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Home My WebLink About2619 REGENT RD; ; CB044326; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 .,. 12-02-2004 Plumbing Permit Permit No: CB044326 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2619 REGENT RD CBAD PLUM Status: Parcel No: 2081330674 Lot#: 0 Applied: Construction Type: NEW Entered By: Reference #: Plan Approved: Issued: Project Title: KOSIK RES REPLACE GAS LINE Inspect Area: Applicant: NORTH COUNTY PLUMBING PO BOX 1758 VISTA CA 92085 760 735-4900 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 Owner: KOSIK WILLIAM A&CHRISTINA M 2619 REGENT RD CARLSBAD CA 92008 ISSUED 12/02/2004 SB 12/02/2004 12/02/2004 $20.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 Total Fees: $27.00 Total Payments To Date: $0.00 Balance Due: $27.00 6639 12/02/04 0002 01 CGP Inspector: Date1 Clearance: NOTICE: Please take NOT E 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 f hi vril ivnNTIEirhir ihh liiin I 02 27 •00 PERMIT APPl,.ICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faroctay Ave., Carlsbad, CA 92008 Legal Description Lot No. Subdivision Name/Number Description of Work SO. FT. 2,. Q.Otfif:A:C1l.·'PERSQN41f.,dlff~11'8nUroni.0,appllcantl Name 3; APP~ICAl\lt ~traotor. Address □.Agent for·contractor □·owner Name Address Address #of Stories City D Agent• for Owner City City FOR OFFICE USE ONLY~ 7 6 PLAN CHECK NO. Ov/ 7 C,; EST. VAL. __________ _ Plan Ck. Deposit~-------- Validated By__.=,,,._.,._._ _____ _ Date•----\C'.:+..:-\--=+-+ff'.l,----- Unit No. Phase No. Total # of units Proposed Use # of Bedrooms # of Bathrooms State/Zip Telephone# Fax# State/Zip Telephone# S.tate/Zip 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 tt:ie 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 e e 19,ti~ An"-violation of Section 7031,SJ,y any apP,licant .!Rr a permit subjects the 1P_RliCant1£.,a civil penalty of fft more than five undre dollars [$5QOlJ. J ..... /-'. /-r\ ( ..0 P,,... I 7 JC, V L f ·,,., 1.Jl "'"' 7? r. '11.a 0 ame State License # c;_ S-'i I ) 7 Address (_.JI City State/Zip Telephone # City Business License # l 2. 0 q fo 7,l;, license Class _____ IO ____ _ Designer Name Address City State/Zip Telephone State License # _________ _ ·e. woa~s· COMPEt,1$,\\TJON Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D 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. ~ have and wilt 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'sJ;>mPJJl)Satior1J91svcance carper and policy number are: 7) I /. _ Insurance Company l{O.,Gt,~ lf\.J l O Policy No. flp S / / Q(o ?8 O / Expiration Date /_/LO.) (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) / ; O CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California, WARNING: FaHure t e ure satlon coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand doll ($ 0,0 01, ost of compensation, damages as provided for In Section 3706 of the Labor code, interest and attorney's fees. SIGNATUREc,.l,-<\;::::_ _ _,!s::::__..-,,~c::,,---..:::______________ DATE ________ _ 7. OWl\!Ell!BUI I hereby affirm that I am exempt from the Contractor's License Law for the following reason: O 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, Bl,!siness 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 f_or 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 for such projects with contractor(sl licensed pursuant to the Contractor's License Law). 0 lam exempt under Section ______ Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for constructiOI") of the proposed property improvement. 0 YES ONO 2. I (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. t plan to provide portions of the work, but I have hired the fol1o~ing person to coordinate, supervise and provide the major work (include name / address / phone number/ 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/ address/ phone number/ type of work): ___________________________________________________________ _ PROPERTY OWNER SIGNATURE ______________________ _ DATE __________ _ CQMP~EfEt,THIS SECTION FOR NON-RESIDENTIAL BUILPING·PERMITS ONLY 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 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. 8, . ·. CP.NINl!UCllON·l.ENOINGtAGENCY I hereby affirm that there is a construction lending agency tor the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME _____________ _ LENDER'S ADDRESS ________________________ _ ·9' Allffl.lCANT oeaIIFICATIONi 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 Citt 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 p11rmit 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 buildin Official under the provisions of this Code shall expire by !i'mitation and become null and void if the building or work authorized by such permit is not co n d · m O d om the date of such permit or if the building or work authorized by such p rmit is su pended or abandoned at any tin-1 after the work is comm need f r perio of BO d s (Section 106.4.4 Uniform Building Code). APPLICA T'S SIGNATURE DATE (j ·1... 0'1 WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 12/03/2004 Permit# CB044326 Title: KOSIK RES REPLACE GAS LINE Description: Type: PLUM Sub Type: Job Address: 2619 REGENT RD Suite: Lot 0 Location: OWNER KOSIK WILLIAM A&CHRISTINA M Owner: KOSIK WILLIAM A&CHRISTINA M Remarks: Total Time: CD Description 23 Gas/Test/Repairs Associated PCRs/CVs Inspection History Date Description Act lnsp Comments Phone: 7607354900 Inspector: ---- Requested By: NICOLE Entered By: CHRISTINE