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Home My WebLink About1215 BASSWOOD AVE; ; CB052936; PermitCity of Carlsbad i 1635 Faraday Av Carlsbad, CA 92008 08-11 -2005 Plumbing Permit Permit No: CB052936 Building Inspection Request Line (760) 602-2725 Job Address: 1215 BASSWOOD AV CBAD Permit Type: PLUM Status: ISSUED Parcel No: 2051122700 Lot#: 0 Applied: 08/11/2005 Construction Type: NEW Entered By: MDP Reference #: Plan Approved: 08/11/2005 Issued: 08/11/2005 Project Title: DARNAY RESIDENCE Inspect Area: WATER HEATER REPLACEMENT Applicant: Owner: ARS DARNEY CHARLENE STE 100 6162 NANCY RIDGE DR 1215 BASSWOOD AVE SAN DIEGO CA 92121 CARLSBAD 92008 858-677-5455 Plumbing Issue Fee $20.00 Fixture or Trap 0 $0.00 Building Sewer 0 $0.00 Roof Drain 0 $0.00 Install/Repair Water Line 0 $0.00 Water Heater and/or Vent 1 $7.00 Gas Piping System 0 $0.00 Vacuum Breaker 0 $0.00 Other Plumbing Fees $0.00 Master Drainage Fee $0.00 Sewer Fee $0.00 Additional Fees $0.00 TOTAL PERMIT FEES $27.00 Total Fees: $27.00 Total Payments To Date: $0.00 Balance Due: $27.00 EXPIRED PEi ». ,, SECTION 106.4.4 AS AMENDED 8Y C.M.C.18.04.W525 ^^OS 0002 01 02CGP 27-00 DATE ^/i SIGNATURE FINAL APPROVAL Inspector: Date: — ' 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, PERMIT APPLICATION , i CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 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.division Name/Number Unit No.Phase No.Total f of units Proposed Use SO. FT. #of Stories |rt^;j!.J^,'^.i|^^!g||^^|p||f^^N!,!?^;j! * of Bedrooms It of Bathrooms Name 3 ' APPLICANT !DGoritraotdr:! Address City iffer Owner {CO State/Zip Telephone #Fax It Address City State/Zip Telephone # Address City State/Zip Telephone #Name 6. "•CONTRACfOR'^COMPANY'-NAMet (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 Codel or that he is exempt therefrom, and the basis for the alleged AnV violation of Section 7031.5 by any appllcantfor a permit subjects the applicant to a civil penalty of not more than five hundred dollars [S500H. Name State License # r\\ Addre _ _ License Class C*£-O City State/Zip City Business License * Telephone # I/I Designer Name Address City State/Zip Telephone State License # 6.' "" WdRk^flS^cbMPtN^fWW^^'-'--*-;:""-••••--i:i::-:;.:;-:^r^fc;:-:^--^^^^ .'-"•:••• Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Q 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. JS. I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company (Y\A^^t4 (X^At Policy No. ^^^^feH^P "O\ Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) f~| 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 timWorkers' Compensation Laws of California. WARNING: Fallurtyio senire workers' compensatlj thousand dollars (SMOCXapjD), in addition to the cos SIGNATURE \S JL/LQ/^X-^-- ' j ( L^AJ-^l 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 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). [J 1, 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 contractor(s) licensed pursuant to the Contractor's License Law). Q I am exempt under Section Business and Professions Code for this reason: tarage Is unlawful, and shall subject an employer to criminal penalties and cfvil fines up to one hundred ~kation, damages as provided for In Section 3706 of the labu£ode| Interest and attorney's fees. