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Home My WebLink About2711 TIBURON AVE; ; CB100272; Permit02-16-2010 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB100272 Building Inspection Request Line (760) 602-2725 2711 TIBURON AV CBAD PLUM 1675124900 Lot#: Construction Type: BERGSTEDT RES COPPER RE-PIPE 0 NEW Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 02/16/2010 KG 02116/2010 02/16/2010 CALIFORNIA DELTA MECHANICAL BERGSTEDT ALAN W&BEVERLY J FAMILY TRUST 12-01-93 SUITE# 27 12440 OAK KNOLL RD 92064 866-898-0008 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 Total Fees: $130.00 Inspector: 0 0 0 1 0 0 0 2711 TIBURON AVE CARLSBAD CA 92010 $20.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $103.00 $0.00 $0.00 $0.00 $130.00 Total Payments To Date: $130.00 Balance Due: FINAL ~PP~OVl\~ ii) Date ,.).. f 6 1 ' Clearance $0.00 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 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 I I xa i ns f whi h uh v r vi u I een iven a NOTICE imilar to hi or a o whi h the ta t of limit ti ns ha r vi usl x ir d. «~)~- ~ CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Garlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 www.carlsbadca.gov SUITE#/SPACE#/UNIT# Plan Check No. C Est. Value PHASE# # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYP OCC. GROUP DESCRIPTION OF WORK: Include Sque,e Feet of Affected Anta(s) (._..,-Q PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YES □#_ NOD AIR CONDITIONING FIRE SPRINKLERS YES □ NO □ YES □ NOD ADDRESS CITY STATE ZIP PHONE FAX EMAIL (. ZIP 2-o o CLASS (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 1s 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 fhat he ,s exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$5001). WORK-Ell$' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury 011e of the following declarations: □ I have and will maintain a certtficatt of consent to self.insure for worll:ers' compensation as provided by Section 3700 of the Labor Code, for the performance of the worll: for which this pennit is issued. □ I have and will maintain workers' com~en!5-1tion, as required by Section 3700101 the Labor Code, for the performance of the woril which thj_f pe it is issued. My workers' compensation ins~~~nce ~rrier and policy number are: Insurance Co. ~---\-a... 1-<: £: 'u, I\A c! Policy No. • • L Expirat10n Date C ] ( 0 I I, \ 0 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 !tie worl( for which this permit is issued, I shall not employ any person in any manner so as to become su~cl lo the Worl(ers' Compensation laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars {&1D0,000), in addition to the cost of compensation, damages as provided for in Section 37D6 of the Labor cod,.lnterest and attorney's fees. AS coNTRACTORSIGNATURE r_~t';:,.. (' r • ~NT I hereby affirm that I am exempt from Contractor's License Law for the following reason· □ I, as owner of the property or my employees with wages as their scie compensation, will do the worl( and the structure is not intended or offered for sa!e (Sec, 7044, Business and Professioos Code: The Contractor's license Law does not apply to an owner of property who builds or Improves thereon, arid who does such work himself or through his own employees, provided that such improvements are not intended or offered fOf sale. II, however, the building or improvement is sold within one year of comp/ebon, 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 conlractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply lo 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 lhis reason: 1. I personally plan to provide the major labor and materials foc construction of the proposed property improvement. D Yes D No 2. l (have I have not) signed an application for a building permit for the proposed worl( 3. J have contracted with the following pen;on (firm) to provide the proposed conslrnction {include name address I phone I contractors' license number): 4. I plan to provide portions of the worll:, but I have hired the following person to coordinate, supervise and provide the major WOil( (include name I address I phone I contractors' hcense number): 5. I will provide some of the work, but I have contracted {hired) the following persons to provide the work indicated (include name I address I phone I type of wor!(): ,65 PROPERTY OWNER SIGNATURE □AGENT DATE 'COMPLil!TE THIS $il!CTION FOR NON•RE$11>ENTIAL IIIIILl>ING PERMITS ONLY Is the applicant o.r 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? □ Yes □ No Is the applicant or tutu re building occupant required to obtain a permit from the air pollution control district or air quality management district? D Yes □ No ls the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ 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. I certify that I have read the application and state that the above lnfonnation Is correct and that the infom,ation on the plans is accurate. I agree to a,mpt, with aH Cit, ordinances and St.ate laws relating to building construction. I hereby auh>rize representative of lhe City of Cartsbad to enter upon the atx>ve mentioned p~erty fcx' inspecoon purposes. I ALSO AGREE TO SAVE, INDEMNIFY MID KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT, OSHA: /vi OSHA permit is required k>r excavations over 5'0' deep and demolition or construction of structures over 3 sk:>ries ri heghl. EXPIRATION: Every permit issued by the Buitlir,g Oflbal under the provisioos of this Cooe shall expire by limitation and become null and void tt lhe buildi'lg or ......ark authorized by such permit is not commenced 'Ml'lin 180 days from te date of such pemlit oc ~ lhe buildilg or work aullorized by such pe,mil is suspended or abandoned at anytime after tie v.ork is commenced fcx' a period of 180 days (Secti:in 106.4.4 Unibm Buik:lng Code). {7 /J// •• /// -/ J • ,) I I I AS APPLICANT'S SIGNATURE a ~Jc:-L.---/ c, u,e----r 1 5 ,r cs-7 DATE L ? 2 o ( o City of Carlsbad Bldg Inspection Request For 02/18/2010 [} (5 Inspector Assignment: _G-/ Title: BERGSTEDT RES COPPER RE-PIPE Permit# CB100272 Description: Type:PLUM Sub Type: Phone: 8584051390 Job Address: Suite: 2711 TIBURON AV Lot: 0 p Inspector: ___j_'-:, Location: OWNER BERGSTEDT ALAN W&BEVERL Y J FAMILY TRUST 12-01-93 Owner: BERGSTEDT ALAN W&BEVERLY J FAMILY TRUST 12-01-93 Remarks: BEFORE NOON PLEASE Total Time: ----- CD Description 29 Final Plumbing ;__z__comments Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act tnsp Comments Requested By: EMANUELLA Entered By: CHRISTINE f1 '.' ,, ·' .~ ;;