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Home My WebLink About1617 CORMORANT DR; ; CB044451; Permit12-13-2004 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB044451 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 1617 CORMORANT DR CBAD PLUM 2156500402 Lot# Construction Type SHARP RESIDENCE WATER HEATER REPLACEMENT 0 NEW Applicant CENTRAL PLUMBING HTG & COOLING 6152 MISSION GORGE ROAD #H SAN DIEGO,, CA 92120 619-283-5531 Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 12/13/2004 MDP 12/13/2004 12/13/2004 Owner SHARP FAMILY TRUST 04-22-91 1617 CORMORANT DR CARLSBAD CA 92009 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 $2000 $000 $000 $000 $000 $700 $000 $000 $000 $000 $000 $000 TOTAL PERMIT FEES $2700 Total Fees $27 00 Total Payments To Date $0 00 Balance Due $2700 U'tfi>^j4"-'i kAfa 1 PERMIT MAS TXPIRED IN ACCORDANCE WITH ULB.C SECTION 108.4.4 PATE J^Ad- SIGNATURE 7439 12/13/04 0002 Qj CGP 27. Inspector FINAL APPROVAL 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 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 1 PROJECT I FOR OFFICE USE ONLY PLAN CHECK EST VAL Plan Ck Deposit Validated By Date Address (include Bldg/Suite #)Business Name (at this address) Lot No Subdivision Name/Numbernrw .IA Unit No Phase No Total 0 of units Assessor s Parcel #, Existing Use Proposed Use Description of Work v, \ 2 COhtTACT PERSON (If dIHerent from applicant) SQ FT 0of Stories # of Bedrooms # of Bathrooms Address Agent forContractor Q Owner D Name Address ' City ' State/Zip Telephone It 6 CONTRACTOR • COMPANY NAME (Sec 7031 5 Business and Professions Code Any City or CouYity which requires e 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 Name lir-tf^ State License # 7 / O Designer Name State License # Q ' Address 1 3 O License Class C- ^ Address \t&.30sl(a.tt. CiCf1 J State/Z^ ' CCL City Business License # v ' City State/Zip Telephone ff /%><3O Telephone i ^£)Dj Expiration Date "7~/ ~O<S~ Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations ( j 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 55^ 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 compensation insurance carrier and policy number are Insurance Company l^ 7~Qj€- rUL^XC/ Policy No (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) D 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 it unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars telQJX.OOBI in addition to the cost of compensation damages as provided for in Section 3706 of the Labor code interest and attorney s fees SIGNATURE A) IyWfiYVWTL) . DATE / ?r /Q -Q (^ 7 OWNER-BUILDER DECLARATION i hereby affirm that I am exempt from the Contractor s License Law for the following reason C3 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) 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 contractorls) licensed pursuant to the Contractor s License Law) D 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 Q YES [~)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 number / contractors license number) 4 ! 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 ,' typeoi 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? Q 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 Is the facility to be conslructed 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 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 applicat.on and state that the above information is correct and that the information on the plans is accurate ( 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 AGA.NST SA.D CITY IN CONSEQUENCE OF THE GRANTING OF TH,S PERM,T OSHA An OSHA parmit is required for excavations over 5 0" deep and demolition or construction of structures over 3 stories in height aXmo^Irt°hN E h^ PT' 'SSUed by '^ bU"d'n9 0ff'Clal Under th6 Provisions 0( tnis Code ^all exp,re by hmitation and become null and vo,d ,f the building or work I anJ, m r»" m '^T 'S n°' C0mmenfd Wlthln 18° daVs fr°m me da"> °' ^ PS""" °<" '^ building or work authorized by such permit ,s suspended or a>any time after the work is commenced lor a period of 180 days (Section 106 4 4 Uniform Building Code) APPLICANT S SIGNATURE / J DATE WHITE File YELLOW Applicant PINK Finance SO COMPENSATION INSURANCE FUND . -. .-f"\f •• V j . POLICYHOLDER COPY PO BOX 807, SAN FRANCISCO,CA':'9Vi42r0807 1 '-•>' ^-,^"' -,*' < • CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE 07-01-2004 CITY OF CARLSBAD 1635 FARADAY AV CARLSBAD CA 92008 SD .;, "GROUP '' POLICY NUMBER ". 1578609-2004 .'/CERTIFICATE ID ., 130 CERTIFICATE" EXPIRES 07-01-2005 ... ' 07-01-2004/07-01-2005 This is to certify that we have issued a valid Workers' .Compensation insurance* policy in a form approved by the California Insurance Commissioner to the employer named below , for the- policy period indicated,'' ' ;, ' -^Vi^Y^;^-^.... • *'•.'; '; -This policy is not subject to cancellation by the Fund except upon so.dayg'i. advance written'' notice to the employer We will also give you 30 days' advance notice should •this policy be cancelled 'prior to its normal expiration v^;'-'>^v:>-.^.:;:' >. .- -.This certificate of insurance is not an insurance policy^'and -does hot amend,' extend or alter the coverage afforded 'by the policieswith respect policies described s listed herein Notwithstanding any requiremerU, ternv;;or ^'condition of. any /contract- or 'Other documentto which this certificate of insurance _ma'y ^be; issued* or may 'pertain, .thehnsur.ance- afforded by the ibed herein is subject to all the terms, "exclusions ;.ariii conditions 'of 'such policies < . '•' ' ' ' " " AUTHORIZED REPRESENTATIVE , v-r , v" PRESIDENT\ EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 00 PER OCCURRENCE ENDORSEMENT #2065 ENTITLED Cl FORMS A PART OF THIS POLICY. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE .EFFECTIVE 07-01-2004 IS ATTACHED TO AND EMPLOYER CENTRAL PLUMBING HEATING & COOLING STE H 6152 MISSION GORGE RD SAN DIEGO CA 92120 '. •., ^ .' • =< \ t u. f " (REV 3-03) SAN DIEGO CENTRAL PLUMBING INC ._, , 06/17/2004 PDA m THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND