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Home My WebLink About1003 DAISY AVE; ; CB081153; Permit06-17-2008 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB081153 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # PC# Project Title 1003 DAISY AVCBAD PLUM 2144221100 Lot* 0 Construction Type NEW FITZGERALD RES REPALCE WTR HTR Status Applied Entered By Plan Approved issued Inspect Area ISSUED 06/17/2008 KG 06/17/2008 06/17/2008 Applicant FAST WATER HEATER COMPANY 12601 132NDAV NE KIRKLAND WA 98034 4258143124 Owner FITZGERALD FAMILY TRUST 01-03-07 1003 DAISY AVE CARLSBAD CA 92011 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Dram Install/Repair Water Line Water Heater and/or Vent Gas Piping System Vacuum Breaker Other Plumbing Fees Master Drainage Fee Sewer Fee Additional Fees 0 0 0 0 0 1 0 $2000 $000 $000 $000 $000 $000 $700 $000 $000 $000 $000 $000 TOTAL PERMIT FEES $2700 Total Fees $27 00 Total Payments To Date $27 00 Balance Due $000 Inspector FINAL APPROVAL Date Clearance NOTICE Please take NOTICE tnat 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 bd 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 *nd sewer connection fees and capacity changes nor planning zoning grading or other similar application processing or service fees in connection with this prop-l NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired From Fax #760-602-8558 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave, Carlsbad CA 92008 407574 06/17/2008 12 49 rwrv wrrivrc i PLAN CHECK EST VAL 8208 P 006/009 Ran Ck. Deposit Validated Date 1003 DAISY AVE Address (Include BWg/Sute #)Business Name (at Ate address) Legal Description Lot No Subdivision Name/Number Unit No PhasaNo Totals of units Assessor's Paresis Existing Usfl Proposed Use DesortpBonofWortc Remove/Replace Gas Water Heater so. FT # of stories # of Bedrooms # of Bathrooms Name Address Telephone #Fax* KIRKLAND. WA 98034FAST WATER HEA Name Address City Telephone* FITZGERALD. THOMAS CARLSBAD. CA 92011 (760)438-1747 Name Address State/Zip Telephone # (Sec. 7031S Business and Professions Code Any Crty or County which requires a permit to construct, altar Improve demolish or repair any structure pnor to Its Issuance also requires the applicant for such permit to ffle a signed statement that he Is licensed pursuant ID tte provisions of trwContrsttoi'sUoanselJW (Chapter 9, com mereJ Ing with Section 7000 of Division 3 of the Business and Professions Code] or that he Is exempt thereftom and the basts for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applcant to a cMI penally of not more than five hundred dolars [$600]) FAST WATER HEATER COMPANY 12601 132ND AVE NE KIRKLAND. WA 98034 800454-8955 Name Address City State/Zip Telephone # State License a 877489 Ueensa Pass _ C36 Cttv Business License S 1222302 Address dty Telephone? State License* Workers' Compensation DecteraSon. I hereby afflrm under penalty of perjury one of the following deotarattons: D I have and wffl maintain a eertnsate 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 penult Is Issued. J5 I have and wffl martaln worksfs compensation as required by SecBon 3700 of the labor Code tor the performance of the work for which this penult Is Issued. My workaTe compensation Insurance canter and policy number are. Insurance Company California State Fund _ Policy No 1761660 _ Bmhattan Data 12/1/08 _ (THIS SECTION NEED NOT BE COMPLETED IP THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100] OR LESS) D CERTIFICATE OF EXEMPTION I certify that In the performance of the wo* far which this permit Is Issued I shal not employ any person In any manner so as to bacoma subject to the Workers' Compensation Laws of California. WARNING Failure to secure workers' compensation eovange to unlawful, and ahaS subject an employer to criminal penaWas and cIvO fliwa up to on* hundred thousand doUarsffillKMlOO), hi addition to tta cost of compensation, damages are provided for tnSectton 3706 of the Labor Coda, interest and attorney's fees. E 6/17/08SIGNATURE.DATE_ __ I hereby afflrm that I am exempt from the Contractors License Law for tha fotowlng reason. n I, as owner of the property or my employees wtm wages as their sole compensation will d me wo* 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 buBds or Improvas maraon and who does such work himself or through hta own employees, provided that such Improvements ate not Intended or offered for sale. If however the building or Improvement Is sold wlWn one year of completion, the owner-builder wID