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HomeMy WebLinkAbout1411 CRESSA CT; ; CB022598; Permit09-03-2002 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No Building Inspection Request Line (760) 602-2725 CB022598 Job Address Permit Type Parcel No Reference # Project Title 1411 CRESSACTCBAD PLUM 2156212100 Lot# 0 Construction Type NEW FORMAN RES-NEW WATER HEATER Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 09/03/2002 RMA 09/03/2002 09/03/2002 Applicant ARS STE 100 6162 NANCY RIDGE DR SAN DIEGO CA 92121 858-677-5455 Owner FORMAN KATHY A 1411 CRESSACT CARLSBAD CA 92009 5370 09/03/02 0002 01 02 COP 27.00 Total Fees $2700 Total Payments To Date $000 Balance Due $2700 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 Additional Fees 0 0 0 0 1 0 0 $2000 $000 $000 $000 $000 $700 $000 $000 $000 $000 $000 $000 TOTAL PERMIT FEES $2700 Inspected FINAL APP Date V 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 ol 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 UECT INFORMATION FOR OFFICE USE ONLY, PLAN CHECK NO EST VAL Plan Ck Deposit Validated & Date i BY , .-. ,\Qj y//[(/i vx i v Address (include Bldg/Suite tt)Business Name (at this address) Legal Description Lot N ubdivision Name/Number Unit No Phase No Total tt of units Assessor's Parcel tt Existing Use Proposed Use Description of Work 2 CONtTACT PERSON (if different from applicant) SQ FT #of Stories # of Bedrooms # of Bathrooms Name Address t. for Contractor City State/Zip Telephone tt Fax tt NaVne ' ) Address City State/Zip Telephone tt 5 CONTRACTOR - COMPANY NAME " ! (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 Code) or that he is exempt therefrom, and the basis for the alleged .Any vuDlat_io/i of^Sectipn^OSI 5 by anyjjpplicjmt for a permit subjects_the app_lj_cant to a cml penalty of/iqt^mpra than jive ljundjad dollars City (/ State/Zy City Business License # \lame State License it Designer Name Address City State/Zip Telephone State License ff 6 WORKERS'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 ^C I have and will maintain workers' 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 cp^njipensationynsurance^ carrier and policy number are /~\r* <—tt-*A in Insurance Company Expiration Date_////OS (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) |~| CERTIFICATE OF EXEMPTION I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California WARNING Failure to secure workers compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($tOO QJOO) in addition to the, oust of compensation damages as provided for in Section 3706 of the_La£br_code/fnterest and attorney s fees SIGNATURE t A /O i/yO^O^v- C_jtf'^ft/-^g-><, DATE 7 OWNER-BUILDER DECLARATION {^) I hereby affirm that I am exempt from the Contractor's License Law for the following reason d 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) 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) [~l 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 d YES l~lNO 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 / 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 COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY 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 Act? l~l 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? l~l YES [~] NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? |~| 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 8 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(0 Civil Code) LENDER'S NAME LENDER'S ADDRESS 9 APPLICANT CERTIFICATION > 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 CitV 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 stories in height EXPIRATION Every permit issued by the building Official under the provisions of this Code shall