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Home My WebLink About1790 CALLISIA CT; ; CB090685; Permit (2)04-24-2009 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 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 $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 youi 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 J60 6P2 2717 /• 2718 / 2719 Fax 7606028558 Building Permit Application Plan Check Est Value Plan Ck Deposit Date JOB ADDRESS m(? (^VU^^ CT/PROJECT# LOT# PHASE* # OF UNITS ((BEDROOMS SUITE#/SPACE#/UNIT# APN // ((BATHROOMS 1 TENANT BUSINESS NAME CONSTR TYPE OCC GROUP DESCRIPTION OF WORK Replace, Mo aftltflA a^vi U>*ter Ncoftrj j S«m€ iOC&f/Dft; G<xr^c\<L V EXISTING USE PROPOSED USE GARAGE (SF) CONTACT NAME (It Different Fom Applicant) ADDRESS CITY STATE ZIP PHONE FAX EMAIL PROPERTY OWNER NAME _- i».a x-, OU.G»»tH iJLA&rioYN ADDRESS J S t\TV\ft_ CITY STATE ZIP PHONE . __ , . _, IFAXS5&-50H - 1l*t3 X EMAIL ARCH/DESIGNER NAME 4 ADDRESS STATE LIC « PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES D # NO D YES D NO D YES D NO D APPLICANT NAME .Sittt Uff/tFfiiM ADDRESS Btteu) CITY STATE ZIP PHONE FAX fefel-,^'7/31 W/-^5^'9r«. EMAIL _Scott @ AUMlCom CONTRACTOR BUS NAME/JFFa relate UVter Heceterj ADDRESS JHfto Rai/rcftcl »\te CITY STATE ZIP M«u>hA/J ^A 9/34I PHONE FAXfcfcf-^^orAo EMAIL STATE LIC # 1 CLASS CITY BUS LICK fr*"?*^ | <L3t> /»7^7/ (Sec 7031S Business and Professions Code Any City or County which require:! a permit to construct, alter improve, demolish or repair any structure, prior to it! issuance also requires the applicant for such permit to file i signed statement that he islicensed .pursuant to the provisions of the Contractors 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 eiemption Any violation ofSection 7031S by any applicant for i permit sublets the applicant to a civil penalty of not more than five hundred dollars {$500}) K.H'Xi;1' Worker* Compensation Declaration I hereby affirm under penalty of perjury one of the foltowmg declarations I O I have and will maintain a certificate of consent to self Insure for workers compensation as provided by Section 3700 of the Labor Code lor the performance of the work for which this permit is issued ' GO I have and will maintain workerscompensatlpn as required by Section 3700 of the Labor Code for the performance of the work for which thispermit is issued My workers compensation insurance came: and pol cy ''• number are Insurance Co ^feFMTK Policy No %.Q b*7f T f*) D$ Expiration Date I *" / " I C This section need not be completed if the permit is for one hundred dollar ($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 ciny manner so as lo 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 (&100 000) in addition to the cost of compensation damageiflas provided for In Section 3706 of the Labor code Interest and attorney s fees J&I CONTRACTOR SIGNATURE AdQtf'L- DATE ^-" I &" I hereby affirm that I am exempt from Contractor s License Law for (he following reason I as owner of the property or my employees with wages as their sola 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 properly 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 hat he did not build or improve for the purpose of sale) I 3S owner of the properly am exclusively contracting with licensed contractors to construct the project (Sec 7044 Business and Professions Code The Contractors License Law does not apply lo an owner of properly who builds or improves thereon and contracts for such projects with contractor(s) licensed pursuant to the Contractor s Licen>e Law) I am exempt under Section Business and Professions Code for this reason 1 I personally plan lo provide the major labor and materials for (onstruction of the proposed property improvement D Yes O No 2 I (have / have not) signed an application for a building permit 'or 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 lo 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 bull have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work) >t£f 