01-2003 CITY OF CMUJSBAD ATTN: BtJILOISO DEPARTMENT 2075 LAS PALMAS DKIVB CA 92009-4859 This is to certify that we nave Issued a valid Wort*:"* Compensation Insurance policy in a form approved by the California Insurance Commissioner to the employer named Mow for the policy period indicate!. This policy ts net subject to cancellation by the Fund except upon 10 days advance written1 notice to the employer. We wil also glw you 10 day* advance notice should this policy be cancelled prior to its normal expiration. This ccrtfficMe of insurance is not an insurance policy and does not amend, extend or altar the coverage afforded by the poiiow lifted herein. Notwithstanding any requirement, term or conditiDn of any contract or other document with respect to which this certificate of Insurance may be issued or may pertain, the Insurance afforded by the poiidM described herein to subject to all the terms, exclusions, and conditions, of such policies. ATIVE EMPLOYER'S LIABILITY LIMIT INCLUDING DEPSBSB COSTS: $1,000,000 ?ER OCCURRENCE HEBERT/ JOHN OKMNIS DBA: JOHN D. HBBERT LASDSCAPE CONST. CO • 5460 BL ARBOL DR CARLSBAD CA 92008 •eiF 10S82E rEPP-UI:KSl