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HomeMy WebLinkAbout1322 SAVANNAH LN; ; CB041859; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB041859 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: 1322 SAVANNAH LN CBAD PLUM 2157103100 Lot#: 0 Construction Type: NEW Status: Applied: Entered By: Plan Approved: Issued: ISSUED 05/19/2004 KMT 05/19/2004 05/19/2004 Project Title: GINN RES-GAS & ELEC TO BBQ & Inspect Area: FIREPLACE/ BUILD FIREPLACE@ REAR YARD (CITY STDS) Applicant: BURL JORDAN LANDSCAPE 2740 LUCIERNAGA ST 92009 760 04-0675 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 Total Fees: $136.00 0 0 0 0 0 1 0 Owner: GINN LIVING TRUST 09-17-01 1322 SAVANNAH LN CARLSBAD CA 92009 $20.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $109.00 $0.00 $0.00 $0.00 $136.00 Total Payments To Date: $0.00 Balance Due: $136.00 f'INAL APPROVAL 1 3 zZo1 DATE -v. N,'c=---- SIGNATURE ~" PERMIT APPLICATION FOR OFFICE USE ONL v £/ l 0 ~ PLAN CHECK NO. C,f?(J If ' CITY OF CARLSBAD BUILDING DEPARTMENT EST. VAL. __________ _ 1635 Faraday Ave., Carlsbad, CA 92008 Plan Ck. Deposit --,---=-------- Validated By __ ~-=-'-i----'-+------ Date ___ sjEij----+---+-tJ..,._¼-- 1. PROJECT INFORMATION Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # z,s-71 o -~ l Existing Use FD . Proposed Use Description of Work Gi_a.5 ~ f;R ~ C i;o -!f :!e Pl a_ e..e_ ~-CONTACT PERSON (If different frorp applicant) &,· r"" S~c.l-t-e-'-- f Bathrooms Name Address City State/Zip Telephone# Fax# 3. APPLICANT O <;:ontractor O Ag,ent for Contractor O Owner O /\gent for Owner Name Address City State/Zip Telephone# 1/4 -(,A -&D-s 001 J State/Zip L6-CON'i'.RACTOR • COMPANY 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 exemp · . Any v· lation f Sectio 7031.5 '1Y any api:1 ·cant for a permit subjects the applican to a civil penalty of not more than five undred dollars $5001). o-r L _ ;) ;;;,;; oc . AJ. vo -Ot1J 7-:$' Name State License # --'?J"'-_l ..:5'--'6"""-oB--'""---License Class __ {_'2> __ 7.,_-___ _ City State/Zip Telephone # City Business License # ·17,;,/ '2~ ( Designer Name Address City State/Zip Telephone State License # _________ _ [6. WORKER~' COMP~NS~TION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 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 his per it is issued. My worker's compensation insurance carrier and policy number are: Insurance Company __ ::::n __ f\_---n:: ___ ~'ft-.' __ ,v_p __ J _____ _ Policy No .. _-'-;-'7_{,P_7"--lf_7 __ / __ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 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: Fallura to c re workers' compensation coverage la unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand doll•~ 00, ), in addition to the cost of compensation, damages•• provided for in Section 3706 of the Labor code, Interest and attorney's fees. SIGNATURE , . DATE 2 1 / c>; . 04 , . ow~ii_i1_u1:(D.[R DECJ.AliATION _ 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 wa9es 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, es 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(s) licensed pursuant to the Contractor's License Law). 0 I am exempt under Section ______ Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction 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 / address / phone number / 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 / 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 __________ _ (COMPLETE THIS SECTION FOR NON-RESIDENnAL BUILDING 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? O 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. Ls, __ ~O~STRU~IION L.ENDING 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(i) Civil Code). LENDER'S NAME ______________ _ LENDER'S ADDRESS ----------------------------l!J. APPLICl\ttit.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 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 permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. LLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 07/29/2004 Permit# CB041859 Inspector Assignment: PD --- Title: GINN RES-GAS & ELEC TO BBQ & Description: FIREPLACE/ BUILD FIREPLACE@ REAR YARD (CITY STDS) Type: PLUM Sub Type: Job Address: Suite: Location: 1322 SAVANNAH LN Lot 0 APPLICANT BURL JORDAN LANDSCAPE Owner: GINN LIVING TRUST 09-17-01 Remarks: CARRIED OVER FROM WEDNES. Total Time: Phone: 760j4,~2 lnspector:dL__ Requested By: JOE Entered By: CHRISTINE CD Description Act Comment i~Fina_l Plu-mbi-ng ~-t ===g~, µ~(\:~---t--=-====== Associated PCRs/CVs lns12ection Histoty Date Description Act lnsp Comments 07/28/2004 29 Final Plumbing NS cw CALLED JOE 9AM · NO INSPECTION WEDNES. 05/26/2004 68 Fireplace/Tie Straps AP PD GROUT 05/20/2004 11 Ftg/Foundation/Piers AP PD F.P. FTG 05/20/2004 23 Gas/Test/Repairs AP PD TO BBQ & F.P. 05/20/2004 31 Underground/Conduit-Wiring AP PD TO BBQ