HomeMy WebLinkAbout1416 SAPPHIRE DR; ; CB054287; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
12-21-2005 Plumbing Permit Permit No: CB054287
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
1416 SAPPHIRE DR CBAD
PLUM
Parcel No: 2121900500 Lot#: 0
Construction Type: NEW
Reference #:
Project Title: NELSON RES-REPLACE WATER HTR
Applicant:
A&J FOSTER, INC.
STE B
13706 HWY 8 BUS
EL CAJON CA 92021
619-390-4477
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
0
0
0
0
1
0
0
Owner:
Total Payments To Date:
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
12/20/2005
LSM
12/21/2005
12/21/2005
$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: $0.00
PERMIT HAS EXPIRED IN,,-r'tY<l' AW:;, 'N'l"H C.B.C.
SECTION 106.4.4 AS AMENL•!:D ,n l., 1,: C. i~.04.030
Inspector:
DATE v,.,h,.\~, SIGNAT'JRL&!/..L., . ., ____ _ •
FINAL APPROVAL
Date: 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
f x i n f hi h h v r vi I n iv n N Tl E imil r hl r whi h h limi i n
/
FOR OFFICE USE ONL V
IPIERMff APPLICATION PLAN CHECK NO. _____ _
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
EST. VAL. __________ _
Plan Ck. Deposit ________ _
Validated By __________ _
Date--,-____________ _
Address (include Bldg/Suite II) Business N~me (at this address)
Le;1ial Description :J./2. -/10 -a--0<=>
Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units
Asffs:~rs Parcel # Y::Y:!._~~l: LJcik
Existing Use Proposed Use
Description of Work SQ. FT. #of Stories # of Bedrooms # of Bathrooms
Name Address City State/Zip · Telephqne # Fax #
:· ,,,, .. ,,.., .. 2~00\!;rii~nk"'d!ilt.~r;i. ==="""' _ __,_, r-~i;rt~q•?•!'"'t•~
/sic r,,, C''T
Name Address City
ls::~'lj''c.9.JiiittHg~lt~'f\Q.'G§Mt!.~N:f@mM.}• '"'·
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construe~. alter. Improve, demolish or repair any structure, prior to Its
issuance, also requires the app(lcant for such permit to file a signed statement that t:,e 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
ex mption. ny violat(on of Section 7031,~bt any applicant for a permit subjscts the app~nyo a civil penalty of not more than five hundred dollars [ $ 5001).
l ~-t-e.,' j:,.,ic ~/06 t l...,u 'O ~D l5 £I' C 1.oi. tr -J 70· 1-()
Name
State License II __:C,_3::..::v...;le..:2:_..:::. ____ _
Address City · State/Zip · Telephone #
License ClasC "' 3 b City Business License # / 2-f 0~ .Sb
Designer Name Address Ci,ty State/Zip Telephone
State License II
6~'"W0J1Ji~-~:;Ji:1.;;:0;;_0;;;_M;::'.;2J;;_:;;l§;.~::;.AII;;:;iF~-i:;W-;;;Jl;eo1n.;,_;;_:;,";'!.;_;. ... ,..,.,.,,...,,~£~;!.:~2.i10s~~t1tm"~~is~lr~~~~·'ili~W~~-11Jlrn
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
O 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 worl< for which this permit is issued.
El_ 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 ls
issued. My worker's compensation insurance carrier and policy number are:
Insurance Company ,S.,-i:i-\-?-6,.,v1 2' Policy No. {)o\fl.y{ -1..~
(THIS SECTION NEED NOT BE COMPLETED If THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS!
Explretlon Date 'j / '2. ill { '
O CERTIFICATE OF E><EMPTION: I certify that in the performance of the work for wl!lch this permit is Issued, I shall not employ any person In any manner so as
to become subject to the Workers' Compensation Lews of California.
WARNING: Failure to secure workers' compensntion coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars ($10 ddition t e cost pensotlon, damages as provided for ln Section 3701! of the Labor coda, Interest and attorney's fees.
DATE / Z.-/~f-CI) SIGNATURE
\.'illiflfilv_.:mtffi:iji . . .•
I hereby affirm that I em exempt fro
O I, as owner of the property or my employees with wages as their sole compensation, wit( 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 improvemants are not intended or ottered for sale. If, however, the building or improvement is
sold within one year of completion, the owner-builder wit( have the burden of proving that ha did not build or improve for the purpose of sale),
O 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 hnproves thereon, and contracts for such projects with contractor(s) licensed
pursuant to the Contractor's License Law).
O 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. 0 YES ONO
2. I (have/ hove 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 I 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 _________ _
ri;.oMrt4~lr.g~iil;i!sTis.~g[l1(<!i~i i.l!m~~iiWlg~Z:at~rl4~[G1il~1ffulF~ll@Jj:~~~-l.&"fm-~~-~~tli.1&~1~!~~~~~
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk managem·ent a_nd prevention
program under Sections 26505, 25533 or 26634 of the Presley-Tanner Hazardous 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 ANO THE AIR POLLUTION CONTROL DISTRICT.
~--,, • .--.r;,• ••·-•w._,, ,-"= rrn:·---,..... -~~.,,,·•--""'"->r""'"·':!!W,,_!ll!l:f'. __ ""'"_ .....,.,,.,,,'l'!•;t;;l'l1\t1"r::1,l•;ri:-oi::M,AA.,ffl-ill!tii<!'../lfflri1Jll'!Oil!i"''"' ';'tl"l:l'f,:J;~,,,~,,.,,!!!i:,li:i:l'ill!1\M!111i,
08~ · ,:fi:.G.9.1!?.,iLtl!J,9.:!i!~.N!m.~Nlil",ij~ 1~!>.!rN.f;.~'hiil'iil.':i~!:iil~l=.i:.~,l'ililili1,:i,ili:1,'ll::l'il:i~alk'i:1,1;;.':ll1'1!,i'r}.l;l'l.l';.'!/iill~lli'~H:,:li.i;;i!:il.l:it~t~l,~wi;;i~~~llni~~J~1"'i:.•vtc,~
1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Code),
LENDER'S NAME LENDER'S ADDRESS ,9':.ffl'Ar..r.1-tG.ANt.:..c~ilili'J:cAmlQ'N!:~~~-w.11t~\i..~Z~;;···,;d.;;=""!"':;;~;;;·~:::m=·;;;~;;;;,=_ =-=a=iil,J=1fil=~= .... =· =. :;_;;:·'i=m=,;;;;~~=1=· rm= .. =.~:;:;;;",=t'1=1=e::;:;.:.:.1:;:;;:::· =.i!i;li;;;;;,.=,-. ;:. ~;;;-;;:;; .. =.::.~=. · ·,
1 certify that I have read the application and stat e that the above Information Is correct end that the information on the plans ls accurate. I agree to comply with all
City ordinances and State laws relating to building construction. I hereby authorize representatives of tha Cit\t of Carlsbad to enter upon the above mentioned
property for inspection purposes. I :ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES,
JUDGMENTS, COSTS ANO EXPENSES :,"JHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE Of THE GRANTING Of THIS PERMIT.
OSHA: An OSHA permit is required for 1excavetlons over 6'0" deep end demolition or construction of structures over 3 stories In height.
EJCPIRATfON: 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 wo.rk
authorized by such permil Is not commenced within 180 days from the date of such permit o.r II the building or work authorized by such permit Is suspended or abandoned
al any time after lhe work Is commenced for o 180 days ( clion Uniform Building Code).
APPLICANT'S SIGNATURE DATE
PINK: Finance