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HomeMy WebLinkAbout2655 CARLSBAD BLVD; ; CB070263; Permit01-30-2007 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB070263 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 2655 CARLSBAD BL CBAD PLUM 2031420300 Lot #: Construction Type: EBBTIDE INN / BEACH ST SALON REPLACE EXISTING SEWER V Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 01/30/2007 MDP 01/30/2007 01/30/2007 Applicant: TOWN & COUNTRY PLUMBING 321 N ENGELST ESCONDIDO 92027 745-0337 Owner: PHILLIPS JACK D 2667 OCEAN ST CARLSBAD CA 92008 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 Inspector:, FINAL APPROVAL Date:Clearance: NOTICE: Please take NOTICE thai approval ol 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 v\ 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 vou have previously been oiven a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. PERMIT APPLICATIONi CITY OF CARLSBAD BUILDING DEPARTMENT 1635' Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO. 6*7 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 It of units Assessor's Parcel ft Existing Use Proposed Use Descrition of Work SQ. FT.#at Stories # of Bedrooms # of Bathrooms Name Address City State/Zip Telephone (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 ES5001). i Name ' "-* Address I/ State License ff *%% 2-9 ' V License Class C_ — , 1 Designer Name Address State License # City State/Zip . Telephone # >fc City Business License # £. ^Xf^^ ^ 1 City State/Zip Telephone Workers' Compensation Declaration: E hereby affirm under penalty of perjury one of the following declatations: Q 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. Q"""! 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 P($,4&t-9 &t*Ple\tfrS Tu$ &L* _ Policy No.foj&tf lit 7s2-> _ Expiration Date j> - /' ~& ~7 (THIS SECTION NEE NOT BE COMPLETED IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS [6100] 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 addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. ' _ DATE / *- > d - O ~7~ thousand dollnrs ,OO I hereby affirm that I am exempt from the Contractor's License Law for the following reason: n 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). n 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). n 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, fj 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 j^fi^ Is the applica.nl or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program undor Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? O 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 D 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 | 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. 1 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 QSHA 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 il 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 a.fter the work is compwrroed fOMrtferiod of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE * ^^U^/QgU* — - -- " _ DATE ("~ ^^ ~~ ° 7 _ WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 01/31/2007 Permit* CB070263 Title: EBBTIDE INN / BEACH ST SALON Description: REPLACE EXISTING SEWER Inspector Assignment: 2655 CARLSBAD BL Lot 0 Type: PLUM Sub Type: Job Address: Suite: Location: OWNER PHILLIPS JACK D Owner: PHILLIPS JACK D Remarks: Phone: 7605804221 Inspector: Total Time: CD Description 22 Sewer/Water Service Act Comment Requested By: LUCKY Entered By: CHRISTINE Com ments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description ^ Act Insp Comments From. Ertca Wilson At: Murria & Prick Insurance FaxlD; 858-259-6069 To: Daisy Date: 11/16X16 01:43 PM Pafle:2oT2 ACQBD. CERTIFICATE OF LIABILITY INSURANCE *,sw PRQOOCBt tturria & Frick insurance 380 Stevens Ave. , Tirst Floor Solana Beach CA 92075 Phone: 858-259-5800 Fax; 858-259-6069 MSURED Town & Country PlumbingPO Box 1S25 ^Escondido CA 92023 DATE HNUDUVYYV) 11/16/06 THIS CERTIFICATE 13 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 INSURER* Golden Eagle Insurance INSURERS: rnmnd fe*l*r*n jam. on. INSURER C INSURER D: INSURER E: NAtCtf COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAJJEDABO^FOft THEPatCYPOflOO ITOICATED. f«TWTHSTAMO(NG ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DCCUWEW WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO Aai«TB?MS,EXCtUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEH REDUCED BY PAD CLAIMS. LTO A B * NSRC 09 TYPE OF M8URANCE CRALUABLTTY COMMERCIAL GENERAL LIABILITY } CLAIMS MAPE [~j OCCUR G6KL A6GREGATE LIMIT APPLIES PER:m «**•(» ns& n«* AU1 ]T = •OMQ8LE UABUTY WiYAUTQ ALL OWNED AUTOS HIRED AUTOS MON-OWNED AUTOS GARAGE UABUTY — !AN >*JT ~J OCCUR 1 I CLAIMS fcWDE 3DEDUCTIBLE RETENTION $ EMPLOYES' LIABILITY OFFICER/MEMBER EXCLUDED? II yes, describe inter SPECIAL PROVISIONS tttlow OTHER Property Section Equipment Floate POLICY NUMBER ' BAB112667 HKN1119825 CBP8051958 DA1E(UWOWVY} 02/11/06 08/01/06 07/31/06 DATE (MWDOttY) 02/11/07 08/01/07 07/31/07 uumt EACH OCCURRENCE PREMISES <Ea OCCU-BOC*) MED EXP (Ary one jwrson) PERSONAL A ADV INJURY GENERAL AGGREGATE PRODUCTS - COMWW AGG COMBINED SINGLE LIMIT (Ea occiciert} BODILY INJURY (Per person) BQDB.Y INJURY(Peraxutert) PROPERTY DAMAGE (Per &cc«Jert> AUTO ONLY - EA ACCIDENT OTHFBTHAN EAACC AUTO ONLY: ^ 5ACH OCCURRENCE AGGREGATE ._] WCSIATU- 10IH- E.L EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT *f I f $ f f (1,000,000 (1,000,000 ( 1,000,000 « f ( *( f f f * 1000000 1 1000000 t 1000000 OesCHST10NOFOP6WTON3/UKATIOt«<VmC^ CERTIFICATE HOLDER CANCELLATION ******* Proof of Insurance i SHOULD AKT OF WE ABOVE DB8CRBB) POLICIES BE CANCEU-EO BEFORE THE EXPIRATION DATE THEREOF. THE ASUMQMSURSt WIU. EfOEAVCR TO IUL 10 QAYSVWrTTEN NOTICE TO THE CSHlUCATe MOUJCR NAMED TO THE LEFT. BUT FMLURE TO DO SO SHAU UPOSE NO OBLJCATION OR UW1LJTY OF Mff WW> UPON THE HSUROt, ITS AS&fTS OR REPRESBOATNES. AlpyBHl REPRE3EKTATVE 7 1 1 * - j/i IZv. ACORD 25 (2001/08) ^*-~v .^— - ©ACORD CORPORATION 1988