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HomeMy WebLinkAbout2380 CAMINO VIDA ROBLE; ; CB090818; Permit05-14-2009 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB090818 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: 2380 CAMINO VIDA ROBLE CBAD PLUM 0000000000 Lot#: 0 Construction Type: NEW SEWER CLEAN OUT REPAIR Status: ISSUED Applied: 05/14/2009 Entered By: JMA Plan Approved: 05/14/2009 Issued: 05/14/2009 Inspect Area: Applicant: NRC ENVIRONMENTAL 2950 KURTZ ST SAN DIEGO CA 619-235-3320 Owner: 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 1 0 0 0 0 0 $20.00 $0.00 $15.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $35.00 Total Fees:$35.00 Total Payments To Date:$35.00 Balance Due:$0.00 EXPIRED PERMIT PERMIT HAS EXPIRED IN ACCORDANCE WITH C.B.C. SECTION 106.4.4 AS AMENDED BY C.li " BATE FINAL APPROVAL Inspector: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 you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. City of Carlsbad 1635 Faraday Ave., Carlsbad, CA 92008 760-6(52-2717 / 2718 / 2719 Fax:760-602-8558 www.carlsbadca.gov Building Permit Application < ( ,1 xistBvyflr^vK Plan Check No- C&O^O& ( <f" cL^p^e Est. Value ^JjjIS^^ Plan Ck. Deposit Date g~(fc( IQ <^ J(^yy^~~ JOB ADDRESS SUITE#/SPACE»/UNIT# APN .2.300 £oLV*t*e i/l'of^ (r^oLl^ , lav./;*.^ ft ' ' CT/PROJECT # | LOT # I ' I PHASE # * OF UNITS DESCRIPTION OF WORK: Include Square Feet of Affected Area(s)' c / ±.•• j -e u^ -e v: @_ 1-e.a w. AtvT" i^-fficLi' EXISTING USE CONTACT NAME (If Different Fom Applicant) ADDRESS CITY PHONE EMAIL PROPERTY OWNER NAME ADDRESS CITY PHONE . ' EMAIL ARCH/DESIGNER NAME & ADDRESS PROPOSED USE STATE ZIP FAX ((BEDROOMS * BATHROOMS TENANT BUSINESS NAME CONSTR. TY«E OCC. GROUP 1 |T GARAGE (SF) 1 PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YESD # NO Q YES D NOD YES U NO d APPLICANT NAME ADDRESS CITY STATE ZIP PHONE FAX EMAIL tACTOR BUS. NAJ0E _,, ss STATE ZIP CITY STATE ZIP FAX STATE LIC. # PHONE ' FAX &/4) 2. "J J' - 332 a EMAIL JfcTATE LrC.# ' • CLASS >. felTY BUS. LIC.# Sec. 7031.5 Business and Profession Code: Am 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 J signed statement that he iscensed pursuant to the provisions of the Contractor's license law {Chapter 9, commending with Section 7000 of Division ) ol the Business and Professions Code} or that he is exempt there from, and the basis for the jBeged exemption, l,iy violation ofection 703 1.S by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500}). |U WORKERS COMPENSATION 'i ,\ Workers' Compensation Declaration: / hereby affirm under penalty of perjury one ol the following declarations: O 1 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 issud. <S*£3XI 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 workers' compensation insurance earner and policy "i number are: Insurance Co"7t/ VI* f-h*- ft IfM-f \rPCa.*. ZVi? I/ r&\te.-e. Policv No. L^> £, Q. 1 & 2. ft 2. V Exoiration Date /O/O//Q9 This section need not be completed if the permit is for one hundred dollars ($100) or less. C3 Certificate of Exemption: 1 certify that in the performance of the work for which this permit is issued, 1 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>«npensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100 000), in i addition to the cost of compensation, damagesrairovided for in Section 3706 of the Labor code, interest and attorney's fees. y\ ." jET CONTRACTOR SIGNATURE JZf DATE 0S~//£//0& • OWNER BUILDER DECLARATION K 1 hereby affirm thatl am exempt from Contractor's License Law for the following reason: rj 1, 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 c.t ei ed 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). O 1, 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 own,!' of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). D 1 am exempt under Section Business and Professions Code for this reason: 1 . 1 personally plan to provide the major labor and materials for construction ol 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 ol the work, but 1 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 1 have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): ^PROPERTY OWNER SIGNATURE | COMPLETE THIS SECTION FOR NON DATE -RESIDENTIAL BUILDING PERMITS ONLY '), j\ '< 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 o! the Presley-Tanner Hazardous Substance Account Act? a Yes D No 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? OYes ONo EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. CONSTRUCTION LENDING AGENCY 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 Addtess APPLICANT CERTIFICATION I certify that I have read the application and state that the above information is ccmect and that the infbrmatiOT on the rjlatis is accurate ^^ I hereby authorize representative 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 commencefj within 180 days from the date of such permit or if the buWng or work authorized by such rjemre suspended or abawloned at any time after the work is awmerc ..