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Home My WebLink About2720 CIRCULO SANTIAGO; K; CB000272; Permit01/31/2000 City of Carlsbad Plumbing Permit Permit No CB000272 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 2720 CIRCULO SANTIAGO CBAD St k PLUM Lot# 0 Construction Type NEW UNIT K RES INSTALL WASHER & DRYEW W/ELEC DRYWALL & VENT Status ISSUED Applied 01/31/2000 RMA 01/31/2000 01/31/2000 Entered By Plan Approved Issued Inspect Area Applicant R & R ELECTRICAL AND GENERAL 559 W GRANADA CT ONTARIO CA 91762 9099837173 Owner —,_ Total Fees $9600 Total Payments To Date"H Balance Due $9600 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Dram Install/Repair Water Line Water Heater and/or Vent Gas Piping System Vacuum Breaker Other Plumbing Fees Master Drainage Fee Sewer Fee TOTAL PERMIT FEES O; $2000 $700 ,$000 $000 $000 $000 $000 $000 $6900 $000 $000 EXPIRED PERMIT$9600 SIGNATURE 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 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 FROM R8.R ELEC & GEN CBNTRftCTBRS PHONE NO 909 986 0404 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr Carlsbad CA 92009 (760)438 1161 Lngal 0*acnptton' Jan 28 2000 02 12PM P2 FOR OFFICE USE OIMLY PLAN CHECK NO EST VAL Pare I*Exlitl BUM N m S" "~ Addrw* ^^usa^^ssss^ssss^^E^ Ctry S a/Zip «&gatesZ&^~ Addr«M jyUUBttyg^^ T ) phO 7/7 77 «) 7 ^.^,.^ . ._._.. ,.-v " PT iwh 'a^ i._n^r^t ^,- ^ IS 7031 S Bujmwj . d Frofmiene COO. 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O I t llrtv t D struct d wrth 1 000 (am f tn out be nd ry I chool a» 7 D YES O N° F ANV OF THE ANSWERS AHE YES A FOMAL CEfttlFICATE OF OCCUPANCY WAV NOT U ISSUIfc UNLESS THE APFUCANT HAS MET OR IS MECTINO TH6 RtOUlREMeNTS OP THE OFF1CS OF EM6ROENCY SERVICES AND THE AtR POLLUTION CONTHOL blSTRIOT 8 ^ONSTRUCTIOniQr^meSBEriC^niSS^KS^SP'it:' ~55«5SSWSS 'KIw.rfM Hrf^^,5u,^_" i h «by eff m th I tft e struetl la d) g agancy 1 tna parform nc f tha w k for whi h thi pa rffl d <S 309?( 1 C I C 0 1 LtNt!8R S NAM! ______ _ _ LENDER S ADQHESS s - AWUftAjw oanne>vna«9S13iSMfiStSIES3^^^ <ffiartr^~ I nlfy th 1 1 h d h I. d «tat that th t» Inform tlon ta onaot a d th« tha I f rm I ttia plan «s g ms w Citod dS Iw I 00 budding co avuct) 1 h by uthom present ti «s f tha CrrV (Cnbdt t D t b m or>4 B P rty f B « t, rpou: I ALSO tomes TO BAWE, WOEMNrFY AND KEEP KARMUSS THE CITY OF CARLSBAD AGAINST ALL UA8II TIES OSHA A OSHA parrn mi d for vetiona E 0 deep d demolrtiafi Co st et I atructu «a ov 3 «t I h oh EX018ATION E V parm d by tha 8 IMno OHie I d. tha p v<a»na f ttv C«aa haK xplr b I mrt d b m Id I wkuth zdb ohorm mm nead with 36& daya ffem the d t of such permit orlfihblldng wk auth d by p m b d d rty t m ft tha work M comm eedf period of tBO du<je«cton 106 4 a U if m Build! o C d J ^C3^Jt^] -- g- a 9 A PICA BONATUP-S /ELLOW A pi PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr Carlsbad CA 92009 (760)438 1161 r-~~^ZS&szS2^ 1^r:fl^S^^:1(ysm^Tt3^^^^:^ - 'o u/v/r.jK FOR OFFICE USE ONLY PLAN CHECK NO EST VAL _____ Plan Ck Deposit Validated By Date s (include Bldg/Suite Legal Description Lot No Subdivn on Name/Number Unit No Phase No Total t of n ts (Sec 7031 5 and xemp, on Any violation of Code Any Ctty or County wh,ch requ.res • permrt to construct slt.r improve demolish or repair any structure p or to its r^subect, the appem to acr«l P.nay_pf notmor, than five hund ed dols l$500|)031 5 for a na£y_pf notm -l 0rJrnKi-N ^.L-i^ii1-'1— ^ tr ' NarrU _. <T* I "^ ^'t ^-/ / Des gner Name State L cense * Address j Li«in» Class €> *J- ^ ~ '^ Address city State/Zip ' Telephone tfcjCj ^33 T City Business License 0 City Stete/Zip Telephone 4 WORKERS COMPENSATION '^KsS^£sSSeaSkxi^r'!sf:KSi ""^ -"irr as",-4.