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Home My WebLink About1986 HIGH RIDGE AVE; ; CB121366; Permit.., 07-19-2012 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB121366 Building Inspection Request Line (760) 602-2725 1986 HIGH RIDGE AV CBAD PME 2073851000 Lot#: 0 GRODANZ: REPLACE WTR. HEATER Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 07/19/2012 JMA 07/19/2012 07/19/2012 ALL STAR WATER HEATERS & PLUMBING GRODANZ ELLIS B&JULIE E INTERVIVOS TRUST 17886 LAKESHORE DR 92530 1-800-727-0977 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES 1986 HIGH RIDGE AVE CARLSBAD CA 92008 $30.00 $0.00 $0.00 $65.00 $95.00 Total Fees: $95.00 Total Payments To Date: $95.00 Balance Due: Inspector: f'.11. ~ FINAL efHOVAL Date: 0 { (Z Clearance: $0.00 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 pennit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set tortt1 in Government Code Section 66020(a), and file the protest and any other required infonnation 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 f h v r v· I iv n N i ii r hi h h f lim' i n h r vi I /4f~ .. ··"~.ii.'.:· "' i:.,,v +· ~···CI TY OF CARLSBAD JOB ADDRESS 1986 High Ridge Ave. CT/PRUJECI # ILOT# IPH~E# I# OF UNIT:; I# BEDROOMS DESCRIPTION OF WORK: Include Square Feet of Alrected Area(•) SUITE#/SPACE#/UNIT!i Plan Check No. CBt 2--l S LP k::> Est. Value Plan Ck. Deposit Date 12.-- IAPN --- #BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE l occ. GROUP Replace existing water heater. Same size and location. EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) I FIREPLACE IAIR CONDITIONING I FIRE SPRINKLERS YES □#_ NOD YES O NOD YES □ NOD CONTACT NAME (ff Dlff•Nnt Fom Appl/cent) APPLICANT NAME Ken Block ADDRESS ADDRESS 30300 Puerto Vallarta CITY STATE ZIP CITY STATE ZIP Menifee CA 92584 PHONE IFAX PHONE IFAX 951-345-4083 EMAIL EMAIL PROPERTY OWNER NAME Julie Grodanz CONTRACTOR BUS. NAME All Star Water Heaters ADDRESS ADDRESS Same as job 30300 Puerto Vallarta CITY STATE ZIP CITY STATE ZIP Carlsbad CA 92008 Menifee CA 92584 PHONE I FAX PHONE I FAX 760-434-4764 951-345-4083 EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS I STATE UC.# STATE LIC.# l'lASS c 36 j"lYizz. \ l1 \ x' 812894 Workers' Compensation Declaration: / hereby affirm under penalty of petjury one of the following decJara~ons: D I have and will maintain a certificate of consent to self-Insure for workers' oompensation as provided by Section 3700 of the LaOOr Code, for the perfomiance of the work for which this permit is issued. 21 I have and will maintain workers' compensation, as required by Section 3700 of the LaOOr Code, for the perfomiance of the work for which this pemiit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. Granite State Ins. Co. Policy No. 1646180 Expiration Date 08/02/2012 This section need not be completed if the permit is for one hundred dollars ($100) or less. D Certificate of Exemption: I certify that in the performance of the worll for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worllers' Compensation Laws of California. WARNING: Failure to secure workeni' compensation coverage is unlawful, and shall subject an employer to criminal penaltles and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages s lded fo In Section Labor code, Interest and attomey's fees. ,i!S CONTRACTOR SIGNATURE I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: □ I, as owner of the property or my employees with wages as their sole oompensation, will do the worll 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 himseH 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 lt1at he did not build or improve for the purpose of sale). □ I, as owner of the property, am exclusively contracting with licensed contractors to oonstruct 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). □ 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 the proposed property improvement. □ Yes □ No 2. I (have I have not) signed an application for a building permit for the proposed wori< 3. I have contracted with the following person (firm) to provide the proposed construction (include name address/ phone I contractors' license number): 4. I plan to provide portions of the work, but l have hired the following person to coordinate, supervise and provide the major worll (include name I address/ phone I contractors' license number): 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the worll indicated {include name/ aidress / phone I type of worll): ,/1$ PROPERTY OWNER SIGNATURE AGENT DATE Inspection List Permit#: CB121366 Type: PME Date Inspection Item 08/15/2012 25 Water HeaterNents 08/15/2012 25 Water HeaterNents 08/15/2012 29 Final Plumbing 08/15/2012 29 Final Plumbing Thursday, August 16, 2012 Inspector MC MC Act RI AP RI Fl GRODANZ: REPLACE WTR. HEATER Comments AFTER2 PM EXISTING LOCATION Page 1 of 1