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Home My WebLink About1267 MARIPOSA RD; ; CB033075; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 11-10-2003 Plumbing Permit Permit No: CB033075 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 1267 MARIPOSA RD CBAD PLUM Status: Parcel No: 2122204500 Lot#: 0 Applied: Construction Type: NEW Entered By: Reference #: Project Title: CALLENBACH RES GAS TO FIREPIT AND ELEC TO FOUNTAIN Applicant: GREEN LAND CO 1270 PLUM TREE RD CARLSBAD, CA 92009 760-4329999 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 0 0 1 0 Plan Approved: Issued: Inspect Area: Owner: GORDON MARK A&LAURA T 976 SHORE CREST RD CARLSBAD CA 92009 ISSUED 11/10/2003 SB 11/10/2003 11/10/2003 $20.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $20.00 $0.00 $0.00 $0.00 $47.00 Total Fees: $47.00 Total Payments To Date: $0.00 Balance Due: $47.00 8419 11/10/03 0002 01 02 CGP 47-00 Inspector: Date: , Clearance: NOTICE: Please take NOTICE tha 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 pem,it 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 l'ght to protest the specified feesfexactions 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 f . n r i I i Tl i ii hi h fli i ti nsh hr.vi ··------------- FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK No.CJ5O5,3~7y- CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. _________ _ 1., PROJECT .INFORMATION · I D. fn 1 l'1 r fl.fr/Jo S If ll..J) Address (include Bldg/Suite #) Business Name {at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # G 11:S f'tJ/1..,, b /'L~ P/ '7 Existing Use Eu.:--r Fe¥<... Pr~sed Use G .. ~ -Fo [< Description of Work sa. FT. #of Stories # of Bedrooms # of Bathrooms 2. C.ONTACT PERSON:Ut,dJtferl!lnt:t,o:9:~~p_llc■ntl J,1--1 'Pe-t5v~ 1,),zo Name ..r Address State/Zip Telephone# Fax# 3. APPLICANT . ti[c~m~ractor O"Ag1;tnt:for:Contr,Ct_or Q:_Q_wn_.'r 0.A.g·imt,fpf'.0-wnElr! Name Address City State/Zip Telephone# 4. PROPERTY OW~ER Name+//'1 l>', l15>t -?'7o 9SI l9'1 I Address City State/Zip Telephone# 6. CONTRACTOR' COMPANY' 1-jAME (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 besis for the alleged tion. An-1 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 ($5001. (;/V L,+fl/L} -0 c; t, (3 2- Address City State/Zip Telephone # State License # (p I 6 'l 2=9 License Class e ;?.. 2 City Business License # / 2 0 b z / 6 Designer Name Address City State/Zip Telephone State License # _________ _ 6. WQR~ERS., COMPEN$ATJQJ'j woy.ers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Cit 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 issued. 0 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 issued. My worker's compensation insurance carrier and policy number are: , / / Insurance Company '51ft '[ (: FtirJ I) PoHcy No. {C? 0 If Z--2 Exp;,at;on Date 4/11-Z.O (J t/ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS l$100) OR LESS) D CERTIFICATE OF EXEMPTION: I certify that in the performance of the work tor 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' compe • u lawfu thousand dollars ($100,000), In addition th dama and st.all 1ubject an employer to criminal penalties and civil fines up to one hundred ea aa provided for In Section 3706 of the Labor coda, Interest and attornev•• fees. SIGNATURE,_-:-:-----,,-\--4,.,JI.ID.b: _ _:__~::'!,,&'.l-:Lc~➔---,-,.,,.,--:-: 7. OWNER•BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: DATE ________ _ 0 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 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 wlll have the burden of proving that he did not build or improve for the purpose of sale). D 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 tor such projects with contractor(s) licensed pursuant to the Contractor's License Law). D I am exempt under Section ______ Business and Professions Code for this reason~ 1, I personally plan to provide the major labor ~nd materials for construction of the proposed property improvement. 0 YES ONO 2. / (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 I address I phone number I 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 I address I phone number I contractors license 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 / phone number / type of work): __________________________________________________________ _ PROPERTY OWNER SIGNATURE ______________________ _ DATE _________ _ COMPLETE THIS,$ECTION.F0fl NON..JIESIDEN.TIAI, BUILDING'PERl\:'IIT$'0NLY 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 D 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. 6, CONSTRUCTION LENPING,AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 30971i) Civil Code). LENDER'S NAME _____________ _ 9. APP~ICANT CERTIFIC/HION• .. 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 Cit\' 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 ANO 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 Offici nder the provisions of this Code shall expire by limftalion and become null and void if the building or work authorized by such permit Is not commenced within 180 ys ro the date of such permit or ii the building or work authorized by such permit is suspended or abandoned at any time after the work is commen ed I a period of 8 e ion 106.4.4 Uniform Bullding Code). DATE WHITE: File YELLOW: Applicant PINK: Finance . m City of Carlsbad Bldg Inspection Request For: 05/11/2004 . Permit# CB033075 Title: CALLENBACH RES GAS TO FIREPIT Description: AND ELEC TO FOUNTAIN GAS TO BBQ Type: PLUM Sub Type: Job Address: Suite: Location: 1267 MARIPOSA RD Lot APPLICANT GREEN LAND CO 0 Owner: CALLENBACH TIMOTHY C&LISA K Remarks: Total Time: CD Description Act Comment Inspector Assignment: PY --- Phone: 7602247153 Inspector: ----- Requested By: TIM Entered By: CHRISTINE 29 Final Plumbing • f\-7'). :?'1 -~~zr-+----11--R-----------~ Associated PCRs/CVs lnsriection Histo[Y Date Description Act lnsp Comments 11/14/2003 23 Gas/TesVRepairs WC PY GAS APP ON 11/12 11/14/2003 31 Underground/Conduit-Wiring PA PY CONDUIT ONLY 11/12/2003 21 Underground/Under Floor WC PY 11/12/2003 23 Gas/TesVRepairs AP PY 11/12/2003 31 Underground/Conduit-Wiring PA PY CONDUIT ONLY