HomeMy WebLinkAbout1003 DAISY AVE; ; CB112695; Permit12-21-2011
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing/Mechanical/Electrical (PME) Permit
Permit No: CBl 12695
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Reference #:
PC #:
Project Title:
1003 DAISY AV CBAD
PME
2144221100 Lot#:
FITZGERALD: REPLACE WATER HEAT
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
12/21/2011
jma
12/21/2011
12/21/2011
Applicant:
ALL STAR WATER HEATERS & PLUMBING
17886 LAKESHORE DR 92530
1-800-727-0977
Ovwier:
FITZGERALD FAMILY TRUST 01-03-07
1003 DAISY AVE
CARLSBAD CA 92011
Plumbing Fees
Electrical Fees
Mechanical Fees
Other PME Fees
$150.00
$0,00
$0.00
$0.00
TOTAL PERMIT FEES $150.00
Total Fees: $150.00 Total Payments To Date: $150.00 Balance Our. $0.00
7^ Inspector:
FINAL APPROVAL
Date: Clearance:
NOTICE: Please take NOTICE that approval of your project Includes the "Imposition" of fees, dedications, reseivations, or other exactions hereafter collectively
refened to as lees/exactlons." You have 90 days from the date this pemnit was issued to protest Imposition of these fees/exactions. If you protest them, you must
follovK 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 accoidance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal actlon'to attack,
review, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified tees/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes, nor planning, zoning, grading or other similar application processing or sewlce fees in connection with this project. NOR DOES IT APPLY to any
fees/exactions of which vou have oreviouslv been given a NOTICE similar to this, or as to which the statute of limitations has previously othenvise expired.
if^ #1 «.
^ CITY OF
CARLSBAD
Builcling Ptrmit Application
1635 Faraday Ave., Carlsbad, CA 92008
760-602-2717/2718/2719
Fax 760-602-8558
vmw.carltbadca.gov
Plan Check No. Cb\\- ^^^C
Est. Value
Plan Ck. Deposit
Date 2d. SWPPP
JOB ADDRESS
CT/PROJECT #
1003 Daisy Avenue
Thisfb
SUnE#/SPACE#/UNIT#
TENANT BUSINESS NAME CONSTR. TVPE I OCC. GROUP # OF UNITS # BEDROOMS * BATHROOMS
DESCRIPTION OF WORK: /nc/ud» 8qu*i« FMt ofAtfaeted Areafs)
Replace existing water heater. Same size and location.
EXISTINO USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE
YESQ* N0| I
AIR CONDITIONING
YES! I NO I I
FIRE SPRINKLERS
YES I |NO| I
CONTACT NAME (II Dltfarant Fom Applicant APPLIOANT NAME Robert Block
ADDRESS ADDRESS 30300 Puerto Vallarta
CITY STATE ZIP CITY Menifee STATE CA ZIP 92584
PHONE FAX PHONE 951 •3454083 FAX
EMAIL EMAIL
PROPERTT OWNER NAME Thomas Fitzgerald CONTRACTOR BUS. NAME All Star Water Heaters
ADDRESS Same as iob
ADDRESS 30300 Puerto Vallarta
CITY Carlsbad
STATE
CA
ZIP
92011
CITY Menifee
STATE
CA
ZIP
92584
PHONE
760-438-1747
FAX PHONE 951-345-4083 FAX
EMAIL EMAIL
ARCH/DESIGNER NAME & ADDRESS STATE LIC.# 812894 C36
crrv BUS. uc.#
(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 otthe Contractor's License Law (Chapters, commending with Section 7000 of Division 3 ofthe 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 (1500)).
WORKERS' C O IM P E N $ A T I O N n
Workan' Comptnittlon DKliration: I hereby afUrm under penally of peijury one of the fijllowtng declarations:
SI hav* and will maintain • caitlficita of eontant to ttlMntur* for workers' compensatkin as provkled by Sectkin 3700 of the Labor Code, for the perfomiance of the woik for which this pemiit is Issued.
I havt and will maintain workart' companiation, as reguired by Sectton 3700 of the Labor Code, for the performance of tha woric fer which Ihls pennit is issued. My woikeis' compensatton Insurance carrier and poltey
number are: insurance Co awilt» «ui» in«. c«. Policy No. ^ Expiratton Dale mmM
Bsection need nol be completed If the pernilt is for one hundred dollars ($100) or less.
