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HomeMy WebLinkAbout1372 CASSINS ST; ; CB053696; Permit10-27-2005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB053696 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 1372CASSINSSTCBAD PLUM 2156914800 Lot* 0 Construction Type: NEW GAUNTLETT RES-NEW H2O HEATER Status: ISSUED Applied: 10/27/2005 Entered By: RMA Plan Approved: 10/27/2005 Issued: 10/27/2005 Inspect Area: Applicant: ARS STE100 6162 NANCY RIDGE DR SAN DIEGO CA 92121 858-677-5455 Owner: GAUNTLETT FAMILY TRUST 05-14-02 1372CASSINSST 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:$27.00 Balance Due:$0.00 Inspector: FINAL 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 oreviouslv been aiven a NOTICE similar to this, or as to which the statute of limitations has oreviouslv otherwise exoired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 f FOR OFFICE USE ONLY PLAN CHECK EST. VAL. Plan Ck. Deposit. Validated Date Business Name (at this address)Address (Include Bldg/Suite *) Legal Description Lot No.Name/Number Unit No.Phase No.Total * of u ilts 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 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 Codal or that he is exempt therefrom, end the basis for the alleged exejnptfen^Any violation of Section 7031 .6 by any applicaritfor a pjsrmit subjects the applicant to a civil penalty of not more than five hundred dollars |$500|).' Name State License ##2^0 Addr License Class Ot-jQ City State/Zip City Business License f Telephone # Designer Name State License Address City State/Zip Telephone 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. i M I have and will maintain workers' compensation, as required by Section 3700 of the Labor Coda, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: _ _ Insurance Company (W^St-l UgA _ jj Policy No. 242rf&4'2> ~Qt *Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100] OR LESS) n 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 tba^Workers' Compensation Laws of California. WARNING: FsRurfcAo secWe workers' compensation coverage Is unlawful, and shad subject an employer to criminal penalties and cIvH fines up to one hundred damages as provided for hi Section 3706 of the DATE d attorney's fees.thousand dollars ( SIGNATURE ji; I hereby affirm that I am exempt from the Contractor's License Law for the following reason: Q I, as owner of the property lor 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 bijrden of proving that he did not build or improve for the purpose of sale). Q 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 pursuent to the Contractor's License Law). D I arri 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. l~l 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 name / address / phone number / contractors license number): i i ': 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): ; i .... . . i ; _____ 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): I ' L^ PROPERTY OWNER SIGNATURE DATE ^Is the applicant or future building occupant required to submit s 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 Act? D YES O NO Is the applicant or future building occupant required to obtein a permit from the air pollution control district or air quality management district? f__ YES Q NO Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? D 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 lerfding agency for the performance of the work for which this permit Is issued (Sec. 3097(1) 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 811forma I her 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 stories in height. EXPIRATION: Every