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Home My WebLink About2673 REGENT RD; ; CB062127; Permit07-26-2006 Job Address: Permit Type: Parcel No: Reference #: Project Title: Applicant: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB062127 Building Inspection Request Line (760) 602-2725 2673 REGENT RD CBAD PLUM 2081330413 Lot#: 0 Construction Type: NEW TERRY RES-REPLACE WATER HEATER Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 07126/2006 RMA 07/26/2006 07126/2006 WATER HEATERS ONLY INC. TERRY-LLOYD SIMON M&KELL Y M FAMILY TRUST 04-25-0 400S EL CAMINO REAL SAN MATEO, CA 94402 415-375-8751 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 Total Fees: $27.00 PO BOX 131718 CARLSBAD CA 92013 0 0 0 0 1 0 0 Total Payments To Date: $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 $27.00 Balance Due: Inspector: ~ ~ Clearance: $0.00 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 lo any f /ex ion h. h h ve revi I n iv naN Tl E iml! hi r owhich he tut flimi in h r vi u I h IWis x ir ~ PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 1. PROJECTINFORMATION 2673 Regent Rd Address (indude Bldg/Suite#) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Assessor's Parcel # Existing Use Replace 40 gal gas water heater in garage Like for Like Description of Work SQ. FT. 2. CONTACT PERSON (If different from appllcllnt) • Name Address City # of Stories State/Zip FOR OFFICE USE ON~ r t) })_. 7 PLAN CHECK NO. (A:}{)b t?',..., / EST. VAL. __________ _ Plan Ck. Deposit--------....---. ~:~:ated By z/2 b ?~ le /(.~ I {- Phase No. Total # of untts Proposed Use # of Bedrooms # of Bathrooms Telephone# Fax# 3. APPLICANT 0 Contractor IZl Agent for Contractor a Owner D Agent for Owner Jennifer Cole e o Box 711564 Santee CA 92072 ■ 619-405-2648 Name Address City State/Zip Telephone# 4. PROPERTY OWNER Simon. Kellv. Terrv. Llovd 2673 Res:ient Rd Carlsbad CA 92008 760-802-3217 Name Address City State/Zip Telephone# &. CONTRACTOR • COMPANY NAME (Sec. 7031.5 Business and Professions Code: Arry City or County which requires a permit to ronstruct. alter, improve, demolish or repair arry slructure, prior to its issuance, also requires the applicant for such permit to lite a signed statement that he is licensed pursuant to the provisions al the Conlracto(s License Law [Chapter 9, commending with Section 7000 al Division 3 al the Business and Proressions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Arry violation al Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500)). Water Heaters Onlv 970 E . Main St. Ste 200 Grass Valley CA 95945 530-274-3001 Name Address City State/Zip State License# _3_7_4_5_7_3 ____ _ License Class _C_3_6 _______ _ City Business License # Designer Name Address City State/Zip Telephone# State License# _______ _ II. WORKER'S COMPENSATION Workers' Compensation Oedarstion: I hereby affirm under penalty al perjury one al the following declarations: IZ] 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. D I have and will maintain worker's 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 Ca. Deot. of lndust Relations Policy No.4503-049 Expiration oate_N_o_n_e ______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100) OR LESS) □ CERllFICA TE 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 W011!ers' Compensation Laws al Caliromia. WARNING: Fallu'9 to MCU'9 nlawflll, and shall subject an employer to criminal penalties and civil tlnu up to one hundnod thousand doHars1$100,000), In addition lded for In Section 3706 of the Labor Code, In-and attorney's fen. SIGNATURE.---,~=...c.L~~---=::>'""<rl-..:::::J,-.L...:;.--1,,_..::.,.._.-:e.._. _________ DATE 7 -&b-Qv:, 7. OWNER-BU1,...,,..,.)I~ I hereby affirm that a exempt from the Contractor's License Law for the following reason: a I, as owner of the property or my employees with wages as their sole compensation, will d the worll and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contrador's License Law does not apply to an owner al property who builds or improll85 thereon, and who does such wOl1! himself or through his own employees, provided that such imprm,ements me not intended or offered for sale. If, however, the building or i~ is sold within one year al completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). O I, as CNlfler al the property, em exdusively contracting with licensed contractors 10 construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner al property who builds or imPfOll8S thereon, and contrac:ts for such projects with contradOl(s) licensed pursuant to the Contractor's License i..