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Home My WebLink About1675 CALLIANDRA RD; ; CB032590; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Building Inspection Request Line (760) 602-2725 1 09-1 9-2005 Plumbing Permit Permit No: CB032590 Job Address: Permit Type: PLUM Status: ISSUED Parcel No: 2159000700 Lot#: 0 Applied: 09/19/2003 Reference #: Plan Approved: 09/19/2003 Issued: 09/19/2003 Project Title: NlKlAS RES GAS FOR FUT BBQ Inspect Area: 1675 CALLIANDRA RD CBAD Construction Type: NEW Entered By: SB ELEC FOR FUT FOUNTAIN Applicant: ANDERSON'S LA COSTA NURSERY 400 LA COSTA AV ENClNlTAS CA 92054 760-753-31 53 Owner: NlKlAS PETER A&KATHERINE J 1675 CALLIANDRA RD CARLSBAD CA 92009 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 $20.00 $0.00 $0.00 $0.00 $47.00 ~~ Total Fees: $47.00 Total Payments To Date: $0.00 Balance Due: $47.00 - FOR OFFICE USE ONLY PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT PLAN CHECK NEB ZS?~ 8 1635 Faraday Ave., Carlsbad, CA 92008 Existing Use ' Proposed Use " SQ. FT. ' #of Stories # of Bedrooms # of Bathrooms tL+S &C&L $"DL Fi2PrcrTp.l d . -. 5 c e RM Description of Work - Name Address City Statelzip Telephone # (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Codel or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars lb5001). Name State License # qoq Lq 3 Designer Name Address ' City Statelzip Telephone State License # Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 of the work for which this permit is issued. a . cb-qav 1-3 3- hY4.Tr P&=zF\ s7 Statelzip Tefephone'l City CA~Wc%L?j 33 Address b\C\nQ Lrxr%= License Class ( - z 7 City Business License # I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier Insurance Company 57 WZ FN-Q Policy No\ 7 I Z 7 I 7 Expiration Date 1. 2 . a, 0 3 ~~ - (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS I$lOOI OR LESS1 0 to become subject to the Workers' Compensation Laws of California. WARNING: Failu thousand dollars ( 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 ion coverage is unlawful, and shall subject an employer to crimlna t of compensation, damages as prodded for in Section 3706 of the I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 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 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 prolects with contractor(s) licensed pursuant to the Contractor's License Law). 0 1. 2. 3. 4. number I contractors license number): 5. of work): I am exempt under Section I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ON0 I (have / have not) signed an application for a building permit for the proposed work. I have contracted 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 I have contracted (hired) the following persons to provide the work indicated (include name I address I phone number I type Business and Professions Code for this reason: PROPERTY OWNER SIGNATURE DATE. 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 site7 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 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). LENDER'S NAME LENDER'S ADDRESS 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 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, 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 permit is the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any tirr (Section 106.4.4 Uniform Building Code). APPLICA SIGNATURE DATE 1 JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. 