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HomeMy WebLinkAbout1790 CALLISIA CT; ; CB090685; Permit04-24-2009 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB090685 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # PC# Project Title 1790CALLISIACTCBAD PLUM 2158812703 Lot# Construction Type SERGERSON RES REPLACE WTR HTR 0 NEW Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 04/24/2009 KG 04/24/2009 04/24/2009 Applicant AFFORDABLE WATER HEATER 24707 SAN FRANANDO RD SANTA CLARITA, CA 91321 661 259-7131 Owner SEGERSON JUDITH A 1790CALLISIACT CARLSBAD CA 92011 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 Additional Fees 0 0 0 0 1 0 0 $2000 $000 $000 $000 $000 $700 $000 $000 $000 $000 $000 $000 TOTAL PERMIT FEES $2700 Total Fees $27 00 Total Payments To Date $27 00 Balance Due $000 Inspector 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 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 City of Carlsbad 1635 Faraday Ave , Carlsbad, CA 92008 760-602-2717 /• 2718 / 2719 Fax 760-602-8558 Building Permit Application Plan Check No Est. Value Plan Ck Deposit Date JOB ADDRESS ) -i £ n CT/PROJECT# DESCRIPTION OF WORK Aft £<xue s LOT* Place Mo r*(M PHASE # * , # OF UNITS fl|Alt0A <i^S' \J J S**!*^ I oc,&Tf*of\ * EXISTING USE PROPOSED USE » BEDROOMS SUITE*/SPACE#/UNI™ APN /I # BATHROOMS TENANT BUSINESS NAME CONSTR TYPE OCC GROLP UWer Neater GcN./"tfv(^.(L V* GARAGE (SF) CONTACT NAME (If Different Fom Applicant) ADDRESS CITY STATE PHONE EMAIL PROPERTY OWNER NAME _-Uol-tV ZIP FAX JLWfov•N ADDRESS " S 6\fv\Q— CITY PHONE . _- . £5%- £OM ~ H ( STATE -»03 ZIP FAX EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LIC # PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES D # NO D YES D NO O YES D NO D APPLICANT NAME .5c9tt I- '+T} €-?{£,! #• ADDRESS BelocJ CITY STATE ZIP PHONE FAX fefel-^TI •• 7 '3 ' (obi ~£5>Q" ^f5"f> EMAIL .^Scott @ AuMP.Cot* CONTRACTOR BUS NAME/JFFAr^/xtlg I0a.ter Heccters: ADDRESS CITY STATE ZIP M*U>HA// £^* ^133-1 PHONE IFAX EMAIL STATE LIC # 1 CLASS CITY BLS LIC* (Sec. 7031S Business ind Professions Code Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance alsolicensed niirsuant to the provision! of the Contractor s License Law {Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code} or that he isSection (Oil 5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500}) also requires the applicant (or such permit to Tie a signed statement that he isL~ E exempt therefrom and the baits for the alleged exemption Any violation of | !j&'.f'.1JB*»*^^iK*»w:^'!3&'!^^ l^IfcgllililC^ Workers' Compensation Declaration / hereby affirm under penalty of perjury one of the following declarations illpffwt ifcl1** D 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 Ihe work for which this permit is issued Cfl I have and will maintain workers'compensation as required by Section 3700 of the Labor Code for the performance of the work for which thispermit is issued My workers compensation insurance carrier and pel cy number are Insurance Co pfelMTK . Policy No ^.Q b*7f T f70 3 Expiration Dale I - / ' I C This section need not be completed if the permit is for one hundred dollars ($100) or less O Certificate of Exemption I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of 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 (&1QQ,OQO), m addition to the cost of compensation, damageiOas provided for in Section 3706 of the Labor code, Interest and attorney's fees ^CONTRACTOR SIGNATURE XQjQtf'l . DATE V - I &" - VWX%SVZ!n^m^^,^Ws!K^?S^^^WWlVVi~'Vit|piU:illii;D;E,;ic«fD:E.:Ci^A;i»iAiT;l;0!.N:; / hereDy affirm that I am exempt from Contractor s License Law tor the following reason d I, as owner of the properly 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 Coniracloi 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 wilhm one year of completion (he owner builder will have the burden of proving that he did not build or improve tor Ihe purpose of sale) D 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 contractor(s) licensed pursuant to the Contractor s License Law) a I am exempt under Section Business and Professions Code for this reason 1 I personally plan to provide the major labor and materials for construction of Ihe