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HomeMy WebLinkAbout2445 MOUNTAIN VIEW DR; ; CB022364; Permit08-15-2002 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB022364 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 2445 MOUNTAIN VIEW DR CBAD PLUM 2030231000 Lot# Construction Type MULLINS RES GAS LINE REPAIR 0 NEW Status ISSUED Applied 08/15/2002 Entered By RMA Plan Approved 08/15/2002 Issued 08/15/2002 Inspect Are:a_ OS/15/02 00^2 01 Da. Applicant BROWN PLUMBING CO ARTHUR A 2697 STATE ST CARLSBAD, CA 92008 6197294914 Owner MULLINS LINDA J&WALLACE G FAMILY TRUST P O BOX 2327 CARLSBAD CA 92018 Total Fees $27 00 Total Payments To Date $0 00 Balance Due $27 00 Plumbing Issue Fee Fixture or Trap f , ' s Building Sewer , ' ' Roof Drain 1 * Install/Repair Water Line ''' Water Heater and/or Vent Gas Piping System < Vacuum Breaker ''" Other Plumbing Fees t '• Master Drainage Fee , ' Sewer Fee , Additional Fees * 0 0 0 0 0 1 *o '• j i , , f •*> $20 00 \ " * $0 00 i ' $000 - ,,, ' " ( $000 . „ " $000 $000 $7 00 $0 00 $0 00 \ ^ . $0 00 , 4 ' T $0 00 i - $000 ' TOTAL PERMIT FEES $2700 NOTICE Please take TOTICE trftcAroval of your project includes the Imposiffon of fee? dedications reservations or other exactions hereafter collectively referred to as fees/exactions Yoinlrce 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',s) i//eu) FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total tt of units Assessor s Parcel #Existing Use Proposed Use Description^ Work ,2. CONTACT PERSON (if different from applicant) SQ FT #of Stones tt of Bedrooms # of Bathrooms Name APPLICANT Address I Contractor Q Aqent for^ Contractor City lUwner ' Q Agent for^Owner State/Zip Telephone tt Fax tt f ^ ,.. Name Address City State/Zip Telephone # Name s /CONTRACTOR ^.COMPANY NAME Address City State/Zip Telephone tt (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])fa Name State License tt Address License Class City State/Zip Telephone # City Business License tt / 7 O@ O Designer Name Address City State/Zip Telephone State License tt 6 WORKERS "COMPENSATION * . I * » „ "V Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations ^4£jt? •eg' 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 JS)' 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 __ Insurance Company iST/fT?- @0~7?1r£--/t/5tf'776AJ 7~f)M[) Policy No /.? /6v3 to ~~0 ^~ Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] 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 Failurexo secure workers compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollar&£MOQXfoO) in addition to the co&of compensation damages as provided for in Section 3706 of the Labo/code interest and attorney s fees SIGNATURE ^^L^^^<(L^^f^J^^\^--^^^-^~~— DATE O/fS/C^S-^ I OWNER BUILDER DECLARATION ' - "> ' '' £?• fi ^ „ * * '> 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) Q 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) O 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 Q YES 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 /VO/V-/?£S/D£W7Mi BUILDING PERMITS ONLYl >*„*„ &" *T > 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 Js 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? Q 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 |8 . .CONSTRUCTION LENDING AGENCY *t« t i ' > , I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(0 Civil Code) LENDER S NAME _ LENDER S ADDRESS ___ _____ _ •9 _ APPMCANT CERTIFICATION ,, * ^ J> S*A\ ^ „ s, 4i,, /*- , 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 CitV 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 corpmencecl within 180 days from 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 conjffWced^fjr a period on 80 days (Secton 106 4 4 Uniform Building Code) APPLICANT S SIGNATURE DATE WHITE File YELLOW Applicant PINK Finance UNSCHEDULED BUILDING INSPECTTQN DATE PERMIT # JOB ADDRESS. DESCRIPTION CODE DESCRIPTION 7" INSPECTOR PLAN CHECK # ACT COMMENTS ACORD. CERTIFICATE OF LIABILITY INSURANCfe^ PRdDUCiER Rubin Insurance Agency Inc 6363 Greenwich Dr, #120 CA#0645355 San Diego CA 92122 Phone 858-457-5720 Fax 858-457-5729 INSURED ) Arthur A Brown Plumbing 2697 State St Carlsbad CA 92008 I DATE (MM/DD/YY) 01/07/02 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 INSURERA Navigator Insurance INSURERS State Conxp Ins Fund INSURERC Hartford Fire Insurance Co INSURER D INSURER E COVERAGES ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WIT H 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 AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LTR A C B C C TYPE OF INSURANCE GEr- JC^ X IERAL LIABILITY COMMERCIAL GENERAL LIABILITY | CLAIMS MADE | X | OCCUR 1,000 DED GEN L AGGREGATE LIMIT APPLIES PERn POLICY n$E& ruoc AUTOMOBILE LIABILITY X X X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS LIABILITY | OCCUR [ | CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY OTHER BUILDING BUS PER PROP POLICY NUMBER GA500645 72UTJCGJ4857 1590156 72UUCGJ4857 72UTJCGJ4857 POLICY EFFECTIVE DATE (MM/DD/YY) 01/01/02 01/01/02 07/01/01 01/01/02 01/01/02 POLICY EXPIRATION DATE (MM/DD/YY) 01/01/03 01/01/03 07/01/02 01/01/03 01/01/03 LIMITS EACH OCCURRENCE FIRE DAMAGE (Any one fire) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS COMP/OPAGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY EA ACCIDENT OTHFR THAN ^ ACC AUTO ONLY AGG EACH OCCURRENCE AGGREGATE _, WCSTATU OTH X TORY LIMITS ER EL EACH ACCIDENT EL DISEASE EA EMPLOYEE EL DISEASE POLICY LIMIT $1,000,000 $ 50,000 $5,000 $1,000,000 $2,000,000 $1,000,000 S 1, 000,000 $ $ $ $ S s $ $ $ s $ $1,000,000 $ 1,000,000 $ 1,000,000 SPEC FORM 130,600 SPEC FORM 113,600 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ongoing plumbing operations of named insured *10 DAY NOC IN THE EVENT OF NON-PAYMENT OF PREMIUM CERTIFICATE HOLDER N ADDITIONAL INSURED INSURER LETTER CANCELLATION CITYCAl City of Carlsbad 2075 Las Palmas Dr Carlsbad CA 92009-1576 i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SW IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES Bernie Sharpe /} J^l&SseJL ACORD 25-S (7/97)©ACORD CORPORATION 198