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Home My WebLink About2245 CAMINO VIDA ROBLE; 101; CB052560; Permit07-12-2005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No. CB052560 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 2245 CAMINO VIDA ROBLE CBAD St: 101 PLUM 2130502400 Lot#: 0 Construction Type: NEW MICROSTAR WATER HEATER REPLACEMENT Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 07/12/2005 MDP 07/12/2005 07/12/2005 Applicant: ARS STE 100 6162 NANCY RIDGE DR SAN DIEGO CA 92121 858-677-5455 Owner: R B CO R E L P PO BOX 1780 LA MESA CA 91944 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:$0.00 Balance Due:$27.00 2396 07/12/05 0002 01 02 CGP1 27-00 Inspector: FINAL APPROVAL Date:Clearance: NOTICE: Please take NOTICE (hat 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, von hav&previojjslv beenjiiven 3 NOTICE similar to this, or as to wbich_the_statute of limitations-has previously otherwise expired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 r i FOR OFFICE USE ONLY PLAN CHECK EST. VAL. Plan Ck. Deposit Validated By Date Address (include Bldg/Suite 8)Business Name (at this address) Legal Description Lot No. _. ^^.Sjjbdlvision Name/Number Unit No.Phase No.Total n of units xisting Use Proposed Use Description tf Work SO. FT. #of Stories EiiMttffittftm •*?'** *> # of Bedrooms of Bathrooms Name ^ Address City Tr-.iTi*fo3'i?["Tj!l' fEEfg^J^g£ v <""•. p ATSJ Jl_ *-*siollSSpSmlr'^ CJArfinfftr Owner State/Zip Telephone ff Fax State/Zip Telephone Name Address City State/Zip Telephone # (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 of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [S50Q1). Name State License « '^- J *P 2-O Addre__ License Class O 2-O City State/Zip City Business License # Telephone Designer Name State License # Address City State/Zip.Telephone i/k lot* Workers' Compensation Declaration: I 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. H. I have end 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 IVinfcC&re JA^^C Policy No. £r\•LToe^'TP "Q' Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) D 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 tbaJWorkers' Compensation Laws of California. WARNING: Fallurfeyto senire worker*' compensation coverage la unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (4jOQvV/>). in addition tt> the cosf oi,coiu»Ttsation, damages at provided for In Section 3706 of the Labor code/ Interest and attorney's fees.\ vi J/v(jr\ r^ • * /ivv*it/~i* ^ r T i - —- SIGNATURE ^JL/\JL^>4 7. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D 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 pcopeity who builds or improves thereon, and contracts for such projects with contractnt(s) licensed pursuant to the Contractor's License Law). f~l t 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 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 cOMPLEtrrHis DATE NO r^!fH!j0!S|^^ • • 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 Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? d 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. .