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Home My WebLink About2874 RANCHO CORTES; ; CB030085; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 01-09-2003 Plumbing Permit Permit No: CB030085 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2874 RANCHO CORTES CBAD PLUM Status: Parcel No: 2226600700 Lot#: 0 Applied: Construction Type: NEW Entered By: Reference #: Plan Approved: Issued: Project Title: GUSTAFSON RES GAS/ELEC TO BBQ Inspect Area: Applicant: ANDERSON'S LA COSTA NURSERY 400 LA COSTA AV ENCINITAS CA 92054 760-753-3153 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 0 0 0 0 0 1 0 Owner: GUSTAFSON SUSAN M 2874 RANCHO CORTES CARLSBAD CA 92009 ISSUED 01/09/2003 SB 01/09/2003 01/09/2003 $20.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $20.00 $0.00 $0.00 $0.00 $47.00 Total Fees: $47.00 Total Payments To Date: $0.00 Balance Due: $47.00 5363 OJ/09/03 0002 01 O? Inspector: FINAL APPROV ,.Y. Date: Q.Y I ?--o ./ Clearance: NOTICE: Please take approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exa ions Y 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 s orth 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 · t r 1 Tl · i1 r · r whi h f l'mi · h i I i ir FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK No.C'i1o !, o:C:)es- CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. _________ _ Plan Ck. Deposit _________ _ Validated By_S=-_B=------- Date ( -? -0 ) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # (..,A5 L ,\?e li,xisting Use Proposed Use De~cription of Work "r,BL{ -:S Y;:l ££:t '.½\CP.. L • SQ. FT. #of Stories # of Bedrooms # of Bathrooms 2,. ~ Address City State/Zip Telephone# Fax# • D Agent tor Contractor , .0 Q,wnlir [] Agerit for Own~r .... c c.~'\\>\ t'--<..-::\. VI.DZ> ~ C()\),c,., 111,-e fR (,\-1 ,,()\.S Address City State/Zip 'Telephone # • J1 . "1..01 ':\ 1u,~ Ho C cn-1:E:. 2 'Address Ob. City S.tate/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 Any violation of Section 7031 .5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hu dred dollars ($5001). pe,)..),, f\S l Name City State License # 3.C>l¼\.\3 License Class ~C. ...... --_z __ J--\--------City Business License # _______ _ Designer Name Address City State/Zip Telephone State License # _________ _ !-6,. ,-ti ' ,, ··•tttfi ~~ . Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: ~ 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 Ji1he work for which this permit is issued. O 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 ':)'1 f\TG° (. 0 <\,.._£ Policy No. k::)t,\ ~ LO::) 2 Expiration Date S · c>\ · ..,.3 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) 0 CERTIFICATE OF EXEMPTION: I certify that in the pert rmance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Ca ifornia. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subjact an employer to criminal penalties and civil fines up to one hundred thousand dollars ($ 00,000 · addition to the cost of comp naation, damages III provided for In Section 3706 of the Labor code, inte~st and attorney's fees. SIGNATURE=::::::!64~::::,c~?=-::-::::-::---:----::::--=::---::::'.t:::--:=-:=:=-::=::-:::::--:--::::-~-::-::=~ DATE -;:;--\-'--.;_;-:--:-oq-:;--:;;-:-· -;;o;;_j~--;;-::;,=,._,,.....,,·-=· 11 QWl'tlfi:.B . D!R OEQ.bAMTION · r . ''>" , ' "''" ,, • I hereby affirm that I am exempt from the Contractor's Licenj Law for the following reason: 0 I, as owner of the property or my employees with wa~es 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'.~ 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 t t 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 ha the burden of l)roving that he did not build or improve for the purpose of sale). 0 I, as owner of the property, am exclusively contractin 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 p operty 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 a Professions Code for this reason: 1. I personally plan to provide the major labor and material for construction of the proposed property improvement. 0 YES ONO 2. I (have I have not) signed an application for a building p rmit for the proposed work. 3. I have contracted .with the following person (firm) to prpvide 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 t he 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 ______________________ _ rCOMPLETE ifHIS,SECTION FOR NON:RESIDENTIAL BUILDIN~RMITS.,19Nl;.Y 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 Haiardous 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? 0 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. :e. CON~TRUCJ(c[N LENDIN~ AGENCY -., ,, , "lt• 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 ______________ _ ~' IImGAl'U,.C.E_BJIFXCATIQN 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 Citt 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 ANO 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 comm ed 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 after the work is c a period ol 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance UNSCHEDULED BUILDING INSPECTION DATE D3 -/6--03 ,--- PERMIT# CB 0 300 5$ INSPECTOR _(72 ___ · .... ~--- PLAN CHECK# ___ _ JOB ADDRESS 2, 6?4 ~o a;,~2:- DESCRIPTION . ;B<5"'&.. r-a{-6 . + ~ CODE DESCRIPTION ACT COMMENTS h'?' ;::-,,, q,,r -hJ City of Carlsbad Bldg Inspection Request For: 01/10/2003 Permit# CB030085 Title: GUSTAFSON RES GAS/ELEC TO BBQ Description: Type: PLUM Sub Type: Job Address: 2874 RANCHO CORTES Suite: Lot O Location: APPLICANT ANDERSON'S LA COSTA NURSERY Owner: GUSTAFSON SUSAN M Remarks: Total Time: CD Description Act Comment Inspector Assignment: Phone: 7607533153 Inspector: Requested By: ANDERSONS LA COSTA NUR Entered By: CHRISTINE 23 Gas/Test/Repairs AP 01(.. "'Tb t,.Ot,/ 11,11,--- ~ cu,,Le"feou.• cD"''O"" r AP I) t£-"TO ( 0 .J t! (L-- Associated PCRs/CVs Inspection History Date Description Act lnsp Comments