proposed property improvement D Yes O No 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 address / phone / contractors license number) 4 I 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 I will provide some of the work but I have contracted (hired) the following persons to provide (he work indicated (include name / address / phone / type of work) ^PROPERTY OWNER SIGNATURE 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 Ihe Presley Tanner Hazardous Substance Account Act? Q Yes 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? D Yes O N'o Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 Yes O No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPAh 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 tfiat I have read trie 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 (he City 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 excavators ever 5'G" deep and demolition or construction of structures over 3 stones in height EXPIRATION Every permit issued by the Building Official under the provisions of this Code shall expire by Mtabon and become null and void if the building or work authorized by such permit is not commenced within 16t) days from the (fate of su* penriit or if the buildina or wonV aulhonze^ ^APPLICANT'S SIGNATURE DATE ( ^ ' O City of Carlsbad Bldg Inspection Request For 10/02/2009 Permit* CB090685 Title SERGERSON RES REPLACE WTR HTR Description Inspector Assignment 1790 CALLISIA CT Lot Type PLUM Sub Type Job Address Suite Location OWNER SEGERSON JUDITH A Owner SEGERSON JUDITH A Remarks Phone 8582047663 Inspector Total Time CD Description 25 Water Heater/Vents Act Comments Requested By JUDITH Entered By CHRISTINE Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments WMI 023140pm 01-06-2009 2/3 ACQR& CERTIFICATE OF LIABILITY INSURANCE PRODUCER (661)948-1003 FAX (661)948-1533 Walter Kort'ensen 'Insurance License fOO44424 1113 West Ave H-4 *C Palmdale, CA 935S1 INSURED Affordable Water Heaters & Plumbing, Inc. 24663 Railroad Avenue Newhall, CA 91321 "SAW/SB" THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW INSURERS AFFORDING COVERAGE INSURER A. Zenith Insurance Conpany INSURERS' INSURER C INSURERS INSURER E. NAIC* COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDtTION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS MSRLTR A MJDtHSR TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY | CLAIMS MADE | j OCCUR GEM L AGGREGATE UMTT APPLIES PER.n««*n5& nLOC AUl GAf fOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS (AGE LIABILITY ANY AUTO EXCESS/UMBRELLA LIABILITY | occur; | | CIAH-SHADE 3 DEDUCTIBLE RETENTION ( WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETORyPARTNERtXECLN '\ L- OFFICERWEMBER EXCLUDED' 1 yes describe under SPECIAL PROVISIONS Selow OTHER POLICY NUMBER Z067898703 POLICY EFFECTIVEDATE rMM/DDlYYI 01/01/2009 POLICY EXPIRATIONDATE fMM/DD/YY) 01/01/2010 LWITS EACH OCCURRENCE DAMAGE TO RENTED PRFUIRFR (Fa nry^ifnpr^ MED EXP (Any one person) PERSONAL & AOV INJURY GENERAL AGGREGATE PRODUCTS COMP/OPAGG COMBINED SINGLE LIMIT (Es acaoem) BODILY INJURY (Per person) BODILY INJURY (Per acadenl) PROPERTY DAMAGE (Per accident) AUTO ONLY EA ACCIDENT OTHER THAN LA ACC AUTOONLY AGG EACH OCCURRENCE AGGREGATE 1 WCSTATU- 1 OTH1 TORY 1 IWITS 1 PR E L EACH ACCIOLN1 E.L. DISEASE EAE'.PLOYEE EL DISEASE POIICYIIM1T t s s % ( I $ s t t i $ $ 5 $ S > $ s 1,000.000 $ 1,000,000 $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS ' VEHICLES / EXCLUSIONS ADU6D BY ENDORSEMbW / SPECIAL PROVISIONS .ertificate of Insurance CERTIFICATE HOLDER CANCFLIATION Affordable Water Heaters & Plumbing Inc 24707 Railroad Avenue Santa Clanta, CA 91321 SHOULD «sr OF T"E AbOVP. DESCRIBED POLICIES 5C CANCELLED BLi 0UC Till" IXBR-'IOf CATC 'n£lREOF THE ISSUING INS.IRI.K Wl 1 t NDLAUIK fO Mill _10 DA', S WRITIES NOTICE TO T.HE CERTIFICATE MO-DER NAMED TO THE LETT BUT FA.LURE TO MAIL SUCH NOTICE SHALL IMPOSE MO OBLIGATION OK L.ABILIVY OF ANY KIKO UPON THE INSURER ITS ACLNIS OK KEPKtSI Nl AIKEM HTHOB:?.". P"RtstNTATrvc j' f Mark Hevne/KJN ' ... ACORD 25 ;200>VOS)©ACORO CORPCKATION 1983 State a California ^.-.. CONTRACTORS STATE LICENSE BOARD _ _ — ACTIVE LICENSE 627368 ,., CORP . ~_ AFFORDABLE WATER HEATERS AND PLUMBING INC 09/30/2010