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Home My WebLink About1255 CYNTHIA LN; ; CB002069; Permit06-01-2000 City of Carlsbad Plumbing Permit Permit No CB002069 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 1255 CYNTHIA LNCBAD PLUM 1562302000 Lot# Construction Type REPLACE WATER HEATER 0 NEW Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 06/01/2000 JM 06/01/2000 06/01/2000 Applicant ARS STE 100 6121 NANCY RIDGE DR SAN DIEGO CA 92121 619-677-5445 Owner AGUNDEZ CARLOS&BELINDA 1255 CYNTHIA LN CARLSBAD CA 92008 Total Fees $2700 Total Payments To Date $000 Balance Due $2700 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 TOTAL PERMIT FEES 0 0 0 1 FIRED P $2000 $000 $000 $000 $000 $700 $000 $000 $000 $000 $000 106.4.4 SIGNATURE. Inspector FINAL APPROVAL 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 capactiy 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 2075 Las PalmasDr, Carlsbad, CA 92009 (760)438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las. Palntas Dr., Carlsbad CA 92009 (760)438-1161 FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date Address (include Bld Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total * of units Assessor's Percel *Proposed Use SQ FT tof Stories # of Bedrooms # of Bathrooms Fax* m? linn sn.ra Q7171 Name J f] Address* City State/Zip Telephone * (Sec 7031 5 Business and Professions Coda Any City or County which requires a permrt to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed ststement that he Is licensed pursuant to the provisions of the Contractor's License Lew (Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that ha Is exempt therefrom, end the basis for the alleged exemption Any violation of Section 7031 5 by any applicant for a permrt subjects the applicant to a civil penalty of not more than five hundred dollars ($5001) ARS/DBA COAST/MAIO/TORREY PINES PLUMBING 6121 NANCY RIDGE PR #100 SD.CA 92121 Name Address City Stste/Zip Telephone 9 r * n **--,-, r- . A r- StateLicense, 742039 License Clas^/C- 36 /C- 20 City Business License * 1030700 1619)677-5445 Designer Name State License # '«. -WORKERS' COMPE Address City State/Zip Telephone NSATK)I»C^¥I^^^^ 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 0 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 AON Insurance Policy NA 7082973 Expiration Datfc 04-01-0| (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) Q 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 to unlawful, and shin subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (4100,000), In addition to the costgf compensation, damages as provided for hi Section 3706 of the Labor code, rnteresjend attorney's fees SIGNATURE \J jUJLATvl L^f \fY\C ^L^dhhji DATE ^1 ?A \ F^Jte&^-s^^issssssx^^ ^zp^Km® 1 hereby affirm that I arKWempt from the Contractor's License Law for the following reeson D I, es 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 end Professions Code The Contractor's License Law does not epply to en owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that auch improvements ere not intended or offered for sale If, however, the building or improvement is sold within one year of completion, the owner-builder will heve the burden of proving that he did not build or Improve for the purpose of ssle) l~l I, as owner of the property, em exclusively contracting with licensed contractors to construct the project (Sec 7044, Business end Professions Code The Contractor's License Law does not apply to en owner of property who builds or improves thereon, end contrects for such projects with contrsctor(s) licensed pursuant to the Contractor's License Lew) l~l I em exempt under Section _^_______ Business end 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 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 / contrectors license number) __^____ 5 I will provide some of the w>rk, but I have contracted (hired) the following persons to provide the work indiceted (include name / address / phone number / type of work) PROPERTY OWNER SIGNATURE DATE COMPLETETHIS SECTION FOR TOWtfEtfaai-'^AU^^ 1V/ Is the applicant or future building occupant required to submit s business plsn, acutely hazardous materials registration form or risk management and prevention program under Sections 25S05, 2SS33 or 25534 of the Presley-Tanner Hezardous Substance Account Act?