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Home My WebLink About2620 ROOSEVELT ST; 3; CB101841; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 10-07-2010 Plumbing Permit Permit No: CB101841 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 2620 ROOSEVELT ST CBAD St: 3 PLUM 2031022800 Lot #: 0 Construction Type: NEW Status: Applied: Entered By: Reference #: Plan Approved: PC#: Issued: Project Title: HARRISON RES-REPLACE 30" Inspect Area: OF CORRODED GAS LINE FROM METER TO UNIT 3 Applicant: HARRISON KEITH&SARA PO BOX 231594 ENCINITAS CA 92023 858 395 3408 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: HARRISON KEITH&SARA PO BOX 231594 ENCINITAS CA 92023 ISSUED 10/07/2010 LSM 10/07/2010 10/07/2010 $20.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 Total Fees: $27.00 Total Payments To Date: $27.00 Balance Due: Inspector: FINAL APPROVAL Date ;tJ -p-;p Clearance: $0.00 NOTICE: Please take NOTICE that approval of your project includes the "tmposition' of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You !1ave 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIE.D that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fee x i ns of which ou h ve r--:ivio sl been iv n N TICE similar to this or which he statute f limita i ns has reviousl o herwi ex ired. ~~ Building Permit Appiication Plan Check No. IB IO I '6Lt I 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value ~ CITY OF 760-602-2717 / 2718 / 2719 CARLSBAD Fax: 760-602-8558 Plan Ck. Deposit ww.w,r.;.a[lsbaQQsJ,gQ)'. 10!, /rO lswPP Date JOB ADDRESS SUITE#/SPACE#/UNIT# IAPN 2.GZ.o /lro s EVlc-""Z..,. AfJ'i'. #3 --- " /PRuJE(.;1 # ILOT# I PHASE# I# OF UNITS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I \,lJN$TR. I lt'l;. I DCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Atl'ected AIN{aJ • ) /(J?P Ute€ ,, ' ( ::1~ Sa.r:r:-t".V 11-)P-tCJ/'. oF G .+1-vr...a-~ Pr/'~ (6.+S .SvPkv l Tl#t, a...t -r' ;Jc,,=-.L. ,v' ..,..,-~~{; .. EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) I FIREPLACE IAIR CONDITIONING I FIRE SPRINKLERS A.PA-11.TM8<if"S YES □#_ NOD YES □ NOD YES O NOD CONT ACT NAME (If Different Fom AppHcant) APPLICANT NAME I< H. f:r71+-*~ c9 . .(/ ADDRESS ADDRESS ().0. l3oK 2 3 iS"i '( CITY STATE ZIP CITY STATE ZIP ev c .c:-u ... "i?r:S Cll--c,zoz J PHONE IFAX PHONE ) IFAX C..&-S-6" 5'7) -J '{ 0 &-Cr6") <t1, ---q.:E"1-/ EMAIL EMt /. '::ZV"lf-~-UCA.J € '[;/JC. t,U>(l ,,,--<._ , iVET' PROPER~S,WNER NAME ;,..n.F ,ts APP=cA • .,..._ CONTRACTOR aus-,;:E ! ' ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZJP PHONE IFAX PHONE IFAX EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS -__ __j~ATELIC.~ STATE UC.# JC!ASS_ ~ , __ J cnv BUS. UC.# --·-· --·-------------------------. ----.. . (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 Oiat he is exem_P.t 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}). WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby afmm under panalty of pe,jury one of the following declarations: □ I have and will maintain a cartlficate of consent to self-Insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance oflhe WOO( for which lhis permit is issued. 0 I have and will ·maintain w·onlf1i cOfflpensatlon, as reqlired by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. ____________________ Policy No. _____________ Expiration Dale ________ _ ~on need not be completed if the pem1il is for one hundred dollars {$100) or less. jlJ Certificate of Eumption: I certify that in the performance of the work for which this permit is issued, l 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' compensaUon coverage is unlawful, and shall subject an employer to almlnal penaHln and civil fines up to one hundred thousand doHars (&100,000), in addltk>n to the coat of compensation, damages as provided for In Section 3706 