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Home My WebLink About1772 DOVE LN; ; CB010480; Permit02/05/2001 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No:CB010480 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 1772 DOVE LN CBAD PLUM 2159200100 Lot#: 0 Construction Type: NEW ROZANSKY RES/ GAS LINE TO BBQ AND FIREPIT Status: ISSUED Applied: 02/05/2001 Entered By: CB Plan Approved: 02/05/2001 Issued: 02/05/2001 Inspect Area: Applicant: ROZANSKY JON&JULIE Owner: ROZANSKY JON&JULIE 1772 DOVE LN CARLSBAD CA 92009 1772 DOVE LN CARLSBAD CA 92009 0722 02/05/01 0002 01 02 CBP 27.00 Total Fees: $27.00 Total Payments To Date: $0.00 Balance Due: $27.00 Plumbing Issue Fee $20.00 Fixture or Trap 0 $0.00 Building Sewer 0 $0.00 Roof Drain 0 $0.00 Install/Repair Water Line 0 $0.00 Water Heater and/or Vent 0 $0.00 Gas Piping System 1 $7.00 Vacuum Breaker 0 $0.00 Other Plumbing Fees $0.00 Master Drainage Fee $0.00 Sewer Fee $0.00 TOTAL PERMIT FEES $27.00 Inspector: FINAL APPROVAL 7-T-Oi 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 "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 Govemment Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Cailsljad Municipal Code Section 3.32.030, Failure to timely follow that procedure will bar any subsequent legal action to attacii, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exacttons 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 you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously othenwise expired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1. PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO EST. VAL. Plan Ck. Deposit Validated Bv JJ<^ Date 7^' ^'6 I Address (IncJ Delude BIda/Suite y)/^ J . TT. Business Name (at tl tbic^ddress) Legal I^escrlptian '/<e^//)e^L^ LotN t No. Subdivision Name/Number Unit No. Phase No. Total tt of units Assessor's Parcel # Existing Use Proposed Use Description of VVork CONTACT reRSONlPdiffmMfram^ SQ. FT. ^of Stories tt of Bedrooms tt of Bathrooms Name Address City i3i APPlllCANT •Contractor • Agent for Contractor • Owner OAflsnt for Owner State/Zip Telephone # Fax tt Name 4. PROPERTY OWNER Address City State/Zip Telephone tt Address City State/Zip Telephone tt Name 6. CONTRACTOR • COMPANY NAME \-~ , . . . .i , , . , <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 IChapter 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 ($5001). Name State License tt ^ ^j-^ Address License Class City State/Zip City Business License tt Telephone # Designer Name Address City State/Zip Telephone State License tt 6. WORKERS' COMPENSATION Worl^ri'^ Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self-insure for woricers' 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 ^'')0(2yWA3^ 3 Policy No. Expiration Date Y'Q>' C^/ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS (»100l OR LESS) Q 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 ia unlawful, and shaH subject an •mployar to criminal panaltias and civil fines up to one hundrad thousand dollars ($100,000), in addition to tha cost of compensation, damagas aa provided for In Section 3706 of the Labor code, Intereat and attomey'a feea. SIGNATURE DATE 7. OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason: Q. 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). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractpr'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). O I am exempt under Section Business and Professions Code for this reason: I oar^iMlly plan to provide the major labor and materials for construction of the proposed property improvement. Q YES \3KiO [ (have lAave not) signed an application for a building permit for the proposed work. [contracted with^the fojlowing person (firm) to provide the proposed construction (include name / address / phone number / contractors licgnse ny (include name / address / phone number / contractors license number): I plan to provide portions of the work, but l>t)ave hired the followinoperson to coordinate, supervise and provide the major worlc(|nclu|le name / a number / contractors license number): OAA) iD \J A^Sn^yT^HBf^ 7ajKi'^viipOTAi Utf) SOtTA2- ' address / phone 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work): PROPERTY OWNER SIGNATURE _ COMPLETE THIS SECTION FOR I Is the applicant or future buildy program under Sections 25509 iiDENtmwmmmm O&Y \ : requirec^o sabmit a business plan, acutely hazardous materials registration form or risk management and prevention DATE / /fl / • YES • NO 533 or 25534 of tftTPresley-Tanner Hazardous Substance Account Act? • YES • 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? Q YES Q 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 POUUTION CONTROL DISTRICT. 8. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Code). LENDER'S NAME LENDER'S ADDRESS 9 APPUCANT CERTIFICATION 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 pemlt issued by the building Olfidaljunder the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced withiryp 80 days from the date of such permit or If the building or work authorized by such permit Is su^nded or abandoned at any time after the work is commeQc^bLl^r a p^f|5d ol/lw days (Sectloa40e4;4 Uniform Building Code). APPLICANT'S SIGNATURE DATE PINK: Finance CityofCarlsbad BIdg Inspection Request For: 08/02/2001 Permit# CB010480 Title: ROZANSKY RES/ GAS LINE TO BBQ Description: AND FIREPIT Inspector Assignment: SR Type: PLUM Sub Type: Job Address: 1772 DOVE LN Suite: Lot C Location: APPLICANT ROZANSKY JON&JULIE Owner: ROZANSKY JON&JULIE Remarks: Phone: 7609300009 Inspecti Total Time: CD Description 19 Final Structural 29 Final Plumbing Act Comments CJUC Requested By: JOHN Entered By: CHRISTINE hior Bo CUT Associated PCRs Inspection Historv Date Description Act Insp Comments 02/09/2001 21 Underground/Under Floor WC SR 02/09/2001 23 Gas/Test/Repairs AP SR 02/08/2001 21 Underground/Under Floor WC SR 02/08/2001 23 Gas/Test/Repairs CO SR NO PSI IN GAS LINE