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Home My WebLink About1316 SHOREBIRD LN; ; CB021446; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 05-14-2002 Plumbing Permit Permit No: CB021446 Job Address: Permit Type: Parcel No: Reference #: Project Title: Building Inspection Request Line (760) 602-2725 1316 SHOREBIRD LN CBAD PLUM 2157910900 Lot#: 0 Construction Type: NEW TIRNACKUS -REPLACE EXIST GAS LINE TO EXISTING BBQ & FPLACE Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 05/14/2002 JM 05/14/2002 05/14/2002 Applicant: TOWN & COUNTRY Owner: HAYASHI ROBERT 7112 05/14/02 0002 01 CGP 321 N ENGEL STREET ESCONDIDO CA 92027 760-745-0337 Total Fees: Plumbing Issue Fee Fixture or Trap Building Sewer Roof Drain $27.00 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 Inspector: 1316 SHOREBIRD LN CARLSBAD CA 92009 Total Payments To Date: 0 0 0 0 0 1 0 FINAL APPROVAL Date: $0.00 Balance Due: $27.00 $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 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 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 seivice fees in connection with this project. NOR DOES IT APPLY to any I i ii r . 02 27-00 FOR OFFICE USE ONLY PERMIT AFPLICA TION PLAN CHECK No.LP30Ult'% CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. _________ _ Plan Ck. Depo.~•:.:it="="------,--~ Validated By•"""/.--,L..::..\--=,,..,'-,-,+- Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Proposed Use # of Bedrooms II of Bathrooms 2. CONTACT PERSON,Clf different.from appllc■ntl ,-r- 3. APPLICANT Name Address Name Address 6. CONTRACTOR· COMPANY· NAME City O.wner 0. Agent-for Owner City o.,,s City State/Zip Telephone# Fax II State/Zip Telephone# State/Zip Telephone II (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 exem tion. An-,.,.violation of Sec ion 7031.5 by any applicant for a permit subjects the applic t to a civil pe alty of not r• t an five hundre ctollars 001). ;..µ.u,..,.L...:.!f.-;\..:..Ql.!,JO.:n.,µ~1~~2U,.,'t--~3~2:.1..._~~:......s~~~S'.J..__JI....Q.bf!.j~~•~~~H:::7~k~o'--JLU.::-..lL0~37 Address City State/Zip License Class <'.!---Sb Designer Name Address City State/Zip Telephone State License # _________ _ 6. WORKERS' COMPENSATION Workers' Compensation Declaration: J hereby affirm under penaltv 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 will maintain workers' compensation, as required by Section 3700 of the Labq.r_ CJda, for the perf~ance of the work tor which this permit is issued. My worker's compensation insurance carrier and policy number are: < /J'~L-I 34# t'> Z ?D / I Insurance Company (i?r O ~' f' s.s,iVe ;r:,,. ,'ic,L(<ullCe ()I Polley No. I i p RI I it aaa, -b' Expiration Date O ~IO f O '2---- ITHIS SECTION NEED NOT BE OMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) I O CERTIFICATE OF EXEMPTION: I certify that in the performance of the work tor which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' co nsatlon coverage Is unlawful, and shall subj■ct an employer to criminal p■naltles and civil fines up to one hundred thousand doJlara I$ 001, in addition e coat of compensation, damages as provided for In Section 3706 of the labor co , lnter,,t d attorney'• feea. SIGNATURE c DATE / L_ 7. I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D 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). 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 contractorts) licensed pursuant to the Contractor's License Law). D I am exempt under Section ______ Busines5: and Professions Code for this reason: 1, I personally plan to provide the major labor and materials for construction of the proposed property improvement. D YES ONO 2. I (have I 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 / 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-RESIDENTIAL BUILDINO 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? D YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D 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. 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(i) Civil Code). LENDER'S NAME ______________ _ LENDER'S ADDRESS ________________________ _ 9. APPLICANT 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. l agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Cit\' of Cartsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO £.AVE, 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 tor 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 not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a perio f 180 days (Section 106.4.4 Uniform Building Code). ,...,,,,,-/tJ !o--- APPLICANT'S SIGNATURE ~_,\.=:'-/5-c::=~_;~'f::.'.:c~=====:..____________ DATE ___ J_.::?_-/./ ·'...!'. l:._...(..L,J.{;--___\L~-'::::==- WHITE: File YELLOW: Applicant PINK: Finance l r 0.Jor~ . m City of Carlsbad Bldg Inspection Request For: 05/16/2002 . . Permit# CB021446 Title: TIRNACKUS • REPLACE EXIST GAS Description: LINE TO EXISTING BBQ & FPLACE Type: PLUM Sub Type: Job Ad~ress: 1~SHOREBIRD LN Suite: 1:.;...~ Lot 0 Location: / 3 ,:;r,_,. APPLICANT TOWN & COUNTRY Owner: HAYASHI ROBERT Remarks: Total Time: Inspector Assignment: Phone: 7606442943 Inspector: ---- Requested By: REX CD Description 21 Underground/Under Floor Entered By: ROBIN (J /) Act Comment ~ &P-----1,Wi~~~-:-- Associated PCRs Inspection History Date · Description Act lnsp Comments