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HomeMy WebLinkAbout2200 CAMINO ROBLEDO; ; CB102416; Permit12-10-2010 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB102416 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: 2200 CAMINO ROBLEDO CBAQ PLUM 2552613600 Lot#: 0 Construction Type: NEW REYNOLDS RES REPLACE WTR HTR Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 12/10/2010 KG 12/10/2010 12/10/2010 Applicant: AFFORDABLE WATER HEATER 24707 SAN FRANANDO RD SANTA CLARITA, CA 91321 661 259-7131 Owner: REYNOLDS PETER D&SUSAN H 2200 GAMINO ROBLEDO CARLSBAD CA 92009 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Drain Install/Repair Water Line Water Heater and/or \fent 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 APR Date:Clearance: NOTICE: Please take NOTICEtyat apHwal of your project includes the "Imposition" if fee's, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You ha])e 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. ' Building Permit A| V^*^*' 1635 Faraday Ave., Carlsbac ^7 CITY OF 760-602-2717/2718 r* A n I CD A 1^1 Fax:760-602-85 CAKLboAU www.carlsbadca.E JOB ADDRESS . n , O \ 1 1 (yi.rj.0v V_^-*V\\ r\O \(^i P '.£ & 6 CT/PROJECT * LOT* PHASE* * OF UNITS # BEDROOMS pplicdtion i, CA 92008 1 /2719 58 1 <oy SUITES/SPACES/UNIT* # BATHROOMS TENANT BUSINE DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) S*V.*Y\€_ loC.Ok.'HOft - Cs^CmML, EXISTING USE PROPOSED USE GARAGE (SF) CONTACT NAME (If Different Fom Applicant) ADDRESS CITY STATE ZIP PHONE FAX EMAIL PROPERTY OWNER NAME TJ 1 /) \ ADDRESS ' . CITY , . STATE ZIP C^r\$n«--r7\ C$ ^l^oo^ PHONE FAX 1 bo C?^S" 05 S^ EMAIL ARCH/DESIGNER NAMES ADDRESS STATE UC.# PATIOS (SF) DECKS (SF) F Y APPLICANT NAMEStott Plan Check No.Cp/ @Mt fc Est. Value Plan Ck. Deposit ( y/ Oate fjL-JWb -T^K APN /y SS NAME CONSTR. TYPE OCC. GROUP IREPLACE AIR CONDITIONING FIRE SPRINKLERS ES D # NO D YES O NO D YES n NO O tit-Me.FTe.lcl ADDRESS BtlBUJ cm PHONE STATE ZIP FAX EMAIL ^ • CONTRACTOR BUS. NAME ADDRESS CITY PHONE EMAIL Peri«its@ A< STATE Ua# STATE ZIP JFAX jJhAO.COm CLASS 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 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 civil penalty of not more than five hundred dollars ($500)). Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the Mowing declarations: O 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. Dl I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the v"5tiOj1S1 this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. t-fctM^lrN _ ___ Policy No. TC.OV*?Xnc TO _ Expiration Date I " I " t \ _ 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 Ms 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. 'L. . fjrJAGEItr DATE I & " (0 ~ ( 0CONTRACTOR SIGNATURE ''C tAM ATitJ N; thereby affirm that I am exempt from Contractor's LJcense Law for the following reason: O I, as owner of Vie property or my employees with wages as Iheir 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 hat 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 hat he did not build or improve for the purpose of sale). n 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). D 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 for 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 fallowing 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): pROPERTY OWNER SIGNATURE BAGEKT DATE 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? D 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? D Yes D No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? DYes DNo IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPAN EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I hereby affirm that there is a construction tending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address