^APPLICANT'S SIGNATURE Jry OATE Storm Water Compliance Exemption Form I am applying to the City of Carlsbad for the following type(s) of construction permit: EjBuildingPermit D Right-of-WayPermit JMy 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 Mobjfo Plumbin Patio/Deck Re-Roofing Sign Spa-Factory Sprinkler Water Discharge Project Storm Water Threat Assessment Criteria* No Threat Assessment Criteria [~~| 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 | | 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 stockpiling). Tier 2 • Moderate Threat Assessment Criteria \ [ 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). Tier 3 - Significant Threat Assessment Criteria | | 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 | | My project is part of a phased development plan that will cumulatively result in soil disturbance totaling one or more acres including any associated construction staging, equipment storage, refueling and maintenance areas: or, | [ 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 acknoxleriij* that even thcn;r;r: this project does not rs-juire preparation ot a construction SWPP, I must still adhere to, and at all times during construction activities for -he 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 highte Construction SWPPP Tier Level is warranted. Project Address:Assessor Parcel No. Owner/Owner's Authorized Agent Name; Daunt Fin. Owner/Owner's Authorized Agent Signature: oncjjirence: l Q NO By:Dale: Title: Date: Project ID: City of Carlsbad Bldg Inspection Request For: 11/16/2009 Permit# CB090818 Title: SEWER CLEAN OUT REPAIR Description: Inspector Assignment: Type: PLUM Sub Type: Job Address: 2380 CAMINO VIDA ROBLE Suite: Lot 0 Location: APPLICANT NRC ENVIRONMENTAL Owner: Remarks: can you final this permit? Repair work? Total Time: CD Description 29 Final Plumbing Act Comments Phone: 0000000000 Inspector: Requested By: NA Entered By: CHRISTINE AJ -T& fwrt/f jtJ 3*4 < Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments Check a License or Home Improvement Salesperson (HIS) Registration - Contractors Stat... Page 1 of 1 Department of Consumer Affairs Contractors State Li Contractor's License Detail - License # 716581 e Board >^ DISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this information, you should be aware of the following limitations. * CSLB complaint disclosure is restricted by law (B&P 7124.6). If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action information. • * Per B&P.7071J.7, only construction related civil judgments reported to the CSLB are disclosed. •••» Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. ' Due to workload, there may be relevant information that has not yet been entered onto the Board's license database. License Number:Extract Date: 05/14/2009 Business Information: Entity: Issue Date: Expire Date: License Status: Classifications: Certifications: _716581 ^ __ _ _____ NRC ENVIRONMENTAL SERVICES INC PIER D BERTH 47 LONG BEACH, CA 90802 Business Phone Number (562) 432-1304 Corporation 12/20/1995 12/31/2009 This license is current and active. All information below should be reviewed. CLASS DESCRIPTION A :GEN£RAkENGINEE.BI.NGC.QNIRAC.TQB C21 BUILDING MOVING. DEMOLITION CERT DESCRIPTION HAZ HAZARDOy,S..S.UBSIANCES REMOVAL. ASB ASBESTOS - (for bidding purposes only) Bonding: Workers' Compensation: CONTRACTOR'S BOND This license filed Contractor's Bond number K07093846 in the amount of $12,500 with the bonding company WESICHE.SIER.flBEJMUBMCE COMPANY, Effective Date: 01/01/2007 ContracjQri..Bond.ina.History BOND OF QUALIFYING INDIVIDUAL 1. This license filed Bond of Qualifying Individual number K07093834 for ASHER BENSON GRIMES in the amount of $12,500 with the bonding company WESICHESEfifJBEJNSUFWNCE.CQMPANY. Effective Date: 01/01/2007 B.Qrs.Bonding..Hislory. This license has workers compensation insurance with the ' ZURICH. AMEBI.CANJNSU.BANCE. COMPANY Policy Number: WC9162024 Effective Date: 10/01/2008 Expire Date: 10/01/2009 Workers', Compensation History Personnel listed on this license (current or disassociated) are listed on other licenses. Conditions ofJJse | Privacy. Policy Copyright © 2009 State of California https://www2.cslb.ca.gov/OnlineServices/CheckLicense/LicenseDetail.asp 05/14/2009