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Home My WebLink About1669 CHAMISAL CT; ; CB101529; Permit08-17-2010 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB101529 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: 1669 CHAMISAL CT CBAD PLUM 2157300705 Lot#: Construction Type: SHINSATO RES REPLACE WTR HTR 0 NEW Status: ISSUED Applied: 08/17/2010 Entered By: KG Plan Approved: 08/17/2010 Issued: 08/17/2010 Inspect Area: Applicant: AFFORDABLE WATER HEATER. 24707 SAN FRANANDO RD SANTA CLARITA, CA 91321 : 661 259-7131 Owner: SHINSATO POWERS REVOCABLE TRUST 1669 CHAMISAL CT CARLSBAD CA 92011 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Drain 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 $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $27.00 Total Fees:$27.00 Total Payments To Date:$27.00 Balance Due:$0.00 Inspector: FINAL APPR Date:Clearance: NOTICE: Please take NOTICE thrf approval of your project includes the "Imposition" of'fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." Y/u 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. Xj[fw^ Building Permit Application vKj^/x 1635 Faraday Ave., Carlsbad, CA 92008 ~^y CITY OF 760-602-2717/2718/2719 /"""' ADI C* D A 1""% Fax: 76°"602-8558 ^AKLOtJAL/ www.carlsbadca.fiov JOB ADDRESS 1 « / Oi f\ f - /vi CT/PROJECT* LOT# PHASE* # OF UNITS * BEDROOMS SUITE#/SPACE*/UNIT» # BATHROOMS TENANT BUSIh DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) S^v.*v\^- loC-<X^"i OKN - \O<^c\C\B.J EXISTING USE PROPOSED USE GARAGE (SF) CONTACT NAME (If Different Fom Applicant) ADDRESS CITY STATE ZIP PHONE FAX EMAIL PROPERTY OWNER NAME -^ y C\-x AI ' fvtfL 3 Ki Ai^cO ADDRESS X CITY STATE ZIP PHONE FAX "lltfO toO"^^T\H EMAIL ARCH/DESIGNER NAMES ADDRESS STATE UC.# PATIOS (SF) DECKS (SF) Plan Check No.C-5£> f 0 I ^^-f Est. Value Plan Ck. Deposit x'y* Date fcV/ 7-/ 0 /^ APN ^^ ESS NAME CONSTR.TYPE OCC. GROUP FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES D # NO D YES D NO D YES D NO D APPLICANT NAME _ .... 1Se-ott DttlefTelel ADDRESS B«.(&fa CITY PHONE EMAIL Perm J STATE ZIP FAX HS@du>HA?. C6ITN CONTRACTOR BUS. NAME /9FFortXftbl£_ uJfltrf^r H€.etT€-rS ADDRESS CITY PHONEf«fcViS^"TI EMAIL STATE UC.# STATE ZIP ] FAX3 1 \ f t \ < CIS -. 4 <"<V3| I Wv\*'w-JT \J**V CUSS CITY BUS. UC.# ; (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 theapplicant 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 theBusiness and Professions Code] or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to acivil penalty of not more than five hundred dollars ($500)). Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: O I have and will maintain a certificate of consent to self-insure for waters' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. M | have and will maintain workers' compegsation, as required by Section 3700 of the Labor Code, for the performance of the wp bnvhjch this permit is issued. My workers' compensation insurance carrier and policy'number are: Insurance Co.V>Policy No.Expiration Date 1 " t " l\ This section need not be completed if the permit is for one hundred dollars ($100) or less. California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100.000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. JSS CONTRACTOR SIGNATURE A&'t . SfAGENT DATE 0"/3"|O / hereby affirm that I am exempt from Contractor's License Law for the following reason: ^ 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). O 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 contractors) licensed pursuant to the Contractor's License Law). I am exempt under Section Business and Professions Code for this reason: 1 . 1 personally plan to provide the major labor and materials for construction of the proposed property improvement. O Yes O No 2. 1 (have / have not) signed an application for a building permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone /contractors' license number): 4. 1 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 / contractors' license number): 5. 