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HomeMy WebLinkAbout1568 CORMORANT DR; ; CB091634; Permit10-05-2009 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB091634 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: 1568 CORMORANT DR CBAD PLUM 2156500206 Lot#: 0 Construction Type: NEW OSWALD RES REPLACE WTR HTR Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 10/05/2009 KG 10/05/2009 10/05/2009 Applicant: ARS STEA 9895 OLSON DR SAN DIEGO CA 92121 858 457 6557 Owner: OSWALD SALLY J TRUST 02-28-07 1568 CORMORANT DR CARLSBAD CA 92011 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 o 1 0 s ;' $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00> I $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: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 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 Building Permit Application Plan Check N Est. Value Plan Ck. Deposit Date dL^ JOB ADDRESS PHASE* I # OF UNITS I # BEDROOMS SUITE#/SPACE#/UNIT# # BATHROOMS [TENANT BUSINESS NAME CONSTR. TYPEfl OCC. GROUPCT/PROJECT* DESCR OR WORK: EXISTING USE PROPOSED USE GARAGE (SF)PATIOS (SF)DECKS (SF)FIREPLACE YES D # NO D AIR CONDITIONING YES D NOD FIRE SPRINKLERS YES D NOD CONTACT NAME (If Different Font Applicant)APPLICANT NAME ADDRESS CITY STATE ZIP "j fj) STATE PHONE FAX CAX EMAIL EMAIL PROPERTY OWNER NAME CONTRACTOR BUS. NfME/") £- (Sec 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any strutlicensed pursuant to the provisions of the Contractor's license Law {Chapter 9, commending with Section 7000 of Division 3 of the Business andSection 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500}). its issuance, also requires the applicant for such permit to file a signed statement that he isJ-' or that he is exempt therefrom, and die basis for the alleged exemption. Any violation of WORKERS' COMPENSATION Workers' Compensation Declaration: / hereby affirm under penalty of perjury one ofthe following declarations: LD I have and will maintain a certificate of consent to serf-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 have and will maintain worker*' compensation, as required by Section 3700 of the Labor Code, for the performance ofthe work for which this permit ^i«->j ' Corkers' compen number are: Insurance Co. L/>^i^^TVt^ Policy No. WL' /K>£7 J^yD&fc?.^ 1I/1_ I xpirab'on Date'. ensation insurance carrier e! fO/l / ID and policy This section need not be completed if the permit is for(g)ie 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 the Workers' Compensation Laws of California. WARNING: Failure to secure wodfSrV^ompensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100.000), in addition to the cost of compensation, damWes as provided for in Section 37Bfrptttae labor code, interest and attorney's fees. ^CONTRACTOR SIGNATURE DATE OWNER-BUILDER DECLAR AT JO N thereby affirm thaf / am exempt from Contractor's License Law for the following reason: O 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 contractors) licensed pursuant to the Contractor's License Law). D I am exempt under Secb'on Business and Professions Code for this reason: 1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement O Yes a No 2.1 (have / have not) signed an application for a building permit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): 4.1 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): 5.1 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 COMPLETE THIS SECTIONS OR 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? DYes 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? O Yes O No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? O Yes d No IF ANY OF THE ANSWERS ARE YES, / EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. CONSTRUCTION LENDING AGENCY 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 APPLICANT CERTIFICATION^ I hereby authorize 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. OSH A: An OSHA permit is required taex<g*Si67^ EXPIRATION: Every permit issued by Die Building Official under the provisos of ftis&xte shall eicpre by Watim 180 days from the date of surtpermitMif fie buMindVv^ ^APPLICANT'S SIGNATURE DATE City of Carlsbad Bldg Inspection Request For: 10/16/2009 Permit# CB091634 Title: OSWALD RES REPLACE WTR HTR Description: 1568 CORMORANT DR Lot 0 Type: PLUM Sub Type: Job Address: Suite: Location: OWNER OSWALD SALLY J TRUST 02-28-07 Owner: OSWALD SALLY J TRUST 02-28-07 Remarks: PM 2-4 Inspector Assignment: Phone: 7604387331 Inspector: Total Time: CD Description 25 Water Heater/Vents 29 Final Plumbing Act Comments Requested By: SALLY Entered By: JANEAN Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments ACORDm CERTIFICATE OF LIABILITY INSURANCE maow PRODUCER Lockton Companies,LLC-J New York 7 Times Square, Suite 3802 New York NY 10036 INSURED ARS AMERICAN RESIDENTIAL SERVICES OF CALIFORNIA 1073055 DBA ARS OF SAN DIEGO BRANCH 81 12 9895 OLSON DRIVE SUITE A SAN DIEGO CA 92121 DATE (MM/DD/YYVY) 9/22/2009 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: Liberty Mutual Fire Insurance Company INSURER B: Liberty Insurance Corporation INSURER C: National Union Fire Ins Co Pittsburgh PA INSURER D: INSURER E: NAIC# 23035 42404 19445 COVERAGES AMERE02 RB THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUlf*INSURER(8|. AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. 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. INSR LTR A A C B wxnNSRI TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY J CLAIMS MADE |X [ OCCUR GEN'L AGGREGATE LIMIT APPLIES PER:n POUCY res r~Koc AU X — — TOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY J ANY AUTO EXCESS/UMBRELLA LIABILITY X] OCCUR _| CLAIMS MADE 1 FT! UMBRELLA DEDUCTIBLE LU FORM 1 RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRI6TOR/PARTNER/EXECUT1VE OFFICER/MEMBER EXCLUDED? If ye«. describe under NO SPECIAL PROVISIONS below OTHER POLICY NUMBER TB2-631-508631-029 AS2-63 1-50863 1 -039 NOT APPLICABLE 27471455 WC7-63 1-50863 1-0 19 POLICY EFFECTIVE DATE (MM/DD/YY) 10/1/2009 10/1/2009 10/1/2009 10/1/2009 | POLICY EXPIRATIONDATE (MM/DD/YY) 10/1/2010 10/1/2010 10/1/2010 10/1/2010 LIMITS EACH OCCURRENCE DAMAGE TO RENTED PREMISES [Ea occurence) MED EXP (Any one person) PERSONAL 1 ADV INJURY GENERAL AGGREGATE PRODUCTS - COUP/OP AGO COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT OTHFRTHAN ,E^*CC AUTO ONLY: AGQ EACH OCCURRENCE AGGREGATE Y 1 WCSTATU- I IOTH-x 1 TORY LIMITS 1 1 ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY UMIT $ 2,000,000 * 1,000,000 t 10,000 j 2,000,000 $ 4,000,000 $ 4,000,000 j 2,000,000 * xxxxxxx * XXXXXXX * xxxxxxx J XXXXXXX * xxxxxxx $ xxxxxxx J 5.000,000 « 5.000.000 « xxxxxxx * xxxxxxx $ xxxxxxx $ 1,000,000 * 1,000,000 ( 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS AGGREGATE POLICY LIMIT. FOR INFORMATION PURPOSES ONLY CERTIFICATE HOLDER CANCELLATION 3720536 EVIDENCE OF INSURANCE ACORD 25 (2001 /08) f« q— > SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER 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. AUTHORiaWTS'RESENTATIVE j .-j-foA+^/t . y*%zzz. — ^ om regarding thU mtlfluto. contact th« numbw lilted In th< 'PrcKluOT' Motion »!&• «xl ipccffy ttw dtant cod< 'AMEREOr. ©ACORD CORPORATION 1988