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HomeMy WebLinkAbout1918 SWALLOW LN; ; CB042621; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 07-02-2004 Plumbing Permit Permit No: CB042621 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 1918 SWALLOW LN CBAD PLUM 2150521303 Status: Lot#: Applied: Construction Type: 0 NEW Entered By: Reference #: Project Title: Applicant: MATTIS RESIDENCE COPPER RE PIPE ANDERSON PLUMBING INC,WALTER 1150N MARSHALL EL CAJON, CA 92020 619-449-3852 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: Owner: MATTIS ROBERT 1918 SWALLOW LN CARLSBAD CA 92009 Issued: Inspect Area: ISSUED 07/02/2004 MOP 07/02/2004 07/02/2004 $20.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $30.00 $0.00 $0.00 $0.00 $57.00 Total Fees: $57.00 Total Payments To Date: $0.00 Balance Due: $57.00 5783 07 /02/04 0002 01 CGF" Date: Clearance: NOTICE: Please take NOTICE at approval of your project includes the "I position" f 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 lees/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 f x i nsofwhi h h v r viousl be n iv n N Tl E im·1 r r t whi hthe flimiati n herwi 02 57-00 PERMIT APPLICATION FOR OFFICE USE ONLY PLAN CHECK NO. -----·---- CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL.--------·--- Plan Ck. Deposit ________ _ Validated By_~---------- Date _______________ _ Addres (include Bldg/Suite #I rt'.l ED LeAal Description \ ~ I rr BusRess Name lat this address, \A, 1 ~~t 1U1\&!1 ~ L\ DC,: h Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Existing Use Proposed Use SO. FT. #of Stories # of Bedrooms # of Bathrooms Name (3. Name Address City : State/Zip Telephone # (Sec. 7031.6 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 7031.6 by any applicant for a permit subjects the applicant to a civil penalty of not more than fJve hundred dollars [$5001). \J. I a\ +e.c ~nd£Mn2 h VLbm'D ~~ ,1.bL HS o rl • m. o i, ... d l:.1 u ·or-c/J 1 h,6J,. Q Name . 1 Address City State/Zip J Telephone # (, /GI) 41 4 "f _ 7-, ft State License # l-J 1 ~ t? °) License Class G ~ b City Business License # !ti 1 '; '-I O l) 1,: Designer Name State License # Address ,; ' f City State/Zip WKE~S ~~~ i·~--~~ Workers' Compensation Declaration: I hereby affirm under penalw 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. O 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 S \;CA.It Yll\,o,0 Policy No. <\ b -J--0(9 ~ Expiration Date. _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100) OR LESSI 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 the Workers' Compensation laws of California. WARNING: Failure to secure workers' compensation coverage la unlawful, and shall subject an employer to criminal penalties and clvll fines up to one hundred thouaand dollars (!1.Q0,000), In addition to the cost of cqmpensatlon, damages as provided for In Section 3706 of the La , lnte st and attorney's fees. SIGNATURE ~ ~ <,4'----'== DATE f' ~ o.W,W,1iQJliP..ffl:l~.'c]T,filiKt. . . . · · r· · · • ~~1~mm"&~ . ;,• -~~ I hereby affirm that I am exempt from the Contractor's License Law for the following reason: O 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), O 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). 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 / have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm I 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 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 nam!! / address / phone number / type of work): · PROPERTY OWNER SIGNATURE DATE- tcAM.Wet~f~1.QiioN:lfd~.mzff$mfNif~~tlv.!t.1J;>JBffiilMJm'&N ~' • ... 'If,' '. ', •. ~f 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 26505, 26533 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? 0 YES O NO . Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 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. : jfts1f@,"¢J.©Jlf!le.N.mfl~<i\flii::Y~~~i:'mt~m...•(~4t~W!lr~fiiii£~fi~ 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). 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 Cit'!' of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALS.O 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 by the building Official under the provisions of this Code shall expire by limitation and become null and void If the building or work authorlzen 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 tirr ,fter the work is ~menced for a period of 180 days (Section 106.4.4 Uniform Building ~ode). --Z! ~/,A.'-/ APPLICA _:, SIGNATURE ~ -DATE L f..P u --~~--+-+----7+------ WHITE: File YELLOW: Applicant PINK: Finance m • . City of Carlsbad Bldg Inspection Request Permit# CB042621 Title: MATTIS RESIDENCE Description: COPPER RE PIPE For: 07/16/2004 Type: PLUM Sub Type: Job Address: Suite: Location: 1918 SWALLOW LN Lot 0 APPLICANT ANDERSON PLUMBING INC,WALTER Owner: MATTIS ROBERT Remarks: Inspector Assignment: ~ Phone: 8582929228 Inspector: ~ Total Time: CD Description Requested By: BRANDY Entered By: ROBIN 'Ji,,() Comment UL P, '--&rr? :Af? 24 Rough/Topout • Associated PCRs/CVs Inspection History Date Description Act lnsp Comments