OSHA: An OSHA permit is required for excavations over 5'0" deep and demolition or mnstnj<&n of sta*resover3s1ones in height EXPIRATION: Every permit issued by the Building Offrial ureter Ite provisions of this Code shall expire 180 days fan Die date of such permit or if the buldira or work audorized by sudipermrs suspended w abandon at am finie after the vi^ is comrren^ ~s V IJ&) APPLICANTS SIGNATURE XftO^L . DATE t<5-~^-"tO c CITY OF STORM WATER COMPLIANCE ASSESSMENT B-24 Development Services Building Department 1635 Faraday Avenue 760-602-2719 www.carlsbadca.gov I am applying to the City of Carlsbad for the following type(s) of construction permit: £f Building Permit Q Right-of-Way Permit Q My project is categorically EXEMPT from the requirement to prepare a storm water pollution prevention plan (SWPPP) because it only requires issuance of one or more of the following permit types: Electrical Fire Additional Fire Alarm Fixed Systems Mechanical Mobile Home Plumbing Patio/Deck Re-Roofing Sign Spa-Factory Sprinkler Water Discharge Project Storm Water Threat Assessment Criteria* No Threat Assessment Criteria H My project qualifies as NO THREAT and is exempt from the requirement to prepare a storm water pollution prevention plan (SWPPP) because it meets the 'no threat" assessment criteria on the City's Project Threat Assessment Worksheet for Determination of Construction SWPPP Tier Level. My project does not meet any of the High, Moderate or Low Threat criteria described below. Tierl • Low Threat Assessment Criteria p My project does not meet any of the Significant or Moderate Threat criteria, is not an exempt permit type (See list above) and the project meets one or more of the following criteria: • Results in some soil disturbance; and/or • Includes outdoor construction activities (such as roofing, saw cutting, equipment washing, material stockpiling, vehicle fueling, waste Tier 2 -^Moderate Threat Assessment Criteria H My project does not meet any of the Significant Threat assessment Criteria described below and meets one or more of the following criteria: • Project requires a grading plan pursuant to the Carlsbad Grading Ordinance (Chapter 15.16 of the Carlsbad Municipal Code); or, • Project will result in 2,500 square feet or more of soils disturbance including any associated construction staging, stockpiling, pavement removal, equipment storage, refueling and maintenance areas and project meets one or more of the additional following criteria: • Located within 200 feet of an environmentally sensitive area or the Pacific Ocean, and/or • Disturbed area is located on a slope with a grade at or exceeding 5 horizontal to 1 vertical, and/or • Disturbed area is located along or within 30 feet of a storm drain inlet, an open drainage channel or watercourse, and/or • Construction will be initiated during the rainy season or will extend into the rainy season (Oct. 1 through April 30). Tier3 • Significant Threat Assessment Criteria Q My project includes clearing, grading or other disturbances to the ground resulting in soil disturbance totaling one or more acres including any associated construction staging, equipment storage, stockpiling, pavement removal, refueling and maintenance areas: and/or Q My project is part of a phased development plan that will cumulatively result in sd disturbance totaling one or more acres including any associated construction staging, equipment storage, refueling and maintenance areas: or, Q My project is located inside or within 200 feet of an environmentally sensitive area (see City ESA Proximity map) and has a significant potential for contributing pollutants to nearby receiving waters by way of storm water runoff or non-storm water discharge(s). / certify to the best of my knowledge that the above checked statements are true and correct I understand and acknowledge that even though this project does not require preparation of a construction SWPP, I must still adhere to, and at all times during construction activities for the permit type(s) check above comply with the storm water best management practices pursuant to Title 15 of the Carlsbad Municipal Code and to City Standards. 