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Home My WebLink About1314 SAVANNAH LN; ; CB043938; Permit/ L{w-n ~5 \ )~,clQy'l City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 10-19-2004 Miscellaneous Permit Permit No: CB043938 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: Building Inspection Request Line (760) 602-2725 1314 SAVANNAH LN CBAD MISC 2157103300 $3,220.00 Subtype: OTHER Lot#: 0 FIDEL RES-FIREPLACE >6 FT.GAS TO BBQ&FIREPLACE, ELECT TO BBQ Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 10/19/2004 RMA 10/19/2004 10/19/2004 Applicant: BURLJORDANLANDSCAPE FIDEL VADIM&HOCHMAN-FIDEL JANNIE 2740 LUCIERNAGA ST 92009 760 04-0675 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: $136.00 1314 SAVANNAH LN CARLSBAD CA 92009 PEMIT FEE Total Payments To Date: $0.00 $136.00 $0.00 $0.00 $136.00 Balance Due: $136.00 3572 l0/1.9/04 0002 01 CGF" Inspector: Date: Clearance: t approval of your project includes the "Imposition" of fees, dedications, rese1Vations, or other exactions hereafter collectively referred to as "fees/exactions." ou 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/ x ions of whi h u have revio I b en iv n NOTICE similar hi or st hich he tatu f limi i n h r viou I the i PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1. PROJECT INFORMATION I FOR OFFICE USE ONLY PLAN CHECK NO:...,__ ___ _ .? ?-::LO EST. VAL. __.. _ _._}_.__ _______ _ Plan Ck. Deposit P' Validated By r= Date /u{( 1/ (d~ . t 3 J '-I 5A. va n. rtc:1---h Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total It of units Proposed Use It of Bedrooms # of Bathrooms 2. CONTACT PERSON Hf different from applicant) \Ic,e if);;,1 Lake.v Av< Name Address City 0 Agent for Owner {, State/Zip Telephone It Fax It 3. APPLICANT O Contractor @I Agent for Contractor O Owner JI /( /f Name Address City State/Zip Telephone It 14. PROPE.RTY OWNER t F,¼ I 6dtJr> s::~ Va, L1,U O(.J. Name Address City 01 State/Zip Telephone# 6. CONTRACTOR -COMPANY NAME (Sec. 7031.5 Business and Professions Code: Ant 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 pe·•nit 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 [),vision 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)). r -a :n (. c; ~ J,, -I)~ City State/Zip Telephone It State License It J:LS 'it a 8'.' License Class---------City Business License It /,l t f f'I/ Designer Name Address City State/Zip Telephone State License # _________ _ 6. WOR!{ERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 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. ~ 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 <-fo,.f-c ~ r->'\.s Fun.d PolicyNo. /71p7G "7/-t?~ Expiration Date lj"?/jPL (THIS SECTION NEED ~T BE COMrualF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100] OR LESS) 0 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 dollars ($100, 00), in n to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. s1GNATURE. __ -=1-c.__:__,:__'-'-r-:-,; !C.11-:, _== _r -----=-----------------~~ DATE Ltff// '11/';' 7. OWNER-BUILD I hereby affirm that I am exempt from the Contractor's License Law for the following reason: O 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 IJuilds 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). 0 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 contractor(s) licensed pursuant to the Contractor's License Law). 0 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/ 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 _________ _ COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant requi ,•d to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES D NO Is the applicant or future building occupant requireu 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. 8. " CONSTRUCTION LENDING AGENCY 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 __________________________ _ 19, APPLICANT 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 Citl' 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 after the work is commenced f a perio _ ys (Section 106.4.4 Uniform Building Code). YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 11/16/2004 Permit# CB043938 Title: FIDEL RES-FIREPLACE >6 FT,GAS Description: TO BBQ&FIREPLACE, ELECT TO BBQ Type: MISC Sub Type: OTHER Job Address: 1314 SAVANNAH LN Suite: Lot 0 Location: APPLICANT BURL JORDAN LANDSCAPE Owner: FIDEL VADIM&HOCHMAN-FIDEL JANNIE Remarks: Total Time: CD Description Act Comment Inspector Assignment: PY --- Phone: 7606446992 Inspector: ---~- Requested By: JOE Entered By: CHRISTINE 29 39 Final Plumbing \v:0 _F_i_n_al_E_l_e_ct_r_ic_a_i ____ ~cV\ u--------------------- Associated PCRs/CVs lnsgection Histo!Y Date Description Act lnsp Comments 11/09/2004 23 Gas/Test/Repairs WC PY 10/29/2004 68 Fireplace/Tie Straps AP PD GROUT 10/22/2004 11 Ftg/Foundation/Piers AP PY FIREPLACE 10/22/2004 23 Gas/T esVRepairs AP PY 10/22/2004 31 Underground/Conduit-Wiring PA PY CONDUIT ONLY