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Home My WebLink About1835 CHESTNUT AVE; ; CB021588; Permit•05-24-2002 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB021588 Building Inspection Request Line (760) 602-2725 Job Address: 'Permit Type: Parcel No: , Reference #: Project Title: 1835 CHESTNUT AV CBAD PLUM 2052303200 Lot #: Construction Type: GROSSE - REPLACE WATER HEATER 0 NEW Status: ISSUED Applied: 05/24/2002 Entered By: JM Plan Approved: 05/24/2002 Issued: 05/24/2002 Inspect Area: Applicant: ARS 3TE 100 6162 NANCY RIDGE DR :3AN DIEGO CA 92121 :358-677-5455 Owner: LEY URSULA 1835 CHESTNUT AVE CARLSBAD CA 92008 75*30 05/24/02 0002 01 02 CBP 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 Drain Install/Repair Water Line Water Heater and/or Vent ; Gas Piping System Vacuum Breaker Other Plumbing Fees Master Drainage Fee 'r 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 EXPIRED PERMIT PERMIT HAS EXPIRED IN ACCORDANCE WITH U.B.C. SECTION 106.4.4 DATE Inspector: FINAL APPROVAL 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 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 creviouslv otherwise exoired. PEftMIT 'APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1. FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. DepospA Validated Bvi J *v Date Address (include Bldg/Suite tt)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No. Phase No. Total tt of units Assessor's Parcel ff Existing Use Proposed Use 2. CONTACT PERSON (if different,from applicant) SQ. FT.#of Stories ft of Bedrooms tt of Bathrooms Name 3. ' APPLICANT Address City Coniractor Ql Agent for Contractor O Owner." Q Agent-for Owner State/Zip Telephone tt Fax tt -5455 Address State/Zip Telephonfe tt Address City State/Zip TelephoneName S CONTRACTOR - COMPANY NAME " ~* •• •< (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 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, and the basis for the alleged exemption. Any violation of^SfiStion 703 U hy anv applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001). Name State License tt Address License Class lp y D \J&\ 6> Z-C1.) City Business License # [ Designer Name Address City State/Zip Telephone State License tt 6.' WORklRSH^MPENSATION •• " . ' ' .'- \ Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 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 the work for which this permit is issued. |~| | have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which thte permit is issued. My worker's compensation insurance carrierjmd^policy number are: £~\s** rt (~\-l /./•<p*~5 .**-». "#Sl / Insurance Company Policy I Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) |~l 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 ($100,QOO),,Jn additionyo the costof/compensation, damages as provided for in Section 3706 of the Labor/code, int/rest and attorney's fees. SIGNATURE iiTrjHpWNER-BUILPERipJ-CLARATION '. - < „-„ .,' " l^j~S, ,'." * ."-' <-", ^-,--'""- ' ': I hereby affirm that I am exempt from the Contractor's License Law for the following reason: O 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). Q 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). l~l I am exempt under Section Business and Professions Code for this reason: 1. I personally plan to provide the major labor arid materials for construction of the proposed property improvement. l~] YES i~lNO 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 number / 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 number / contractors license number):^ 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work): PROPERTY OWNER SIGNATURE DATE eoMPLlf Eitttis SECT ibNfi^ ; '•*;" 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? l~l YES £] NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? [H YES Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? l~l YES l~) 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. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME LENDER'S ADDRESS X APPLICANT iCERTIFJCAf ION 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 representatives of the 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'Q" deep and demolition or construction of structures over 3 stories 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 authorized by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a periockpf 180 days (Sddlion 106.4.4 Uniform Building Code). / APPLICANT'S SIGNATURE M Or /SAA^-^- / WA./tfUJ-^—N DATE 5 I &*L>\ WHITE: File PINK: Finance •IfiARSHUSAINC. CERTIFICATE OF INSURANCE «»™CATE NU«B6R•*• • - • CHI-QOOTS-J/np 10 PRUCWCER . Marsh USA Inc. 500 W. Monroe Chicaao. IL 60661 Attn: LOLA DAVIS 312627-5379 THIS CERTIFICATE IS ISSUED A3 A HATTER OF INFORMATION ONLY AND CONFERS ' HO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POLICY. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN. COMPANIES AFFORDING LUVhKAGb COMPANY A ZURICH AMERICAN INSURANCE COMPANY INSURED ARS American Residential Services of California, Inc. dba 860 Ridge Lake Blvd. Memphis, TN 381 20 COMPANY B ILLINOIS NATIONAL INSURANCE COMPANY COMPANY C COMPANY D COVERAGES -r.TIiis.ceftificat8- supersedes and replaces any previously issued certificate for the policy period noted below. THIS IS TO CERTIFY THAT POUCHES OF1 INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. MAY HAVE BEEN REDUCED 3Y PAID CLAIMS. CO LTR A A 3 A TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABLTTY I CLAIMS MADE | X | OCCUR OWNER'S A CONTRACTOR'S PROT AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS OARAGE LIABILITY ANY AUTO EXCESS LIABILITY X UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' UABIUTY THE PROPRIETOR/ X INCL OFFCERS ARE EXCL OTHER POLICY NUMBER GLO 2938645-00 BAP 2938646-00 (ACS) BAP 2938647-00 (VA) TAP 2938648-00 (TX) BE 309-79-07 WC 2938643-00 POLICY EFFECTIVE DATE (MM/DO/YY) 01/01/02 01/01/02 01/01/02 01/01/02 01/01/00 01/01/02 POLICY EXPIRATION 01/01/03 01/01/03 01/01/03 01/01/03 01/01/03 01/01/03 LIMITS GENERAL AGGREGATE PRODUCTS - COMP/OP AGO PERSONAL iADV INJURY EACH OCCURRENCE FIRE DAMAGE (Any ant lire) MED EXP (Any ona Dur-on) COMBINED SINGLE LIMIT BODILY INJURY (Pwpwmn) BODILY INJURY (Per acodant) PROPERTY DAMAGE AUTO ONLY - £A ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE EACH OCCURRENCE AGGREGATE ,, I WCSTATU- X | TORY LIMITS OTH- ER EL EACH ACOOENT EL DISEASE-POLICY LIMFT EL DISEASE-EACH EMPLOYEE S 5,000.000 $ 1 ,000,000 S 1,000,000 S 1 ,000,000 $ 1,000,000 S 5.000 $ 1,000,000 S $ S S S S S 5,000.000 S 5,000.000 S S 1,000,000 S 1,000.000 S 1,000.000 CERTIFICATE HOLDER • . . , -.-,.-,- -.CANCEELAT1OH SHOULD ANT OF THE PCUOE3 DESCRIBED H6REIH BE CANCELLED BEFORE THE EXPIRATION DATE THERECf THE INSURER AFFOWOWG COVERAGE WIU. ENDEAVOR "O WAIL -Irj CAYS WRTTTEN NOTICE ^0 "-* CERTIFICATE HCXBER NAMED HEREIN. 31/T FAILURE TO MAIL SUCH NOTICE SHAU. IMPOSE NO OBLIQATIOM Cfl LlAflUTYOFANrKNOUPCN THE INSURES AfpCROING COVERAGE. :7S AGENTS OR REPRESENTATIVES. HARSH USA INC. BY: clsa M Lynch <_ ^)oJ"r?~i_' yrvcA.* MM1(9/93) VALID AS OF: '2/14/01 I