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Home My WebLink About111 TAMARACK AVE; 107; CB101135; Permitl City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 06-21-2010 Plumbing Permit Permit No: CB101135 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 111 TAMARACK AV CBAD St: 107 PLUM Status: Parcel No: 2060112101:> Lot#: 0 Applied: Construction Type: NEW Entered By: Reference #: Plan Approved: PC#: Issued: Project Title: BONES: REPAIR GAS LEAK@ EXTER Inspect Area: Applicant: PROPERTY SERVICE PLUS 12341 OAK KNOLL 92064 858-486-6364 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: BONES KELLY F 16154 CRESTROCK CT PARKER CO 80134 ISSUED 06/21/2010 JMA 06/21/2010 06/21/2010 $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: $27.00 Balance Due: FINAL APl?ROV L Date: '2-7 1.-C> I 0 Clearance: $0.00 approval of your project includes the "Imposition of fees, d ications, 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. ·---------- ~ . Plan Check No. CB101 l 3.S-«,.~ Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value ~ CITY OF 760-602-2717 / 2718/ 2719 CARLSBAD Fax: 760-602-8558 Plan Ck. Deposit WWW.!;;!;! rl~!Jag~ .gQV Date IO {'2-1 I IV t)'· -·vvr \ JOB ADDRESS / I ( tr. l'V\ ... r... c, k Ave ,1,:,1 '- SU~PACE#/UNIT# rPN -7 /0~---- CT/PROJECT# rOT# I PHASE# I# OF 71TS I# BE3MS # BATHROOMS TENANT BUSIN£SS NAME I CONSTR I IM: I occ. GROUP 2.. DESCRIPTION~ WORK: Include Squa,. Feet of Alfected Alea(•) -;, I '-.,., ... .'v---,'A .. -,.A _ " I I h (,,, . , ./ ✓ EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE IAIR CONDlTIONING I FIRE SPRINKLERS YES □#_ NOD YES O NOD YES O NOD CONTACT NAME (ff Dlffetent Fom Applicant) APPLICANT NAME ADDRESS ADDRESS C1TY STATE ZIP CITY STATE ZIP PHONE I FAX PHONE IFAX EMAIL EMAIL PROPERTY OWNER NAME -CONTRACTOR BUS. NAME P. 'r.:/ <,.,, -P4-6 .__ r-'°"'tf'. rv,as · ADDRESS ADDRESS , / Ro .... d /2-~'--( ( 0 ,,..J,c_ /,,i,,,,, I, I CITY STATE ZIP CITY Pt. STATE CA--ZIP "! z~ (:, '-{ OW<><-v PHONE IFAX PHONE ✓ f.5'{-'it (-GJ !,'f l'~st -'f3t-6'f'r( EMAIL EMAIL l ss-f,,+l.t.-fS ts:> .onu:,,r-l-✓~<Zrv,a-s o t.-5' • c.,,,._, ARCH/DESIGNER NAME & ADDRESS 1 STATE UC.# f,TATE££Lf 'l'-/t; f . I°'~ ~ "izt~ l'l'i . (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demohsh or repair any structure, pnor to Its Issuance, also requires the appllcant 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 B_usiness and Professions Code} or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any appllcanffor a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500}). WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one ofth6 following declarations: GI 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 lhls pem,lt is issued. Iii I have and wtll maintain wo ers' mpenpn, as required by Secf 3700 of the Labor Code, for lhe perfonnance of)heP. for which !his permit is I~ My workers' cornpensalion insurarx:e,carrier and policy number are: Insurance Co. :&-• S ..,. V o~ A f'\. PolicyNo.0(()1<.XM.l-2t?OJ. .,.¥~ Expiration Date / f / o I l.1P This seclioo need not be completed if lhe permit is for one hundred dollars ($100) or less . .ii Certificate of Eumptlon: I certify Iha! in the performance of the work for which this pemiit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and dvil fines up to one huAdrad thousand dollars (&100,000), In addition to the cost of compensaUon, damages as p,ovlded for In Section 3706 of the Labor code, Interest and attorney's fees . .,6$ CONTRACTOR SIGNATURE I hereby affinn that I am exempt from Cootrsctor's IJcense Lsw for the fol/owing reason: □ 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 lo an owner of property 'M'lo 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, howevef, the building or improvement is sold within one year