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HomeMy WebLinkAbout2605 CARLSBAD BLVD; ; CB042570; Permit06-28-2004 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB042570 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 2605 CARLSBAD BL CBAD PLUM Lot #: Construction Type: ARMY & NAVY ACADEMY- REPLACE 6 WATER HEATERS 0 NEW Status: ISSUED Applied: 06/28/2004 Entered By: KMT Plan Approved: 06/28/2004 Issued: 06/28/2004 Inspect Area: Applicant: H&M MECHANICAL SERVICES 4914 SKYLINE TERRACE 92509 760-801-7147 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 $20.00 $0.00 $0.00 $0.00 $0.00 $42.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $62.00 Total Fees:$62.00 Total Payments To Date:$0.00 Balance Due:$62.00 5305 06/28/04 0002 01 02 CGP 62.00 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated B^ Date Address (include Bldg/SuitB #1 Business Name (at this address) Legal Description TotaN* of units Description of Work # of Bathrooms Fax # ^*^-^;i*^:^^^".^w^r trV'-'l">; (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for feealUged exemption. Any violation of Section 7031.5 by any Applicant for a pejmit subjects the appljcanj^wTfcivil £ef$fty of not more thajftfivejiundred dollars "* Name State License City State/Zip Telephone # City Business Licens/ # / &\ / s(-& L (~f Designer Name State License H Add/ess City /State/Zip Telephone ^iSSu .i. .,>,...,^vu-V-; /.vtf.^ ,-;\... • '-...-. • ,•• . ' \ . . • • Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: I nave 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. 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 policvrjwnber are: Insurance Company <*^J&pf&'£ff?3& -Z%^£ ^t+T^O Policy No. Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [SI001 OR LESS) 0 CERTIFICATE OF EXEMPTION: I 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: Failura^lb sacun workers' compensation coverage la unlawful, and shall subject art employer to criminal penalties and civil fine* up to one hundred thousand doHua^iftw.OOulJnaddHion to the cost of compjuuatlon, damages as provided for in Section 3706 of the Labpr codeinterwt and attorney'* fees. SlGNATURB>^/^^gWj^^7^^-i Vvg^-^ftt^grX/ DATE 1 hereby affirm thwf-t am exempt from(tj)e 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 tn/provements 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 bunen 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). I n I *rn 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. CD 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 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 &ityii£ife^*&&io^ 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 25605, 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? 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. 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 ADDRESSLENDER'S NAME illS^^^ 1 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 1 80 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 cqrajpgnced fofep-period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE,DATE YELLOW: Applicant PINK: Finance f City of Carlsbad Bldg Inspection Request For: 09/22/2004 Permittf CB042570 Title: ARMY & NAVY ACADEMY- REPLACE Description: 6 WATER HEATERS Type: PLUM Sub Type: Job Address: 2605 CARLSBAD BL Suite: Lot 0 Location: APPLICANT H&M MECHANICAL SERVICES Owner: Remarks: pm please (6) pater heaters Total Time: CD Description 25 Water Heater/Vents Act Comment Inspector Assignment: Phone: 9516408542 Inspector: Requested By: KENT Entered By: CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments License Detail Page 1 of2 California Home Monday, June 28, 2004 License Detail Contractor License # 809663 CALIFORNIA CONTRACTORS STATE LICENSE BOARD DISCLAIMER A license status check provides information taken from the CSLB license data base. 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 7071.17. only construction related civil judgments known 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 data base. * * * Extract Date: 06/28/2004 Business Information * * * H & M MECHANICAL SERVICES INC 4914 SKYLINE TERRACE RIVERSIDE, CA 92509 Business Phone Number: (909) 685-5077 Entity: Corporation Issue Date: 06/19/2002 Expire Date: 06/30/2006 * * * License Status * * * This license is current and active. All information below should be reviewed. * * *Classifications * * * Class C36 C-4 B A I Description PLUMBING BOILER. HOT WATER HEATING AND STEAM GENERAL BUILDING CONTRACTOR GENERAL ENGINEERING CONTRACTOR FITTING http://www2.cslb.ca.gov/CSLB_LIBRARY/License+Detail.asp 06/28/2004 License Detail Page 2 of 2 C16 FIRE PROTECTION CONTRACTOR * * # DAM^JIHM 1 nfA *>m <*4l A n * * *Bonding Information CONTRACTOR'S BOND: This license filed Contractor's Bond number GCL1233238 in the amount of $10,000 with the bonding company INTERNATIONAL BUSINESS AND MERCANTILE REASSURANCE COMPANY. Effective Date: 05/06/2004 Contractor's Bonding History BOND OF QUALIFYING INDIVIDUAL(I): The Responsible Managing Officer (RMO) KENT ALAN HESSELGRAVE certified that he/she owns 10 percent or more of the voting stock/equity of the corporation. A bond of qualifying individual is not required. Effective Date: 06/19/2002 * * *Workers Compensation Information This license has workers compensation insurance with the SIATE COMPENSATION INSURANCE FUND Policy Number: 229-0025536 Effective Date: 10/19/2002 Expire Date: 10/01/2004 Workers Compensation History Personnel listed on this license (current or disassociated) are listed on other licenses. Personnel List Other Licenses License Number Request Contractor Name Request Personnel Name Request Salesperson Request Salesperson Name Request © 2003 State of California. Conditions of Use Privacy Pjjjjcy http://www2.cslb.ca.gov/CSLB_LIBRARY/License+Detail.asp 06/28/2004