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HomeMy WebLinkAbout111 TAMARACK AVE; 205; CB090185; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 02-03-2009 Plumbing Permit Permit No: CB090185 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 111 TAMARACK AV CBAD St: 205 PLUM Parcel No: 20601121~1 Lot#: 0 Construction Type: NEW Reference #: PC#: Project Title: BOKIDES RES-REPLACE H2O HEATER Applicant: Owner: LARRY A HUDSON PLUMBING SERVICES 4158 POPLAR ST SAN DIEGO CA 92105 858 565-7848 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: Inspector: $27.00 0 0 0 0 1 0 0 Total Payments To Date: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 02/03/2009 RMA 02/03/2009 02/03/2009 $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 $27.00 Balance Due: Clearance: $0.00 NOTICE: Please take NOTICE that approval of your project includes the 'Imposition" of fees, de 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. City of Carlsbad 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718/ 2719 Fax: 760-802-8558 www.carlsbadca.gov Building Permit Application JOB ADDRESS /)) Plan Check No. Est. Value CT/PROJECT# LOT# PHASE# # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) l {l,,::Jv/i,v OF WJ:Jt't:."--.J.-Jc»felr. EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS {SF) CONTACT NAME (ff Different Fom App/leant) APPLICANT NAME ADDRESS ADDRESS CITY STATE ZIP CITY PHONE FAX PHONE EMAIL EMAIL ADDRESS p O Bo! CITY s. ,)C/::.itJJv {'. FAX EMAIL ARCH/DESIGNER NAME & ADDRESS STATE UC.# FIREPLACE YES □# __ NO □ STATE FAX AIR CONDITIONING YES D NOD ZIP FIRE SPRINKLERS YES D NO □ /Ste. 701U Busintu and Profmiont Codt: Any City or Count,: which requires a ptrmit to con1truct, alttr/ improve, demolish or reP.air any 1tructurl!,, prior to its issuance, also requires the aP.plicant for such permit to file a 1!2:ned llatement that he i1 tictnsed pursuant to the pro'fision1 of the Contractor's License Law {Chapm 9, commending with Stclion 000 of D1vi1ion l of the Business and Pro1e11ions Code} or that he is exempt there from, and the basis for the alleged exemption. Any violation of Section 7031.S by any appliun1 for a permit 1ub~ct1 the applicant to a civil penalr:, of not more than fivt hundred dollars {$500}). WORKERS' COMPENSATION Workers' Compensation Declaratlon: 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 ol the Labor Code, for the performance of the work for which this permit is issued. D I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work tor which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. ______________________ Policy No _______________ Expiration Date. __________ _ ~ section need not be completed if the permit is for one hundred dollars ($100) or less. ~-Certificate of Exemption: l certify that in the performance of the work for which this permit is issued, I shall no! employ any person in any manner so as to become subject to the Workers' Compensation Laws of Cahtornia. WARNING: Fallure to secure worker ' ompensatlon coverage Is lawful, and shall subject an employer to criminal penalties and civll fines up to one hundred thousand dollars {&100,000), in addition to the cost of compensation, dama rovided for in Sectio '7 of t1'7Labor code, interest and attorney's tees. 2S CONTRACTOR SIGNATUll!e'--,,.C:---t:"-<-~ I hereby affirm that I am exempt from 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 tor 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 !hat such improvements are not intended or offered for sale. If, however, the building or improvement is sok:I 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 !, 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 ol property who builds or improves thereon, and contracts tor 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 maior labor and materials for construction ol the proposed property improvement. □ Yes □ No 2. t (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/ 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/ contractors' license number): 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the wor'K indicated (include name I address/ phone/ type of work): ,.€5 PROPERTY OWNER SIGNATURE DATE l.s 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? □ Yes □ No Is the applicant or future building occupant required to obtain a permit lrom the air pollution control district or air quality 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 AND THE AIR POLLUTION CONTROL DISTRICT. I certify that I have read the application and state that the above lnfom1atlon Is correct and that the lnfom1ation on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representative of the City 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 Atff WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permtt is required for excavations over 5'0' deep and demolttion or construction of structures over 3 stories in height. EXPIRATION: Every permtt issued by the Building Official under the provislOns of th~ Code shall expire by limitation and become null and void tt the building or work authorized by such permn is not commenced within 180 days from the date of such permn or~ the bu~r work authorized by ch permit is suspended or abandoned at any time after the work is commenced for a penod of 180 days (Section 106.4.4 Un dorm Building Code). 2SAPPLICANT'SSIGNATURE~C,(..4. 4, . ~ DATE GI--03-;;2_ OO"J --··--------- City of Carlsbad Bldg Inspection Request For: 02/11/2009 Permit# CB090185 Title: BOKIDES RES-REPLACE H2O HEATER Description: Type:PLUM Sub Type: Job Address: 111 TAMARACKAV Suite: 205 Lot: 0 Location: APPLICANT LARRY A HUDSON PLUMBING SERVICES Owner: HEINITZ GARY R&NANCY C Remarks: AM PLEASEW Total Time: CD Description Inspector Assignment: Phone: 8585657848 Inspector: L Requested By: LARRY Entered By: JANEAN 25 Water HeaterNents 29 Final Plumbing &ZComments -ftif----- Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act lnsp Comments