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HomeMy WebLinkAbout1120 CHESTNUT AVE; ; CB101207; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 06-30-2010 Plumbing Permit Permit No: CB101207 Building Inspection Request Line (760) 602-2725 Job Address: 1120 CHESTNUT AV CBAD Permit Type: PLUM Status: ISSUED Parcel No: 2051202500 Lot#: 0 Applied: 06/30/2010 Construction Type: NEW Entered By: LSM Reference*: Plan Approved: 06/30/2010 PC#: Issued: 06/30/2010 Project Title: HALL RES- REPLACE WTR HTR Inspect Area: Applicant: Owner: HANNA PLUMBING HALL THOMAS L&MONICA H TRUST 06-03-97 643 S. SANTA FE 4115 SKYLINE RD VISTA CA 92083 CARLSBAD CA 92008 760-726-2002 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 0 0 0 0 1 0 0 $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $27.00 Total Fees: $27.00 Total Payments To Date: $27.00 Balance Due: $0.00 FINALAPPROVAL Inspector: JL v ky-i**^ Date: &&l °*f /<» Clearance: NOTICE: Please take NOTICE that 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 bar 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 and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. 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. CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave.t Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 www.carlsbadca.gov Plan Check No/2& f 0 Est. Value Plan Ck. Deposit Date JOB ADDRESS CT/PROJECT *LOT*PHASEi SUITE#/SPACE»/UNIT# TENANT BUSINESS NAME CONSTR. TYPE I OCC. GROUPf OF UNITS I # BEDROOMS * BATHROOMS DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) Rep(M & EXISTING USE PROPOSED USE GARAGE (SF)PATIOS (SF)DECKS (SF)FIREPLACE YESD #NOD AIR CONDITIONING YES O NO D FIRE SPRINKLERS YES D NO D CONTACT NAME (If Different Font Applicant) Ju,V » APPLICANT NAME ADDRE ADDRESS CITY STATE ZIP CITY , eft-STATE ZIP PHONE FAX PHONE FAX R-C. 0 EMAIL rvA P D EMAIL I A EWM^^I -)t/uvx ft??PROPERTY OWNER NAME CONTRACTOR BUS. NAME J°/ ADDRESS ADDRESS S. CITY CWU STATE ZIP CITY STATE ZIP PHONE FAX PHONE AX EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS CITY civil penalty of not more than five hundred dollars {$500}). SW O R K E RS € OM P E N $ A "t! O N Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: 13 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. r;r I have and will maintain workers' compensation, ai required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatiojl insurance carrier and policy number are: Insurance Co.&.AYV3y|i/toViUl /VUvwUrKit: fl^V KS fH*»CVPcilicy No. ^-Ot b(X> 3?34fe ^ 6 3 Expiration Date \ I i I J- O > ) \ • This section need not be completed if the permit is for one hundred dollars ($100) or less. GK Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (4100,000), in addition to the cost of compensatiojvdamages as provided for in Jiection 3706 of the Labor code, interest and attorney's fees. JS$CONTRACTORSIGNATURE^~L\ ^~\ t-"''~~X__-- ~- f)JAGENT DATE (/ <-% 6 -(o B UI't» £ tt;: tf f ;Cli;A B A'T l.o H / hereby affirm that I am exempt from Contractor's License Law for the following reason: D 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). D 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 contractors) licensed pursuant to the Contractor's License Law). d I am exempt under Section Business and Professions Code for this reason: 1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement. O Yes O No 2.1 (have / have not) signed an application for a building permit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): 4.1 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): 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): ^PROPERTY OWNER SIGNATURE DAGENT DATE COM PL E TE TH IS SECTION FOR N ON-R £ SI OENTI A L B U I I, O I N G PERM ITS '.ON L Y Is the applicant ovfuture 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 Presl^-Tanner Hazardous Substance Account Act? a Yes ONo Is the'pplicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q Yes G No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? OYes D No EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. CON STR UCT1ON LE N DIN G AGENCY I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address A P P L f C A N T C E R T J F I C A T'f O N ' I certify that I have read the application and state that the above information is correct and that the informatics on the plans is aca rate J agree to comply with all City onlirances and State laws relating to building construction. I hereby authorize representative of to City of Carlsbad to enter upon Ihe above mentioned property^ COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID OTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.AGAINST ALL LIABILITIES, JUDGM OSHAAnOS EXPIfWION: ._-—"7 ^APPLICANT'S SIGNATURE DATE ^z_r City of Carlsbad Bldg Inspection Request For: 08/02/2010 Permit* CB101207 Title: HALL RES- REPLACE WTR HTR Description: Inspector Assignment: 1120 CHESTNUT AV Lot: 0 Type: PLUM Sub Type: Job Address: Suite: Location: OWNER HALL THOMAS L&MONICA H TRUST 06-03-97 Owner: HALL THOMAS L&MONICA H TRUST 06-03-97 Remarks: CALL W/ETA PLEASE Phone: 7607300913 Inspector: Total Time: CD Description 25 Water Heater/Vents 29 Final Plumbing Requested By: ED Entered By: JANEAN Act Comments AT ft Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act Insp Comments HANNPLU-01 CWG ACORDa CERTIFICATE OF LIABILITY INSURANCE PRODUCER (858) 541-2900 Vanorsdale Insurance Services 4909 Murphy Canyon Road, Suite 510 San Diego, CA 92123 INSURED Hanna Plumbing and Supply, Inc. 643 Santa Fe Avenue Vista, CA 92083- DATE (MMIDfVYYYY) 12/31/2009 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATEHOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR* ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE MSURERA: Pennsylvania Manufacturers' Association INSURER B: INSURER C: INSURER D: INSURER E: NAIC# COVERAGES MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR"jjL A IDDTfiSRD TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY | CLAIMS MADE | | OCCUR GENt AGGREGATE LIMIT APPLIES PER: ~~] POLICY! I SECT I I LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS/UMBRELLA LIABILITY I OCCUR | | CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS- LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? If y«, describe under SPECIAL PROVISIONS below OTHER POUCY NUMBER 2010003396363 POUCY EFFECTIVEFIATF tMMJPtMYYl 1/1/2010 POLICY EXPIRATIONDATE (liMJOC/YY) 1/1/2011 LIMITS EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurencel MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMFTOP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per parson) BODILY INJURY (Per accident) PROPERTY DAMAGE(Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN ^* A*'C AUTO ONLY: AGG EACH OCCURRENCE AGGREGATE V 1 WCSTATU- 1 lOTH-A 1 TORY LIMITS 1 1 ER EL EACH ACCIDENT EJ_ DISEASE - EA EMPLOYEE EJ_ DISEASE - POLICY LIMIT $ t t $ $ t $ $ $ $ $ J $ $ $ $ $ t j 1,000,00( , 1,000,00( , 1,000,00t *10 Day Notice of Cancellation is Provided for Non-Payment of Premium* Re: All Operations. CERTIFICATE HOLDER CANCELLATION City of Carlsbad 1635 Faraday Avenue Carlsbad, CA 92009- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAR. 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AU^RrZEOREPRESEHTATWE _£^ ^=jL^ * — * — *^-0^ <sx^rr fs^p^ i. »_ ACORD 25 (2001/08)© ACORD CORPORATION 1988