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Home My WebLink About2045 CORTE DEL NOGAL; ; CB023795; Permit12-19-2002 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No Building Inspection Request Line (760) 602-2725 CB023795 Job Address Permit Type Parcel No Reference # Project Title 2045 CORTE DEL NOGAL CBAD PLUM 2130610900 Lot# Construction Type 0 NEW SEASILVER RUN 2" WATER LINE FROM METER TO BUILDING Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 12/18/2002 RMA 12/19/2002 12/19/2002 Applicant STEVEN WICKLUND 13210 FLORENCE 90670 562 777-0983 Owner TEYSSIER LEONARD&MONICA FAMILY TRUST 10-14 92 3200 HIGHLAND AVE #B4 2 NATIONAL CITY CA 91950 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 0 0 0 $2000 $000 $000 $000 $000 SO 00 $000 $000 $4000 $000 $000 $000 TOTAL PERMIT FEES $6000 Total Fees $6000 Total Payments To Date $0 00 Balance Due $6000 3884 12/19/02 0002 01 02 CGP 60 .-00 PLANS .IN STORAGE .ATTACHED PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 "NylPROJECT INFORMATIO FOR OFFICE USE ON PLAN CHECK NO _L EST VAL Plan Ck Deposit Validated \Bv,' JDate / 6V / ' t / D/ Q/* \ e XY^$o-&r,Vs (fffa — /I ^ Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor s Parcel #Existing Use Proposed Use "\/t)escription of Work A 3'' ,2 .XQNfACT PERSON (if different" from applicant) SQ,FT Ir #of Stones # of Bedrooms of Bathrooms Name Address ...APPLICANT*!; nSontractor H Agent for Contractor; dlOwner \V City I Agentfor..6wner .. State/Zip Telephone #Fax if NaTfiT ^"~ 4 . •;FpROPERTY.bWf|ER';hi:::. ™ Address City State/Zip Telephone :!;..T:-.:--:^^. Address City State/Zip Telephone #IName 5 'CONTRACTOR COMPANY NAME'igSsr -^r 7 J", ,-lii ; ^.3:'' '^ ..sT"" .rS?' ,„'< KET •' ••"•.. " J ' .,* JVst "...;• (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 qLSection 703J 5 by any applicant for a permit subjects the appjipant to a civil penalty of ipt more thanf* hundred dollars[£500])" Cltv State/Zi City Business License tt Designer Name State License tt WORKERS .COMPENSATION %,.• ,.,. :, ..... • '.'• /_-, -.Ki.. .,,.; - „•,. '- - . "-U ...A- Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations l~l 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 l~l I have and will maintain workers compensation as required by Section 3700 of the Labor Code for the performance of the work for which this permit is issued My worker s copwensjjfipn insurance carrier and policy number are Insurance Company ff^^f^f> - £<?•$$,**? ^fs'**ts' Policy Nof^Z: ^JPg^53fg>^flgxpiration Date^4g> -/— £? (THIS SECTION NEED NOT BE-G</MPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) l~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 overage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred ompensation damages as provided for in Section 3706 of the Labor code interest and attorney s fees - __ DATE :"6WNERBUiLbER ~ ~~' I hereby affirm that I am exempt from the Contractor s License Law for the following reason l~l 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) f~l 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) C] 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 CH YES QNO 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 COMPLETETHIS SECTIQN.,FOR../«?/V«FS«J£y7Mt.BUILDiNG PERMITS ONLY'.." ...;,-;,„: ."'.';.: ......... ^ i'l , ...... , _.„ ,: ..... ';;,._, :^,..i,:^.^i-.:,, 1 J ? >._ ,:,,. .,•- > .-, ^'r:., .., 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? 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? l~l YES Q NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? fj YES fj 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 a" 'CONSTRUCTION LENDING AGENCY -::-::' • , ..;.f £&< .