-*, ^-w- '"- *"• Workers Compensation Declaration I hereby affirm under penalty of penury one of the following declarations ^L 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 perfo mance of the work for which this permit is issued S I have and w II maintain workers compensation as required by Section 3700 of the Labor Code for the performance of the work for wh ch this permit E ssued My worker s compensation insurance carrier and policy number are I Insurance Company \J S p Policy No S/*7 0 (O IP- | Expiration Date TH S SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOB ONE HUNDRED DOLLARS l«1001 PR LESS) (J 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 o-iy narr er o as to become subiect 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 Tines up to one hund ori thousand dolle • 18100 000) In addition to the coat of compensation damages as provided tor In Section 3706 of the Labor code Interest and attorney s fees SIGNATURE DATE 7 I nereby affirm that I em exempt from the Contractor s License Lew 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 offe ed for sale (Sec 7044 Business and Professions Code The Contractor s License Law does not epply to an owner of property who builds or improves thereon end 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 imp ovement is old w th one yea of complet on the owner builder will have the burden of proving that he did not build or improve for the purpose of sele) Q I as owner of the property am exclusively contracting with licensed contractors to construct the protect (Sec 7044 Business and Professions Code The Co tractors L cense Law does not apply to an owner of property who builds or improves thereon and contracts for such projects with contractor(s) I censed pursuant to the Contractor s License Law) /- Q I am e emot und r S ction Business end Profess ons Code for th s eason 1 I personally plan to provide the major labor and matenals for construction of the proposed property improvement l~l YES DNO 2 I (ha e / h e ot) signed n application for a build ng 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 I cense number) 4 I plan to p ov de port ons of the work but I heve hired the following person to coordinate superv se end provide the major work I nclude name / address / phone umbe / co t actors I cense 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 worki PROPERTY OWNER SIGNATURE DATE COMPLFTE THIS SECT10NTOR WWJaStoilrV^^ Is the appl cam or future building occupant required to aubmrt a business plan acutely hazardous materials registration form or isk management and pre ent o p ogram under Sections 25505 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Q 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? Q YES D NO Is the tacil ty 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 AGENCS"" 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 I cert.fy that I have read the application and state that the above information is correct and that the information on the plans ,S accurate I agree to comely w th n City ord n nces and State laws relating to building construction I hereby authorize representatives of the CrtV of Carlsbad to enter upon the abo e mem o ed 1,?n^« 'nSBeC110n Puroos« ' 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 AGA/NST SAID CfTY IN CONSEQUENCE OF THE GRANTINGi OF-THISPERMIT OSHA An OSHA permit is required for excavations over 5 0 deep and demolition or construct on of structures ove 3 stor es n he ght 1 byrVsuPc'hrmermrtU|Sd ^ ** Bl"'d'n9 Offlc"' under the orovis ona of tnis Coo<! •"•" «P"» by limitation end become null and o d f th b Id g I at any time afterjhe_work is commenced for a penod of 180 davs^Section 106 4 4 Umfo m Build ng Code" APPLICANT S SIGNATURE ' ~~DATE WHITE Fie YELLOW Aopl cant PINK F nee CALIFORNIA INDEMNITY INSURANCE COMPANY HOME OFFICE