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Home My WebLink About2276 CAMINO ROBLEDO; ; CB100544; Permit04-27-2010 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB100544 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: 2276 CAMINO ROBLEDO CBAD PLUM 2552704000 Lot #: 0 Construction Type: NEW HEPBURN RES REPLACE WTR HTR Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 03/30/2010 KG 04/27/2010 04/27/2010 Applicant: AFFORDABLE WATER HEATER 24707 SAN FRANANDO RD SANTA CLARITA, CA 91321 661 259-7131 Owner: HEPBURN 2005 TRUST 09-02-05 2276 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 $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 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 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 vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. <&jW^> Building Permit Application V^^-v 1635 Faraday Ave., Carlsbad, CA 92008 ^X CITY OF 760-602-2717/2718/2719 ^-» A p| i c D A r\ Fax: 76°-602-8558 LAKLbDAU www.carlsbadca.gov JOB ADDRESS .. CT/PROJECT/I LOT* PHASE* * OF UNITS * BEDROOMS SUITE#/SPACE*/UNIT# * BATHROOMS TENANT Bl DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) SA.iy\€. loCft.^i OK\ = 6jcvrcx-<\i- EXISTING USE PROPOSED USE GARAGE (SF) CONTACT NAME (If Different Fom Applicant) ADDRESS CITY STATE ZIP PHONE FAX EMAIL PROPERTY OWNER NAME Stuuxr-T- H£Pb*\rrN ADDRESS CITY . i STATE ZIP PHONE FAX EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LIC. # PATIOS (SF) DECKS (SF) Plan Check MoCBIGO^/ Est. Value Plan Ck. Deposit / DateLf-p//^/^ (Jfa APN - - ^ JSINESS NAME CONSTR. TYPE OCC GROUP FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES D # NO n YES D NO G YES D NO O APPLICANT NAME .... 1Scott Lit-HeFTe.lcJ ADDRESS B<-l&tJ CITY PHONE STATE ZIP FAX EMAIL CONTRACTOR BUS. NAME ADDRESS CITY PHONE EMAIL STATE LIC.* STATE ZIP JFAX CLASS CITY BUS. LIC.# C.Wt> IS«7A71 (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 theBusiness 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 acivil penalty of not more than five hundred dollars ($500)). W O H'.K.CHt S"':,-C-.0 M Pf.it* S A T I O N Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: 0 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. 01 I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for Jtfhich this permit is issued. My workers' compensation insurance earner and policy number are: Insurance Co. *%.£•*>» "VK _ Policy No. tOW*?*** ' ° _ Expiration Date I " I " \\ _ This section need not be completed if the permit is for one hundred dollars ($100) or less. II Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not empby 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. wttft/%- SfAGENTCONTRACTOR SIGNATURE DATE 3 ~ O W N E R - B OltDEROECLARATI ON / hereby affirm that I am exempt from Contractor's License Law for the following reason: n 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 a 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 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 following 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): >£fpROPERTY OWNER SIGNATURE /<y$L . BAGENT DATE ^- ^"5 10 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? OYes DNo Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? O Yes O No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D Yes O No EMERGENCY SERVICES AND THE MR POLLUTION CONTROL DISTRICT. CONSTRucnoN I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address I:A. P1M 1C ft N T I hereby auKrarize representative of Ihe Cty of Carfebad to enter upon Hie above menticfledpoperty for inspection rxin»ses. I ALSO AGREE TO SAVE, INDWNII^ 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 denrolition or construdiwirfstiu^ures ever 3 stories in height. EXPIRATION: Every permit issued by the Building Official under Ihe provisions of this &>te stall expre by ImMon and become null ami v^ 180 days frcm the date of sudi permit a if Ihe buidina or work aufrorized b^ .