••/ CdNSTRUCTroNlENDlNCTAGEN.Cyxh^ i» ." • -:1\:1'/"1 V • lereby 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). MDER'S NAME LENDER'S ADDRESS tify 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 ordinances and State laws relating to building construction. I hereby authorize representatives of the CitV of Carlsbad to enter upon the above mentioned rty for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, MENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. \TION: Every permit issued b/ttiebuilding Official under the provisions of this Code shall expire by limitation and become null and void if the building or work ed by such permit is not ne after the work is com NT'S SIGNATURE encea within 180 days from the icedJrla period of 180 days (Se Q nt06 4 -HJnilorm Building Code). ich permit or if the building or work authorize^ t$ such permit Is suspended ot abandoned DATE WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 07/25/2005 Permits CB052560 Title: MICROSTAR Description: WATER HEATER REPLACEMENT Inspector Assignment: TP 2245 CAMINOVIDAROBLE 101 Lot 0 Type: PLUM Sub Type: Job Address: Suite: Location: APPLICANT ARS Owner: Remarks: has a ladder for inspector Phone: 7609314949 ex 1121 Inspector: Total Time: CD Description 25 Water Heater/Vents Act Comment Requested By: CHRIS Entered By: CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 07/20/2005 25 Water Heater/Vents NR TP NEED ACCESS TO W/H ^ MARSH CERTIFICATE OF INSURANCE ^^^™ PRODUCER ServiceMaster Certificate Team MARSH USA. Inc. 500 W Monroe St. Chicago. IL 60661 Attn Fax. 877-732-7799 8112 INSURED (#S112)ARS AMERICAN RESIDENTIAL SERVICES OF CALIFORNIA INC. dbaARS OF SAN DIEGO 860 RIDGE LAKE BLVD. MEMPHIS. TN 38120 THIS CERTFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS HO RIGHTS UPOH THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POLICY. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED er THE POLICIES DESCRIBED HEREIN. COMPANIES AFFORDING COVERAGE A ZURICH AMERICAN INSURANCE COMPANY B ILLINOIS NATIONAL INSURANCE COMPANY COVP^NY C CCMPANV D COVERAGES- . Thiacertiftca*&super»deaandrepiacesany previously issued cwfiflt^Bfermepoticy periodrratedbelow. Tn.S iS TO CERTIFY THAT PO-'CES Or INSURANCE DESCRIBES nrREN lAVE 3E5N 'SSbED TO THE iNSjREG NAMED HERE'N r=QR THE PaiCY =E3IOO 'NDlCATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANV CONTRACTOR OTHER DOCUMENT WTH RESPECT TO VWICH THE CERTIFICATE WAY 9E ISSUED OR MAY ===IT«N THE: NSURANCE Cf^OROeO BY THE POLICES DESCRIBED nEREN !S SUBJECT TO M THE TERMS CONDITIONS AND EXC.U3ONS OF SUCH POLiCSS AGGREGATE JVIT3S-O<ftN MAY HAVE BEEN REDUCED BY ° AID CLAIMS CO LTR A , * [ L j- TYPE OF INSURANCE 3ENERAL LIABILITY < COMMERCIAL GENERAL LIABILITY '"] j CLAIMSMADE j X j OCCUR OWNER'S & CONTRACTOR'S PROT UTOMOQLE LIABILITY J-1 ^ ANY AUTO ALL OViWED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OVWED AUTOS 3ARAQE UABH.ITY ~~I wy NaTQ Q EXCESS LIABILITY i X UM8RELLAFCRM1 OTHER THAN UMBRELLA =ORM A WORKERS COMPENSATION AND EMPLOYE RELIABILITY ! TH= PROPRIETOR/ '~X~"i NCL CF='.CEPSARE ' ~XCL POL.CYNg«BER wT^mSKf GLO 2938645-01 01/01/03 BAP 2938646-01 (AOS) 01/01/03 BAP 2938647 -OA (VA) ' Q1 ;0i;03 TAP 2938648-01 (TX) 01/01/03 ». ; POLICY EXPIRATION 01/01/06 01/01/06 QVQ-W06 01/01/06 BE 309-79-07 04/01/01 04/01/04 VW; 2938643-01 (AOS) 01/01/03 01/01/03 LIMITS GENERAL AGGREGATE PRODUCTS • COMP/OP AGG °ERSONAL & AQVINJURY EACH OCCURRENCE $ 5,000,000 $ 1 ,000,000 $ 1,000,000 $ 1 .000,000 FSREQAMAGeiAnvOT«(;t«) 5 ' ,000,000 MED EXP (Any coo p«rson) CCMBNED SNGLE LIMIT BODILY I NJJSY (Per parscn] BODILY INOJRY (Per aooOont) PROPERTY OJMA.GE *JTQ ONLY - EA ACCIDENT OTHER THAN AUTO ONLY EACH ACCIDENT AGGREGATE S 5,000 $ 1 ,000,000 $ 5 % $ ^.la^r^i'lt"";':''. $ $ EACH OCCURRENCE ; $ 5,000,000 AGGREGATE $ 5,000.000 $ v | WCSTATlj- . i OTH4 - .-/ . ... - A i TORYUMITS i I ER .' -' " ••" EL EACH ACODENT $ 1.000,000 El. 7SPAS=-sa.tCY;.MIT J 1.000.000 =L ^!S=ASE-EN> SMPi O^=~'- $ 1 ,000.000 OTHER DESCRPTtQN OF '.iPERATIOMS'LOCATIONSfVEHICLESISPECtAL ITEMS CERTIFICATE HOLDER CANCELLATION EHOUlJ *MVO= TM= -<X C=S D = ^N NOT MO o«, HARSH USAHC. 3Y: Chnsly N Phoeous HIM (3/M>VALiD A3OP- KV26/02