PLEASANTON CALIFORNIA DECLARATIONS ITEM 1 Named Employer and Address (No Street Town County State Zip Code) MATHEWS ROCK (AN IND ) (DBA) R & R ELECTRICAL AND GENERAL ELECTRICAL 559 W GRANADA COURT ONTARIO CA 91762 p,olicy N 8058316ANumber Employer is INDIVIDUAL ITEM 2 Policy Period (Mo Day Yr) 1201 AM standard time as to each of said dates From 4/06/99 to 4/06/00 Producer JETTON & ASSOC INS SRVCS INC Renews No NEW Number 4-800163~00-1000-Q ITEM 3 Locations All usual workplaces of the Employer at or from which operations covered by this policy are conducted are located at the above address unless otherwise stated herein ITEM 4 CodeNos CLASSIFICATION OF PRINCIPAL OPERATIONS ESTIMATED ANNUAL REMUNERATION RATE PER $100 OF REMUNERATION ESTIMATED ANNUAL PREMIUM SEE EXTENSION SCHEDULE ATTACHED EAP ENDORSEMENT ATTACHED 1 E18 2 E39 3 E01 4 E23 5 E09 $15 348 The language of the classification or classification of operations inserted in the policy declarations shall not be interpreted to extend insurance or obligate the Company to the payment of benefits to any person who is excluded from insurance by express statement elsewhere in this policy or in any endorsement hereto OTHER OPERATIONS proper classifications and rates to be determined in accordance with the manual in use by the Company ITEM 5 The following persons are specifically covered as employees anything in the Policy Exclusions to the contrary notwithstanding ALL EXCLUSIONS APPLICABLE TBM 6 Minimum Premium $ 2 500 Deposit Premium $ ITEM 7 Payroll reporting and premium adjustment penod MONTHLY ITEM 8 Limit of Liability Coverage B Employers Liability $1 000 000 Countersigned at BURBANK on 3/18/99 X2 N 8058316A * SEE ENDORSEMENT // 2 AUTHORIZED REPRESENTATIVE UND6201/O (03/94) 2,500 + 45" + 27* USF Insurance Company 100 Campus Drive Florham Park, New Jersey 07932 DECLARATIONS This Declarations Page is issued in conjunction with and forms a part of Policy Number SHO 10121 01 Renewal of Number SHO 10121 Item 1 Name of Insured R & R ELECTRICAL AND GENERAL CONTRACTORS ROCKY G MATHEWS Address 559 WEST GRANADA COURT ONTARIO CALIFORNIA 91762 Item 2 Policy Period MARCH 12 1999 to MARCH 12 2000 (12 Olam unless otherwise specified) Item 3 Description of Insurance afforded hereunder COMMERCIAL GENERAL LIABILITY Item 4 Limits of Liability Coverage is provided only if a limit is shown below General Aggregate Limit (other than Products-Completed Operations) $ 2 OOP OOP 00 Products - Completed Operations Aggregate Limit $ 1 OOP OOP 00 Personal & Advertising Injury Limit ' $ 1 OOP OOP 00 Each Occurrence Limit $ 1000 000 00 Medical Payments Limit $ 5 OOP 00 (any one person) Fire Damage Limit $ 50 OOP 00 (any one fire) Item 5 Self Insured Retention $ O Per Claim Q] Per Occurrence/Offense See Endorsement Number Item 6 Deductible $ 250000 ^ Per Claim Q Per Occurrence/Offense See Endorsement Number 6 Item 7 The Named Insured is C3 Individual [~~| Partnership [~1 Corporation l~] Joint Venture f~~| Other QD Limited Liability Corporation Item 8 Premium The premium stated herein is the minimum premium for the policy period Any adjustment upon audit will be upward only There will be no premium refund of the minimum premium upon audit if the estimated exposure is less than shown herein Twenty five percent (25%) of the annual premium is fully earned as of the inception date of the policy IE! Annual D Term $6 630 00 MINIMUM & DEPOSIT QFlat 03 Adjustable at a Rate of $8 50 PER $1 OOP 00 OF GROSS RECEIPTS D Flat Fully Earned Estimated Exposure $780 OOP 00 Item 9 Endorsements and forms attached to this Policy USF ADDLDEC (ED 12/97) USF OCCUR (ED 12/97) (Rev 6/98) ENDORSEMENTS 1 THROUGH 12 Countersignature Date March 17 1999 COUNTEWHGNATURE OF AUTHORIZED REPRESENTATIVE USF OCCDEC (ED 12/97) (Rev 8/98)