HomeMy WebLinkAbout1331 CHINQUAPIN AVE; ; CB070816; Permit03-26-2007
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing Permit Permit No CB070816
Building Inspection Request Line (760) 602-2725
Job Address
Permit Type
Parcel No
Reference #
Project Title
1331 CHINQUAPIN AV CBAD
PLUM
2061403600 Lot# 0
Construction Type NEW
MCFADDEN RES REPLACE WTR HTR
Status
Applied
Entered By
Plan Approved
Issued
Inspect Area
ISSUED
03/26/2007
KG
Applicant
AFFORDABLE WATER HEATER
24707 SAN FRANANDO RD
SANTA CLARITA CA 91321
661 2597131
Owner
MCFADDEN FAMILY TRUST 02 07-97
1331 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
1
0
0
$2000
$000
$000
$000
$000
$700
$000
$000
$000
$000
$000
$000
TOTAL PERMIT FEES $2700
Total Fees $27 00 Total Payments To Date $27 00 Balance Due $000
Inspector
FINAL APPROVAL
Date $~'*Clearance
NOTICE Please take NOTICE that approval of your project includes the Imposition of fees dedications reservations or other exactions hereafter collectively
referred to as fees/exactions You have 90 days from the date this permit was issued to protest imposition of these fees/exactions If you protest them you must
follow the protest procedures set forth in Government Code Section 66020(a) and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3 32 030 Failure to timely follow that procedure will bar any subsequent legal action to attack
review set aside void or annul their imposition
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes nor planning zoning grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any
fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave , Carlsbad, CA 92008
A
FOR OFFICE USE ONLY
PLAN CHECK
EST VAL
Plan Ck Deposit
Validated By~
Address (include Bldg/Suite tt}
Legal Description
Assessor & Parcel #w$acJL lOfc
Description of Work
Business 1
Lot No Subdivision Name/Number
, ( Existing Use
SQ FT
'AM\JL A
ttof Stories
Name (at this address)
Unit No Phase No
' j Proposed Use
tt of Bedrooms
Total tt of units
tt of Bathrooms
fent from applicant) %*<„
Name Address City
ontraotor " Q Owner JD Aaent torJ3wner
* e,AV $
Fax tt
Name Address City State/Zip Telephone if
(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
Anyjriolatipn 9f Sectipn 793,1 f by any. applipa/tt for a pj}nm subjects the applicarrt to ajjivil^nalty of rjpunore than five hundred dolj^fp l^jSOOl
NameU / nO —7 *2. / C/ Address ^-
State License it <-£ ^^ / \^\J" 0 License Class ( .
^j i City ' State/Zip Telephone # /~ )Pr~£\ (^
j _? Lz? City Business License tt j LA 1 2-~7 1
Designer Name Address
State License tt
City State/Zip Telephone
Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations
l~) 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
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
ed My worker s compensation irjsyrance carljer and policy number are , _,,-,,-, ^.^-—,/^^ I 1 ^/-t. <")
or the
N?f I
/issued
Insurance Company
Dispensation insurance carfier an
Policy No Expiration Date_
(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
thousand dollars ($100
SIGNATURE
compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred
ie cost of compensation damages as provided for in Section 3706 of the LaboF-cj^de'] jnteiesy ajid-e^torney s fees
DATE
I hereby affirm that I am exemprftojrf 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)
Q 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 contractor(s) licensed
pursuant to the Contractor s License Law)
O I am exempt under Section Business and Professions Code for this reason
1
2
3
I personally plan to provide the major labor and materials for construction of the proposed property improvement f| YES
I (have / have not) signed an application for a building permit for the proposed work
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 work) ____ _ _ _ _ _
PROPERTY OWNER SIGNATURE DATE
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? CD YES Q NO
Is the facility to be~£onstructed 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
"ftuLi CCLNSTRgCIIOri'LENDING'AGENlCY > _, f *'« ~ > L _ t , -'»." ' ,
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 30970) Civil Code)
LENDER S NAME _ LENDER S ADDRESS
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 by the building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work
at any time after the work is cornmeAcexMor a/f enod/efNl80 days (Section 106 4 4 Uniform Building Code)
APPLICANT S SIGNATURE DATE
WHITE File YELLOW Applicant PINK Finance
City of Carlsbad Bldg Inspection Request
For 05/01/2007
Permit* CB070816
Title MCFADDEN RES REPLACE WTR HTR
Description
Inspector Assignment
1331 CHINQUAPIN AV
Lot 0
Type PLUM Sub Type
Job Address
Suite
Location
OWNER MCFADDEN FAMILY TRUST 02-07-97
Owner MCFADDEN FAMILY TRUST 02-07-97
Remarks!
