HomeMy WebLinkAbout2075 CORTE DEL NOGAL; K; CB012259; Permit07/02/2(701
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing Permit Permit No CB012259
Building Inspection Request Line (760) 602-2725
Job Address
Permit Type
Parcel No
Reference #
Project Title
2075 CORTE DEL NOGAL CBAD St K
PLUM
2130610700 Lot# 0
Construction Type NEW
QUOREX
ADD SINK, CABINET & ELECTRIC
Applicant
GOOD & ROBERTS INC
1090 JOSHUA WAY
VISTA, CA 92083
619-598-7614
Status ISSUED
Applied 07/02/2001
Entered By MDP
Plan Approved 07/02/2001
Issued 07/02/2001
Inspect Area
Owner
SAN-GAL TRUST
550 WCST #1820
SAN DIEGO CA 92101 07/02/01 0002 01 02
54.00
Total Fees $5400 Total Payments To Date $000 Balance Due $5400
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
1
0
0
1
0
0
0
$2000
$700
$000
$000
$700
$000
$000
$000
$2000
$000
$000
$000
TOTAL PERMIT FEES $5400
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 capactiy
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
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave , Carlsbad, CA 92008
\'"~- PROJECT INFORMATION
FOR OFFICE USE ONLY
PLAN CHECK NO
EST VAL
Plan Ck Deposit
Validated By
Date
•
X
Address (include Bldg/Suite #)Business Name (at this address)
Legal Description Lot No Subdivision Name/Number Unit No Phase No Total tt of units
Assessor s Parcel tt Existing Use Proposed Use
SO FT #of Stones # of Bedrooms tt of Bathrooms
jKrflst I! T- ..:.
Name Address City State/Zip Telephone tt Fax tt
Name Address City State/Zip Telephone
Name Address City
- COMPANY-NAME
State/Zip
7: V~-A ^jii~-¥*f! •.
'SjSl:^^
Telephone #
(Sec 7031 5 Business and Professions Code Any City or County which requires a permit to constru:t 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 Section 7031 5 by any applicant for a permit subjects the applicant to a c ivil penalty of not more than five hundred dollars ($5001)
^rr-70 ^ /L-fc&Trt .T^fc.. QZ-O Ccrd<?re/W <^T Ofr/rt S^S^^fY
Name
State License #_3 7 } S5~f
•Address
License Class 6
City State/Zip
City Business License tt
Telephone #
Designer Name Address City State/Zip Telephone
State License tt
:6l*w6RKERS ICOMPENSAfiON'''*'^;.'^'-" *?&>:;' :' ;•• •'" *.-'$ A' „ & ir. ?',-..'s-,S""i- *3£--° :,.:4'U TV*'' V*?- "' •'•**£•,. ,-' ;' I'iv ."
Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations
Q 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
/Ql 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 compensation insurance carrier and policy number are
Insurance Company .3 Cf^G. f^Cj/ULJ Policy No .J? j ~~3 fr^S""" £>Q Expiration Date_
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FORGONE HUNDRED DOLLARS [$100] OR LESS)
C] 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 for in Section 3706 of the Labor code interest and attorney s fees
SIGNATURE C 4£-J£\s£f- — DATE _2
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)
0 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)
n 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 Q YES (UNO
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.
COMPLETEaHIS::SECJIQNFORA«WflfB/DflV7Mi BUILDING PERMITS QNLY;f^ vj,j ;. ;j;Vi : ;, ,,3- __ if.^.^
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? CD YES CD NO
Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? Q YES O 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
;,8 CONSTRUCTION LENDING AGENCY .'•;.'•.' , :,J: ' ^ • gj J :;; C\ , -b- , .,V ::' •••
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
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 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 penod^flBO days (Section 106 4 4 Uniform Building Code)
APPLICANT S SIGNATURE &££ s&^^i DATE /'"'i
WHITE File YELLOW Applicant PINK Finance
City of Carlsbad Bldg Inspection Request
For 07/30/2001
Permit# CB012259
Title QUOREX
Description ADD SINK, CABINET & ELECTRIC
Inspector Assignment TP
2075 CORTE DEL NOGAL
K Lot 0
Type PLUM Sub Type
Job Address
Suite
Location
APPLICANT GOOD & ROBERTS INC
Owner PLETA TRUST
Remarks
Phone 6197193630
Inspector
Total Time
CD Description
24 Rough/Topout
Act Comments
Requested By J P JONES
Entered By ROBIN
Associated PCRs
Inspection History
Date Description Act Insp Comments
07/24/2001 24 Rough/Topout CO TP TRAP PRM
KDB
ACORDru CERTIFICATE OF LIABILITY INSURANCE
PRODUCER (858) 541-2900
Vanots'dale North County Insurance Services
Ooug S Galloway
1 Murphy Canyon Road, #200
San Diego CA 92123-
INSURED
Good & Roberts , Inc
2320 Cousteau Court
Vista CA 92083-8346
DATE (MM/DD/YY)
10/3/2000
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 State Compensation Insurance Fund
INSURER B
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
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
INSRLTR
•,
A
TYPE OF INSURANCE
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
| CLAIMS MADE | | OCCUR
GEN L AGGREGATE LIMIT APPLIES PERn POLICY n JPERC°T riuoc
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
ANY AUTO
EXCESS LIABILITY
I OCCUR II CLAIMS MADE
DEDUCTIBLE
RETENTION S
WORKERS COMPENSATION AND
EMPLOYERS LIABILITY
OTHER
POLICY NUMBER
\
333-345-00
POLICY EFFECTIVEDATE (MM/DD/YY)
10/1/2000
POL ICY EXPIRATIONDATE (MM/DD/YY)
10/1/2001
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
OTHER THAN ^* A^
AUTO ONLY AGG
EACH OCCURRENCE
AGGREGATE
y WC STATU OTHA TORY LIMITS ER
E L EACH ACCIDENT
E L DISEASE EA EMPLOYEE
EL DISEASE POLICY LIMIT
S
S
S
S
$
$
S
S
S
S
$
S
S
S
$
S
S
S
s 1,000,000
s 1,000,000
s 1,000,000
*1 0 days notice of cancellation given if for nonpayment of premium*
All operations of the named insured as certificate holders interest may appear
CERTIFICATE HOLDER ADDITIONAL INSURED INSURER LETTER CANCELLATION
City of Carlsbad
Purchasing Department
2075 Las Palmas Drive
Carlsbad CA 92009
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF THE 13SUING INSURER WILL ENDEAVOR TO MAIL 30 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 REPRESENTATIVE
ACORD 25-S (7/97)
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1988