'ter the work is com \ . WHITE: File YELLOW: Applicant PINK: Finance A City of Carlsbad Bldg Inspection Request For: 09/24/2003 Permit# CB032590 Title: NlKlAS RES GAS FOR FUT BBQ Description: ELEC FOR FUT FOUNTAIN Type: PLUM Sub Type: Job Address: 1675 CALLIANDRA RD Suite: Lot 0 Location: APPLICANT ANDERSON'S LA COSTA NURSERY Owner: NlKlAS PETER A&KATHERINE J Remarks: Total Time: Inspector Assignment: PD Phone: 7607030484 Inspector & Requested By: NA Entered By: CHRISTINE CD Description 23 Gas/Test/Repairs 31 UndergroundConduit-Wiring Associated PCRs/CVs lnwection History Date Description Act lnsp Comments 09/22/2003 23 GasiTesVRepairs CO PD COVERED 09/22/2003 31 Underground/Conduit-Wiring AP PD \ . c / :++ , agree to issue a valid worker’s compensation insurance the full premium to be adjusted later upon the total remuneration of employees during the policy period policy in a form approved by the California Insurance Commissioner to: 12/6/02 to 12/1/03 ANDERSON’S LA COSTA NURSERY Alc Nursery Inc 400 La Costa Ave Encinitas CA 92024 FAX (760) 753-3263 THE EXECUTIVE OFFICE OF THE FUND RESERVES THE AUTHORITY TO GRANT INSURANCE COVERAGE AND THE RIGHT TO REJECT ANY AND ALL APPLICATIONS, BUT WHEN ACCEPTED, INSURANCE WILL BE MADE EFFECTIVE AT 1201 A.M. PACIFIC STANDARD TIME THE DAY FOLLOWING RECEIPT OF THE COMPLETE0 APPLICATION FOR CALIFORNIA WORKER’S COMPENSATION INSURANCE AND YOUR CHECK FOR THE DEPOSIT PREMIUM AND ANY MANDATORY SURCHARGE BY THE FUND UNLESS A LATER DATE IS REQUESTED BY YOU. POLICYNUMBER- 1. 7 1 2 2 1 1712217 STATE COMPENSATION INSURANCE FUND DIVIDEND STATEMENT. UNDER CALIFORNIA LAW IT IS UNLAWFUL FOR AN INSURER TO PROMISE THE FUTURE PAYMENT OF DIVIDENDS UNDER AN UNEXPIRED WORKERS COMPENSATION POLICY OR TO MISREPRESENT THE CONDITIONS FOR DIVIDEND PAYMENT. DIVIDENDS ARE PAYABLE ONLY PURSUANT TO CONDITIONS DETERMINED BY THE BOARD OF DIRECTORS OR OTHER GOVERNING BOARD OF THE COMPANY FOLLOWING POLICY EXPIRATION. IT IS A MISDEMEANOR FOR ANY INSURER OR OFFICER OR AGENT THEREOF, OR ANY INSURANCE BROKER OR SOLICITOR TO PROMISE THE PAYMENT OF FUTURE WORKER’S COMPENSATION DIVIDENDS. THE STATE COMPENSATION INSURANCE FUND HAS AN UNINTERRUPTED HISTORY OF DIVIDEND PAYMENTS SINCE THE INCEPTION OF OPERATIONS IN 1914. OUR DIVIDEND PROGRAM PROVIDES THAT UPON THE TERMINATION OF EACH POLICY YEAR AND AFTER ADJUSTMENT OF PREMIUM, YOU WILL BE ENTITLED TO PARTICIPATE IN ANY DIVIDEND PLAN APPLICABLE TO THIS POLICY WHICH MAY BE APPROVED FOR DISTRIBUTION BY OUR BOARD OF DIRECTORS IF THE FINAL PREMIUM DETERMINED AT THE END OF THE POLICY PERIOD IS MORE THAN THE MINIMUM PREMIUM, WITH THE FOLLOWING EXCEPTIONS: YOU WILL NOT BE ALLOWED TO PARTICIPATE IF YOU FAIL TO PAY ANY PART OF THE PREMIUM FOR THIS POLICY AFTER WE REQUEST PAYMENT IN WRtTING, OR ALLOW IT TO REMAIN UNPAID FOR 90 DAYS AFTER WE MAIL A STATEMENT OF PREMIUM TO YOU AT THE MAILING ADDRESS SHOWN IN THE DECLARATIONS. YOU DO NOT KEEP ADEQUATE RECORDS OF INFORMATION NEEDED TO COMPUTE PREMIUM, OR DO NOT PROVIDE THEM TO US WHEN WE ASK FOR THEM; OR WE MUST BRING SUIT AGAINST YOU TO OBTAIN THE RECORDS NECESSARY FOR US TO COMPUTE PREMIUM, OR TO ENFORCE THE COLLECTION OF ALL OR ANY PART OF THE PREMIUM FOR THIS POLICY. YOUR PARTICIPATION WILL BE ACCORDING TO THE RULES ADOPTED BY OUR BOARD OF DIRECTORS.