Loading...
HomeMy WebLinkAbout2852 CAZADERO DR; ; CB090226; Permit02-10-2009 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB090226 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # PC# Project Title 2852 CAZADERO DR CBAD MISC 2153401002 $000 Subtype Lot# OTHER 0 PETERS RES REPLACE DRYWALL @ KITCHEN,LIVING RM.BATHROOMS.AND GARAGE CEILING Status Applied Entered By Plan Approved Issued Inspect Area Applicant HELLENIC CONSTRUCTION CO STE 206 7670 OPPORTUNITY RD SAN DIEGO CA 92111 858-560-9345 Owner PETERS DONALD G FAMILY TRUST C/O STEPHEN PETERS 22737 ERWIN ST WOODLAND HLS CA 91367 ISSUED 02/10/2009 KG 02/10/2009 02/10/2009 MiscelaneousFee#1 PERMITTEE Miscelaneous Fee #2 Additional Fees $7000 $000 $000 TOTAL PERMIT FEES $7000 Total Fees $70 00 Total Payments To Date $70 00 Balance Due $000 Inspector FINAL APPROVAL Date CT7 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" Von have 90 days from the date this permit was issued to protest imposition of these fees/exactions If you protest them you must lollow 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 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 1635 Faraday Ave , Carlsbad. CA 92008 760-602-2717 / 2718/2719 Fax- 760-602-8558 www carlsbadca gov Building Permit Application Plan Check Est Value Plan Ck Deposit JOB ADDRESS CT/PROjrCT t! OF UNITS 1 It BEDROOMS SUITE#/SPACE«/UNIT# ,'/ BATHROOMS / TENANT BUSINESS NAME CONSTR TYPE OCC GROUP DESCRIPTION OF WORK Include Square Feet of Affected Area(s) (Sec 7031 S Business and Profusions 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 lor such permt \ffile a signed statement that he islicensed pursuant to the provisions of the Contractors License Law {Chapter 9 commending with Section 7000 of Division 3 of the Business and Professions Code} or that he is exempt there from and (he basis for the alleged exemption Any violation ofSection 70! 15 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500}) Workers' Compensation Declaration / hereby affirm under penalty of perjury one of the following declarations O 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 ff. I have and will maintain workers' compensation as required'by Section 3700 of the Labor Code for the performance^ the ^fijt'a^jjjjjj this permit isissugd My workers compensation insurance carrier and policy number are Insurance Co ^7'^^"<^~ /^C*.***'& Policy No / J@ ff& S~~ f Expiration Date This section need not be completed if the permit is for one hundred dollars (S100) or less O Certificate of Exemption I certify that in the performance of the work for which this perrrHHfissued, 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'Mn^nsajjoncfliterage ig-MfltarffuI and shall subject^»«niployer to criminal penalties and civil fines up to one hundred thousand dollars (8.100,000), in addition to the cost of compensation, damage&a£|BBffi&rar^ecJjerf^?Dlfof the Labor codjvtnterest and attorney's fees ^"CONTRACTORSIGNATURE I hereby affirm (hat I am exempt from Contractors License tSw lor 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) Cl 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) O 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 Cl Yes in 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 / 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 / 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 / type of work) ^PROPERTY OWNER SIGNATURE DATE fe^™^'•'•"••• ••'' f • • '-' V 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 Act9 O Yes a No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district' Cl Yes Cl No Is the facility to be constructed within 1 000 feet of the outer boundary of