- Q ¥E6 — Q- NO Is the applicant or future building occupant required to obtain e permrt from the air pollution control district or air quality management district 7 Q YES D 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 e^coNSTHucnOfJ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(0 Civil Code) LENDER'S NAME ___ _ LENDER'S ADDRESS I certify that I have read the application and state that the above information is correct 'end that the information on the plans is accurete I agree to comply with ell City ordinances end State laws relating to building construction I hereby authorize representetives 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 stones in height EXPIRATION Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permrt is not commenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned et any time after^he work is commenced for a penod of 180 days (Section 108 4 4 Uniform Building Code) LC _ DATEAPPLICANT S SIGNATURE WHITE File YELLOW Applicent PINK Finance ACQBD. CERTIFICATE OF LIABILITY INSURANCE 'moouem Lipscomb & Pitts Ins., LLC 2670 Union Avenue'Extended Suite 200 Memphis, TN 38112 THIS comncATE ooes NOT AMEND, EXTEND ORtun THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A. National Union Fire Ins. Co.INSUREDAmerican Residential Services Inc. dba 860 Ridge Lake Blvd Memphis, TN 38120 INSURER B American Home Assurance INSURER a American International South Ins. INSURER a Illinois National Insurance Co. INSURER & COVERAGES THE PODGES OF MSURANCE LISTED BELOW HAVE BEEN KSUED TO THE NSURED NAMED ABOVE FOR THE POLICY PEROONDICATED NOTMTHSTANDMG ANY REaUW=VENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VWTH BESPECT TO WHICH THIS CERTFICATE MAY BE ISSUED OR MAY PERTAIN. THE WSURANCE AFFORDED BY THE POLICES OESCRBED HERBN IS SUBJECT TO AU. THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE UMTS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAMS. NSRLTR A B B D B B C D TYPEOF INSURANCE GENERAL LIABILITY J{_COMMEHCIALSENSRAL LIABILITY ~~] CLAIMS MADE) X I OCCUR GEN LAGQRB3ATE LIMIT APPLIES PER | POLICY fxl^f fxllOC AUTOMOBILE LIABILITY X X X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS OARAGE LIABILITY ANY AUTO EXCESS LIABILITY | OCCUR (__j CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY OTHER ^^^^^rffTW^^^^^Mli tVi'f1 Mri 1 ' ••Vi^fi'i'Vl'i'/' J^^^^^^^Btfff^^^^^^^Mi 9330417 OS: 8260281 TX: 8260280 BE3097907 OS: 7082974 CA: 7082973 GA: 7082982 IL: 7082976 04/01/00 04/01/00 04/01/00 04/01/00 04/01/01 04/01/01 04/01/01 04/01/01 EACH OCCURRENCE FIR E OA MAG E (Any on* nra) MED EXP(Any on* pwson) PERSONAL & AOV INJURY GENERAL AGGREGATE PRODUCTS -COMP/OPAGG COMBINEDSINGLE LIMIT(Ea accident) BO OILY INJURY(Pw person) BOOILYINJURY(Per •ctidonl) PROPERTY DAMAGE tParaccutonl) AUTO ONLY- EA ACCIDENT QTUCBTU4M EAACC AUTOONLY AGG EACH OCCURRENCE AGGREGATE Y IWCSTATU- 1 IOTH-rroRY LIMITS 1 PER £L EACH ACCIDENT EL DISEASE-EA EMPLOYEE E.L DISEASE POLICY LIMIT •1. 000,000 '1,000,000 s5,000 (1,000,000 •1.000.000 11,000,000 si, 000, 000 t t t s t *s2, 000. 000 s2, 000, 000 $ t 1 si, 000, 000 si, 000,000 si, 000, 000 DESCRIPTION OF OPERA TIONS/LOCATIONS/VEHICI. SB/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONSBranch # CERTIFICATE HOLDER ADDITOWAL INSURED-. INSURER LETTER CANCELLATION 1 SHOULOANYOFTHEABOVEOESCRIBEDPDLICIESBECANCEllEDBEroRETHEEXPIRATION OATETHEREOr.THEBSUINO INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICETOTHE CERTIFICATE HOLDERNAMEOTOTHELEFT. BUT FAILURE TO DOSOSHAIL IMPOSE NO OBLQATION OR LIABILITY OF ANYKINO UPON THEINSURER,IT3 AGENTS OR REPRESENTATIVES AUTMOftaeD MPflESENTATIVE^Z-,fe ACORD 25-8(7/97)1 of 2 *S13830/M13828 AIW ACORD CORPORATION 1968