of completion, the owner-builder will have lhe burden of proving that he did not build or improve for the purpose of sale). □ I, as owner of the property, am exdusively contracting with licensed contractm to construct the project (Sec. 7044, Business and Professions Code: The Cootractor's License Law does not apply lo an owner of property who builds or Improves thereon, and contracts for such projects with contractor{s) licensed pursuant lo the Contractor's license Law). □ l am exempt under Section _____ .Business and Professions Code for this reason: 1. I personally plan lo provide the major labor and materials for construction of the proposed property improvement. □ Yes □ No 2. I (have I have not) signed an application for a buildlng permit for the proposed work. 3. l have contracted with the foUO'Mng person (finn) lo provide lhe proposed construction (include name address I phone I contractm' license number): 4.1 plan lo provide portions of the woot, but I have hired the following person lo coordinate, supervise and provide the major work (include name I address I phone I 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 I address/ phone/ type of work): ,,1$ PROPERTY OWNER SIGNATURE □AGENT DATie COMP(ETE' THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building OCC1Jpanl required to submit a business plan, acutely hazardous materials registration form or risk management and preV9ntion program under Secllons 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Acf'! □ Yes □ No Is the applicant or future building occupant required lo obtain a pE!fTTllt from the air pollution control disbict or air qua~ly management district? □ Yes □ No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ Yes □ 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 ANO THE AIR POLLUTION CONTROL DISTRICT. (ONSTRUCTION LENDING AGEN(Y I hereby affirm that there 1s a cxmstruct1on lending agency for the performance of the work this permit 1s issued (Sec 3097 (1) CMI Code). Lender's Name Lender's Address APPLICANT CERTIFICATION I certify that I have read the application and state that the above Information Is conect and that the lnfoonatlon on the plans Is aca.iiabl. I agiee to comply with all Cit)' on:llnances and State laws relating to bulldlng conslruc:tlon. I he,eby aullorize repn,senlative ol lhe Cit/ of Callsbad ~ en~r upon lhe aix,.,e rronlilned property for <spec11)n purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY Cl' CARLSBAD AGAINST ALL LWllUTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN f>l,JY WAY ACCRUE AGAJNST SA[) CITY IN CONSEQUENCE OF THE GRANTING Cl' THIS PERMIT. OSHA: AA OSHA pelTTlil is requred b" excavaoons over 5'0' deep and demolition oc construction of structures rNef 3 sbies in heighl EXPIRATION: Every penn~ issued by the Building Offtial under the provisions of this Code shall expire by lrrlitaOOrl and become nuH and void I !he building or work auflorized by sud, pemit is not corrmenced 'Milin 180days tom tie dateof sudl pennil crif lhe buidhg orwor1< aullorized by such penni is suspended or abandoned at any tine after tie v.ak is ccmnenced b a peood of 180 days (Secli:>n 106.4.4 t.kibm Eluildi"lg Code). 'LA!_AP_P_L_ic•_•_r•_•_ .. _ .. _ru_•_• ~-~;.;.~;;:~--:::.-::._:~:=:c::.=i~; _________ o_•_re _ _:6:_,/--=~_:_f !._/.:_I_D=---____ ~ ___ _J City of Carlsbad Bldg Inspection Request For 06/23/2010 Permit# CB101135 Title: BONES: REPAIR GAS LEAK@ EXTER Description: Type:PLUM Sub Type: Job Address Suite: 111 TAMARACKAV 107 Lot: ,~ Location: APPLICANT PROPERTY SERVICE PLUS Owner: ALBRIGHTHELE~MTR /~ "11 1 ~ Remarks ii// I ~ { II . / Total Time: CD Description Act Comments 23 Gas/Test/Repairs Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act lnsp Comments Inspector: ---- Requested By: W' Entered By: CHRISTINE