~-^ .. ^.vJi-r^'j ^ :, , I hereby affirm that there is a construction lending agency for the performance of the work for which thr permit is issued (Sec 3097(0 Civil Code) LENDER S NAME _ LENDER S ADDRESS 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 0" deep and demolition or construction of structures over 3 stories in height EXPIRATION Every permit issued by the bidding Official under tr%proyision^ of this Code^sfialJ expire by limitation and become null and void if the building or work authorized by such permit is not commencfecmttiia-l8&-dHys trorn the date of^uch permit orlf the,ouilding or work authorized by such permit is suspended or abandoned at any time after the work is commence^^pfaperiod of 180 days (Section 106 4 4 Umfojm Buildfrig Code) PPLICANT S SIGNATURE WHITE File YELLOW Applicant PINK Finance DATE City of Carlsbad Bldg Inspection Request For 12/23/2002 Permit# CB023795 Title SEASILVER-RUN 2" WATER LINE Description FROM METER TO BUILDING Inspector Assignment Type PLUM Sub Type Job Address 2045 CORTE DEL NOGAL Suite Lot 0 Location APPLICANT STEVEN WICKLUND Owner TEYSSIER LEONARD&MONICA FAMILY TRUST 10-14-92 Remarks Phone 7146813075 Inspector Total Time Requested By DAN Entered By CHRISTINE CD Description 22 Sewer/Water Service Act Comment Associated PCRs/CVs Inspection History Date Description Act Insp Comments ACORQ. CERTIFICATE OF LIABILITY INSURANCE PRODUCER (270)651-8837 FAX (270)651-8127 Pedigo-Lesseftberry'lns Agency, Inc 103 Pin Oak Lane P 0 Box 1899 Glasgow, KY 42142-1899 INSURED ICE Builders, Inc 421 East Cerritos Ave Anaheim, CA 92805 i DATE (MMJDD/YY) 09/30/2002 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 American Zurich Insurance INSURERS American Guaranty & Liability Insurance Co INSURER C INSURER D INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING 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 INSRITR A A B A TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 1 CLAIMS MADE | X [ OCCUR GEN L AGGREGATE LIMIT APPLIES PER~~i POLICY njTc°T r^oc AUTOMOBILE LIABILITY X X X X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS Hired Physical Ding GARAGE LIABILITY ANY AUTO EXCESS LIABILITY X [ OCCUR (_J CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY OTHER POLICY NUMBER GL03865506-00 BAP3865507-00 $500 DED COMPREHENSIVE $500 DED COLLISION AUC3865 504-00 WC3865505-00 POLICY EFFECTIVEDATE (MM/DD/YY) 10/01/2002 10/01/2002 10/01/2002 10/01/2002 POLICY EXPIRATIONDAI E (MM/DD/YY) 10/01/2003 10/01/2003 10/01/2003 10/01/2003 LIMITS EACH OCCURRENCE FIRE DAMAGE (Any one fire) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS COMP/OPAGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY(Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY EA ACCIDENT OTHFRTHAN ^ ACC AUTO ONLY AGG EACH OCCURRENCE AGGREGATE X I WCSTATU OTH1 TORY LIMITS ER EL EACH ACCIDENT EL DISEASE EA EMPLOYEE EL DISEASE POLICY LIMIT $ 1,000,000 s 300,000 $ 10,000 s 1,000,000 $ 2,000,000 $ 2,000,000 $ 1,000,000 $ $ $ $ $ $ $ 25,000,000 $ 25,000,000 $ $ $ $ 1,000,000 $ 1,000,000 $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONSicense #775947 CERTIFICATE HOLDER ADDITIONAL INSURED INSURER LETTER CANCELLATION Contractors State License Board P 0 Box 26000 Sacramento, CA 95826 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THE REOF THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THIU:OMPAf^T^GdW£OR/X9>REJ@Na^TIVES* AUTHORIZED REPRESENT^^E*^**^ • • b&dcJffA**'^ PEDIGO-LESSENBERRY INSURANCE ftCORD 25-S (7/97)agency irwgACORD CORPORATION 1988 r~~ ~o ~n en o2- i~ 3D m DO tt|0>S 05 m m O i—cza O £ b>m O m m O D