Certificate of Exempticn; I certify that in Ihe performance of Ihe wortt for which Ihls pemiit Is Issued, I shall not emptoy any person in any manner so as to become subiect lo the Wortieis' Compensatton Laws of
Callfomia. WARNINQ: Failura to tacurt worker*' compentatlon coverage It unlawful, and thall tubjtct an employar to criminal panaMat and civil finet up to one hundrad thoutand dollart (&100,000), In
addKlon to the cott of compentatlon, difnagat at provldgitbr In Section 3706 of the' -llBi; "^* and attornay't fees. . ,
1^ // ^/l ( A!^ CONTRACTOR SIGNATURE •AGENT DATE
O W N E R - B U I L D E R D E C I. A R A T l O N
I hereby affimi that I am exempt from Conlraclor's Ucense Law for the following reason.'
I I 1, as owner of the property or my emptoyees with wages as Iheir soto compensatton, wHI do the woric and the stiuctute Is not intended or offered for sale (Sec. 7044, Business and Professtons Code: The Contractor's
License Law does not apply to an owner of property who builds or improves thereon, and Who does such wortc himself or through his own emptoyees, provWed that such improvements are not intended or offered for
sale. If, however, the building or Improvement is sokJ within one year of completton, Ihe owner-buikler will have the burden of proving that he did not buikl or Improve for the purpose of sale).
I I I, as owner of the property, am exdusively contracting with Itoensed contractors to oonstwct the project (Sec. 7044, Business and Professtons Code: The Contractor's Ltoense Law does not apply to an owner of
property who buiids or improves thereon, and contracts for such projects with contractorft) licensed pursuant to the Contractor's Ltoense Law).
I I I am exempt under Section Business and Professions Code for this reason:
1.1 personally plan lo provkie the major labor and materials for oonstruction of Ihe proposed property Impravemanl. Q Yes ^jNo
2.1 (have / have not) signed an appltoatton for a buikling pennit for the proposed wortc.
3.1 have conlracted wilh the foltowing person (firm) to provkle Ihe proposed constmctton (include name address / phone / conlraclois' Iteense number):
4.1 plan to provide porttons of the wortc, but I have hired the foltowing person to cooidinate, supervise and provide Ihe major wortc (Include name / address / phone / contractois' Iteense number):
5.1 wiii provtoe some of the wortc, but i have contracted (hired) the foltowing persons to provtoe the wortc indteated (Include name/address/phone/typeol wortc):
>€irPROPERTY OWNER SIGNATURE •AGENT DATE
COMI^IETE THIS SECTION FOR N O N - R E S I D E N T I A I. B Uii. O I N G P £ Pt M tt S P ULY
Is the appltoant orfoture buitoing occupant required to submit a business plan, acutely hazardous malertals registratton form or risk management and preventkm program under Secttons 25S0S, 25533 or 25534 of the
Presley-Tanner Hazardous Substance Account Act? QYes [_JNo
Is Ihe appltoant or future buitoing occupant requiied to obiain a pernilt from the air pollutton control dislrici or alraualitv management district? LJYes Q No
Is the facilily to be constnicted within 1,000 feet of the outer boundary of a school site? n^es LJNo
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
CONSTR tic TION LENDING AGfeNCV
I hereby affirm that there is a constmction lending agency for the perfomiance of the work this permit Is Issued (Sec. 3097 (1) Civil Code).
Lender's Name Lender's Address
APPtlCANT CERTIFICATION
I ceiti^ that I have lead the applhzAon ami state that the abom Infonnaiion is conwt and thM the infomiaton ^
I hereby authorize repiBsentativB of the City of Cartsbad to enter upon the above mentkmed property for inspectton 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:AnOSHApennitlsiequiredfbr excavattons over S'O' deep and demolition or constmction of structures over 3 stories In heighL
EXPIRATION: Every pernilt Issued by the Buikling Oflkjal under the piovisons of this Code shall expire by Itnltatkm and become nun and void if the building or wortc authorized by such pemiit Is not commenced within
180 days fiom the date of such pemiit or If the bui^iaioiHkjuthorized by such pemiit is suspended or abandoned at any lime alter the woric Is oommencBd fof a period of 180 days (Sectton 106.4.4 Unifomi Buikling Code).
>€irAPPLICANT'S SIGNATURE DATE
City of Carlsbad BIdg Inspection Request
For: 12/28/2011
Permit* CB112695
Title: FITZGERALD: REPLACE WATER HEAT
Description:
Inspector Assignment:
Type: PME Sub Type:
Job Address: 1003 DAISY AV
Suite: Lot: 0
Location:
APPLICANT ALL STAR WATER HEATERS & PLUMBING
Owner: FITZGERALD FAMILY TRUST 01-03-07
Remarks:
Phone: 7604381747
Inspector:
Total Time:
CD Description
25 Water HeaterA/ents
Act Comments
Requested By: TOM
Entered By: CHRISTINE
Comments/Notices/Holds
Associated PCRs/CVs/SWPPPs Original PC#
Inspection Historv
Date Description Act Insp Comments