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HomeMy WebLinkAbout2191 CAMINO ROBLEDO; ; CB071894; Permit07-16-2007 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB071894 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 2191 CAMINO ROBLEDO CBAD PLUM 2552613400 Lot#: Construction Type: CAPPS RES REPLACE WTR HTR 0 NEW Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 07/16/2007 KG 07/16/2007 07/16/2007 Applicant: AFFORDABLE WATER HEATER 24707 SAN FRANANDO RD SANTA CLARITA, CA 91321 661 259-7131 Owner: CAPPS FAMILY TRUST 10-04-00 2191 CAMINO ROBLEDO 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 $6.00 $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 Date: VAL 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 lees/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. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 51,, ^ROJECT INFORM ATIQN ,np FOR OFHICe USE ONLY PLAN CHECK NoPEO! / ft? ^ EST. VAL. Plan Ck. Deposit Validated By Date 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 tt Existing Use / ,L-o r/&n Proposed Use Description of Work J?,',, CONTACT PERSON <lf different from applicant) SQ. FT.#of Stories if of Bedrooms # of Bathrooms Name LICANT;ctor, Address lent for.Contractor Q Owner City Agent fjjtwO-wner State/Zip Telephone # ; Fax* Name 'A. .,'iPROPERTY.O Address City State/Zip Telephone # Address City State/Zip TelephoneName 6,- < CONTRACTOR - COMPANY NAME " ' • ' ' ,' '•.,'.-'>?.> • * , r, "J-'f^ ' (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 ex«npjijm. Any Violation of Section 7931.5 by, an^.applipa/it for a permit subjects the applicant to a_civiljj«nalty of rjflUnore than five hunjlre_d dol^fp 1^500]). State License « City ' State/Zip City Business License # j *ZJ / 2-"7 | Designer Name Address City State/Zip Telephone State License 9 .6,,.WORKERS;COMPENSATION, , , ..... Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: CI] 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. XT] 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 yiSued. My worker's compensation insurance carfier and policy number are: , ,.. i , i ^--^ s\ Insurance Company \ V\*£_ I j2AA^^v^n ^ Policy No. L^D\D i i) I Q / (-/ ( Expiration Date I > ^ O (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) Q 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 ($10 SIGNATURE to tna cost Of compensation, damages as provided foi In Section 3706 of the Labor code, IrUaiaat and attorney'* fees. DATE I hereby affirm that I am exenript from the Contractor's License Law for the following reason: CD 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). D 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). D 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. CD 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 tilillittH^ „„ , A , ,„ „ , . ,j M, i,. ', , „«, .,,'•' 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? O YES O 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 (~1 NO Is the facility to be°£onstruct8d within 1,000 feet of the outer boundary of a school site? Q YES Q 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. ^..^CONSTRUCTION LE.NDING AQEN.CY . - , 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 i9<;; APPLICANT CERTIFICATION, , ' , ,. , , , ,, > : ,.,,,, 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 commenceo/^ithin 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 comme^nce^ for^a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT S SIGNATURE WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For. 08/07/2007 Permit* CB071894 Title: CAPPS RES REPLACE WTR HTR Description: Type: PLUM Sub Type: Job Address: 2191 CAMINO ROBLEDO Suite: Lot: 0 Location: OWNER CAPPS FAMILY TRUST 10-04-00 Owner. CAPPS FAMILY TRUST 10-04-00 Remarks: Inspector Assignment: Phone: 7607535255 Inspector: Total Time: -CD Description 25 Water Heater/Vents Act Comments Requested By: MICHELE Entered By: CHRISTINE Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments ACQRD^ CERTIFICATE OF LIABILITY INSURANCE DATE (MMUOO/YYYY) 3/23/2007 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 PRODUCER (805)379-2203 FAX: (805)379-5299 Hogan Insurance License #OC54750 P.O. Box 7419 Thousand Oaks CA 91359 INSURERS AFFORDING COVERAGE NAIC# INSURED Affordable Water Heaters and Plumbing Inc. , 24707 San Fernando Road ,. INSURER A: The Zenith INSURER 8: INSURER C INSURER 0: Santa Clarita CA 91321 INSURER t: 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 ADO'L NSRO f F TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY 1 CLAIMS MADE | | OCCUR GEN'L AGGREGATE LIMIT APPLIES PER3 POUCY n^f r~iLOc AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS/UMBRELLA LIABILITY j OCCUR 1 ) CLAIMS MADE DEDUCTIBLE RETENTION S WORKERS COMPENSATION AND EMPLOYERS' UABWJTY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes. describe under SPECIAL PROVISIONS below OTHER POLICY NUMBER Z067898702 POLICY EFFECTIVEDATE (MM/DD/YY) 1/1/2007 POLICY EXPIRATION DATE (MM/DD/YY) v 1/1/2008 LIMITS EACH OCCURRENCE DAMAGE TO RENTEDPREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMPICfr AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN EAACC AUTO ONLY:AGG EACH OCCURRENCE AGGREGATE -V I WCSTATU- OTH-X | TORY LIMITS ER EL EACH ACCIDENT E.L DISEASE - EA EMPLOYEE EL. DISEASE - POLICY LIMIT | ; ; > > > $ $ $ $ $ $ $ $ $ $ $ s $ 1,000,000 $ 1,000,000 $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS *Only 10 days notice of cancellation will be given for non payment of premium. ****EVIDENCE ONLY**** CERTIFICATE HOLDER CANCELLATION Affordable Water Heaters and Plubing, 24707 San Fernando Road Santa Clarita, BC 91321 Inc SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING 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 Robert Hogan/AG ACORD 25 (2001/08)© ACORD CORPORATION 1988