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