HomeMy WebLinkAbout2768 SOUTHAMPTON RD; ; CB054145; PermitCity of Carlsbad .. 1635 Faraday Av Carlsbad, CA 92008
12-08-2005 Plumbing Permit Permit No: CB054145
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
2768 SOUTHAMPTON RD CBAD
PLUM Status:
Parcel No: 2081403500 Lot#: 0 Applied:
Construction Type: NEW Entered By:
Reference #: Plan Approved:
Issued:
Project Title: HENRY RES-REPLACE H20 HTR 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:
HENRY MICHAEL J&KATHLEEN L
2768 SOUTHAMPTON RD
CARLSBAD CA 92010
ISSUED
12/06/2005
LSM
12/08/2005
12/08/2005
$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: $0.00
EXPIRED PERMIT
Inspector:
PERMIT HAS EXPIRED IN ACCORDANCE WITH C.B.C.
SECTION 106.4.4 AS AMENDED BY C.M.C.18.04.030
DATE<4VZI ti~ SIGNATURE-1,rJ,,wdA1,,1;r: ___ _
FINAL APPROVAL
Date: Clearance:
NOTICE: Please take NOTICE that approval of your project includes the 'Imposition" of fees, dedications, reseNations, 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 !T APPLY to any
f f h' h r i I n iv n N T E i ii r hi hi h f limi i n h vi I h rwi
FOR OFFICE USE ONLY
PLAN CHECK NO. Of:, Q °S <.p4-5"
PERMIT APPLICATION EST. VAL. __________ _
Plan Ck. Deposit-~~~------
Validated By ___ Vifu0~~~-=---CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad CA 92008 Date ____ \~.}_."-+) ~(O"-+'[f»_-__ _
Address (indude Bldg/Suite#)
Legal Description
Assessor's Parcel#
Description of Work
Name
,3,,;;:,~13~tt?JF' -,•\l ~,
Name
4;,
Name
Lot No.
Address
Address
Business Name (at this address)
Subdivision Name/Number Unit No. Phase No
Existing Use Proposed Use
SQ. FT. # of Stories # of Bedrooms
City State/Zip Telephone#
-~Blili1lllllll'M~J?'l!Q~i\li1::,;1l•:,.·
City State/Zip Telephone#
.s. -J~:&Qt.ttM · ✓-~.. " , , .;"?.,.··:sr£¥rrull¼~,m~,1:Rr~rfilfilrSW!E⇒i1?{:rn:2;m0:r:;1;:;;::
Total# of units
# of Bathrooms
Fax#
(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
an applicant for a permit subjects the applicant to a civil penalty of not more than five hundred do!!ars ($500]). 6'.:i , ·7c ) LLSi""-L . .,. ~. Jo" .>6 'A.J(c'l-To vr➔U.rlZ'T/l ,>1r-~, ,:.Ll" C/ZJ}1/ a.-77
Name Address City State/Zip Telephone#
State License# R IZf\"il/ License Class G. 5 G City Business License# f+PP Li -e.-c>
Designer Name Address City State/Zip Telephone#
State License# _______ _
6,i,;..l~~IF'l'M1'5'1CPI p mrsz, W:Fl!!T!lllll!Dllffli•'ll:"'Jllfi;:i;\lt':', I;'i:;l1t
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
□ 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.
-Jl..-I have and will maintain worker's compensation, as required by Section 3700 of the labor Code, for the performance of the work tor which this permit is issued My
worker's compensation insurance carrier and policy number are:
Insurance Company ,:SZ:AJ:f: f}.IJC Policy No. J](;J (,, y'/o:( Expiration Date ['/·· / • G l_,
(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
WARNING: Failure to secure worke
dollars($100,000), in addition to the c
SIGNATURE
7• ciL4l.'!N.mYLJ,£i!l
n erage ls unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand
Ion, damages are provided for Jn Section 3706 of the Labor Code, interest and att,o,oov's
I hereby affirm that I am reason:
□ 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 01
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).
□ 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).
D 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. □ YES □ NO
2. I {have/have not) signed an application for a building permit for the proposed work.
3 I have contracted with the following person {finn) 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 1
/ontractors license number): ----------------------------------------------
6, 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 __________ _
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