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HomeMy WebLinkAbout2802 ATADERO CT; ; CB051186; Permit03-31-2005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No:CB05ii86 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 2802 ATADERO CT CBAD PLUM 2551012200 Lot#: 0 Construction Type: NEW AYLSWORTH RES NEW H20 HEATER Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 03/31/2005 SB 03/31/2005 03/31/2005 Applicant: CALIFORNIA DELTA MECHANICAL SUITE # 27 12440 OAK KNOLL RD 92064 866-898-0008 Owner: AYLSWORTH JAMES W&DINSMORE BETTY T 2802 ATADERO CT CARLSBAD CA 92009 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 0 0 0 1 0 0 $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $27.00 Total Fees:$27.00 Total Payments To Date:$0.00 Balance Due:$27.00 EXPIRED PERMIT PERMIT HAS EXPIRED IN ACCORDANCE WITH C.B.C. 5YC.M.C \ffp SlfiMATURE fflti SECTION 106.4,4 AS AMENDED BY C.M.C.18.04.03%012 03/31/05 0002 PATE 27-00 Inspector: FINAL APPROVAL 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 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 given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. k PERMIT APPLICATION fiLjFffltfll CITY OF CARLSBAD BUILDING DEPARTMENT ^^sfe^T 1635 Faraday Ave., Carlsbad CA 92008 ^**^*^ 1. PROJECT INFORMATION 2^02. ^TAbgRQ CT C Address (include Bldg/Suile'#) Legal Description Lot No. Assessor's Parcel # Description of Work /?&L<*A/9£ cA FOR OFFICE USE ONLY, — / ; fry &*> //O^>PLAN CHECK NO. ^ < EST. VAL. Plan P-W nppnsit ^ _ Validated By T2 Date <^Z /-^J> f J C3 > r /*<1 t Business Name (at this address) Subdivision Name/Number Unit No. Phase No. Existing Use SQ.FT. Proposed Use # of Stories # of. Bedrooms Total # of units # of Bathrooms/ -/n&tf^t&v' 2. CONTACT PERSON {If dtffrtwft from applicant) Name " Address City 3. APPLICANT D Contractor D Agent for Contractor D Owner State/Zip Telephone # D Agent for Owner Fax# Name 4. PROPERTY Address City State/Zip Telephone # City State/Zip Telephone #Name Address 8. .CONTRACTOR-COMPANYNAME \ , (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. 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 aPPli(¥ir]t'for a permit subjects the applicant to a cjOil penalty of not more than five hundred dollars [$500]). Name , Address / City State/Zip ' Telephone ^J State License # o 1 f f 1 7 License Class C~ *J D Citv Business License # / % I*T 2.r*\ Designer Name Address State License # 4 R-O- ^^^'^Oc City State/Zip Telephone # 8; WORKER'S COMPENSATION , ; Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D 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. D I have and will maintain worker's 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 oojicv number are;-, t Insurance Company J._ j Policy No._ Expiration Date__ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [J100] OR LESS) D 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' corjUfinsatton coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars<$100,000), in additloVi n the c^ptw cbmpenj^jion, damages are provided for In Section 3706 of the Labor Code, Interest and attorney's fees, f I r~ SIGNATURE \ \,/!\^^ V DATE ^ f 7-2- [ Q-S 7. OWNER-BUILDER | I hereby affirm that I am exe^Mrtr^ntotle-Sontraetor's License Law for the following reason: D I, as owner of the pifeperty or my employees with wages as their sole compensation, will d the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contrachir'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. !f, 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). D 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 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. O YES P NO 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 / /ontractors license number): 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 / typa of work): PROPERTY OWNER SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Page 2 of 2 Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration for or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES O 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 D NO Is the facility to be constructed within 1,000feetoftheouter boundaryof aschootsite? O YES D NO (F 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. 6. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Code). LENDER'S NAME LENDER'S ADDRESS «,-/ APPLICANT CERTIFICATION -;'• ', •.": /.• . .--• ,-'• •• -• .V_ -V--:- •.-* t •':•• • ' • , : '••';.:''• '- -i-l'.£:-.• '• :,-•• ' -^ !>';' -."'-• ""• - 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 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, JUDGEMENTS, COSTS AND OSHA: An OS HA permit is required for excavations of 5'0* deep and demolition or construction of structures over 3 stones in height. EXPIRATION: Every permit issued by the building Official under theVovisions 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 180 days from the-dateof sugb/permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 iaye (^ectfo^ne^friipi^rn Building Code). APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance ACORD prPTIFIPATF OP 1 IARITM. OCr\ 1 iriOM 1 C. \Jr LIMDI PRODUCER ALL COMMERCIAL INSURANCE SERVICES, LLC. 6790 TOP GUN STREET #3 SAN DIEGO CA 92121 Agency Lic#: OC64552 INSURED CALIFORNIA DELTA MECHANICAL, INC. 2500 SOUTH POWER RD., STE. # 129 MESA AZ 85208 LITY INSURANCE "ToT' 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 INSURER A: LINCOLN GENERAL INSURANCE CO. INSURERS: INSURER C: INSURER D: INSURER E: NAIC# COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH 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. IMSR LTR A ADD'LINSRp TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GEN CLAIMS MADE ERAL LIABILITY JJTj OCCUR GEN'L AGGREGATE LIMIT APPLIES PER POLICY | | PROJECT I I LOG AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY ANY AUTO _BCCESS / UMBRELLA LIABILITY ~~ [ OCCUR ] CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? If yu, describe under SPECIAL PROVISIONS below OTHER: POLICY NUMBER 6320014111 00 POLICY EFFECTIVE DATE IMM/DOfYY) OCT 30 04 POLICY EXPIRATION DATE IMMIDD/YY) OCT 30 05 LIMITS EACH OCCURRENCE * 1,000,000 DAMAGE TO RENTED MED. EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS-COMP/OP AGG. COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE(Per accident} AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EAACC Ann EACH OCCURRENCE AGGREGATE I WC STATTJ, I TnRY 1 IMITS OTHER E-L EACH ACCIDENT E.L. DLSEASE-EA EMPLOYEE E.L DISEASE-POLICY LIMIT £ 100,000 $ 5,000 3 1,000,000 S 2,000,000 $ 1,000,000 $ $ $ $ $ $ 3 $ S $ 3 $ $ S S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY. MO DAY NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM. CERTIFICATE HOLDER CANCELLATION 1 Attention: MARIE ROUTON 972 881-8317 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ___ ^7 ^-^ '^^f^k RubhS^^ ACORD 25 (2001/08)Certificate # 40823 ©ACORD CORPORATION 1988