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Home My WebLink About2605 CARLSBAD BLVD; ; CB002413; Permit06/29/2000- City of Carlsbad Plumbing Permit Permit No:CB002413 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 2605 CARLSBAD BL CBAD PLUM Lot#: 0 Construction Type: NEW ARMY NAVY ACADEMY REPIPE (2) WTR HEATERS & (2) FAD'S Status: ISSUED Applied: 06/29/2000 Entered By: JM Plan Approved: 06/29/2000 Issued: 06/29/2000 Inspect Area: Applicant: VILLAGE PLUMBING 1359 KNOLL DRIVE OCEANSIDECA 92054 760-757-1415 Owner: 1572 06/29/0 0001 01 02 C--PRHT Total Fees:$70.00 Total Payments To Dale:$0.00 Balance Due: $70.00 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 $20.00 $0.00 $0.00 $0.00 $14.00 $0.00 $7.00 $0.00 $29.00 $0.00 $0.00 TOTAL PERMIT FEES $70.00 Inspector: FINAL APPROVAL/ Date: Afe^Afo 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 6602Q(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 capactiy 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 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 PERMIT APPLICATION CITY Of CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 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 Name Address City State/Zip Telephone #Fsx # Name Address Ctty 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, after, 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 exemptton/ Any violation of Se/$on 7031.5 by any applicant for a pernjjt subjects the applicant to a civil penalty of nojnore than fiveiundred dollars $ 500 Name / r-^ State License # VT«/> X ^ Address _7 *2- License Class fr^&6. City State/Zip / 7 City Business License » *\ I Telephone # • /"7 Designer Name State License # Address City State/Zip Telephone Workejs^Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: |H 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 workjor which this permit is issued. D—TfiavQ 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 /Cs&&'C^~ /^^s&tdr Policy No. (THIS SECTION NEED NOT BE COMPLETED l^fHE PERMIT IS FOR ONE HUNDRED DOLLARS 1*100] OR LESS) O CERTIFICATE OF EXEMPTION: I certify that in/um 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 tows of California. WARNING: Failure itf'MCUM workers' cornpep^rfion coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (rfoO.OOflJ, In additianflofe/co*t of compensation, damage* •• provided for In Section 3706 of the Labor code, tottrest and attorney's fees. SIGNATURE / /^7X- I hereby affirm that I am e&mpt-frtim 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). 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). D 1 "Hi 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 end provide the major work (include name / address / phonenumber / 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 / ohone number / tvoe of work): PROPERTY OWNER SIGNATURE DATE NO 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? D YES Q 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. 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 I certify that I have read the application and state thet 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 WAX ACCRUE AGAINST SAID CITT IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over B'O" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued bythe Building Official uDflef/'fhe provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such perrr^isjjo^mmence^jwthiojaS^s '">m the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time aftfr the fytff is corflmenced<>ot£ pSfSB-ofeWqrdays (Section 106.4.4 Uniform Building Code) / _.—v -.™*A^2?a^2^_ IITC: File YELLOW: Applicant PINK: Finance APPLICANT'S SIGNATURE City of Carlsbad Bldg Inspection Request For: 6/30/2000 PermiW CB002413 Title: ARMY NAVY ACADEMY Description: REPIPE (2) WTR HEATERS & (2) FAU'S Inspector Assignment: Type: PLUM Sub Type: Job Address: 2605 CARLSBAD BL Suite: Lot 0 Location: APPLICANT VILLAGE PLUMBING Owner: ARMY NAVY ACADEMY Remarks: AM PLEASE - BEHIND THE MESS Phone: 7602131141 Inspector: Total Time:Requested By: MIKE Entered By: CHRISTINE CD Description 23 Gas/Test/Repairs Act Comment Inspection History Date Description Act Insp Comments CM.GOMP WORKERS COMPENSATION and EMPLOYERS LIABILITY INSURANCE POLICY FORM NUMBER WC-00-00-01A (A stock Insurance Company)(Ed. 5-68) WCIRB Company No.: 011657 INFORMATION PAGE 1. The Insured: Mailing address DELANZO, MIKE (AN IND) DBA: VILLAGE PLUMBING 1359 KNOLL DRIVE OCEANSIDECA 92054 POLICY NO. L983175623 PRIOR POLICY NO. New X Individual Corporation or Partnership Group : OOERLINK Line : Non-Participating Interim Premium Adjustment : Stipulated Semi-AnnuallyOther workplaces not shown above : (See Schedule of Locations - Extension of Information Page) (8ee Schedule of Identification Numbers - Extension of Information Page) 2. The policy period is from 3/26/98 to 03/26/99 at the insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers' Compensation Law Of the States listed here: CA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 1,000,000 each accident Bodily Injury by Disease $ 1,000,000 policy limit Bodily Injury by Disease $ 1,000,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: All states except those in Item 3A AND NV,ND,OH,WA,WV,WY » D. This policy includes these endorsements and schedules: WO99-03-94, WC-99-04-01A, WC-99-03-60 , WC-99-03-31 , WC-04-03-01 A, WC-9£-04-82 , WC-04-06-01A 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit Classifications Minimum Premium $500 Code Premium Basis No. Total Estimated Annual Remuneration (See Extension of Information Page) Total Estimated Annual Premium Expense Constant Name of Producer: TOM THOMPSON INSURANCE AGENCY, INC. Countersigned byCode of Producer: 010594 Servicing Office: 95 - Special Programs Date Printed: 04/30/98 (Sys Id 0002) Rate Per $100 of Remuneration Estimated Annual Premium Territory: 4 - PIA Diam 698 0 INSURED COPY Page: 1