^APPLICANT'SSIGNATURE DATE City of Carlsbad Bldg Inspection Request For: 05/25/2010 Permit# CB100544 Title: HEPBURN RES REPLACE WTR HTR Description: Inspector Assignment: 2276 CAMINO ROBLEDO Lot: 0 Type: PLUM Sub Type: Job Address: Suite: Location: OWNER HEPBURN 2005 TRUST 09-02-05 Owner: HEPBURN 2005 TRUST 09-02-05 Remarks: Total Time: CD Description 25 Water Heater/Vents 29 Final Plumbing Act Comments Phone: Inspector: Requested By: STEWART Entered By: JANEAN Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments 16619481533 WMI 10:54:31 a.m. 01-05-2010 2/3 ACORD CERTIFICATE OF LIABILITY INSURANCE PRODUCER (661)948-1003 FAX: (661)948-1533 Walter Mortensen Insurance CA License tOD44424 1113 West Ave., M4, Suite C Palmdale CA 93551 INSURED Affordable Water Heaters & Plumbing, Inc. 24707 Railroad Avenue Santa C^arita CA 91321 OKI* (HNDonrm) 1/5/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIONONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATEHOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND ORALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE DOURER A. Zenith Insurance Company INSURER ft INSURER C INSURER 0: INSURER E: N/UC» 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 CONDTnON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THB CERTIFICATE MAY BE ISSUED OR POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS. MM IHL A ton TYPE OF INSURANCE GENERAL UABIUTY GE COMMERCIAL GENERAL UABUTY 1 CLAMS MAOE ( | OCCUR «. AGGREGATE UMTT APPLES PER:poucYns^ riLoc AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE UABIUTY ANY AUTO EXCESS ) UMBRELLA UABajTY 1 OCCUR | | CLAIMS MADE DEDUCTIBLE RETENTION t WORKERS COMPENSATION AND EMPLOYERS' LIABUTT y,N ANY PROPRETOWPARTNERCXECUTIVE 1 1OFFICER/MEMBER EXCLUDED? 1 1 (Mandatory kiNH) ' ' t yaa. oaacribe undar SPECIAL PROVISIONS DttM OTHER POLICY NUMBER ! nOTFrMaMTIVTYYVl 1 DMEnsSSrYml UMrn 067898704 1/1/2010 1/1/2011 EACH OCCURRENCEiViMftnf TO RENTED MED EXP (Any m paraon) PERSONAL C AOV NJURY GENERAL AGGREGATE PRODUCTS -COMPlOP AGO COMBMEO SMGLE UMTT (EaaocidanQ BOCHLY INJURY(Pwpanon) BOOLY NJURY(Paractidant) PROPERTY DAMAGE(Paracddonl) AUTO ONLY - EA ACCOENT OTHER THAN EAACC AUTO ONLY: ^Q EACH OCCURRENCE AGGREGATE 1 WCSTATU- 1 OTH-ITHRVUMTTsi ER EJ_ EACH ACCOENT E4- DISEASE - EA EMPLOYEE E.L DISEASE - POLICY UMTT t I t t t t S t t t t t t *$ $ I $ t 1,000,000 t 1,000,000 * 1,000.000 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT (SPECIAL PROVISIONS Certificate of Ineurance. 10 day notice of cancellation for non-paya*nt of preaiua. CERTIFICATE HOLDER CANCELLATION Affordable Water Heaters & Plvunbing Inc 24663 Railroad Avenue Hewhall, CA 91321 SHOULD AMY OF THE ABOVE OESCRHED POLICES BE CANCELLED BEFOR DATE THEREOF, THE BSUMG USURER WLL ENDEAVOR TO MAI. 30 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAMJUR REPRESENTATIVES. ETHEEXPIMTION DAYS WRITTEN E TO DO SO SHALL AUTHORIZED REPRESENTATIVE ^_ ^^ - Ronald Burcham/MNASTE *-*- — '—' & ££- — ^ ACORD 25 (2009/01) INS025 (200901) ® 1988-2009 ACORD CORPORATION. Al rights i»s«fv«d. TIM ACORD nsiiM and logo am registered marks of ACORD