1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): vfiJfpROPERTY OWNER SIGNATURE BAGENT 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? DYes D No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? CJ Yes O No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D Yes D No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPAN EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) 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 representative of Ihe City of Carfebad 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 demoffion or construction of structures over 3 stories in height 180 days from Ihe date of such permit or if the .^APPLICANT'S SIGNATURE or woilc authorized by such permit is suspend wabarataied at aty DATE -13-10 City of Carlsbad Bldg Inspection Request For. 01/12/2011 Permit* CB101529 Title: SHINSATO RES REPLACE WTR HTR Description: Sub Type: 1669 CHAMISAL CT Lot: 0 Type: PLUM Job Address: Suite: Location: APPLICANT AFFORDABLE WATER HEATER Owner: SHINSATO POWERS REVOCABLE TRUST Remarks: Please inspect 3:30 to 4:30pm(gate1234) Total Time: CD Description 25 Water Heater/Vents Act Comments Inspector Assignment: Phone: 7607178424 Inspector: Requested By: TINA Entered By: CHRISTINE Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act Insp Comments ACOKO CERTIFICATE OF LIABILITY INSURANCE PRODUCER (661)948-1003 FAX: (661)948-1533 Walter Mortensen Insurance CA License KOD44424 1113 West Ave., M4, Suit* C Palmdalo CA 93551 INSURED Affordable Hater Heaters fi Plumbing, Inc. 24707 Railroad Avenue Santa C^arita CA. 91321 DATE (UWOtVYYYY) 1/5/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE OQES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW \ « INSURERS AFFORDING COVERAGE .t USURER* Zenith Insurance fibmpany MSURERft USURER C WSURERO: (MSURERt NAIC* COVERAGES TH M Ul PCysg\ JOB. A 6 POLICIES OF INSURANCE USTH) BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING IY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR Vf PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRBED HEREM IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONOmONS OF SUCHXJOES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS.wotWSRS TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL UAOUTY ICLAMSMAOE 1 1 OCCUR GEKL AGGREGATE UMT APPLES PER AUTOMOBILE LUBUTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE UABILTTY ANY AUTO EXCESS 1 UMBRELLA LIABILITY ~j OCCUR 1 1 CLAMS MWE DEDUCTIBLE RETENTION t WORKERS COMPENSATION ANY PROPWETOWPARTNERIEXECUnVE 1 1OFFICER/MEMBER EXCLUDED? I (MmtfatoiytnNH) — • ye*, describe underSPECIAL PROVISIONS bdow OTHER POLICY NUMBER COC189fl'704 jS&SISm 1/1/2010 POLICY EXPfUTIONDAT£MMII»rYVYI 1/1/2011 UMTS EACH OCCURRENCE "DAMAGE TO RENtEOPRCMSES IE* ocajmncrt MEDEKPfAryanEpaaonl PERSONAL « AW UJURY GENERAL AGGREGATE PROOUCTS-COMPWAGG COMBMED SMGU UMff (Eatoaien) BODLY INJURY(Perperun) BOOA.YMJURY (Poraoidart) PROPERTY DAMAGE(PWMeidenq AUTO ONLY - EA ACCCENT OTHER TH/W EAACC AUTO ONLY: ^g EACH OCCURRENCE AGGREGATE 1 WCSTATU- 1 JOTHITORYIJMmii 1 FR EJL.EACHACCOENT Ei. DISEASE -EA EMPLOYEE EL DISEASE- POLICY UMTT t t I t t t S S t S t S t S t t t S t 1,000,000 j 1,000.000 S 1,000,000 OESC1llPTK>NOFOPEMTIOKS/LoCATK>MSfVEHCLES(E»ajUSIOMSA[^^ C«rtific*t« of Inroranc*. 10 day; notice of cancellation for non-pofMnt of pcaaium. CERTIFICATE HOLDER CANCELLATION Affordable Water Heaters £ Plumbing Inc 24663 Railroad Avenue Hewhall, CA 91321 SHOULD AMY 01 DATE THEREOF NOTICE TO WE NrFOSENOOai REPRESENTATI = THE ABOVE OESCMBEO POUCCS BE CANCEUEO BEFORE THE EXPWATION . THE ISSUMG MSURCR WILL EMDCAVDR TD MAI 30 DAYS WRITTEN CERTIFICATE HOLDER NAMED TO THE LETT. MIT FAILURE TO DO SO SHALL UGATKM OR UASUTY OF ANY KIND UPON THE WSURER. ITS AGENTS OR WES. . AUTHORIZED REPRESENTATIVE Ronald Burcham/MNASTE <Z? / ' S <7 £%—/' ACORD 25 (2009/01) INS025 (200901) e 1989-2009 ACORD CORPORATION. All rights r»S«rv^l. The ACORD name and logo are registered maria of ACORD