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. Q YES QNO 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 1 have contracted (hired) the following persons to provide the work indicated (Include name / address / phone number / type of work): . DATEPROPERTY OWNER SIGNATURE COMPLETE THIS Is 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? Q YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q 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 :: f •" • », »•* '» 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) Civil Code). LENDER'S NAME LENDER'S ADDRESS 9; APPLICANT CERTIFICATION"''- :':> ' ' ' * " ^ -1" < i. J <• ^* 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 b/the\uilding Official under the provisions of this Code shall expire by limitation and become null and void if the building or work aulhorized by such permit is not cbrnrnencedj within 180 days from the date of/Such permit or if the building or work authorized by sucb permil is suspended or abandoned al any time after the work is comoWicedJprla period of 180 days (Sec4bn\lD6H^Hdniform Building Code). /7*Jy~ / WHITE: File YELLOW: Applicant PINK: Finance APPLICANT'S SIGNATURE ^ MARSH PRODUCER ServiceMister Gertificat^Tea MARSH USA. Inc. 500 W. Monroe SI.Chicago. IL 60661 Attn. Fax: 877-732-7799 8112 NSUREO (#81 12)ARS AMERICAN RES OF CALIFORNIA INC. dbaARSOF SAN DIEGO 860 RIDGE LAKE BLVD. MEMPHIS, TN 38120 CERTIFICATE OF INSURANCE CERTIFICATE NUMBER CHI ^10094941 2-01 THIS CERTFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS m NORtQHTSUPONTHE CERTIF CATe HOLDER OTHER THAN THOSE PROVIDED IN THE POLICY- THIS CERTFICATE DOES MOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED fff THE POLICIES DESCRIBED HEREIN. COMPANIES AFFORDING COVERAGE A ZURICH AMERICAN INSURANCE COMPANY IDENTIAL SERVICES • B ILLINOIS NATIONAL INSURANCE COMPANY ; CCMPWIY c COMPANY D COVERAGE* ;;:..\f '-<:;;.- ;: liia-c^lfc^ttf^^ .'• - "•:.-. - - Tn.S IS TO CERTIFY THAT POLICES OF INSURANCE DESCRIBED nERBN lAVE 3EEN iSSuED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF AN* CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE.NSURANCE AF=OROED BY THE POLICIES DESCRIBED HERSN IS SUBJECT TO fLl THE TERMS CONDITIONS AND EXG.USONS OF SUCH POUGES AGGREGATE UMTS 9-OVNN MAY HAVE BEEN REDUCED BY °AIO CLAIMS CO ',-Z! TYPE OF INSURANCEL IK A 1 GENERAL U ABILITY X COMMERCIAL GENERAL LIABILITY ^_j [ CLAMS M«E [ X | QCCUR ' OWIER'S & CONTRACTOR'S PRQT I A AUTOMOBLE LIABILITY X WIY AUTO »LL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NCN-OWJED AUTOS OARAGE LIABILITY ANY AUTO g EXCESS LIABILITY * UMBRELLA FORM t OTHeR THAN UMBRELLA FORM A WORKERS COMPENSATION AND EMPLOYE ftS- LIABILITY • ^.<z._. _ ...—'.— i " 'NCL : a^cSiwe ^ ! '~xa POLICY uuMBCR POLICr EFFECTIVEPOLICY NUMBER DAT£ ^mom) 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 fc BE309-7M7 04/01/Q1 WC 2938643-01 (AOS) 01/01/03 POL ICY EXPIRATION DATE (MMIDDfTY) 01/01/06 01/01/06 01/01/06 01/01/06 04/01/04 01/01/06 LIMfTS GENERAL AGGREGATE PRODUCTS - CCMP/OP AGG °EHSON/1 & WVINJURY EACH OCCURRENCE FIRE DAMAGE {Any oi« «r«) MED EXP (Any 01 « oersan) COMBINED 3NGLE LIMIT BODILY IN JURY (P» p vwn) BODILY IN JURY PROPERTY DAMAGE AJTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY EACH ACCIDENT AGGREGATE EACH OCCURRENCE AGGREGATE $ 5,000,000 S 1 ,000,000 $ 1 ,000,000 $ 1 ,000,000 S 1 ,000,000 S 5,000 $ 1 ,000,000 S * S S ^ll^fSiifiivMi'Sv' $ $ S 5.000,000 $ 5,000,000 S vi WCSTATU- 1 : OTH-f -,•'.*;-,-.... -•--.- AI TORY LIMITS! 1 ER K-. •..--- V: - =" • •• : .•:'• EL EACH ACODENT St. OiSFASe-Pa.iCYL.MtT 5LaaEAaE*KH=MR.avee $ 1 .000.000 S 1 .000.000 $ 1 ,000.000 OTHER QESCRPTION OF OPERATIONSfLOCATIONSfVEHICLESISPectAl. ITEMS CERTIFICATE HOLDIft i CAMCELLAT1OM ! (S*T* C*T? HQ.J?1! f*»N«0 k*»8N =l/T *• ..^f *O Kt»-i SkX>l NOT O! 9+*-. >»*"O* NO OS-, Ci»TOI C« ' . -S- "r o= »wf< HM^ONTHS N3L«=^ *==O*3 NG CCW=^*(K TS*GEWSC* *==a = SEh/T*T v^S O* T>* MARSH USA NC. HIM (3/02) VAUDA30F UJ— 10/26/02