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Home My WebLink About2256 SARA WAY; ; CB052270; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 06-20-2005 Plumbing Permit Permit No: CB052270 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2256 SARA WY CBAD PLUM Status: Parcel No: 1675401900 Lot#: 0 Applied: Construction Type: NEW Entered By: Reference #: Project Title: POLACEK RES-REPLACE WATER HEATER Applicant: ALL STAR WATER HEATERS & PLUMBING 17886 LAKESHORE DR 92530 1-800-727-0977 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 1 0 0 0 Plan Approved: Issued: Inspect Area: Owner: POLACEK FAMILY TRUST 3 07-10-03 2256 SARA WAY CARLSBAD CA 92008 ISSUED 06/20/2005 LSM 06/20/2005 06/20/2005 $20.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 Total Fees: $27.00 Total Payments To Date: $0.00 Balance Due: EXPIRED PERMIT $27.00 PERMIT HAS EXPIRED IN ACCORDANCE WIT:ltP;l3.~; '01 r;, oo )2 , · SECTION 106.4.4 AS AMENDED BY C.M.C.18.04.030 Inspector: DATE .c.\Ju.\.DJ,-SIGNAT\JRE----!<:!aMLl41.d) ___ _ FINAL APPROVAL Date: Clearance: NOTICE: Please take NOTICE that approval of your project includes the "lmpositionw 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 sim~lar application p~ssing or seivice fees in connection with t~is project. NOR DOES IT A~Pl Y to any "\"J PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO. C.(Q O -S "c?"'a-1 0 EST. VAL. ___________ _ Plan Ck. Deposit --,,,------- Validated By --,,<-..311o<'-'--'-=------- Date ---~-----.------ Address (indude Bldg/Suite#) / Business Name (at this address) Legal Descnption Assessor's Parcel # WAt t:'7 Descr,ption or Worl( Name 3,-Af'.el.!C J q,-l"'IJ>\":!,,.) Name H09rE:fl Lot No. Subdlvlalon Name/Number c/o Existing Use SQ. FT. Address City # of Stones State/Zip Unit No. Phase No Proposed Use # of Bedrooms Telephone# ll.l!l1.f9c..Qwntc qi..r.Jc. Re',• 1 2 2 "" 7, Telephone# Total # of un,ts # of Bathrooms Fax # (Sec. 7031.5 Buainesa and Profeaalona Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair a;y structure, pnor 10 ,1s 1ssuon;d also requires the applicant for auch permit to file a algned atatement that he Is llcenaed pursuant to the provisions of the Contractor's License Law [Chapter 9. commend,ng v.,:r, Sectlon 7000 ol Dlvlaion 3 of the Buaineu and ProfeaaiON Code) Of that he la exempt therefrom, and the basis for the alleged exemption. Any violat,on of Secuon 703 t ; ~, any applicant f0< a permit subjecta the applicant to • civil penalty of not more than five hundred dollara ($500)). 11l....ks1.,.,R.. v..lA1C:::Jl.. f:tt;AJ§g..~ nee, LA&.<;,> ,-tau ur~E:>-s ,~ State/Zip 8oc, 7 ·2,, )Cf1,-; Telephone # ~;a~ee License# ?>1101 4 Addre~cense Class C-3 b City City Business License# ___________ _ Designer Name Address City State/Zip Telepnone 11 State License# ________ _ 6. I have and will maintain a certificate of consent to self-Insure for worl(ers· compensa~on as provided by Section 3700 or the Labor Code. for the performance of tne ,.01, for which this permit is issued. ,,er-I have and will maintain worker's compensation, as required by Section 3700 of the labor Code. for the perfo1mance of the work for Nh1ch this pem .. , is ,s,v~- workefs compensauon Insurance carrier and policy number are: • Insurance Company 5"T /\TE:::-,/-.h.J O Policy No. 17<. / b l/ l CJ '-{ Expiration Date C.!J-I -(,. \:.? (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100] OR LESS) O CERTIFICATE OF EXEMPTION: I certify that In the perfonmance ol the worl( for which this permit is issued, I shall not employ any person ,n an1 manner st .,s ·- become subject to the WOl1\era' Compen lion Laws of California. WARNING: Failure to HCUr■ woriter■' mpen• dol~r5($100,000), In addition to the co, of co SIGNATURE 1:' OWN cove la unlawful, and shall subject an employer to criminal penalties and civil lines up 10 on• hunureu 111u-•J11J DATE -~-<. ) naatlon, damag .. are provided for In Section ~7oe of the Labor Code, Interest and atto~s r~ _ thereby affirm that I am • Iha Contractor', License Law for the following reaaon: 0 I, as owner ol the property or my employees with wages•• their aolo compenliBtion, will d the worlt and the structure 1s not intended or offered for sale (Sec 7Css Business and Professions Code: The Contractor'• Llcenao Law doos not op ply to an ownor of property who builds or Improves thereon. and who does such Nork him sc1t or through his own employees, provided that such lmprovementa are not intended Of offered fOf aale. If, however, the building or improvement 1s sold w11111n one 1ear ct completion. the owner-buUder wUI have the burden of proving that he did not build or Improve f0< 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· Tre Comra~1or, 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 tne Con11ac1or, License Law). 0 I am exempt under Section ________ Business and Professions Code for this reason: I personally plan to provide the major labor and materials for construc~on of the proposed property improvement. □ YES □ NO 2 I (have/have not) signed an applicatK>n for a building permit for the proposed worl(. 3 I hase contracted with the following person (firm) to provide the proposed construction (include name I address/ phone number/ contractors license numocr 4. I plan to provide poruons of the worl(, but I have hired the following person to coordinate, supervise and provide the maior wo1k (include namt: I address, pr,~nt: ,.~ .c' /ontract0rs license number): -------------------,.-------------------- 5. 1 will provide some of the worl(, but I have contracted (hired) the following persons to provide the work indicated (incluoe name/ address I pnonc numo~r :,~~ u1 ... • PROPERTY OWNER SIGNATURE __________________________ DATE __________ _ WHITE: File YELLOW: Applicant PINK: Finance