HomeMy WebLinkAbout1600 CORMORANT DR; ; CB002262; Permit06/13/2000
City of Carlsbad
Plumbing Permit Permit No CB002262
Building Inspection Request Line (760) 602-2725
Job Address
Permit Type
Parcel No
Reference #
Project Title
1600 CORMORANT DR CBAD
PLUM
2156500308 Lot# 0
Construction Type NEW
PEYROT RES-NEW WATER HEATER
Status ISSUED
Applied 06/13/2000
RMA
06/13/2000
06/13/2000
Entered By
Plan Approved
Issued
Inspect Area
Applicant
CENTRAL PLUMBING HTG & COOLING
6152 MISSION GORGE ROAD #H
SAN DIEGO,, CA 92120
619-283-5531
Owner
PEYROT MARIO E
1600 CORMORANT DR
CARLSBAD C A 92009
9964 06/13/00 0001 01 02
C-PRMT 27.00
Total Fees $27 00 Total Payments To Date $0 00 Balance Due $27 00
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
0
0
0
1
0
0
$2000
$000
$000
$000
$000
$700
$000
$000
$000
$000
$000
TOTAL PERMIT FEES
T HAS EXPIRED IN ACCORDANCE WITH U.B.C.-1^106.4.4
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 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, C A 92009 (760)438-1161
'PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr , Carlsbad CA 92009
(760)438-1161
PROJECT INFORMATION
FOR OFFICE USE ON,
PLAN CHECK NO
EST VAL
Plan Ck Deposit
Vahdater/By
Date
Address (include Bldg/Suite »)Business Name (at this addrejs]
Leoal Description
Assessor s Parcel *
Description of Work
Lot No ^Subdivision Name/Number
i , . , i Existing Use
' SQ Ft *of Stones
Unit No Phase No
Proposed Use
otel » of units
f of Bedrooms * of Bathrooms
2 CONTACT PERSON (H different from »pplicent)
N«me
3 . APPLICANT 08 o
Address City
for Contractor Q Owner D Agent for Owner
State/Zip
Name Address City
PROPERTY OWNER Cflrlsfaa/J
City State/Zip Telephone »Name I ' Address
S CONTRACTOR - COMPANY NAME " ~~ —* "——'- ~—" "—— - — ~
(Sec 7031 5 Business and Professions Code Any Crty or County which requires a permit to construct, alter improve demolish or repair any structure prior to its
issuance also reauires 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, end the basis for the alleged
exemption Anv violation of Section7031 5 by any applicant for a permit subjects the applicant to a civil P#ial;y of not^nore than five hundred dollars |s$OOI)
Name
State License #
Address
Uc.ns. Class CJSk _
City (J J State/Zip u ' Telephone »
, HJT. City Bu»r»s, Uceos. f t/V9(ffC>O
State/Zip TelephoneDesigner Name Address City
State License »
6 WORKERS COMPENSATION
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
Jjj$ 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 pz^Lf7)A£-lrS J^.SL-X/Zl/"lCg_ Policy No/-^f)/C^/~ JOl ~ / (0 Expiration DateJ
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS |»1001 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 eny person in any manner so es
to become subject to the Workers Compensation Laws of California
WARNING Failure to aecure workers compensation coverage la unlawful, end shall subject en employer to criminal penalties end civil tines up to one hundred
thousand dollars (8100 000) Inaddrjkxi to the coat of compensation, damagese* provided tor In Section 3706 of the Labor code, interest and attorney s tees
SIGNATURE fuQjPPl) ^faPftl/Tfifl ') I (pjfjfP L /Ji&Qy- DATE _(0 ~/£ 'CO
7 OWNER-BUILDER DECLARATION ' C/H) — IT"'-?*-' . . »rn -
I hereby affirm that I am exempt from the Contractor s License Lew for the following reason
Q I as owner of the property or my employees with wages as their sole compensation, will do the work end the structure Is not intended or offered for sale
(Sec 7044 Business and Professions Code The Contractor s License Law does not apply to en owner of property who builds or Improves thereon, end who does
such work himself or through his own employees, provided that such 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 have the burden of proving thet he did not build or Improve tor the purpose of sale)
Q I as owner of the property am exclusively contracting with licensed contractors to construct the project (Sec 7044, Business end Professions Code The
Contractor s License Lew does not spply to en owner of property who builds or improves thereon end contracts for such projects with contractors) licensed
pursuant to the Contractor s License Law)
