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Home My WebLink About2794 SOUTHAMPTON RD; ; CB050611; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 02-28-2005 Plumbing Permit Permit No: CB050611 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2794 SOUTHAMPTON RD CBAD PLUM Status: Parcel No: 2081405700 Lot #: 0 Applied: Construction Type: NEW Entered By: Reference #: Plan Approved: Issued: Project Title: FRANCIS RES REPLACE H2O HEATER Inspect Area: 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 0 1 0 0 Owner: FRANCIS TIMOTHY A&ANNE M 2794 SOUTHAMPTON RD CARLSBAD CA 92008 ISSUED 02/28/2005 KG 02/28/2005 02/28/2005 $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: $0.00 Balance Due: EXPIRED PERMIT $27.00 PERMIT HAS EXPIRED IN Act:tl!fu.RNc~!fii ~s. 01. SECTION 106.4.4 AS AMENDED BY C.M.C.18.04m!SP Inspector: DATE],\i,d,ow SIGNATURE_..Q"'W~----- FINAL APPROVAL Date: Clearance: NOTICE: P!ease 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 whi hi r f · · 02 27-00 FOR OFFICE USE ONLY PLAN CHECK NoC.Bo:;OG> I I • I PERMIT APPLICATION EST. VAL. _________ _ CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Validated By __ ,___,.,_• ___ ~--~ Plan Ck. Deposit_,?..,_ ______ _ Date ___ • "--''J-L...~~}2-'--=-~-=-- Eilfi Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total# of units Assessor's Parcel # \,,_/Atf-17 H\<ATE;/2 Existing Use Proposed Use Description of Work c/o SQ. FT. # of Stories # of Bedrooms # of Bathrooms Name Addre11 City Stala/Zlp Telephone# Fax# jad.,T!'s 771MiGli~i: o,.,,.;J L.v,.-8.S ,~ c.,q qi.s,3p B@ , 2-2 O"J1i Name Addreu City State/Zip Telephone# Address City State/Zip Telephone# ,_\1lj;~'(::</-' (Sec. 7031.5 Business and Professions Code: Arly City or County which requires a permit to construct, alter, improve, demolish or repair any structu~: prii; 1~\iS\~suance. 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·euainess 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 tor a permit subjects the applicant to a civil nalty of not more than five hundred dollars ($500]). iZ.. v.;.,. ~ , ,1ou lv,E:.1--S 1->0'-< Name , 1 City UI State/Zip ~ 7 'Z--7 =, 77 Telephone# State License # _2,.>c:l.:W'.l=.,_'fL... __ _ License Class _C.:.__,3~'2~-----City Business License# ___________ _ Designer Name Address City State/Zip Telephone# State License# _______ _ WOiken' Compenaatlon Declaration: I hereby affirm under penalty of perjury one of the following declarations: □ I have and will maintain a certificate of consent to aelf-lnaure for work.era' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this pennit Is inued. ,li!f"" l have and wiU maintain worker's 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 eaniy and polley number are: /3, I Insurance Company J71'11"E2; ,,_..,_. 0 Policy No. 17, / 4 l/ l C, '{ Expiration Date "'[-I -0 IO (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100) OR LESS) □ 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' Compe lion Laws of California. WARNING: Failure to 1ecure workers' mpen1 cove 11 unlawful, and 1hall 1ubjec:t an employer to crlmlnal penaltie, and civil fines up to one hundred thousand dOUars($100,000), In addlUon to the cos Of co n11Uon, dal'nagff are provided for In Section 3708 Of the Labor Code, Interest and attorney's fees. SIGNATURE ·-DATE .7'''' ' i hereby affirm that I am e O I, as owner of the property or my employees with wages as their sole compensation, will d 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 wUl have the burden of proving that he did not build or improve for the purpose of sale). □ l, 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 build& or Improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). O I am exempt under Section ________ Bualneu and Professions Code for this reason: 1. I personally plan to prcivide the major labor and materials for construction of the proposed property improvement. □ YES □ NO 2. I (have/have not) signed an appHcation for a building permit for the proposed work. 3. I have contracted wtth the following person (firm) to provide the proposed construction (Include name/ address/ phone number/ contractors license number): 4, I plan to p-ovide portion& of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name/ address/ phone number/ /ontractora lioenae number): --------------------------------------------~ s. 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 I type of work): PROPERTY OWNER SIGNATURE ___________________________ DATE __________ _ WHITE: File YELLOW: Applicant PINK: Finance PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Page 2 of 2 .. <~:J]~ttDJt~jJ0'.J, ls the applicant or futllre bUldlng occupant requred to submit a bualneas plan, acutely hazardous materials registration for or risk management and prevention program under Sections 25505, 25533 or 25534 of the Prealey,-Tanner Hazardous Substance Account Acrl □ YES D NO Is the applicant or Mure buKdlng occupant required to obtain a permit from the air pollution control district or air quality management district? □ YES □ NO Is the facility to be constructed within 1,000 feet of the outer boundary of a achool lite? Cl YES □ 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. 1/j 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). LENDER'S NAME __________________ _ LENDER'S ADDRESS ___________________ _ ,, -~~l'ffll+!SIP'J'ffOlnttrrrnrr ;; : r TE ?JJMtPM~-&i'r:ill'At~~l,:S~l?~ 1·,/¼SZ,ii 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. l agree to comply with all City ordinances and State Jaws relating to building construction. I hereby authorize representatives of the City 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, JUDGEMENTS, COSTS ANO EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAi CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required fore EXPIRATION: Every permit lsaued by by such permit is not commenced with' the work is commenced for a period of nd demolition or construction of structures over 3 stories in height g Official u er. e provisions of this Code shall expire by limitation and become null and void if the building or work authorized a of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after .. ◄ Uniform Building Code). WHITE: File YELLOW: AppHcant PINK: Finance