Phone 7607297432
Inspector
Total Time
CD Description
25 Water Heater/Vents
Act Comments
Requested By JEAN
Entered By CHRISTINE
Comments/Notices/Holds
Associated PCRs/CVs Original PC#
Inspection History
Date Description Act Insp Comments
LETTER OF AUTHORIZATION
"I, undersigned, give permission to accept any of the signatures that appear below,
on a permit being issued, in lieu of my signature at the counter I hereby certify
under penalty of perjury, that I will comply with all declarations and agreements on
the permit, which bears my signature or my representative signature, and as
required by this city "
The following authorized representatives have my permission to sign and take
receipt of construction permits m thejiangp<ff my company
Leonce Roux
Contractor Name
Katie LaKamp
Cpnteactoj; Signature
Authorized Representative Ai iresentative Signature
Undersigned Contractor Information
Leonce Roux X>V^ ^ <5/3~/ /£>Ci
Contractor's Name //
Affordable Water Heaters and Plumbing Incf
Company Name x
24707 San Fernando Road, Santa Clarita CA 91321
Company Address
The Zenith
Worker's Compensation Insurance Carrier
627368 C36
Contractor's State License Number and Class
Signature
661-259-7131
Phone Number
661-259-9556
Ysx. Number
#2067898701
Policy Number
09-30-2006
Expiration Date
Date c
01/01/2007
Expiration Date
CMNUKT ACTIVE LICENSE
627368 CORP
AFFORDABLE WATER HEATERS AND
PLUMBING INC
—*> C36
t,..»o. 09/30/2008
TheZenith
ZENITH INSURANCE COMPANY
Company No 13145
21255 CAL1FA ST WOODLAND HILLS CA 91367
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
INFORMATION PAGE
ITEM1
INSURED
NAME AND
MAILING
ADDRESS
PHYSICAL
LOCATION
PRODUCER
091177A
100
Renewal of Z067898701
AFFORDABLE WATER HEATERS AND PLUMBING INC
24707 SAN FERNANDO RD
SANTA CLARTTA, CA 91321
Policy Number Z067898702
DIRECT BILL
24707 SAN FERNANDO RD
SANTA CLARTTA CA 91321
Policy Type WN
Line NON-PARTICIPATING
Entity CORPORATION
Billing Type PAYROLL
Frequency MONTHLY
OTHER WORKPLACES NOT SHOWN ABOVE FEIN 95^660066
See WC-00-99-05 - ADDITIONAL LOCATION ENDORSEMENT
HOGAN INSURANCE SERVICES, INC
PO BOX 7419
THOUSAND OAKS CA 91359-7419
ITEM 2 The Policy Period is from 01/01/07 to 01/01/08 12 01 A M standard time at the tnsured's mailing address
ITEM3 A Workers Compensation Insurance Part One of the policy applies to the Workers Compensation Law of the
states listed here
CALIFORNIA
B Employers Liability Insurance Part Two of the policy applies to work in each state listed in item 3 A The
limits of our liability under Part Two arc
Bodily Injury By Accident $ 1,000,000 Each Accident
Bodily Injury By Disease $ 1,000,000 Each Employee
Bodily Injury By Disease $ 1,000,000 Policy Limit
C Other States Insurance Part Three of the policy applies to the states if any listed here
All states except states listed in item 3 A and
NORTH DAKOTA, OHIO, WASHINGTON WEST VIRGINIA, WYOMING
D See attached list for endorsements and schedules
ITEM 4 The premium for this policy will be determined by our manuals of Rules, Classifications, Rates and Rating
Plans All information required below is subject to verification and change by audit
See endorsement WC-99-00-01 RATING SCHEDULE
Total Estimated Annual Premium $ 141977
Minimum Premium $ 500
Deposit Premium $ 24 470
Countersigned At Woodland Hills CA On 12/29/06 By
WC-OO-OO-OIA
rr»ov