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Home My WebLink About1714 CANNAS CT; ; CB041880; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB041880 uilding Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 1714CANNASCTCBAD PLUM 2155011900 Lot#: 0 Construction Type: NEW ALLEN RES-REPLACE H2O HEATER Status: ISSUED Applied: 05/20/2004 Entered By: RMA Plan Approved: 05/20/2004 Issued: 05/20/2004 Inspect Area: Applicant: AFFORDABLE WATER HEATER 24707 SAN FRANANDO RD SANTA CLARITA 91321 661 259-7131 Owner: ALLEN PHILIP L 1714CANNASCT 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:$0.00 Balance Due:$27.00 2603 05/2Q/04 0002 01 CGF"27-00 Inspector: FiNALAPP 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 FOR OFFICE USE ONLY PLAN CHECK NO./ EST. VAL. Plan Ck. Deposit Validated Bv£-Date .. > Address (include Btdg/Suits *)dr-Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total f of units Assessor's Parcel 9 Existing Use Proposed Use Description of Work "•.^^^ti SO. FT.tot Stories t of Bedrooms # of Bathrooms ^ Name Address City Stale/Zip Telephone »Fax* Name Address (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, alao 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. Any violation of Section 7031.5 by any applicant for a permit subject! the applicant to a civil penalty of not more then five hundred dollars 1*500]), UJsJTLr Ue&T?.^ .WP7 JUfe-jjfcjor KO UuuW>U Name State License * Address License Class d 5 U City State/Zip Telephone * City Business License It /«5- 1 7 e> *7 ) Designer Name State License » 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 thr^vork for which this permit is issued. flfl I have and wilt maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit la issued. My worker's compensation insurance carrier and policy number ere: Insurance Company y^"f<- F*AVJ ^ Policy No. V* jf* &"5 Expiration Date _,__(_"' ~___* (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [1100] OR LESS) Q CERTIRCATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shell not employ any person in any manner so as to become subject to the Workers' Compensation Lews of California. WARNING: Faflore to secure workers' compensation coverage fa unlawful, and shaJ subject an employer to criminal penalties and civil tines up to one hundred thousand dollars 1*100,0001, In eddWbn to the cost of compensation, damages as provided for hi Section 3706 of the Labor code. Interest and attorney's fees. SIGNATURE MJr^~^ DATE I hereby affirm that I am exempt from the Contractor's Ucanaa Law for the following reason: Q t, as owner of the property or my employees with wages as their sole compensation, wilt do the work and the structure is not intended or offered for sale (Sec. 7044, Business end 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 contractor!*} 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 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): 4. I plan to provide portions of the work, but I have hired the following parson to coordinate, supervise and provide the major work (include name / address / phone number / contractors license number): ^^ i __ i i 5. t will provide some of the work, but I have contracted (hired) the following persons to provide th« 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-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 b/c^nstructed 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. IlillStM^^ I hereby 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 that 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. OSHA: An OSHA permit is required for excavations over S'O" 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 if the building or work authorized by such permit is not commenced within 180 days from the 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 far a pe/lod of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE 5/3 6/0 V WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 08/27/2004 Permit* CB041880 Title: ALLEN RES-REPLACE H20 HEATER Description: Inspector Assignment: 1714 CANNASCT Lot Type: PLUM Sub Type: Job Address: Suite: Location: APPLICANT AFFORDABLE WATER HEATER Owner: ALLEN PHILIP L Remarks: AFTER 1 PM PLEASE Phone: 7604760503 Inspector: Total Time: CD Description 25 Water Heater/Vents Act Comment Requested By: KIMBER ALAM Entered By: CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments "*"''.-' ' ''. '.".''•^,>. •'•'-•".•!,'^jffift''/:. .'.?''s-'^~?--''~.~&~'t^^&v<":-'?.-!' ; J'-s '• '"•-, NT -•';' POLICYHOLDER COPY 94142-0807 COMPENSATION I N 5 U R A N^C E FUND CERTIFICATE OF •VyORKEBS' COMPENSATION INSURANCE ISSUE DATE: 01-01-2004 CONTRACTORS STATE LICENSE BOARD WORKERS COMPENSATION UNIT P 0 BOX 26000 SACRAMENTO CA 95826 NT GROUP: POLICY NUMBER: 1659335-2004 CERTIFICATE ID; 1 CERTIFICATE EXPIRES: 01-01-200501-01-20O4/01-01-2005 LICENSE NUMBER: #627353 INCEPTION DATE: 01-01-2004 D.O.: ' NT 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. This policy is not subject to cancellation by the Fund except upon 10 days' advance written notice to the employer. We will also give you jo days' advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate of: insurance 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. AUTHORIZED REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE. EMPLOYER LEGAL NAME : ^-£&<3. •> '/f JAFFdRDABli/'WAT|Rl:HEATERS V.;. PLUMBJNG^:.^-^.,-:' T .-•)'.';"" 7,, SANTX.cJ^R.IX^;^':9132;lJ AFFORDABLE WATER HEATERS & PLUMBING INC TH'S DOCUMENT HAS A BLUE PATTERNED BACKGROUND PRINTFD: