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HomeMy WebLinkAbout2371 CARINGA WAY; I; CB011025; Permit03/15/2001 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No:CB011025 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 2371 CARINGA WY CBAD St: I PLUM 2152404200 Lot#: 0 Construction Type: NEW SEACREST LLC/ REPAIR GAS LINE Status: ISSUED Applied: 03/15/2001 Entered By: CB Plan Approved: 03/15/2001 Issued: 03/15/2001 Inspect Area: Applicant: GRJ ENTERPRISES SUITE A 4599 MISSION GORGE RD SD CA92120 619-287-9806 Owner: SEA CREST LLC CIO THEORA COLE 336SWETHERLYDR BEVERLY HILLS CA 90211 4032 03/15/01 0002 01CGP 02 27»00 Total Fees:$27.00 Total Payments To Date:$0.00 Balance Due: $27.00 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 0 0 0 0 0 1 0 $20.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $27.00 Inspector: FINAL APPROVAL Date:7 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 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 1. PROJECT INFORMATION Address (includeBldg/Suite #) FOR OFFICE USE ONLY PLAN CHECK EST. VAL. Plan Ck. Deposit Validated By ^ Date "V1 C". ^\H Businesl Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total # of units Assessor's Parcel* f_Existing Use Proposed Use Name 3i APPLICANT *rt£ontrattor fidress D Agent lot Contractor Q Owner City Q Agent for Owner State/Zip Telephone #Fax # Address City State/Zip Telephone ft Address City State/Zip Telephone # ~7&3~-Hli- Name 6. CONTRACTOR - COMPANY NAME (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 [$500]). Name State License # Address License Class City State/Zip City Business License # Telephone # Designer Name Address City State/Zip Telephone State License # 6. WORKERS'COMPENSATION /;:-':'-'-.;::..:::':';,':.;::'::."OT/v'.. :::;T;.:-'. :: /''.'•:•. :,.; '"". . .' •'. : Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: >fiSL ! 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 fifth's work for which this permit is issued. [___ 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: vfv?. / -aft »y---v ^t .ffT*^ ^^^^^ I _|^V f J ^^ ^N ^ J^5 f f -Xi r*Insurance Company S \-^»>-*~> TCX*"* / ) Policy No. * ^^ «—'—J IS f Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS {$1001 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 (S^OtLOOO), In addition «o~Ttt6>cost of compensation, damages as provided for in Section 3706 of theLabor code, interest and attorney's fees. SIGNATURE J OiU~-> ^^C^^-Jr^.^, """" DATE ^7f~'s / 5~**<£) | 7. OWNER-BUILDER DECLARATION \J~ I hereby affirm that I am exempt from the Contractor's License Law for the following reason: Q 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). f~) 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). |~| 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. D YES C]NO 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 COMPLETE THIS SECTION FOR NON-RESIDENTJAL BUILDING PERMITSONLY 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 Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? C] YES [__] 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 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 ia." 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 commenced within iaO-daj(sfrom 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 commen^keyta^rtrerioiTof i80dai(S (Section 106.4.4 Uniform Building Code). ~ """" ~7 DATEAPPLICANT'S SIGNATURE File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 05/01/2001 Permit^ CB011025 Title: SEACREST LLC/ REPAIR GAS LINE Description: Inspector Assignment: AR 2371 CARINGAWY I Lot Type: PLUM Sub Type: Job Address: Suite: Location: APPLICANT GRJ ENTERPRISES Owner: Remarks: Phone: Inspector: Total Time: CD Description 11 Ftg/Foundation/Piers Act Comments Requested By: BRIAN Entered By: CHRISTINE fkJLfill a* 6*1 If A' TO'JK)6 Associated PCRs Inspection History Date Description Act Insp Comments 03/16/2001 21 Underground/Under Floor AP AR 03/16/2001 23 Gas/Test/Repairs AP AR CERTIFICATE OF LIABILITY INSflRXtfcE DATE 8/28/2000 PRODUCER CB General Insurance Brokerage 3thi.ll Blvd. #216 CA 91214 3115 .foot! Glenda*le, (818)241-2970 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 INSURED QHJ INSURER A. CLABKNDOM AMERICA XNSURANCK COMPANY INSURER ft 4599 A. Mission Gorge PI San Diego,, CA 92120 INSURER C: INSURER ft 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 AMD CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Tff A TYPE OF INSURANCE GENERAL UABUTY 5\ COMMERCIAL GENERAL UABUJTY [CLAIMS MADE | XI OCCUR GENl AGGREGATE LIMIT APPLIES PER 53 POLICY PI 38 flu* AUTOMOBILE UABUTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS OARAOI UABUTY ANY AUTO EXCESS UABUTY (OCCUR I CLAIMS MADE 1 DEDUCTIBLE 1 RETENTION t WORKERS COMPENSATION AND EMPLOYERS' UABUTY OTHER POLICY NUMBER TJCLT 200 0677 POLICY EFFECTIVE 7/20/2000 POLICY EXPIRATIONBin iwunniwi 7/20/2001 • LIMITS EACH OCCURRENCE FIRE DAMAGE (Any on* lira) MED EXP (Any ont ptmn) PERSONAL *ADV INJURY GENERAL AGGREGATE PRODUCTS - COUP/OP AGO COMBINED SINGLE LIMIT (EtKCkhnQ BODILY INJURY(Pwpmon) BODILY INJURY (PvacckM) PROPERTY DAMAGE(PwaccKtort) AUTO ONLY - EA ACCIDENT OTHER THAN EAACC AUTO ONLY:AGO EACH OCCURRENCE AGGREGATE 1 WCSTATU- I E.L EACH ACCIDENT OTH-ER E.L DISEASE • EA EMPLOYEE E.L DISEASE - POLICY LIMIT ,1,000,000 ,50,000 ,5,000 ,1,000,000 ,2,000,000 ,1,000,000 1 s s s *J s s s s $ s s s s \ \ DESCRIPTION OF OPERATUNMLOCATOHS/VEHICLESIEXCLU8ION8 ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED; USURER LETTER:CANCELLATION VERIFICATION PURPOSES ONLY***************** ******************************************* ******************************************* ******************************************* SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION*10DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAI. *v DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR UABUTY OF ANY KMD UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES. // . /~^_ AUTHORIZED REPRESENTATIVE 4L&-J. f /\ _, . n STEPHEN DUQUE fayLjLfjjTl/ /^^* '*<-< , ACORD 25-S (7/97)f © ACORD CORPORATION 1988