-1. □ I am exempt under Section _______ Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials tor construction al the proposed property improwmenl. □ YES O NO 2. I (have/have not) signed an application for a building permit for the proposed work. 3. I have contraded wtth the following person (firm) to provide the proposed construction (indude name I address/ phone number I 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 worll (indude name I address / phone number I /ontractorslicensenumber): ----------------------------------------- 5. I will provide some of the worll, but I have contracted (hired) the following persons to provide the work indicated (indude name I address / phone number/ type of worll): PROPERTY OWNER SIGNATURE ___________________________ DATE __________ _ WHITE: File YELLOW: Am>licant PINK: Finance .. PERMIT APPLICATION 'CITY. OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Page 2 of 2 ~ THII 8IC!")N fQll NO#f~fOBfllAL BUILDING PERMITS ONl. Y Is the applicant ot flAunt building oca.,panl required to submit a business plan, acutely hazardous materials registration fol" or risk management and pre\lelllion program under Sections 25505, 25533 or 2553-4 of the Presley-Tanner Hazardous Substance Account Ad? D YES D NO 1 Is the applicant ot future building occupant required to obtain a permit from the air pollution control distrid or air quality management distrid? D YES D NO Is the facility to be constructad within 1,000 ,_ of the outer boundaly of a schOol site? D YES D NO IF ANY OF 1HE ANSWERS AR£ YES, A ANAL CERTIFICATE OF OCCUPANCY IIAY NOT BE ISSUED UNLESS 1HE APPLICANT HAS MET OR IS MEETING THE REQt.lREIIENTS OF 1HE OFFICE OF EIIERGENCY SERVICES AND THE AIR POlUJ110N CONTROL DISTRICT. 8. CCIHITIIUCTION I.IN0INQ A4BIIC'( I hereby affim1 that there is a conatrudion lending agency fol" the pefformance of the work fol" which !his perm~ is issued (Sec. 3097(1) Civil Code). LENDER'S NAME __________________ _ LENDER'S ADDRESS ___________________ _ t. ~T ""lP'KiA.11Qfil I cenify that I ha\18 read the application and state that the above information is correct and that the information on !he plans is accurate. I agree lo comply with ell City Oldinances and Stale i-s relating ID building construction. I hereby authorize representatives of the City of Car1sbad to ente< upon the above mentioned property for inspection purpo&eS. I ALSO AGREE 10 SAVE, INDEIINIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST All l.lABIUTIES, JUDGEMENTS, COSTS AND EXPENSES WHICH IIAY .. Alff WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations of 5'0" deep and demolition or construction of strudures Oller 3 stories in height EXPIRATION: Ew,y permit isaued by the building Official under the provisions of this Code shall expire by limitation and become null and \/Oid ~ !he building or work authorized by such permit is not con■neoced 'Mlt1in 180 days ITom the dale a such pennit or if the building or work aulhorizBd by such permit is suspended or abandoned el any time aftef the work ia m111ne11ced for a period cl 180 ~ (Sedion 106.4.4 Uniroml · · Coda). ' 1 APPLICANT'S SIGNATURE __ ---,~:,..::i....:::,[...L.~;,..J..,,...4-=3-::..--~~~---------DATE __ ?_-Bb_--=:..__-_<te_-'='-------- WHITE: File YELLOW: Applicant PINK: Finance (I ., . City of Carlsbad Bldg Inspection Request For: 08/30/2006 . Permit# CB062127 Title: TERRY RES-REPLACE WATER HEATER Description: Inspector Assignment: \lo0 _l-'S" lP t A~ 1 r. VII¼., ,t. '11c<c r ( ~~, 1 r , 4 c. Type: PLUM Sub Type: Job Address: Suite: Location: 2673 REGENT RD Lot 0 Phone: 7608023217 Inspector: fvl c.- OWNER TERRY-LLOYD SIMON M&KELLY M FAMILY TRUST 04-25-0 Owner: TERRY-LLOYD SIMON M&KELLY M FAMILY TRUST 04-25-0 Remarks: NO TYPE ? Total Time: CD Description 24 Rough/Topout ~~~ Act Comment Requested By: SIMON Entered By: JANEAN ~--------- :E: l c>(Z,\ &HJ.At-{; b\.B Comments/Notices/Hold Associated PCRs/CVs Original PC# Inspection History Date Description Act lnsp Comments