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Home My WebLink About1942 SWALLOW LN; ; CB042176; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 06-07-2004 Plumbing Permit Permit No: CB042176 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 1942 SWALLOW LN CBAD PLUM 2150521317 Lot#: 0 Construction Type: NEW Status: Applied: Entered By: Reference#: Plan Approved: ISSUED 06/07/2004 MOP 06/07/2004 06/07/2004 Project Title: Applicant: SPACIE RESIDENCE COPPER REPIPE 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 Owner: SPACIE ANNE 904 SALEM PL LAFAYETTE IN 47904 Total Fees: $57.00 Total Payments To Date: $0.00 FINAL APPROVAL Issued: Inspect Area: $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 Balance Due: $57.00 3752 06/07/04 0002 01 02 CGP 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. _______________ _ Address (include Bldg/Suite #) C: )usiness Name (at this address) frl:t O '"'~ ~1 f:>\V\::i-\-hbr,.h Legal D~cription Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Existing Use Proposed Use SQ. FT. #of Stories # of Bedrooms # of Bathrooms City State/Zip Telephone # Fax # o~~•"l!f."lEIJA"QJ&~l!~~~~ City State/Zip Telephone # Jl!''~~~•m.in~~~~~~~-~~ Name Address City S.tate/Zip Telephone# (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 ls 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 ls exempt therefrom, and the basis for the alleged exemption. Any v'olatlo of Section 703 .5 by any applicant fS>r a oermit subjects the applicant t"o a civil pen•ltv of not more then f)ve hundred dollars ($5001). £ . h \o -H50 O•P1e,\t-~h11ll t:Jt,at{;n!F\(,A °!)-O')..i) ,1"!-4t..fq -..1t'::/,cJ Address ~ City ✓ State/Zip Telephone # State License # ----~'--~---License Class (,. l (;, City Business License # I D1 '-.I LJ Q Q Designer Name Address City State/Zip Telephone State License # _________ _ ~'I"" ,-™ "'CQ'&iff~§At'i'Ol>T~~~~~~ Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: ' 'A A•'f •<, ' 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 ls issued . .-lilf-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 &sued. My w orker's compensation insurance carrier and policy number are: -i_ / J . Insurance Company S fc;;, ±:e £,A YI d . Policy No. q' -Afo/0) Expiration Date OT• _ O -f (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) 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 tci 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 civil fines up to one hundred thousand dollars ($100 000 In ad on to the cost of compensation, damages III provided for In Section 3706 of the Labor code, Interest and attorney's fees. SIGNA TUR DA TE G J7, o:Y.tN"f~lljpJ.[®l(Cil:".Q.~~'r!ctli!D~~~~mr~~~mlm~~-' . ' ,t~ ' • a 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 comi,ensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professio.ns 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) 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 numberl=-----------------------------,--------------------- 5. 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--------,---,,.,--,----,-----------DA T6 _________ _ ~ J!.!:.§:I«~J§lg;,ffif~El!g~ijiJ:m,'.'~q'J_'eg~,mf~·~l~~~~~ 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 Act? 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. tlfm @Nl;fR~9jjQHf~t.Nffil&~~.f~~ •. -. ,· . ,J!iiili!i.~WBmi.11..~~~-f-1&1/DE:~~£~,jf!i!:~•t;~~--ffljg~~f,~, 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. __________________________ _ l'.!im':~fflfo~-Nlf:(e:;ID!OOffi.ll~'l~itt<Y~~-~iZt~~~,~~~~-~J.mD;~ I certify that I have reed 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 autho'rize representatives of the Citt 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 ls required for excavations over 5'0" deep and demolition or construction of structures over 3 stories~n 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 authorized by such permit is not commenced within 1 BO days from the date of such permit or if the building or work authorized by such permit Is suspended or abandoned at any tlfl" ,tter the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). / } APPLICA _; SIGNATURE ~ I DATE b t 12 J /9L/ r r ( I WHITE: File YELLOW: Applicant PINK: Finance m . City of Carlsbad Bldg Inspection Request . . Permit# CB042176 Title: SPACIE RESIDENCE Description: COPPER REPIPE For: 06/24/2004 Type: PLUM Sub Type: Job Address: Suite: Location: 1942 SWALLOW LN Lot 0 APPLICANT ANDERSON PLUMBING INC,WALTER Owner: SPACIE ANNE Remarks: Total Time: Inspector Assignment: ~ Phone: 6194497646 Inspector: Requested By: BRANDY Entered By: CHRISTINE CD Description 24 Rough/Topout ]ll_om_m_e_n_t ----------------- Associated PCRs/CVs Inspection History Date Description Act lnsp Comments