'The City Engineer may authorize minor variances from the Storm Water Threat Assessment Criteria in special circumstances where it can be shown that a lesser or higher Construction SWPPP Tier Level is warranted. B-24 Owner/Owner's Authorized Agent Name Page 1 of 1 Rev.03/09 City of Carlsbad Bldg Inspection Request For: 12/22/2010 Permit* CB102416 Title: REYNOLDS RES REPLACE WTR HTR Description: Sub Type: 2200 CAMINO ROBLEDO Lot: 0 Type: PLUM Job Address: Suite: Location: OWNER REYNOLDS PETER D&SUSAN H Owner: REYNOLDS PETER D&SUSAN H Remarks: Inspector Assignment: Phone. 7604025558 Inspector- Total Time: CD Description 25 Water Heater/Vents omments Requested By: SUSAN REYNOLDS Enteredfiy: CHRISTINE Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act Insp Comments A.CORD* CERTIFICATE OF LIABILITY INSURANCE PROOUCSR (661)948-1003 FAX: (661)948-1533 Walter Mortensen Insurance CA License KOD44424 1113 West Ave., M4, Suite C Palmdale CA 93551 INSURED Affordable Water Heaters t Plumbing, Inc. 24707 Railroad Avanua Santa CJ,arita CA 91321 OATC (UWOTYYf ) 1/5/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS HO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND ORALTER THE COVERAGE AFFORDED BY THE POLICIES BEl*OW. INSURERS AFFORDING COVERAGE 4 Ksureut Zenith Insurance tJompany MSUNERft MSURERC INSURBRO: INSURER E NAIC* COVERAGES ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO YWCH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRBED HEREIN IS SUBJECT TO All THE TERMS. EXaUSIONS WO CONDTTIONS OF SUCH POLKUES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PACCUUMS. MS* ITR A van.TVFEOFINSUIUNCE CEHERM.IMBIUTV = COMMBICIM.GENBW. UMUIV ICIWSMM6 |_J OCCUR GSO. AGGREGATE UMT APPLES F8t "IpoucvriSS Hioc AUTOMOBILE UASUrr AW AUTO ALL OWNED AUTOS SCHEDULED AUTOS H«aj AUTOS NOW-OWNED AUTOS CARAflCUMUTY ANVAUTO excess < OMBMEUA luaunr J OCCUR |_JClAMSI*iOe OEDUCnBLE RETENTION t WORKERS COMPENSATION AMOe«PU)VER3-UAHUrr y(MAMvmapraETomvunMEROEcunvEi — iOFnCERMEMBER BCCU/DED? 1 1(UaniMixylnNH) ' '« va. describe unfcrSPECIAI. PROVtSONS bebw OTHER POUCYMJUBER COCI898704 MUCYEffECTIVE 1/1/2010 POUCVEXPMATMMDATEMKnmvn 1/1/2011 UMTTS EACH OCCURRENCE OAMACETOMNVEDPPFMRES fP* opcwffBt|t MEOEXPfAnrmixnan) PERSONALtAaVMMff GEMEMLAQGREGME PftOOOCTS-COMPWAGG (Eaiocidenj BOOWIKJURY(Ptrponon) BOWLYKJUWf((V«a*rtl PROPERTY OAUAG6(PBTKOKnl) AUTOONLY-EAACCOeff OTHFJRTHAN EAACC AUTO ONLY: ^Q EACH OCCURRENCE AGGSeGATE 1 WCSTATU- I lom-lfmHYiMn;! I at EjUEACHACCOetr tL DISEASE -EA EMPlOrtJ EL. OSEASE - POLICY UMT J s \ s s s s % $ s s s s J t t s f t 1,000,000 j 1,000,000 t 1,000,000 OCSCRIPTKW Of OPERATOR /LOCATX*e/VB«Cl£S;E>ceUtf^^ C«rti£ic»t« of Insurance. 10 day notice of cancellation for non-pajnant of premium. OFRTIFIOATF HOI PFR CANOFHATKW Affordable Water Heaters C Plumbing Inc 24663 Railroad Avenue Newhall, CA 91321 SHOUUI AIKOF THE AAOVE OESCRBGO POUCCS BECANCeiEO aEFORE THE B(P«<ATK>H DATE THEREOF, THE ISSUING INSURSl WU. ENDEAVOR TO HU. ^^ "ATS Y*»T1«< KOIKE TO WE CERTIFICATE HOLDER MAUeO TO TOE LEFT. BUT FAILURE TO DO SO SHALL MPO3E NO OBLIGATION OR UAOUIY OF AMY KIND UPON TOE WSUBER. Irt AGENTS OR tttrmvmmf* AUTHOMJEOfEPRESENTA-nVE .- Ronald Burcham/MNASTE <^~ — /—' *?,££_/ ACORD 25 (2009/01) INS025 (20090D © 1388-2009 ACORD CORPORATION. All rights resarwxi. The ACORO name and logo are registered marks of ACORD