a school site' CJ Yes Cl No IF ANY OF THE ANSWERS ARE YES, t EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT I hereby affirm that there is a construction lending agency for the performance of the work 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 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 authonze representative 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 stones in height I 180 days from the date of such permit or if the building or wgjkauthonzed by suctipefrrCSsflspended or abandoned at any time after the work is commenced for a period of 180 days (Section 106 4 4 Uniform Building Code) j ^Skaton?'^' ^^ \ ^APPLICANT'S SIGNATURE City of Carlsbad Bldg Inspection Request For 03/03/2009 Permit* CB090226 Inspector Assignment MC Title PETERS RES REPLACE DRYWALL @ Description KITCHEN,LIVING RM,BATHROOMS,AND GARAGE CEILING Type MISC Sub Type OTHER Phone 6197876977 Job Address 2852 CAZADERO DR Suite Lot 0 Location Inspector M^ APPLICANT HELLENIC CONSTRUCTION CO. Owner PETERS DONALD G FAMILY TRUST Remarks Total Time Requested By NA Entered By CHRISTINE CD Description Act Comments 19 Final Structural \( <tJg> £&£&<. c*^, | KIT. Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments 02/11/2009 17 Interior Lath/Drywall PA MC INT DRYWALL ONLY EXCEPT @ TUB AREAS Dino Gougoulas Hellenic C 619-536-2225 p.l FACSIMILE COVER SHEET Hellenic Construction Company. Inc. 7670 Opportunity Road, Suite #206 San Diego, CA 92111 (858)560-9345 Phone (858)560-9234 Fax CA License # 534087 Date: February 13,2009 Company: Carlsbad Building Department Attn: Barbara feeanC^ / C^U^L Fax: 760-602-8560 Phone: 760-602-2423 From: Constantine (Dino) Gougoulas Total pages including cover sheet: Five RE: State Fund Comments: Barbara, please find verification that 1 have been reinstated by State Compensation Insurance fund. Thank you, Dino Cougonlas Dino Gougoulas Hellenic C G19-5S6-S225 p,2 STATE COMPENSATION INSURANCE FUND CONDITIONAL RECEIPT This is to certify that wo, in consideration of tho total deposit premium and any mandatory surcharge of $ 1419 and the full premium to be adjusted later upon the total remuneration of employees during the policy period 2/5/09 to 8/1/09 , agree to issue a valid workers compensation insurance policy in a form approved by the California insurance Commissioner to Hellenic Construction Co. 7670 Opportunity Road Suite 206 San Diego CA 92111 FAX (858) 560-9234 THE EXECUTIVE OFFICE OF THE FUND RESERVES THE AUTHORITY TO GRANT INSURANCE COVERAGE AND THE RIGHT TO REJECT ANY AND ALL APPLICATIONS, BUT WHEN ACCEPTED, INSURANCE WILL BE MADE EFFECTIVE AT 12 01 A.M, PACIFIC STANDARD TIME THE DAY FOLLOWING RECEIPT OF THE COMPLETED APPLICATION FOR CALIFORNIA WORKER'S COMPENSATION INSURANCE AND YOUR CHECK FOR THE DEPOSIT PREMIUM AND ANY MANDATORY SURCHARGE BY THE FUND UNLESS A LATER DATE IS REQUESTED BY YOU POLICY NUMBER - 1 9 0 7 9 8 7 DIVIDEND STATEMENT UNDER CALIFORNIA LAW IT IS UNLAWFUL FOR AN INSURER TO PROMISE THE FUTURE PAYMENT OF DIVIDENDS UNDER AN UNEXPIRED WORKERS' COMPENSATION POLICY OR TO MISREPRESENT THE CONDITIONS FOR DIVIDEND PAYMENT DIVIDENDS ARE PAYABLE ONLY PURSUANT TO CONDITIONS DETERMINED BY THE BOARD OF DIRECTORS OR OTHER GOVERNING BOARD OF THE COMPANY FOLLOWING POLICY EXPIRATION IT IS A MISDEMEANOR FOR ANY INSURER OR OFFICER OR AGENT THEREOF, OR ANY INSURANCE BROKER OR SOLICITOR TO PROMISE THE PAYMENT OF FUTURE WORKER'S COMPENSATION DIVIDENDS. THE STATE COMPENSATION INSURANCE FUND HAS AN UNINTERRUPTED HISTORY OF DIVIDEND PAYMENTS SINCE THE INCEPTION OF OPERATIONS IN 1914 OUR DIVIDEND PROGRAM PROVIDES THAT UPON THE TERMINATION OF EACH POLICY YEAR AND AFTER ADJUSTMENT