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Home My WebLink About1145 CHINQUAPIN AVE; ; CB063217; Permit09 132005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB053217 Building Inspection Request Line (760) 602 2725 Job Address Permit Type Parcel No Reference # Project Title 1145 CHINQUAPIN AV CBAD PLUM 2061401900 Lot# 0 Construction Type NEW CHRISTIAN RES REPLACE WATER HEATER Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 09/13/2005 LSM 09/13/2005 09/13/2005 Applicant ARS STE100 6162 NANCY RIDGE DR SAN DIEGO CA 92121 858 677 5455 Owner JONES CAROLYN LOUISE 1145 CHINQUAPIN AVE CARLSBAD CA 92008 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 $000 Inspector NOTICE Please take NOTICE that approval of your project includes the Imposition of fees dedications reservations or other exactions hereafter collectively referred to as "fees/exactions You have 90 days from the date this permit was issued to protest imposition of these fees/exactions If you protest them you must follow the protest procedures set forth in Government Code Section 66020(a) and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3 32 030 Failure to timely follow that procedure will bar any subsequent legal action to attack review set aside void or annul their imposition You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes nor planning zoning grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave Carlsbad CA 92008 1 PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date <$ ~> Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No _ ^^.Subdivision Name/Number Unit No Phase No Total # of units Existing Use Proposed Use SQ FT #of Stones » of Bedrooms # of Bathrooms 2 CONTACT PERSON (If different from applicant) Name 3, APPLICANT Address City I Contractor §3iAgent for Contractor Q Owner Q Agent for Ownar State/Zip Telephone #Fax tt Name 4 PROPERTY OWNER Address City State/Zip Telephone Address City State/Zip Telephone #Name 5 CONTRACTOR COMPANY NAME * (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 ' 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 [$500DVco ^ CAcMjiJi mrrz_ Name State License tt i\. I Addrt License Class City State/Zip City Business License 0 Telephone # I/l Designer Name Address City State/Zip Telephone State License # 6 WORKERS COMPENSATION Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations n 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 performaice of the work for which this permit is issued M. I have and will maintain workers compensation as required by Section 3700 of the Labor Code for the performance of the work for wh ch tris pe n t is issued My worker s compensation insurance carrier and policy number are Insurance Company (YV\^^t4 U^A Policy No J^\^}^e^\^> ~Ot Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) [") CERTIFICATE OF EXEMPTION I certify that in the performance of the work for which this permit is issued I shall not employ any person n any manne so as to become subject to tlwO/Vorkers Compensation Laws of California WARNING Failurb/to secVe workers compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($MO(X&pjb) in addition to the cosfol/oBipeTTSation damages as provided for in Section 3706 of the Laborttope interest and attorney s fees SIGNATURE MjPLOT\X-^ /I \JLU2\ DATE 7 OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor s License Law for the following reason Q 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 build ng 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) I 1 I as owner of the property am exclusively contracting with licensed contractors to construct the project (Sec 7044 Business and Profess ons 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(s) I ce sed pursuant to the Contractor s License Law) PI 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 Q YES (~lNO 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 / 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 / contractors license number) 5 I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of w k) PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOR NON RESIDENTIAL BUILD/NO PERMITS ONtY Is the applicant or future building occupant required to submit a business plan acutely hazardous materials registration form or risk management and p event on p og am under Sections 25505 25533 or 