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Home My WebLink About2016 CARACOL CT; ; CB091804; Permit10-28-2009 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB091804 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: 2016 CARACOL CT CBAD PLUM 2151201800 Lot#: Construction Type: DEVENDORF RES- REPLACE WTR HTR 0 NEW Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 10/28/2009 LSM 10/28/2009 10/28/2009 Applicant: RITE-A-WAY SERVICES 14457 MERIDIAN PKWY RIVERSIDE CA 92504 951-232-4989 Owner: DEVENDORF DON C&ALICE E 2016 CARACOL CT CARLSBAD CA 92009 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 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 previously otherwise expired. CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 www.carlsbadca.gov Plan Check No. Est. Value Plan Ck. Deposit Date JOB ADDRESS PHASE * I * OF UNITS I # BEDROOMS SUITE#/SPACE#/UNIT# # BATHROOMS [TENANT BUSINESS NAMECT/PROJECT CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Ama(s) EXISTING USE PROPOSED USE GARAGE (SF)PATIOS (SF)DECKS (SF)FIREPLACE YES D #NOD AIR CONDITIONING YES O NOD FIRE SPRINKLERS YES D NOD CONTACT NAME (If Different Font Applicant)APPLICANT NAME ADDRESS ADDRESS CITY , ••>STATE T~~ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL PROPERTY OWNER NAME CONTRACTOR BUS. NAME fl ADDRESS ,.ADDRESS CITY STATE ZIP dTK.STATE ZIP PHON FAX PHONE FAX EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LIC.# _CITY BUS. LIC.# (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 ($500)). WORKERS' COMPENSATION Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: d I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. L7*l have and will maintain workers'compensation, as reouired by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. H \W¥11 \\T> Policy No. Q 73~)£$,V\ } ,7.66 ^ 6? < 2- Expiration Date / (? • DI - ( b This section need not be completed if the permit is for one hundred dollars ($100) or less. O Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100.000), in addition to the cost of compensation, damages as provided tor ip Section 3706 of the Labor code, interest and attorney's fees. M$ CONTRACTOR SIGNATUR^AlC^*OAGENT /6 OWNER-BUILDER D C .' LARA T I O N (hereby affirm that I am exempt from 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 tor the purpose of sale). G 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). O 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 tor 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): >£f PROPERTY OWNER SIGNATURE LlAGENT DATE THIS S E C T I O N F O R N O N - R E S I D E N T I A L BUILDING PERMITS ONLY 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? n Yes a No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? G Yes O No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? O Yes d No IF ANY OF THE ANSWERS ARE YES, / EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. CO W S T B U C T I ON 11N OIN C AS EN C Y 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 $** p L i c A N T c E jnr-Ti r t c AW***1 I hereby authorize representative of Ihe City of Cartebad to enter upon Ihe 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 stories in height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by Imitation and become null and void if Ihe building or work authorized by such permit is not commenced within 180 days from the date of such pemrto^ebuMhg a v^ ^APPLICANT'S SIGNATURE : /^T\| f(_AJ\} - DATE \Q" ^ ' 0 ^ City of Carlsbad Bldg Inspection Request For: 04/19/2010 Permit* CB091804 Title: DEVENDORF RES- REPLACE WTR HTR Description: 2016 CARACOLCT Lot: Type: PLUM Sub Type: Job Address: Suite: Location: OWNER DEVENDORF DON C&ALICE E Owner: DEVENDORF DON C&ALICE E Remarks: a m please Total Time: CD Description 25 Water Heater/Vents Act Comments Inspector Assignment: Phone: 7604310716 Inspector: M fV-z/7 Requested By: DON Entered By: CHRISTINE Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments FromiKennail Goad FaxID:909-886-2013 Date:10/27/09 03:50 PM Page: 2 of 3 ACORD CERTIFICATE OF LIABILITY INSURANCE OP»£K?I PRODUCER Alliant Insurance Services , Inc (Lic-OC36861) 735 Carnegie Drive, Ste 200 San Bernardino CA 92408 Phone: 909-886-9861 Pax: 909-886-2013 INSURED Rite A Way Services Inc16415 Tamra LaneRiverside CA 92504 DATE (MM/DD/YYYY) 10/27/09 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 Delos Insurance Co (KRM) INSURER B: INSURER O INSURER D: 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 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 INSR" LTR A MJUT.NSR:TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY | CLAIMS MADE | | OCCUR GEN'L AGGREGATE LIMIT APPLIES PER~~i™«ns£r n^oc AUTOMOBILE LIABIUTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY 1 ANY AUTO EXCESS/UMBRELLA LIABILITY | OCCUR | | CLAIMS MADE R DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes. describe under SPECIAL PROVISIONS below OTHER * POLICY NUMBER 02DKRM12004612 POLICY EFFECTIVEDATE (MM/DD/YY) 10/01/09 DATE (MM/DD/YY) 10/01/10 LIMITS EACH OCCURRENCE PREMISES (Ea occurence) MED EXP (Any one person) PERSONAL S ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT(Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EAACC AGG EACH OCCURRENCE AGGREGATE X ITORY LIMITS 1 ER El EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE El DISEASE - POLICY LIMIT $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1,000,000 $1,000,000 $1,000,000 Proof of insurance CERTIFICATE HOLDER CANCELLATION PROOF-1 Proof of insurance SHOULD ANY OF THE AEIOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 00 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES. AUTHORIZED L? ACORD 25 (2001/08) ' r muCChazL* ©ACORD CORPORATION 1988