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HomeMy WebLinkAbout148 TAMARACK AVE; ; CB043685; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB043685 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: Applicant: 148 TAMARACK AV CBAD PLUM 2042530700 Lot#: 0 Construction Type: NEW LESTER RES SEPTIC TO SEWER CONNECTION Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: LESTER TIMOTHY A&DENISE M LESTER TIMOTHY A&DENISE M 460 BEAUMONT DR VISTA CA 92084 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 1 0 0 0 0 0 460 BEAUMONT DR VISTA CA 92084 ISSUED 09/27/2004 SB 09/27/2004 $20.00 $0.00 $15.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $927.00 $0.00 $962.00 Total Fees: $962.00 Total Payments To Date: $0.00 Balance Due: $962.00 1978 09/27/04 ~'Bf9.1. FINAL APPRO~L Date: fO-S-~ Clearance: _____ _ NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reseivations, or other exactions hereafter ccllectively 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 3.32e030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. \ ~) \ O') ',.. 962-00 PERMIT APPLICATION FOR OFFICE USE Oc-% PLAN CHECK NO. t./ ~ 6 ~ CITY OF CARLSBAD BUILDING DEPARTMENT EST. VAL. __________ _ ' 1635 Faraday Ave., Carlsbad, CA 92008 1. / ~,~CI l~Ju)Ae.)(;, i Address (include Bldg/Suite #I 1' ~ Ca;;]di:a,J' Busiil'ess Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Proposed Use Assessor's Parcel # .J (?ascription of Work #of Stories II of Bedrooms # of Bathrooms 2. CONT ACT PE.RSON ·flf different from ~ppjicant} ·, Name Address City State/Zip Telephone II Fax# [;J, APP.LICANT O Co.ntractor ,, 0 Agent for Co_ritractor O Owner O Agen:t for Owner Telephone II ~f3<? '?iv 7:µjg!tff/ 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 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 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 [ $50011. Name Address City State/Zip Telephone# State License # _________ _ License Class _________ _ City Business License II _______ _ Designer Name Address City State/Zip Telephone State License # -======;::,------ 6. WORKERS'-COMPENSATION ~ i"-11·- 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 this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company ____________________ _ Policy No .. ____________ _ Expiration Date. _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100) 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: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100.0001, In addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE DATE "/., CLW!'f~R:BUILDER l;>l;C!,A~1]0tt :"""''"""'""""""""'""~'"' , , ;;;;;;;;;;;;;;;;;;.;;;;;;;;;;;;:;:;:;:::;;;;;:::::::::;;--~~•-=•-·-~-·- I ereby affirm that I am exempt from the Contractor's License Law for the following 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 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, 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 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 I 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 I contractors license number): __ -.,..---------------------------------------------- I will provide some of the work, but llowing persons to provide the work indicated (include name / address / phone num'ber I type f work):. _____ -;-------,~t7,t---------t'"--:=~:-----------------,..,-;'::----::--+--:--.------ PROPERTY OWNER SIG1NATUAE _ _J_~~~:l&t:::!:.,_.L_-"~t--'~'.l.,,~...l.l'...______ DATE t.J_f/ COMPLl;IE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS'ONL Y : • ' • ., ·/ 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 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? 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. [!I,"' CONSTRUCTION.LEN.!;>ING AGENCY """" I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (S ec. 3097(iJ Civil Code). LENDER'S ADDRESS _________________________ _ 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 Cit\' 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. f PIRATION: Every permit issued by the bu· ing Official under the provisions of this Code shall expire by limitation and become null and void if the building or work lhonzed by such permit is nol commenced i in 180 dais from the date of h permit or if the building or work authorized by such permit is suspended or abandoned any time after the work is commenced lo enod of 180 days (Section .4.4 Urn rm Building Code). ~! /4 PLICANT'S SIGNATURE ___ _j~~~:::3::~~~-_J;z'::~~l,..k~-----DATE _L c!:< 7 _d LJ ' • ✓ WHITE: File YELLOW: Applicant PINK: Finance . (i) · City of Carlsbad Bldg Inspection Request . For: 1 0/01 /2004 . Permit# CB043685 Title: LESTER RES SEPTIC TO SEWER Description: CONNECTION Type: PLUM Sub Type: Job Address: Suite: 148 TAMARACK AV Lot 0 OWNER LESTER TIMOTHY A&DENISE M Owner: LESTER TIMOTHY A&DENISE M Remarks: PM PLEASE Total Time: Inspector Assignment: Requested By: TIM Entered By: CHRISTINE CD Description Act Comment 22 _s_e_w_e_r/W_a_t_er_s_e_r_vi_c_e ___ 1_ fr~ ftlc: Associated PCRs/CVs Inspection History Date Description Act lnsp Comments