expire by limitation and become null and void i) the building or work authorized by such permit is not commenced within 180 days from J^e date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced Iffr a period of 180 de^s/fsection 106 4 4 Uniform Building Code) APPLICANT S SIGNATURE ^/ WMMXjtf^— (^/^J^^-^ v DATE WHITE File YELI Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 10/01/2002 Permit# CB022598 Title FORMAN RES-NEW WATER HEATER Description Type PLUM Sub Type Job Address 1411 CRESSACT Suite Lot 0 Location APPLICANT ARS Owner FORMAN KATHY A Remarks NEEDS AN AM INSPECTION PLEASE Inspector Assignment R Phone 8586775455 Inspector Total Time CD Description 25 Water Heater/Vents Act Comments Requested By YOLANDA Entered By CHRISTINE Associated PCRs/CVs - C7 Inspection History Date Description Act Insp Comments 09/16/2002 25 Water Heater/Vents CA RF 09/16/2002 29 Final Plumbing CA RF r' MARSH USA INC. PRODUCER Msrsn USA !nc 500 N .Vcnroe Chicago IL S0661 Attn-LOLA CAVIS 312627-5373 CERTIFICATE OF INSURANCE CERTIFICATE NUMBER THIS CERTIFICATE IS ISSUED AS A HATTER OF '.MFCRWATIOM ONLY AND CONFERS NO SIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POLICY THIS CERTIFICATE DOES SOT AMEND cXTEHD OR ALTER THE COVERAGE AFFORDED 3f THE POLICIES DESCRIBED HEREIN COMPANIES AFrCRDING COVERAGE COMPANY A ZURICH AMERICAN .NSUPANCc COMPANY INSURED ARS American Residential Services of California, inc dba 860 Ridge Lake Blvd Memphis, TN 38120 I COMPANY B ILLINOIS NATIONAL INSURANCE COMPANY COMPANY C COMPANY D COVERAGES This certificate- supersedes and replaces any previously issued, certificate for the policy period noted below THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE 3EEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONOmCN OF ANY CONTRACT OH OTHER DOCUMENT WFTH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OFI MAY PERTAIN THE INSURANCE AFFORDED 3Y THE POLC1ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS CONDITIONS AND EXCLUSIONS OF SUCH POLICES LIMITS SHOWN MAY HAVE 3EEN REDUCED BY PAID CLAIMS CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATEIMU/DD/YY) GENERAL LIABILITY GLO 2938645-00 01/01/02 01/01/03 GENERAL AGGREGATE COMMERCIAL GENERAL LIABILITY I CLAIMS MADE | X| OCCUR OWNER S 4 CONTRACTOR S PROT PRODUCTS COMP/OP AGO PERSONAL & ADV INJURY EACH OCCURRENCE FIRE DAMAGE (Any onn fire) I MED EXP (Any one parson] 5 000 000 1 000 000 1 000 000 1 000 000 1,000000 5000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS BAP 2938646-00 (ACS) SAP 2938647-00 (VA) TAP 2938648-00 (TX) 01/01/02 01/01/02 01/01/02 01/01/03 01/01/03 01/01/03 COMBINED SINGLE LIMPT 1 000 000 BODILY INJURY (Per person) BODILY INJURY (Par accident) PROPERTY DAMAGE GARAGE LIABILITY ANY AUTO AUTO ONLY EA ACCIDENT OTHER THAN AUTO ONLY EACH ACCIDENT AGGREGATE EXCESS LIABILITY EACH OCCURRENCE 5 000 000 UMBRELLA FORM OTHER THAN UMBRELLA FORM AGGREGATE 5 000 000 BE 309-79-07 01/01/00 01/01/03 WORKERS COMPENSATION AND EMPLOYERS LIABILITY WC 2938643-00 THE PROPRIETOR/ PARTNERS/EXECUTIVE OFFCERS ARE. INCL EXCL 01/01/02 01/01/03 WC STAR)TORY LIMITS OTH- ER EL EACH ACCIDENT 1 000 000 EL DISEASE POLCY LIMfT 1 000 000 EL DISEASE £ACH EMPLOYEE 1 000 000 i OTHER DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/SPeCIAL ITEMS (LIMITS HAY BE SUBJECT TO OEDUCTIBLES OH RETEHTIOHS1 CERTIFICATE HOLDER -CANCELLATION SHOULD »NY Of TVe "XIOE3 DESCRIBED HEREIN 3E OUCOJ-EO BEFORE "HE EXP1BAT1ON OATE TVE USURER AFW3ROWG COVERAGE «IUL EWOEAVOR "0 IJAU. "!fl :>YS WRTTTEN IJOT1CE "O -J« CERTIFICATE HOLDER NAMED HEREIN 3UT FAILURE TO MAIL SUCH NOTICE SHALL MPOSE NO OBLIOAnOM cfl ArtYKWO UPON THE INSURER AFFORDING COVERAGE ~5 AGENTS C3 REPRESENTATIVES jHARSH USA INC JBY Hlsa M Lynch ' MMK9/99)VALID AS OF