Q) I am exempt under Section Business and Professions Code for this reason
1 I personally plan to provide the major labor and materials for conatruction of the proposed property Improvement f"1 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 / sddress / phone number / contractors license number)
4 I plan to provide portions of the work, but I have hired the following person to coordinate, supervise end provide the major work (include name / address / phone
number / contractors license number) __^__^__^____^__^^__^__________^_^^_^__^^_^__^___^__^_^__^__^_^^_^_^^_^_
5 I will provide aome of the work but I have contracted (lured) the following persons to provide the work Indicated (Include name / address / phone number / type
of work)
PROPERTY OWNER SIGNATURE DATE
COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY"
Is the applicant or future building occupant required to submit a business plan, acutely hazardous metenate registration form or risk management and prevention
program under Sections 25505 25533 or 25534 of the Presley-Tenner Hezerdous 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? D 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 ~ " "' " " ~ ~'~ '"" ' -•—'•-- - - — -• -
I hereby affirm that there is a construction lending agency for the performence of the work for which this permit is issued (Sec 3097(0 Civil Code)
LENDER S NAME LENDER S ADDRESS
9 APPLICANT CERTIFICATION " " " ""~ - ' " ~ ' " »-•=•* ••-•*.-»-
I certify that I have read the application and state that the ebove 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 Cit» 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 prov.s,ons of this Code shall expire by limitation and become null and void ,f the bu.ld.ng or
work authorized by such perm,, ,. no, commenced within 365 days from the data of such perm,, or if the building or work authorized by such permit ,s suspended
or aoandoned at any time after the work ,s commencedJor a period of 180 days (Section 106 4 4 Uniform Butldino Code) suspended
APPLICANT S SIGNATURE
Uniform Building Code)
DATE
WHITE File YELLOW Applicant PINK Finance
06.'28,'89 MON 14 20 FA.I roiicy iiutnixf 12)001
ACORD. INSURANCE BINDER (MI
6/29/1S99
TW8 BWOER B A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM
PMBDUOK SSTLno: (868)361-3820 COM
LZLAND INSURANCE
V o BOX j>sa
CRESTLINE, CA. 92325 7'
coot 97-45-327 ! aj.ccoe OB92285
£SrS*T«D ^
HSURSD CENTRAL PtUMBENG, KEATING t COOLING, QIC
LICENSE » 478128 r
c6152-H MISSION GORGE ROAD
SAN DIXCO, CA 9212C
COVERAGES
PRCBeWY CAU«SOCLO5S
| B»8C '; B*O«O | 1 SPEC
1 flAMS l*»OF . i OCCLR ,
SCTRO CA'L TOR CLAIMS MA OC
1 ANY AUTO
A4. C^*N^DAUTOS
S C MGCUL BD A LTTO5 i
1 Mine o AUTOS
NONOW.CDA.TOS
Aim)PWSO«l.ei*»4ACS DEDUCT10LE lALLVehirLtS ' SCHEDULH) VEHCLtS
, ccn.jsorf
I O~MCT TVlANCCi.
GARAGE LIMUJTV
ANYAUTO
MNV BMCCK*
-CENTURA; INSURANCE COMPANY 3599
£A4iCTTvfc DOWATIOMOAYC \ mm Quit 1 rue
VI AM iVll2«1»*.1/1999 12 01 -^ 7/1/2000 ^V1 | •>« ! NOCN
TMIS awOEB IS ISSUED TO CXTUM] COVCRAGE IN THE ASCUC MAMS) COUPANv
MPlKMOFO^MTOH»veMKXesn*«3P0nYllKtiMin)U«*k»>)
NSORED IS A PLUMBING, HEATING C AIR COND
ONTRACTQH
UMfTS
! HEtUCTIBLK CCW*% AMOLBfT
f
tiCH OCCURRENCE I
1
1 MED EXPiAn/oiwp«n«i\ 1
1 PEKSONAL V ADV iNJJKY $
GENERAL AGGREEATT S
PHOOUTTS COMlOrATO 5
. COUBINCDSiN&LtUMlT 1
1 BOOflY INJURY (ra jcaani f
BOOuYihJUfr [Pir icodcni) S
PBOPERTV O/ UAQE S
UED'OU. PAYVCNT9 1
UNINSURED MOTORIST ,J
1 »
' AC TiJM. CASH VALUE
! STATS AMOUNT $
| OTHfcK '
AUTOONLY CAACaOB^T S
OTHiR ThAN ALTTOONLY
eA04ACE>L>CNT I
AGOREO^TC S
BCEES LABflJTV
OTHER THVS LMORe.LA FOR/ RCTt)O CATC FOR CLAIMS MADE
A0109-61-9S
WDfV^C R S COK^CNSATIGN
OMTLOYSTS UOBUTY
»«C«L
NAME & ADDRESS
MCITY OF CARLSBAD f— U(
1200 ELM AVENUE I LOAM i
CARLSBAD, CA 92008-2389
flOTMC
X
1 EACH OCCURRENCE S
ALGtEGATC S
I SELFJMSURSDHrrDVTlCN 'I
1 V[ ! vvc STATUTORY LIMITS
| CL eACMACciofcMr .'11,000,000
J EL 03CAIC tABIPLOYH 1 1 1 , 000 , OOO
CL DISEASE PO.CYL.Mn 51,000,000
rss 5603
TAMS i
ESTIMATHJ TOTAL PREMIUM ' t U , 918
ORTGAGEE ADDfTTONALINSLHSB
»S PAYtt
MB£O «AlteaO<TATNC x^
ACORO 75-S (1/98) MOTE IMPORTANT STATE INFORMATION ONJjgfeRSE SI06__J^AeO«J?6RK>RAfbM ISJj'