permit issued Wmebulldlng Official under the provisions 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 1 80 days from the qatsj otauch permit or if the building or work authorized by such at any time after the work is com(rUiceoV[prla period of 180 days (SedlDmlMM^HJnlform Building Code). APPLICANT'S SIGNATURE rmit is suspended or abandoned DATE WHITE: File ' YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 11/03/2005 Permit* CB053696 Title: GAUNTLETT RES-NEW H2O HEATER Description: Type: PLUM Sub Type: Job Address: 1372 CASSINSST Suite: Lot 0 Location: APPLICANT ARS Owner: GAUNTLETT FAMILY TRUST 05-14-02 Remarks: AM PLEASE OR EARLY PM Total Time: CD Description 25 Water Heater/Vents Act Comment Inspector Assignment: Phone: 7606024354 Inspector: Requested By: SANDY Entered By: CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments MARSH CERTIFICATE OF INSURANCE PRODUCER ServiceMaster Certificate.Team MARS'H USA. Inc. SOO W Monroe St. Chicago. IL 60661 Attn: fax: 877-732-7799 8112 CERTIFICATE NUMBER CHI-000949412-01 THIS CERTFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED M THE POLICY. THIS CERTFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED ar THE POLICES DESCRIBED HEREIN. COMPANIES AFFORDING COVERAGE ZURICH AMERICAN INSURANCE COMPANY NSURED (#8112)ARS AMERICAN RESIDENTIAL SERVICES OF CALIFORNIA INC. dba ARS OF SAN DIEGO 860 RIDGE LAKE BLVD. MEMPHIS, TN 38120 COMPANY B ILLINOIS NATIONAL INSURANCE COMPANY COMPANY c COMPANY 0 COVERAGES Thta OMtitcafe *up«r»Kto*amtrtplacB*aiiy pwrfousty f«w«d certfflcate forBf e policy parfbrtnotad Mow. Tri.S IS TO CERTIFY THAT POLICES CF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE Pa ICY PERIOD INDICATED NOTVllTH STANDING ANY REQUIREMENT. TERM OR CONDITION OF AN* CONTRACT OR OTW3« DOCUMENT WTH RESPECT TOW^ICH THE CBTIFICATE MAY BE ISSUED OR MAY PfRTAJN. THE ;NSURANCH AF-ORDEO BY THE POUQESDESCRIBED HEREIN ISSUBJECT TO ALL THE TERMS CONDITIONS AND EXC.USONS OF SUCH POLICES AGGREGATE LIMITS S-<OV»N MAY HAVE 3EEN REDUCED BY PAID CLAIMS 00 LTR TYPE Of INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMrOOrYY) PaiCY EXPIRATION DATE0lllfDO/YY)Liwrrs OENERAL LIABILITY COMMERQAL GENERAL LIABILITY CLAMS MADE I X I OCCUR OWNER'S * CCNTR ACTOR'S PROT GLO 2938645-01 01/01/03 01/01/08 GENERAL AGGREGATE PRODUCTS - COMPraP AGG PERSONAL A AOVINJURY EACH OCCURRENCE, FIRE QAM AGE (Any c MB EXP (Any m« o«r»on) 5,000,000 1,000,000 1,000,000 1.000,000 1,000,000 5,000 MJTOHOBIE LIABILITY ANY AUTO ALL OVtNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS BAP 2938646-01 (AOS) BAP 2938647-01 (VA) TAP 2938648-01 (TX) 01/01/03 01/01/03 01/01/03 01/01/06 01/01/06 01/01/06 COV«NED SNGLE LIMIT 1,000,000 BODILY INJURY (Par person) BODILY INJURY PROPERTY DAMAGE OARAOE LIABILITY ANY AUTO AUTO ONLY - E A ACCIDENT OTHER THAN AUTO ONLY EACH ACCIDENT AGGREGATE EXCES3LUM.I7Y — | X i UMBRELLA FORM OTHER THAN UMBRELLA FORM BE 309-73-07 04/01/01 04/01/04 EACH OCCURRENCE 5,000,000 AGGREGATE 5,000,000 WORKERS COMPENSATION AMD EMPLOYE Rr LIMMLITY ! THE «?OPRIETORI i SARTNERSE« i a==-C£3S ARE IX l,Na! -- f ' ''• =XC. WC 2938643-01 (AOS)101/01/03 01/01/06 WCSTATU- ITORY LIMITS I OTH-j _SRj ! EL EACH ACO DENT 1,000,000 1.000.000 iSL 3!S5AS=-eACH =VP1.OYE=! $1.000.000 DESCRIPTION OF OPERATIONSfLOCATIONSyVEHICLES'SPECUL ITEMS CERTIFICATE HOLDS*CAMCBUAT1OM =SCT BSD HCT«« *t onc«..;3 ««£*« TH« ?jp ^«T OH D B w-.. =«!«von To M*. 1O :»rs WWTTJN NOT-CE ^T ' £>T« MO. jt* NM*D Hf^f N »OT *'•• (JtS TO MM. SUCH NOT Cf SH*-. If OS NO OS. O»T ON OR i. TYO«»MV<ICU=ONTH! Na«f^ »SICH3 NO CO»f«»G! TS4O5KTSO1 <?=««SSMT»T V«S C« TH« IMARSHUSANC. ar Christy N. Phowus MMK3/02}V*UD AS.OF- 10V26/02