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HomeMy WebLinkAbout1060 BUENA VISTA WAY; ; CB011801; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Building Inspection Request Line (760) 602-2725 0511 7/200 1 Plumbing Permit Permit No:CBOI 1801 Job Address: Permit Type: PLUM Status: ISSUED Parcel No: 1 551 601 800 Lot #: 0 Applied: 05/17/2001 Reference #: Plan Approved: 0511 7/2001 Issued: 05/17/2001 Project Title: LAWYER RES-REPAIR GAS LINE Inspect Area: 1060 BUENA VISTA WY CBAD St: B Construction Type: NEW Entered By: RMA Applicant: Owner: LAWYER JEFFERY P LAWYER JEFFERY P 4706 05/17/01 0002 01 02 1060 BUENA VISTA WAY #C 1060 BUENA VISTA WAY #C CGF 27.00 CARLSBAD CA 92008 CARLSBAD CA 92008 Total Fees: $27.00 Total Payments To Date: $0.00 Balance Due: $27.00 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Drain InstalVRepair 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 $20.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 XPIRED T FINAL APPROVAL Inspector: Date: Clearance: NOTICE: Please take NOTICE that approval of your project includes the 'Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as Yeedexactions.' You have 90 days from the date this permit was issued to protest imposition of these feeskxactions. 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 folbw 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 rQht to protest the specified feeslexactiins 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 prom NOR DOES IT APPLY to any feedexactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 I FOR OFFICE USE ONLY 1 PLAN CHECK NO. ad(/,&??/ - EST. VAL. Plan Ck. Deposit ,e I Validated B (Date 3- Name Address City Statelzip Telephone t NAME (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 he is 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 155001). Name Address City Statelzip Telephone # State License # License Class City Business License # Designer Name Address City Statelzip Telephone State License # kN Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 of the work for which this permit is issued. 0 issued. My worker's compensation insurance carrier and policy number are: Insurance Company Policy No. Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS I51001 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 to become subject to the Workers' 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 ($100.000). in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 1, 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 75 ( e . 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 completron, 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 (Sac. 7044, Buslness 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 1. 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 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 I am exempt under Section I personally plan to provide the major labor and materials for construction of the proposed property improvement. Business and Professions Code for this reason: YES ON0 have not) signed an application for a building permit for the proposed work. R 3. 4. number I contractors license number): 5. ave ontracted with the following person (firm) to provide the proposed construction (include name I address I phone number I contractors license number): 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 I address I phone I will provide some of the work,but lhve fontracted (hired) the following persons to provide the work indicated (include name / address / phone number I type 2- 83 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 0 NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 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. 0 YES 0 NO DING AGE 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). LENDERS NAME LENDERS ADDRESS ON 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 City 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 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 by such Dermit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is.susDended or abandoned at any time after the work is c APPLICANT'S SIGNATURE DATE days (Section 106.4.4 Uniform Building Code). I / WHITE: File YELLOW: Applicant PINK: Finance h L 1/06 UNSCHEDULED BUILDING INSPECTION INSPECTOR. /u