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HomeMy WebLinkAbout1764 BLACKBIRD CIR; ; CB090249; Permit02-17-2009 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB090249 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # PC# Project Title 1764 BLACKBIRD CR CBAD PLUM -2156020500 Lot# Construction Type NEAU RES- REPLACE WTR HTR 0 NEW Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 02/17/2009 LSM 02/17/2009 02/17/2009 Applicant ARS STEA 9895 OLSON DR SAN DIEGO CA 92121 858 457 6557 Owner NEAU CHRISTIAN M&MINER ERICA 1764 BLACKBIRD CIR CARLSBAD CA 92011 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 Total Fees $27 00 Total Payments To Date $27 00 Balance Due $000 Inspector FINAL APPROVAL Date Clearance NOTIPE 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 No. Est. Value Plan Ck. Deposit Pate JOB ADDRESS SUITE#/SPACE#/UNIT# CT/PROJECT # DESCRIPTION OF # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR TYPE OCC GROUP EXISTING USE PROPOSED USE GARAGE (SF)PATIOS (SF)DECKS (SF)FIREPLACE YESD #NOD AIR CONDITIONING YES D NOD FIRE SPRINKLERS YES D NO D CONTACT NAME (If Different Fom Applicant)APPLICANT NAME ADDRESS CITY STATE ZIP CITY STATE PHONE FAX EMAIL EMAIL PROPERTY OWNER CONTRACTOR BUS ADDRESS CITY STATE FAX EMAIL ARCH/DESIGNER NAME & ADDRESS [Sec 7031S Business and Professions Code Any City or County which requires a permit to construct, alter, improve demolish or repair any structure, pnor to its issuance, also require! the applicant for such permit to file a signed statement that he islicensed 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 lection 70315 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$$00}) Workers' Compensation Declaration / hereby affirm under penalty of perjury one of the following declarations 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 have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance gfthe work for which this permit « i«'^ "•• workers' compensation insurance carrier and policy number are Insurance Co \A^?£@A\As Policy No U£^/fc?^i^D^fc?j7 / 01 O .._ Expiration Date'. f 0 / 11 DATE This section need not be completed if the permit is for(o/e hundred dollars ($100) or less O 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 wocKer&Uompensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&1 00,000), in addition to the cost of compensation, darrfccfes as provided for in Section 370ftptttae Labor code, interest and attorney's fees ^CONTRACTOR SIGNATURE \£/A1 &J\L&^ SI f j^C^\ / hereby affirm that I 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 contractor(s) 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 matenals for construction of the proposed property improvement d Yes Q 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 / 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 / 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 / type of work) vgfpROPERTY OWNER SIGNATURE Is the applicant or future building occupant required to submit a business plan, acutely hazardous matenals registration form or nsk management and prevention program under Sections 25505,25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D 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 distnct? O Yes O No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site7 O Yes fj No IF ANY OF THE ANSWERS ARE YES, t EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT 'C'6"N"S?f .'•R:U''C;T fb N: 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 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 representative of the City of Carlsbad to enter upon trie above mentioned properly 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 ts required for excaySffioTiswer 5'0' deep and demolition or construction of structures over 3 stones m height. EXPIRATION Every permit issued by the Building Orfoal under (he prareions of Ins CtaeshaJl expire tytatabw 180 days from tne date of sucfir^nTrtcArfpebuMid DATE City of Carlsbad Bldg Inspection Request For 02/27/2009 Permit* CB090249 Title NEAU RES- REPLACE WTR HTR Description Sub Type 1764 BLACKBIRD CR Lot 0 Type PLUM Job Address Suite Location OWNER NEAU CHRISTIAN M&MINER ERICA Owner NEAU CHRISTIAN M&MINER ERICA RemarksAM PLEASE Total Time CD Description 25 Water Heater/Vents 29 Final Plumbing Act Comments Inspector Assignment llZ/7 Phone 7604769898 Inspector Requested By KRISTEN Entered By JANEAN A- Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments ACORDn CERTIFICATE OF LIABILITY INSURANCE 10/1/2009 "ISST1 PRODUCER Lockton Compames,LLC-J New York 7 Times Square, Suite 3802 New York NY 10036 INSURED ARS AMERICAN RESIDENTIAL SERVICES OF CALIFORNIA 1 073055 DBA ARS OF SAN DIEGO BRANCH 81 12 9895 OLSON DRIVE SUITE A SAN DIEGO CA 92 121 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 NAICff 23035 42404 19445 COVERAGES AMERE02 RB THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUINGINSURER(S) AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE QEHTlFtCATE HOLDER THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING 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 ilf^ A A C B ftDDL NSRD TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY | CLAIMS MADE JX | OCCUR GEN L AGGREGATE LIMIT APPLIES PER ^| POLICY | |PB°T | |LOC AU X — — — TOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY _1 ANY AUTO EXCESS/UMBRELLA LIABILITY X| OCCUR | 1 CLAIMS MADE — 1 FT! UMBRELLA DEDUCTIBLE LU FORM 1 RETENTION $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? If yes describe under ™®SPECIAL PROVISIONS below OTHER POLICY NUMBER TB2-63 1-50863 1-028 AS2-63 1-50863 1-038 NOT APPLICABLE 6358799 WC7-63 1-50863 1-0 18 POLICY EFFECTIVEDATE (MM/DD/YY) 9/29/2008 9/29/2008 9/29/2008 9/29/2008 POLICY EXPIRATION DATE (MM/DD/YY) 10/1/2009 10/1/2009 10/1/2009 10/1/2009 LIMITS EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT(Ea accident) BODILY INJURY (Per person) BODILY INJURY(Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN ." ACC AUTO ONLY AGG EACH OCCURRENCE AGGREGATE Y 1 WCSTATU- 1 lOTHA 1 TORY LIMITS 1 1 ER EL EACH ACCIDENT EL DISEASE EA EMPLOYEE EL DISEASE - POLICY LIMIT $ 2.000.000 $ 1,000,000 $ 10,000 $ 2,000,000 $ 4,000,000 $ 4,000,000 $ 2,000,000 $ XXXXXXX $ xxxxxxx * xxxxxxx $ xxxxxxx $ xxxxxxx $ xxxxxxx $ 5,000,000 $ 5,000,000 $ xxxxxxx I 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 CERTIFICATE HOLDER CANCELLATION 3720536 EVIDENCE OF INSURANCE 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 AUTHORIZJHHlEpRESENTATiyE > j «— j^^-— •^CVt-t^^r sc. f ^f^J&t-^^*' * ^SGV^S ACORD 25 (2001/08)For queallona regarding thl» certificate contact the number lined in the Producer .action above and .poclfy the client code AMERE02 ©ACORD CORPORATION 1988