25534 of the Presley Tanner Hazardous Substance Account Act? fj YES f~l NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? l~l YES O NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? O YES Q 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 8 CONSTRUCTION LENDING AGENCY , I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(i) Ci il Code) LENDER S NAME LENDER S ADDRESS 9 APPLICANT CERTIFICATION 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 CitV 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 EXPIRATION Every permit issued bylhelDuilding Official under the provisions of this Code shall expire by limitation and become null^nd//oid if the building or work authorized by such permit is not cbrntnencedj within 180 days from the date of/auch permit or if the building or work authorized by suchp^fiit/if suspended or abandoned at any time after the work is commanceoVforla period of 180 days (Seflion\1D6l4 4-iniform Building Code) APPLICANT S SIGNATURE Q \ (/J \/^JJ, L/txQ— /[ \ AAAJ^\ DATE WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 09/28/2005 Permit* CB053217 Title CHRISTIAN RES REPLACE WATER Description HEATER Type PLUM Sub Type Job Address 1145 CHINQUAPIN AV Suite Lot 0 Location APPLICANT ARS Owner JONES CAROLYN LOUISE Remarks Inspector Assignment Phone 8586775455ex205 Inspector Total Time Requested By VERONICA Entered By CHRISTINE CD Description 25 Water Heater/Vents 29 Final Plumbing Associated PCRs/CVs Inspection History Date Description Act Insp Comments ^ MARSH PRODUCER Ser/ioeMaste!»Cert!ficate """ea MARSH USA Inc 500 N Monroe St Chicago IL 60661 A tin Fax 877 732 7799 8112 NSUREO (#8112)ARS AMERICAN RES OF CALIFORNIA INC dbaARSOF SAN DIEGO 860 RIDGE LAKE BLVD MEMPHIS TN 38120 CERTIFICATE OF INSURANCE ?™™* THIS CERTFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS m HO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED N "HE POLICY THIS CERTFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AF ORDEO 3Y THE POLICES DESCRIBED HEREIN COMPANIES AFFORDING COVERAGE A ZURICH AMERICAN INSURANCE COMPANY ca -f. IDENTIAL SERVICES B ILLINOIS NATIONAL INSURANCE COMPANY COM ft, C I COVPASV COVERAGE 3 Th is certificate supersedes and replaces any previously issued certificate for the policy period noted bel ow Tn S IS TO CTSTIFY THAT PO.IC S O- I\SU«ANCE DESCRIBED REN HAVE 3c N SSurO TO THE INSur^D NAMeO -K=r<E N OR THc a ICY <=R!OO NDlCAfD NOPMTHSTANDING ANY EQU REMENT T"RM OR CONO TION OF AN" CONTRACT OR OTW=? DOCUMENT WTH RcSP CT TO WHICH THE CERTIFICATE VAY 3E ISSL D OR MAY =RTAIN THE NSURANCT V OROED BY THE POLICES DESCRIBED cRBN IS SUBJECT TO «L THE TERMS COVOTIONS AND cXCLUSONS Or SUCH POL GES AGGREGATE LiVlTSS-'QVW MAY HAV^ 3 N REDUCED BY °«Q CLAIMS CO LT* A A a A TYPE OF INSURANCE 3ENERAL LIABILITY X | COMMEROA. GENERAL IABILITY I | CLAJMSMAOE j X | OCCUR OWNER S 4 CONTRACTOR S PROT AUTOMOBILE LIABILITY X «MY AUTO fLL OWNED AUTOS SCH DUL 0 AUTOS HIRED AUTOS NON OWNED AUTOS | OARAGE LIABILITY «MY AUTOn EXCESS LIABILITY r * UMBRSJ.A CRM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS1 LIABILITY OF CSRSARr ~XC. POLICY NUMBER 'oM^S) GLO 2938645-01 01 01/03 BAP 2938646-01 (AOS) 01/01/03 BAP 2938647-01 (VA) 01/01/03 TAP 2938648-01 (TX) 01/01/03 II BE 309-79-07 04/01/01 \AC 2938643-01 (AOS) 01/01/03 POL ICY EXPIRATION 01/01/06 01/01/06 01/01/06 01/01/06 04/01/04 01/01/06 LIMITS GENERAL AGGREGATE PRODUCTS CCMP/OPAGG OER90NAL & AOVINJURY _ACH OCCURRENCE FIRE 0AM AGE (Any tnef e) MEDEXP(Any<n person) COMBINED 3NGLE LIMIT BOOILV INJURY (Per person) BODILY INJURY (Per accident) PROPERTYD/WAGE AJTOONLY EAACOOENT OTHER THAN AUTO ONLY =ACH ACODENT AGGREGATE EACH OCCURRENCE AGGREGATE ., WC STATU I OTH-X | TORY I MITS I | ~R EL ACH ACQDENT = "3IS5ASE-=a ICY V1IT - T5FASS-'K> MP Ovrr $ 5 000 000 $ 1 000 000 $ 1 000 000 $ 1 000 000 $ 1 000 000 $ 5000 $ 1 000 000 $ $ $ $ $ $ $ 5 000 000 $ 5 000 000 $ $ 1 000 000 $ 1 000000 $ 1 000000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION 3*XO NY O Th* O_ C S 3 SCT 3 t -H= Sf( =< <-R3 NQ COV GE V Ii <X C HO. R r+*M!!) t-PR N tT O NY<N3 rONTH? SLH VARSHUSANC BY Christy N -^hoeDus ^* MH1 (3/02) -P N ONCT 3 CM H= TON 1 HF3 OF KD *VCR 0 ^ Ifl YS VS TT~ NOT C_ A w- LH O SV* =3X» NO CS ">** f^O^ NO O ^T CM Ca j<O NG CO* G- S G~NTSO SENT \^SO^'r>*s ^M^-V? ^&*Z<& VALID A3 OF *J— 10126102