OF PREMIUM, YOU WILL BE ENTITLED TO PARTICIPATE IN ANY DIVIDEND PLAN APPLICABLE TO THIS POLICY WHICH MAY BE APPROVED FOR DISTRIBUTION BY OUR BOARD OF DIRECTORS IF THE FINAL PREMIUM DETERMINED AT THE END OF THE POLICY PERIOD IS MORE THAN THE MINIMUM PREMIUM, WITH THE FOLLOWING EXCEPTIONS YOU WILL NOT BE ALLOWED TO PARTICIPATE IF YOU FAIL TO PAY ANY PART OF THE PREMIUM FOR THIS POLICY AFTER WE REQUEST PAYMENT IN WRITING OR ALLOW IT TO REMAIN UNPAID FOR 90 DAYS AFTER WE MAIL A STATEMENT OF PREMIUM TO YOU AT THE MAILING ADDRESS SHOWN IN THE DECLARATIONS YOU DO NOT KEEP ADEQUATE RECORDS OF INFORMATION NEEDED TO COMPUTE PREMIUM, OR QO NOT PROVIDE THEM TO US WHEN W6 ASK FOR THEM, OR WE MUST BRING SUIT AGAINST YOU TO OBTAIN THE RECORDS NECESSARY FOR US TO COMPUTE PREMIUM. OR TO ENFORCE THE COLLECTION OF ALL OR ANY PART Of THE PREMIUM FOR THIS POLICY YOUR PARTICIPATION WILL BE ACCORDING TO THE RULES ADOPTED BY OUR BOARD OF DIRECTORS Dino Gougoulas Hellenic C 618-586-2225 p,3 FUND 02-03-2009 TERMS OF INSURANCE CONSTANTINE GOUGOULAS HELLENIC CONSTRUCTION CO 7670 OPPORTUNITY RD, SUITE 206 SAN DIEGO CA 92111 Dear CONSTANTINE GOUGOULAS Thank you for the opportunity to provide a quote for CONSTANTINE GOUGOULAS This letter and the attached quote dated 02-03-2009 provide the terms under which State Fund can offer a workers' compensation policy These terms are based upon the information provided to State Fund on the ACORD form and supplemental documentation The payroll reporting and premium billing frequency for this policy will be Monthly The minimum premium is $660 00 and is not subject to proration or refund. Special coverage terms are as follows This quote is for an Individual Employer who will not be eligible for benefits under this policy PLEASE PAY THIS AMOUNT [deposit premium and mandatory assessments)] $1,419 00 California workers' compensation insurance provides coverage for workers' compensation losses related to acts of terrorism You should know that effective November 26. 2002, any losses caused by certified acts of terrorism would be partially reimbursed by the United States under a formula established by federal law Under this formula, the United States pays 85% of covered terrorism losses exceeding the statutory established deductible paid by the insurance company providing the coverage. There Is currently no charge in State Compensation Insurance Fund rates related to the risk of loss due to terrorism Insurance will be made effective at 12.01 A M Pacific Time the day following receipt by State Fund of this signed letter and the check for the deposit premium and any mandatory assessment, unless a later date is requested by your client This quote expires on 04-04-2009 If we do not receive this signed Terms of Insurance Letter and the required payment by the expiration date, and you still require insurance, you will need to reapply for insurance, and a new quote will bo issued A certificate of insurance can be issued the day your policy becomes effective if the deposit is paid with a cashier's check If your deposit is paid with a personal/business check, a certificate of Insurance will be issued when your check clears the bank We look forward to servicing your workers' compensation needs Page 1 of2 Dino Gougoulas Hellenic C 613-596-2225 COMPENSATION IIMSURANCE FUND Date 02/03/2009 06 54 AWl To CONSTANTIN6 GOUGOULAS Company* CONSTANTINE GOUGOULAS Fax (858) 560-9234 Email AddfMS. GOUG@SBCGLOBAL NET Prom SCIF Rep- Phone: Fax- Quoto System Patricia A Ruiz (858) 5S2-7050 (858) 334-7498 Email Address parulz@safcom SCIF Documents HELLENIC CONSTRUCTION CO lebie. of Contents: Please see attached quote and terms. You