of the Labor code, lnte,"1 and attorney's ftes. AS CONTRACTOR SIGNATURE □AGENT DATE OWNER-BUILDER DECLARATION mnn that I am exempt from Conttactor's UC611S8 Law for the following reason: s owner of the property or my employees with wages as their sole compensation, will do the work and Iha structure is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's Ltcense law does not apply to an owoar of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements ara 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 PllfPOS8 of sale). □ I, as owner of the property, am excluslV9ly 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 contractor(s) licensed pursuant to the Contractor's License Law). □ I am exempt under Section ____ ~,usiness and Professions Code for this reason: 1. l personaUy plan to provide the major labor and materials for construction of the proposed property improvement. □ Yes □ No 2. l (have/ have not) signed an application for a buiklng permit for the proposed work. 3. l have contracted with the following person (firm) to provide the proposed construction (include name addrass / phone I contractors' license number): 4. t plan to provide portions of the work, but I have hired the fdlowing person to coordinate, supervise and provide Iha major work (include name I address/ phone/ contractors' license number): 5. 11° provide some of e work, ut I have contracted (hired) the following persons to provide the work Indicated (Include name/ address/ phone/ type of 'Mlfk): COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY 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 Section& 25505, 25533 or 25534 d lht Presley-Tanner Hazardous Substaoce Account Act? □ Yes □ No Is lhe appllcant or Mure building occupant required to obtain a permit from the air pollution coolrol disbic:t or air quality management clstrlcl? □ Yes □ No Is lhe laclUty to be constructed within 1,000 feet of the outer boundary of a school site? □ Yes □ No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFtCATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFtCE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I certilythat I haw read the application and state that the above Information Is correct and that the Information on the plans Is accurate. I agree to complyMth au C11J ordinances and State laws ,etat1ng10 building constntctlan. I heleby aulhorize represenmlM! d lhe City d Car'obad k> enlror upon lhe above mentioned property i>r nspecliJn pu,poses. I ALSO AGREE TO SAVE, NDEMNJFY AND KEEP HARt.1..ESS TI-lE CITY OF CARLS8AO AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AG.'JNST SAID CITY IN CONSEQUENCE OF THE GRANTNG OF THIS PERMIT. OSHA: NI OSHA permit is requied for excavations rMS 5'0' deep and demolik>n or construction of structures (Jlf!I 3 sb'a ii hei;Jhl EXPIRATKJN: Every pennit issued by the Buid"9 ~I "1derlhe provisi)llsofllis Code shaU expn, by 1m-. and beaxre nul aoo ,oid llhe buidi1g or'MJl1<-bylll.dl penrilis ooloorrrnenc:ad- 180 days from lhe dale of Ill.di pem,I or iflhe b.-Jiig or'MJl1< aulhorized by such pem,l il suspended or abandoned at any line allerlhe 'MJl1< is oorrrnenc:ad ilr a period d 180 days (Sedioo 106A.4 lnbm Buidllg Code). f ...@S' APPLICANrS SIGNATURE <. DATE { 0 ( t-1 ( 0 City of Carlsbad Bldg Inspection Request For 10/12/2010 Permit# CB101841 Inspector Assignment: L-6 Title: HARRISON RES-REPLACE 30" Description: OF CORRODED GAS LINE FROM METER TO UNIT 3 Type:PLUM Sub Type: Job Address: 2620 ROOSEVELT ST Suite: 3 Lot: 0 Owner: Remarks: ~tion please ( Total Time: Act Comments Phone: 8583953408 Requested By: KEITH HARRISON Entered By: CHRISTINE CD 23 Description Gas/Test/Repairs fr F~---------c,--~---_/1-F _ _J;a_,, +r,:,.1:-fd,,,-h +:e.l~ w--r-q/<:,,, ,-,'se.r ?--i Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act lnsp Comments