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HomeMy WebLinkAbout1968 SWALLOW LN; ; CB041930; PermitCity of Carlsbad • 1635 Faraday Av Carlsbad, CA 92008 05-21-2004 Plumbing Permit Permit No: CB041930 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 1968 SWALLOW LN CBAD PLUM 2150521323 Lot#: 0 Construction Type: NEW Status: Applied: Entered By: Reference #: Plan Approved: Project Title: ROSINSKI RES COPPER REPIPE Applicant: 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: ROSINSKI KRIS A 1968 SWALLOW LN CARLSBAD CA 92009 Issued: Inspect Area: ISSUED 05/21/2004 SB 05/21/2004 05/21/2004 $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 FINAL APPROVAL ' . DAT#/J...CLEARANCE ___ _ SIGNATURE :JV.,\ PERMIT APPLICATION • CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 Legal Description Lot No. Subdivision Name/Number Existing Use SQ. FT. #of Stories FOR OFFICE USE ONLY ) i) PLAN CH.ECK NO. OL[ f ~ EST. VAL. __________ _ Plan Ck. Deposit ________ _ Validated By __________ _ Date. ____________ -'----- Unit No. Phase No. Total # of units Proposed \)se # of Bedrooms # of Bathrooms State/Zip Telephone # Fax # ", •. l'k~ Address Coty State/Zip Telephone # ~. ,l!fflifl.~Bu,'~ij . ·~ ... 'JI ~JaYJJ!~~A~~~~~~'la~W.~ 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 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 ha Is exempt therefrom, and the basis for the alleged exemption. Any violaJion o Section 7031.5 by an applicant for a permit subjects the applicant to a civil penalty of not more than f)va hundred dollars ($500)). ~n w... ,• c o n .1\1,... n \ 2.1 • a , •4 Designer Name State License # Address City State/Zip I wmm.1~ g~11T!!f§" ··' · , ~~-.. ~· Workers' Compensation Declaration: I hereby affirm ur1der penalty of perjury one of the following declarations: Telephone O I have and will maintain ,i certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. --r9--I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is fs;ued. My worker's compensation Insurance ciyrier and policy number are: /, / / Insurance Company C$:fecl::e f:vn, di Policy No. 1 ~ A <2l1} Expiration Date 6~ 6_'- (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) / □ O I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Coda: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(sl licensed pursuant to the Contractor's License Law). 0 I am exempt under Section ______ Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. D YES ONO 2. I (have / have not) signed an application for a building permit for the proposed work. 3. I have contracted _with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone number/ contractors license number):. __________________________ ...,... ___________________ _ 5. I will provide soma of the work, but I have contracted (hired) tha'following persons to provide the work Indicated (include name / address/ phone number / type · of work): · PROPERTY OWNER SIGNATURE DATE- WJM~tltt:~J$Jq]ijW.i'l£~~.ffiiu~!iPNID~,C•J§~tjj 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. t,!-· .~~i1ru,~fIQNI~:&~i9tij~, ·~~~Y•m~a"lf.~~-•~m~•~1~~1~~~W.!ffl I hereby affirm that there is a construction.landing agency for the performance of the work for which this permit is issued (Sec. 3097(il Civil Coda). 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 authorize representatives of the Cltt of Carlsbad to enter upon the above mentioned property for Inspection purposes. I ALSP 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 authorized l1y 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 tim ,!ter the work Is com~ ~O days~Sectlon 106.4.4 Uniform Building ~ode). L ;· t.,) APPLICA ., SIGNATURE ~ __ 4'::::.::____.::::______:'-=--,.£----------------DATE '$ _ d.J O ~ . 1 WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 06/08/2004 Permit# CB041930 Title: ROSINSKI RES COPPER REPIPE Description: Type: PLUM Sub Type: Job Address: Suite: Location: 1968 SWALLOW LN Lot 0 APPLICANT ANDERSON PLUMBING INC,WALTER Owner: ROSINSKI KRIS A Remarks: Total Time: Act Comment Inspector Assignment: Phone: 6194497646 __.; Inspector: J N\____, Requested By: MARK Entered By: ROBIN CD Description 24 Rough/Topout ~------ Associated PCRs/CVs Inspection History Date Description Act lnsp Comments