will need to sign the TERMS SUMMARY PAGE The required deposit 15 $1419.00. Please be advised that subcontractors are required to be licensed and have workers' compensation insurance if they have employees You should obtain this information for your records Otherwise, they are employees and you will need to report the payroll Please bo advised that quote/policy Is contingent upon final billing of prior State Fund Policy it 1875801-08-2 Any additional premium due will have to be paid or the new policy will be subject to cancellation Thank you The attached document is an official Document from the State Compensation Insurance Fund The information contained in this transmission is confidential and is intended for the recipient listed above If you are not the intended recipient and this information has reached you In error, please contact the sender at the telephone number shown Quote ID: 271304900-000 Page 1 of 1 Dino Gougoulas Hellenic C 619-596-2225 P.5 Proposed Effective Date Proposed Expiration Date Anniversary Rating Date Billing Frequency Minimum Premium Estimated Annual Premium Deposit Required Forms Excluded Individuals Officers Covered Volunteers Covered Employers Liability Limit Endorsements Employer Employer DBA Quote ID IERMS_SUMMABY 02-03-2009 08-01-2009 08-01-2009 Monthly $650.00 $10,00500 $1.41900 N/A N/A No $1,000,00000 N/A CONSTANTINE GOUGOULAS HELLENIC CONSTRUCTION CO 271304900-000 B HELLENIC CONSTRUCTION CO. TSn OPPORTUNITY RD SUITE 206 SAN DIEGO, CAgzni Pay to ihc^^ ' _X**"^ . Ord;r nv-^^rr-~t. C*Hj*&&&4&& *&!_ tttM*rt**S-/&f*>0!*.t>-0— 5272 UH-1IKI/IZ22znu NCALI FORMA 13ANKJTRUST Imu«>«gnici ^Saar-Dniiam fl S57 Patricia A Ruiz State Fund Representative Acc_e.ptaj}£e I accept the Date Pag« 2 of 2 Check a License or Home Improvement Salesperson (HIS) Registration - Contractors Stat Page 1 of 1 y^l~ Department of Consumer Affairs :;-: ^> ? feOV Contractors State License Board Contractor's License Detail - License # 534087 £!_> DISCLAIMER A license status check provides information taken from the CSLB license database 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 reported 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 database License Number Business Information Entity Issue Date Expire Date License Status Classifications Bonding Workers' Compensation Extract Date 02/12/2009534087 HELLENIC CONSTRUCTION CO 7670 OPPORTUNITY RD SUITE 206 SAN DIEGO, CA 92111-1926 Business Phone Number (858) 560-9345 Sole Ownership 07/07/1988 07/31/2010 License is under suspension for the following reasons I License is under suspension for failure to comply with Workers Comp A workers compensation certificate or exemption statement may have been received by the • Board but not yet processed Once the certificate or exemption statement is processed the suspension will be lifted retroactively to the effective date of the certificate or exemption statement Ask the contractor for proof of worker's compensation and contact the insurance company to verify coverage CLASS DESCRIPTION GENERAL BUILDING CONTRACTOR CONTRACTOR'S BOND, This license filed Contractor's Bond number 6327036 in the amount of $12,500 with the bonding company SURETY COMPANY OF.IHEPACJRC Effective Date 01/01/2007 Contractor's Bonding History This license has workers compensation insurance with the STATE COMPENSATION INSURANCE FUND Policy Number 1875801 Effective Date 04/12/2008 Cancellation Date 12/16/2008 Workers' Compensation.History ^ >Persorinel'l!istf; Conditions of.Use | Pny_acy_Pohcy_ Copyright © 2669 State of California http //www2 cslb ca gov/OnlmeServices/CheckLicense/LicenseDetail asp 02/12/2009 r m ? m gft 73 3 >© 5 0 Oo a om