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Home My WebLink About1254 BASSWOOD AVE; ; CB060634; Permit03-08-2006 * City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB060634 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 1254 BASSWOOD AV CBAD PLUM 2050521000 Lot#: Construction Type: 0 NEW HOLLYWOOD RESIDENCE REPAIR SEWER LINE AND INSTALL CLEANOUTS Applicant: C&R DRAINS AND PLUMBING 299 GARRARD DRIVE VISTA CA Status: ISSUED Applied: 03/08/2006 MDP 03/08/2006 03/08/2006 Entered By: Plan Approved: Issued: Inspect Area: Owner: HOLLYWOOD WALTER P TR 5516 MALI FAX ARCADIA CA 91007 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 tfet approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as lees/exactions." *>u 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 you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE OJ&ILY PLAN CHECK NO.. EST. VAL. Plan Ck. Deposit Validated By Date ___ Address (include Bldg/Surte *)Business Nama (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total * of units Assessor's Parcel #Existing Use Proposed Use {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 issusnce, 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^ Anviolatin of Section 7031 -STw an aplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollar* [*500l). Name State Uoense Address Keen,. Clas. City State/Zip City Business Ucense # blephono Designer Name State Ucense * Address City State/Zip Telephone Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 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. O I have end will maintain workers' compensation, aa required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation insunfnce earner and policy number are: - _^ ^ ,^-j — —-~ _, Insurance Company S"?gf AC Ir^f^L Policy No./><Z/ S £ /f-d$t? Expiration Date ~$ ; (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*1001 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: FaHure/^b secure workar*>¥ompensation coverage la unlawful, and she! subject an employer to criminal penalties and cM fines up to one hundred thousand doflars ( SIGNATURE . attorney's fat*.to the cost of compensation, damages es provided for In Section 370S of the Labor code, biterest _ _ DATE ^ g< O I hereby affirm that I am exempt from the Contractor's Ucense Law for the following reason: Q I, as owner of the property or my employees with wagea as their sole compensation, will do the work and the structure Is not intended or offered for sale (Sac. 7044, Business and Professions Code: The Contractor's Ucense 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). Q I, aa owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's Ucense Law does not epply 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). Q 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 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 neme / 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 neme / 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 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-Tenner 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 la 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. I herebv 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 thet I have reed 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. xcavations over B'O" deep and demolition or construction of structures over 3 stories in height. Rebuilding Official under thepiovisions of this Code shall expire by limitation and become null and void If the bulWIng or work fld within 180 days from the'date of such permit or if the building or work authorized by such permit is suspended or abandoned lor a period of 180/r34^pection 106.4.4 Uniform Building Code). OSHA: An OSHA permit is required for/ EXPIRATION: Every permit issued by/ authorized by such permit is not commf at any time after the work is comment APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Aoolicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 03/22/2006 Permit* CB060634 Title: HOLLYWOOD RESIDENCE Description: REPAIR SEWER LINE AND INSTALL CLEANOUTS Inspector Assignment: PY 1254 BASSWOOD AV Lot 0 Type: PLUM Sub Type: Job Address: Suite: Location: APPLICANT C&R DRAINS AND PLUMBING Owner: HOLLYWOOD WALTER P TR Remarks: Phone: 7606309368 Inspector: Total Time: CD Description 22 Sewer/Water Service Act Comment Requested By: RICKIE Entered By: CHRISTINE Comments/Notices/no Id Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments 03/09/2006 21 Underground/Under Floor AP PY ACQBDm CERTIFICATE OF LIABILITY INSURANCE 03/06/2006 LOUIS ADAMS ADAMS INSURANCE AGENCY LIC# 0813479 62Q'S MELRQSE DR #101 VISTA, CA 92083 760-75^9500 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOCS NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAICff HWRED c & R DRAINS & PLUMBING, INC GREG COX & RICKEY RETTKE 299 GANNET DR VISTA, CA 920B3 iNSURMA: STATE COMPENSATION INS FUND MflUfltRB: INSURER C: W8UMKD: IN SURER E: COVERAGES ANY REQUIREMENT, TSRtt OR CONDITION OF ANY CONTRACT O* OTHER DOCUMENT WITH MMPECT TO WHICH THI3 CERTIFICATE MAY Vi ISSUED ORMAY PERTAIN, THE INSURANCE AFFORDED BY TH« POLICIES DESCRIBED HERBIN IS SUBJECT To ALL THE TWM3, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCKD BY PAID CLAIMS. MM wonas. uifi •ouevttMjB LIMITS aENBRALUAMUTY EAOHOCOUNRENCE CQMMEBOAL BgMBRAL UABIUTV [ |MB) EXP (Anr wit p*noro KKaOHALtAOVlhJUMY OENDALAOOhBOATB "SEMI AOaRiOATC LIH FT APPMSB PER:! ] _AUTOMOWLI LIAMLTTY ANYAVTO AU.CVMIOAUTOS SCHWULED AUTOS OQM0MBD9INQLIUMIT BODkLTINJUHY NOM>OWN(0 AUTOS PMOPOlTYDAMAeE eADAOK LIABILITY ANY AUTO AUTOQMLY' EA ACCIPPIT AUTOONUY: BXCEMIUMBRB1A LIAMU1Y ~ OCCUB | | BACH OCCUR REKCC DBDUCTIK.C RBTWTtON A WOMHW eOMPMWATTOH AMD 713-15547-06AMY pnopiwTQiW'iWWCiWMEMBER E 3-1-06 3-1-07 KLEACHACCIOern- EXCLUDED? VCQYES EL. DISe*8C > BA EMPLOYEE EL. WSKHBC • POLItV LIMITOTHUI JERTIFlCATgJOLPB^CANCELLATION C & R DRAINS & PLUMBING, INC GREG cox & RICKEY RETTKE 299 QANNET DR VISTA, CA 92083 XCORD 25 (2001/01) •HOOiJ»MfrgpTHEA0ovcE»*c)tnapOLe)nwcANeiuj^§ero«ThiKXPiRATtoii OATI TMflUOF, TUB MauiPHI KUURBK WILL CMOfiAVOM TO MAIL 10 MYS WDTTIN HOTICf TO THB CdtrmCATt HOLDER NAMED TO TUB |.EFTt BUT FAILURE TO DO IO SHALL MPOtt MO OMJBATttl* OR UUUTY OF ANY KIND UPON THE HtSURIK, IT» ACBtn OR