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HomeMy WebLinkAbout1560 CORMORANT DR; ; CB121866; Permit09-19-2012 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB121866 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC #: Project Title: 1560 CORMORANT DR CBAD PME 2156500204 Lot#: BELLOWS RES-REPLACE 40 GALLON GAS WATER HEATER, SAME LOCATION IN GARAGE Applicant: AFFORDABLE WATER HEATERS AND PLUMBING INC 28372 CONSTALLATION RD VALENCIA CA 91355 855-345-9087 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: OwnGf MIMI BELLOWS 1560 CORMORANT DR CARLSBAD CA 760-931-1577 ISSUED 09/19/2012 SKS Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees $31.00 $0.00 $0.00 $64.00 TOTAL PERMIT FEES $95.00 Total Fees: $95.00 Total Payments To Date: $95.00 Balance Due: $0.00 Inspector: FINAL APPROVAL /6//C/lcA^ Date: Clearance: NOTICE: Please take NOTICE thSt 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 pemiit 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 sut)sequent 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 connectton with this project. NOR DOES IT APPLY to any fees/fixactions of which vou have previouslv been given a NOTICE similar to this, or as to which the statute of limitations has previouslv othenvise expired. CITY CARLSBAD O F Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 www.carlsbadca.gov Plan Check No. Est. Value Plan Ck. Deposit Date Qt-(^-(^ JOB ADDRESS SUITE((/SPACE#/UNIT# CT/PROJECT # PHASE* # OF UNrrs # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCa GROUP DESCRIPTION OF WORK: /nchM t^jmre Feet of Affected Areata) EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YESD # . NOD AIR CONDITIONING YES O NO • FIRE SPRINKLERS YES • NOD CONTACTNAME (IfafferentFomApplicant) APPUCANT NAMF ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL Perm PROPERTV OWNER NAME 11 A CONTRACTOR BUS. NAME ADDRESS /- ^ ADDRESS CITY 1 y/i/l^ / 1 STATE ZIP CITY STATE ZIP FAX PHONE FAX EMAIL' EMAIL Permits ^ 4U)hAp. com ARCH/OESIGNER NAME & ADDRESS STATE UC. # STATE UC.# CLASS CITY BUS. UC.# (Sec. 7031.5 Business and Professions Code; Any City or County whicti 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 exemption. Any violation of Section 703£5 by any applicant for a pemiit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)). WORKERS COMPENSATION Workers' Compensation Declaration: I hereby affirm under psnaUy of perjury one of tfie foSowing dedarations: a I have and will maintain a certificate of consent to self-ftisurs for workers' compensation as provided by Seclion 3700 of Ihe Labor Code, for Ihe performance of the work for which this pemiit is issued. H^have and will maintain workers' compeosadon. as required by Sedkm 3700 of the Labor Code, for the performance of the wodi for which Ihis oemiit is issued. My workers' compensation insurance cajrier and policy number are; Insurance Co. !jInS. CC- Of The„ UlgST Policy No. U)Bfl gOaOSOSOO Expiratton Date I I * 1 This seclion need not be completed if Ihe permit is for one hiihdied dollars ($100) or less. G Certificate of Exemption: I certify that in the performance of the worit for whk;h Ihis pemiit is issued, I shall not emptoy any peison in any manner so as to become subject to the Woriters' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and ctvH fines up to ons hundred thousand dollars (&100,000), in addition to the cost of compensation, daina^ as orovided fprtiiyteclkin 3706jiMk Labor code, interest and attorney's fees. >€S'CONTRACTOR SIGNATURE X-^\J U"^ SIAGENT DATE ^•iu^'i^ OWNER-BUIIDER DCCLARATIOfJ / hereby affirm Uiaf I am exempt from Contractor's License Law for the loSowing reason: a I, asowner of the pmpeF^o^my^employees with wages^-thelrsole compensatnn, will do the work and the stmcture is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's Ucense Law does not apply to an owner of property who builds or improves thereon, and who does such woik himself or through his own empkiyees, provided tiat such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of complelion, the owner^bullder will have the burden of proving that he dkl not buikl or improve for the puipose of sale). a I, as owner of Ihe property, am exclusively contracting with Itoensed contractors to constmct the project (Sec. 7044, Business and Professkins Code: The Contractor's Ucense Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) luensed pursuant to the Contractor's Ucense Law). • I am exempt under Seclkm Business and Professkins Code for this reason: 1.1 personally plan to provide the major labor and materials for constmctton of the proposed property improvement OYes GNo 2.1 (have / have not) signed an applicatkin for a buikling permit for Ihe proposed wori(. 3.1 have contracted with the foUcmng person (firm) to provide the proposed construction (include name address / phone I contractors' license number): 4.1 plan to provide portions of the wori<, but I have hired the foltowing person ki coordinate, supervise and provkle the major worit (include name / address / phone / contractors' Itoense number): 5.1 will provide some of the work, b,ut I t)pve contracted (hired) the foltowing persons to provide the worit Indicated (include name / address / phone / type of wortt): COMPtETE THIS SECTION FOR N O N - R E S I D E N T I A t BUILDING PERMITS ONLY Is Ihe applicant er future building occupant required to submit a business plan, acutely hazardous materials registration fbmi or risk management and prevention program under Secttons 25505,25533 or 25534 of the Pieslly-Tanner Hazardous Substance Account Act? • Yes • 1^ Is the appltoant or future building occupant required to obtain a pemiit from the air pollution control district or air quality management district? • Yes • hto Is the facility to be constnKted wilhin 1,000 feet of the outer boundary of a school site? 13 Yes ONo 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. CONSTRUCTION LENDING AGENCV I hereby afflrm that there is a construction lending agency for the performance of the wotk this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address APPLICANT CERTIFICATION 1 certily that 1 haffi read the appikation and state thatthe above infomiatkin isconect ami thatthe infoiim I hereby authorize representative of Ihe City of Carisbad b enter upon Ihe above mentioned property ft^ AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAD CfTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA An OSHA pemiil is leqUred Ibr excavatnns over S'O'deep and demolilion or constiix&^ EXPIRATION: Every permit issued by tie Buikling Offidal under Ihe provisions of Ihis Code shaH expire by 11^ 180 days Inxn tie date of such pemiit w if the buMng or vicrit authorized by such pemiit i^ jS^APPUCAirrs SIGNATURE DATE Inspection List Permiti^: CB121866 Type: PME BELLOWS RES-REPLACE 40 GALLON GAS WATER HEATER, SAME LOCATION I Date Inspection Item Inspector Act Comments 10/15/2012 25 Water HeaterA/ents - RI GATE CODE 7909 10/15/2012 25 Water HeaterA/ents PY AP 10/15/2012 29 Final Plumbing PY AP Tuesday, October 16,2012 Page 1 of 1