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Home My WebLink About2903 SOMBROSA ST; ; CB000039; PermitI"¥? , City of Carlsbad 01/05/2000 Plumbing Permit Permit No:CB000039 Job Address: Permit Type: Parcel No: Reference #: Project Title: Applicant: Building Inspection Request Line (760) 438-3101 2903 SOMBROSA ST CBAD PLUM 2551452100 Lot#: 0 Construction Type: NEW REPALCE WATER HEATER Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: OTEY LLOYD&CLOMA D ISSUED 01/05/2000 JM 01/05/2000 01/05/2000 ARS STE100 6121 NANCY RIDGE DR SAN DIEGO CA 92121 619-677-5445 2903 SOMBROSA ST CARLSBAD CA 92009 7747 01/05/00 0001 OJ 02 Total Fees: $27.00 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 TOTAL PERMIT FEES <II Inspector: I L- Total Payments To Date: 0 0 0 0 1 0 0 $0.00 Fl NAL AZPRF,VAL Date: ~" r 0 Balance Due: Clearance: $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 C-PRHT 27-00 $27.00 NOTICE: Please 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 Cartsbad 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 capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which ou have reviousl been iven a NOTICE similar to this or as to which the statute of limitations has reviousl otherwise ex ired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 PERMIT APPLICATION FOR OFFICE USE ONL V ~ "' a, PLAN CHECK NO. C/J ./ j / CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. _________ _ Plan Ck. Deposit b ~ , Validated By J ~ , { __ / Date f / f{)O I Address Onclude Bldg/Suite #I Business Name lat this address! Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # V\IA::' ~ Existing Use Proposed Use lf¼2W_J. ~a!.L ll A ±ex: Dei;cription of Work SQ. FT. #of Stories # of Bedrooms # of Bathrooms :2. CONTACT PERSON Pf different tiom llppllcant) Name City State/Zip Telephone # Fax# Designer Name Address City State/Zip Telephone State license# _________ _ .8. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 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 i1111ued. )di.. 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 1ed. My worker's co e se ·on insurance carrier end policy number are: ---,.---0.. a >-4) Insurance Company -..L.-""':;..a.--'-----------------Policy No. _1J,,::!I..L.2:.. 11-.,,I Expiretion Date tl) {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. 1 shell not employ 11ny person in any manner so as to bacome subject to the Workers· Compensetion Law11 of California. WARNING: Failure to secure workers' compensation coverage I■ unlawful. and aha■ ■ubject an employer to crlmlnal penahlea and civil fines up to one hm,drad thousand dollai. ($100,0001. In eddlti the I of c riilltian. damages as provided for In Section 3706 of the Labor code, lntereat and attorney'■ fees. SIGNATURE.~7'--WH"'~-'-'...,.=';lf----"'--''--"'::;..,;..,...LIL.1.....,LIL-'"=------------DATE _________ _ 7. OWNER-BUILD I hereby affirm that the Contrector's Licen11e Law for the following reeson: 0 I, as owner of the property or my employees with wages as their sole compensation, will do the work and th• structure is not intended or offe,ed fm 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-buildar wm have the burden of proving that he did not build or improve for the purpose of saleJ. 0 I, es owner of the property, am exclusively contracting with licensed contractors to construct the proiect !Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or impr011es thereon, and contracts for such projects with contractorlsl licensed pursuant to the Contractor's License Lewi, D I am exempt under Section ______ Business end Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property imprD11ement. 0 YES ONO 2. I !have I have not) signed an epplication for a building permit for the proposed worlc. 3. I have contracted with the following parson (firm) to provide the proposed construction (include name/ address/ phone number/ contractors license number): 4. I plan to provide portions of the work, but 1 heve hired the following parson to coordinata, supervise and provide the major work !include name / 11ddress / phone number/ contr11ctors license number): ______________________________________________ _ 5. I will provide some of the work, but I have contracted lhiredl the following persons to provide the work indicated !include n11me / address / phone number / type of work): ________________________________________________________ _ PROPERTY OWNER SIGNATURE _______________________ _ DATE _________ _ COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY ls the applicant or future building occupant requirad to submit a business plan, acutely hazardous materials ragistration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-T11nner Hazardous Substance Account Act7 0 YES D NO Is the applicant or future building occupant required to obtain • permit from the air poHution control district or air quality management district? D 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. 8. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a con11truction lending agency for the performance of the work for which this permit is issued [Sac. 3097(il Civil Codel. LENDER'S NAME _____________ _ LENDER'S ADDRESS _______________________ _ 9. APPLICANT CERTIFICATION I certify that I have read the application and state that the above information is correct and thet the information on the plans is accurate. I agree to comply with all City ordinences and State laws relating to building construction. I hereby authorize representativas of the Citt 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. 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 OI' 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 limit,tion and become null and void if the building or work 1uthorized by such [>tlrmit is not commenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at eny time ef e e work is commence for Ptlrio of 180 d ya tsection 106.4.4 Uniform Building Cade). I I · I APPLICANT'S SIGNATURE ~::::...~r:st,j)/.:.....l....UL,;l~LI~~~a_.1...,~'...j,,6.,__________ DATE ~ 3 CU I PINK: Finance City of Carlsbad Inspection Request For: 1/11/2000 Permit# CB000039 Title: REPALCE WATER HEATER Description: Type: PLUM Sub Type: Job Address: 2903 SOMBROSA ST Suite: Lot Location: APPLICANT ARS Owner: OTEY LLOYD&CLOMA D Remarks: Total Time: CD Description 0 Act Comments Inspector Assignment: -r k Phone: 7609449034 Inspector: Requested By: LLOYD Entered By: CHRISTINE 25 Water HeaterNents A£_ _______ _ Associated PCRs Inspection History Date Description Act lnsp Comments