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Home My WebLink About1365 SHOREBIRD LN; ; CB011884; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 05/29/2001 Plumbing Permit Permit No:CB011884 Building Inspection Request Line (760) 602-2725 Job Address: 1365 SHOREBIRD LN CBAD PLUM l.U IT~\ D,~.J Permit Type: Parcel No: 2157900900 Lot#: 0 Construction Type: NEW Reference #: Project Title: BRISTOL RESIDENCE INSTALL GAS LINE & SWITCH FOR GENERATOR Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 05/29/2001 MDP 05/29/2001 05/29/2001 Applicant: Owner: BRISTOL ARNOLD&CAROL LIVING TRUST 05-05-83 BRISTOL ARNOLD&CAROL LIVING TRUST 05-05-83 1365 SHOREBIRD LN CARLSBAD CA 92009 Total Fees: $47.00 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 Inspector: 1365 SHOREBIRD LN CARLSBAD CA 92009 Total Payments To Date: $0.00 0 0 0 0 0 1 0 FINAL APPROVAL 05B3 05/29/01 0002 01 02 Balance Due: $20.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $20.00 $0.00 $0.00 $0.00 $47.00 CGP 47-00 $47.00 Date: Clearance: NOTICE; Please take NOTICE that approval of your project includes the 'Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this pennit was Issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required informauon with the City Manager for processing in accordance with Ca~sbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your r~ht to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which vou have nreviouslv been niven a NOTICE similar to this or as to which the statute of limitations has nreviouslv otherwise exnired. PERMIT APPLICATION FOR OFFICE USE ONLY ~ 8 PLAN CHECK NO. Q \ ~ \ .._,\ (;ITV <:>F CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. __________ _ Plan Ck. Deposit ________ _ Validated By __________ _ Date ______________ _ Business Name lat this address) Address :tlude i¾doi,SWlte #) £f; ,-,, /) pGo? :5 If Df? ::-{g--, Legal o8scription lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use Proposed Use # of Bedrooms # of Bathrooms Name Address City State/Zip Telephone# Fax# J.itJ iilpJii:fC.I\Nll :llm) C:<i/:\iiaotor: . O'Agei,t'fol:ll/,i/t?•i:iol½;f0'9,$\l~•H: Ii:l'ifll'!ll(l»~O,W11~1!,, Name Address City State/Zip Telephone # '~'_r:•;_:,:p_Jil:!_'rl..;Etµ!· n,~.· .•:~O:w'....'.· t,1:.:· Jl!:J. ' 1 !:'..··u_·•~_i:· -::i!!.!'.2..!.::.:::::~~L.2.-"'--"L_!.:::.JJ..!,!.fl:::,f.-::..£.4l.£,~.:Ll!l!Ll"'--~dl:i.~'zt:2J.~~.qc::· , .. ~ ~"·.aL'"·_· ~'...'::'....=~-~ l 71 ·~ ... .. .. . ,J &I-i, :"/};, !' 7,--I LJ // Name Telephone # '!i~:1~:e;el'l'l"IIAd'tl:!.~,;l/!lQMflNYiNA!llli"'' ,,:, :1:,:,i•,'· ' (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 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]). Name Address City State/Zip Telephone # State license # _________ _ license Class _________ _ City Business license # _______ _ Designer Name Address City State/Zip Telephone State license # _________ _ ,e,,;;f,Wcilil!l!d!i'!ic:il:!Mi>tNJllTiON'!i'•:. . :'(,. 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 work for which this permit is issued. D 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______________________ Policy No., ____________ _ Expiration Date, _______ _ ITHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS) D 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 worke1'9' compensation coverage la unlawful, and ahall subject an employer to criminal penalties and civil fines up to one hundred thousand dollara ($100,000). In addition to the cost of compensation, damages•• provided for In Section 3706 of the labor code, Interest and attorney's fees. SIGNATURE DATE ,t,ls'ril!w!!Eit~Q,~1$!!'1!>Ec:it!IMt10N ' :J;: ;;., ' I hei"eby affirm that I am exempt from the Contractor's license Law for the following reason: ~ I, as owner of the property or my employees with wages as their sole compensation, witl 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 improvements ere 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). ~ 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. _f}(YES ONO 2. I (hav~ned an application for a building permit for the proposed work. 3. l 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 I address / phone number/ type of work).: __________ 7 -;---t)-?J-l,;\,f'~-~--~_r_-,.,:.=__=_==.:,,-:-7"------------:,=r-::-r----:--------- PROPERTY OWNER SIGNATURE tetiM~~S!i'Hll!"SEc'ito~fFll.ii?NON'lil$/OENVARllfCl>1. (!';~jffllififfi'lj 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 Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardoi.ls Substance Account Act? 0 YES ~ ls the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES ~ NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES _p;(' 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. ;~;;;;; CQN~T.WCTION:~EN~l.NG'All'E~cv 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 '9:,i' :.)AJ111ii[¢4NtcE,!1!'1C/lftONi;; ,.•· 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 Citt 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 permil issued by the building Official under lhe 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 lhe work is commenc r a period of O d s (Se I n 106.4.4 Uniform Bull Ing Code). ~ / / APPLICANT"S SIGNATURE '--DATE ;;:i ,/-;;2, 9,/£'1/ YELLOW: Appli nt PINK: Finance June 13, 2001 TO: CITY OF CARLSBAD A.B.BRISTOL 1365 SHOREBIRD LANE CARLSBAD, CA. 92009 PHONE: 760-438--3535 F AX:766-438-0925 ATTENTION: MIKE PETERSON PLEASE BE ADVISED THAT WE WILL NOT BE INSTALLING A GENERATOR AT OUR HOME AT THE ABOVE ADDRESS. THE PERMIT #CB011884 ISSUED 5/29/01 WILL NOT BE USED. THE ABOVE FOR YOUR INFORMATION. t00"d ~08 160 t0/St/90 9Z60 861> 09L 70.LSI>,B+'o'