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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'