have the burden of proving that he du not buHd or Improve for fte purpose of sate). D I as owner of the property am exclusively contacting 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 wttfi contractors) licensed pursuant to the Contractor's License Law). a I am exampt under Section _ Bustrtess and Professions Code for mte reason 1 I peraonaJfy plan to orovkto thorns^ later art materials for con^ D NO 2. I (have/have not) signed an application tor a bunding permit for the proposed work. 3 I have contracted wifli 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 / /ontraotors license number)' _____^^_____^________^___^^_______________^__^^_________ 5. I will provide some of the work, but I have contracted (hired) the foflowtng persons to pnwkle the worit Indicated (Include name /addngss/ phone number /type of work): PROPERTY OWNER SIGNATURE..DATE. From OB/17/2008 12 51 tt208 P 007/003 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad CA 92008 Page 2 of 2 la the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration tor or risk management and prevention program under Sections 2550B 26533 or 2B534 of the Presley-Tanner Hazardous Substance AooQuntAor? DYES D NO Is flie applicant or future buftSng occupant required to obtain a permit from the air poDutton control district or air quaDry management district? D YES D NO lEttetacfflrytotecoretructedwiminlflOTfeetoffteouterbourrfarybfascftoolsrtB? n YES O NO REQIjr(«r^TSOFTO I hereby affirm that there IB a construction lending agency for the performance of me wort for wIMi this pennlt la Issued (Se& 3097(1) CMI Code) LENDER-SHAME LENDER'S ADDRESS I certify that I have read the applcaOon and slate mat the above Information te correct and that the Information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to bidding construction I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for Inspection purposes. 1 ALSO AGREE TO SAVE. INDEMNIFY AND KEEP HARMLESS THE CtTY OF CARLSBAD AGAINST ALL UABH.ITIES, JUDGEMENTS, COSTS AND EXPENSES WHICH MAY M ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA. An OSHApermRIa reeled foreww'atlonsofS'O'deep enddemanfionOT EXPIRATION Every permit Issued by the building Official under the provisions of his Code shall expire by llmlMon and become null and void ff the bunding or work authortzed by such permit Is not commenced within 180 days from the date of such permit or fftr^buikfing or wc^aumorized by su* permit Is suspended or abandoned at any time after the work Is commenced fbrapertod of 180 days (Section 108A4 Uniform Bidding Code) APPUCANTSSIQNATURE.DATE.06/17/2008 City of Carlsbad Bldg Inspection Request For 07/09/2008 Permit* CB081153 Title FITZGERALD RES REPALCE WTR HTR Description Inspector Assignment Type PLUM Sub Type Job Address 1003 DAISY AV Suite Lot 0 Location APPLICANT FAST WATER HEATER COMPANY Owner FITZGERALD FAMILY TRUST 01-03-07 Remarks P-M-PLEASE> Phone 7604381747 Inspector Total Time CD Description 25 Water Heater/Vents ,ct Comments Requested By TOM Entered By CHRISTINE Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments Fron 06/17/2008 12 48 »208 P 005/008 POUCYHOLDER COPY NB COMPENSATION P° BOX 420807' SAN FRANCISCO,CA 94142-0807 INSURANCE FUND CERTIFICATE OP WORKERS1 COMPENSATION INSURANCE ISSUE DATE- 12-01-2007 GROUP POLICY NUMBER 1761680-2007 CERTIFICATE ID: 10 CERTIFICATE EXPIRES- 12-01-2008 18-01-2007/12-01-2008 CONTRACTORS STATE LICENSE BOARD NB LIC PERMIT* 877488 WORKERS COMPENSATION UNIT INCEPTION DATE: 12-01 -2007 PO BOX 26000 DO NB SACRAMENTO CA 95826-0028 This Is to certify that we hove Issued a valid Workers' Compensation Insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period Indicated. This policy Is not subject to cancellation by the Fund except upon 90 days advance written notice to the employer We will also give you 30 days advance notice should this policy be cancelled prior to Its normal expiration This certificate of Insurance Is not an Insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which Iftls certiftcate of Insurance may be issued or to which it may pertain the insurance afforded by the policy described herein Is subject to all the terms, exclusions, end conditions, of such policy \aUTHORIZED REPREKNTATWEJ PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS $1,000,000 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 12 -01 -2003 IS ATTACHED TO AND FORMS A PART OF THIS POLICY EMPLOYER PAST HATER HEATER COMPANY (A CORP) NB 12601 132ND AV6 Iffi KIRKLAND UA 88084 (REV a-OB) [B11.Se] PRINTED 12-08-2007