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Home My WebLink About1351 SPARROW RD; ; CB053504; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 10-06-2005 Plumbing Permit Permit No: CB053504 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 1351 SPARROW RD CBAD PLUM Status: Parcel No: 2156403000 Lot #: 0 Applied: Construction Type: NEW Entered By: Reference #: Plan Approved: Issued: Project Title: MILLER RES NEW H20 HEATER Inspect Area: Applicant: ARS STE 100 6162 NANCY RIDGE DR SAN DIEGO CA 92121 858-677-5455 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 1 0 0 Owner: MILLER FAMILY TRUST 10-08-84 1351 SPARROW RD CARLSBAD CA 92009 ISSUED 10/06/2005 SB 10/06/2005 10/06/2005 $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 Total Fees: $27.00 Total Payments To Date: $27.00 Balance Due: Inspector:' Date: Clearance: $0.00 NOTICE: Please take NOTICE that approval of your project includes the glmpOSI ion" of s, 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 imposttion 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 · w i r vi I -~-------,·----- FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. O £:;;>So~ CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. __________ _ Plan Ck. Deposit-="'..--,,..------- Validated B/ , S~'q Date r:.,({ .. (o<: Address (include Bldg/Suite II} Business Name (at this address} Legal Description Lot No--Sr:t<'division Name/Number Unit No. Phase No. Total II of units Existing Use Proposed Use SO. FT. /lot Stories II of Bedrooms II of Bathrooms Name Address City Y~~~~-□~~~t~:~:~:hl~~w~r;:w~:~~-•.,•,:·••·r.·•t~ 4. p~~~ti'YOWNE~• •? '}fi !~·Jl'!;'., Name 5. ' CONTRACTOR·c COMPANY. NAME' ,. Address ,_,., City State/Zip Telephone II Fax # ~I State/Zip Telephone II (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any Str\JCture. 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 exe p .. bny violation of tction 2.031.5 by any eppllc nt for a permit subje~th\~cant to a civil penal~o more than five h~rz7ollar-5'500)). Name Addr City State/Zip Telephone # State License# 70. J 'o' 2..0 License Class C 2..o C,3,k, City Business License II \'OiX:)7Q) Designer Name Address City State/Zip. State License # __________ _ Ii. "WORKERS''cbMPENSA'r'idN''T':""· i,1'~." ',,,..r· / " .,,,: ·,,•,,y '":•T'.' i,,"?1""', .,,. ·, .• ,,r:,I,,'"'',J1•"':•':• -~,"•':' Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Telephone 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~ µ@,A-· Policy No. 24°'.6~ ~QI Expiration Date __ l ..:.~_._{_Ob __ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 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 Workers' Compensation Laws of California. WARNING: Fallur thousand dollars ( c erege Is unlawful, end shell subject en employer to crlmlnal penalties and civil fines up to one hundred atlon, damages es provided for In Section 3706 of the Labo co e, interest end attorney's fee,. s1GNATURE _ _::s1...~..uL.<a__(..,~!::::::::=._..L..!_-}-'4~~::....:L--:-----:-------:-----:-----:-----7_ ;,C!•'>-11 r DATE _-+'..,.._+-='½------ I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 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 builds 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(sl 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 I 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 I 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 I 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 I phone number / type ol work): ________________________________________ -'---------------------- PROPERTY OWNER SIGNATURE ________________________ DATE _________ _ COMPLETE THIS SECTldN FOR NOIV'RES/DEIV77Ai.'liUfl.DiNG~PERMfts.,rilil1f~••.J'.tt,,:Yi:'""'T'"""" .,.,,,,,,.,,"' ," 1".",,r•·,• 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 Hazardous Substance Account Act7 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 7 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site1 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(1) Civil Code!. 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 permit issued the uilding Official under lhe provisions of this Code shall expire by llrnilallon and become null and void ii the building or work authorized by such permit is not ence within 180 days from the of uch permil or If lhe building or work authorized by such ermil ·s suspended or abm1doncd at any lime afler lhe work is com for a perio of 180 days (Se ' n 1 6 4. niform Building Code). Jo / L APPLICANT'S SIGNATURE -~:b,~'.....<\~~LJ.,,L\,~.C:::::::___l..-l_L-f,j,,.-a......~=~~-----DATE ___ _.__l_.J~_.. _____ _ WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 10/18/2005 Permit# CB053504 Title: MILLER RES NEW H20 HEATER Description: Type: PLUM Sub Type: Job Address: 1351 SPARROW RD Suite: Lot 0 Location: APPLICANT ARS Owner: MILLER FAMILY TRUST 10-08-84 Remarks: Total Time: Inspector Assignment: ~ Phone: 8586n5455 ex 205 lnspectorr?S Requested By: VERONICA Entered By: CHRISTINE CD Description Act Comment 25 Water HeaterNents t?o _ _,M~O~r2_,~_J;,C::,~,~r~v::it..~-=-_J_f)2'~~·~·~-~"f!!"c=_~--- ~G _____ ,1'1£_ ______ ~~~-------~-~ Associated PCRs/CVs Inspection History Date Description Act lnsp Comments