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 the Presley Tanner Hazardous Substance Account Act? O Yes 3 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 0 No Is the facility lo be constructed within 1000 feet of the outer boundary of a school site? 0 Yes a No IF ANY OF THE ANSWERS ARE YES A FINAL CERTIFICATE OF OCCIJPAI 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 (ii Civil Code) Lender's Name Lender's Address I certify that I have read the application and state tjiattheabovelnfonnatlonlsoorrectandttiatthe Information on the plans Is accurate I agree to complywith all Cih/ordinancesand State laws relatingto building construction I hereby auttionze representative of Die 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 excavations over 5 0 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 limitation and become null and void if the building or work authonzed by such permit is not commenced within IMdays from the tote of such |>emiitwiflhebuildro ^APPLICANT'S SIGNATURE /(QQtf'L DATE W <" ( # ' 0 ^ City of Carlsbad Bldg Inspection Request For 10/02/2009 _> Inspector AssignmentPermit* CB090685 Title SERGERSON RES REPLACE WTR HTR Description 1790 CALLISIA CT Lot Type PLUM Sub Type Job Address Suite Location OWNER SEGERSON JUDITH A Owner SEGERSON JUDITH A Remarks Total Time Phone 8582047663 Inspector Requested By JUDITH Entered By CHRISTINE CD Description 25 Water Heater/Vents Act Comments Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments WWII 02 31 40pm 01-06-2009 2/3 ACQR& CERTIFICATE OF LIABILITY INSURANCE PRODUCER (661)948-1003 FAX (661)943-1533 Walter Kortensen 'Insurance License #0044424 1113 West Ave H-4 *C Palmdale. CA 93SS1 INSURED Affordable Water Heaters & Planting. Inc 24663 Railroad Avenue Newhall, CA 91321 "vSS5 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS Ct RTIFJCATE DOES NOT AMEND, EXTEND OR ALTER THE COVE RAGE AFFORDED BY THE POLICIES BELOW INSURERS AFFORDING COVERAGE INSURER A. Zenith Insurance Conpany INSURER 8- INSURER C INSURER D- INSURER a. 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 CONDITION 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 «SR LTR A «J3Dt NSRC TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY [ CLAIMS MADE | j OCCUR GEYL AGGRLGATE LJMCT APPLIES PER.~~|po"cvn5gr n«* AUl GAF OMO8ILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUl OS NON-OWNED AUTOS !AGE LIABILITY ANY AUTO EXCESS/UMBRELLA LIABILITY | OCCUR | | ClAlk'S VADT 1 DEDUCTIBl f. \ RETENTION t WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRlETOR/PARTNER/EXECLi; i\ t OFFICER-MEMBER EXCLUDED' 1 yes describe under SPECIAL PROVISIONS fjelcw OTHER POLICY NUMBER Z067898703 POLICY EFFECTIVEDATE (MM/DO/YYI 01/01/2009 POLICY EXPIRATIONDATE fMM/DDfYYI 01/01/2010 LNITS EACH OCCURRENCE DAMAGE TO RENTEDPRFUISF3 (Fa nmtrorwt MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS COMP/OPAGG COMBINED SINGLE LIMIT (Ea acodent) BODILY INJURY (Per person) BODILY INJURY(Peracadenl) PROPERTY DAMAGE (Per accident) AUTO ONLY EA ACCIDENT OTHFR THAN *-* ACC AUTO ONLY AGG EACH OCCURRENCE AGGREGATE WC STATU- OTH TORY UWITS ER FL EACHACCIDCN! EL DISEASE EAE'.PLOYEE EL DISEASE POLICY 1 1MIT $ $ s $ I s J $ s s J t I t $ s t $ s 1,000.000 s 1,000,000 $ 1,000,000 DESCKJPIFOM OF OPERATIONS / LOCATIONS VEHICLES / EXCI USKJNS ADUtD BY ENDORSEMENT / SPECIAL PROVISIONS lertificate of Insurance CERTIFICATE HOLDER CANCELLATION Affordable Water Heaters 24707 Railroad Avenue Santa Oantft CA 9H21 Plumbing Inc sioui..1: AST or T-'; AHOVF DESCRISEO POLICIES BC CANCEI.LLD BLr-oPC TMI ^X^IK.-^'r^ CATE "r'.CrtEOF 7HE tSo'Ji'iG INS.JKt R Wl.i t Ni.'hAVOi-: TilMAi; 10 -'iVS WRIIIEN NOTICF. TO 1st CfRTIFlCATE HC-DCRNAMCD TC THE LETT BUT FA.I.URF TO MAIL SU H NOTICE SHALL IMPOSE NO OBLIGATION OR L AHM fTY Of AM KIS^ UPON THE INSURER. ITS AC.LNIS OK Kt:FRi.St Nl AtU!:;: - J-liORL..-: = »RESLNlATr,r Mark Hcyne/MJN ACORD 25 (200-HOS)•DACOKD COKHCRATION 198« State a California <S- CONTRACTORS STATE LICENSE BOARD ^^ _ _ — ACTIVE LICENSECMBUBCT 627368 ,.„, CORP _ AFFORDABLE WATER HEATERS AND PLUMBING INC " 09/30/2010