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Home My WebLink About1941 ALGA RD; ; CB080789; Permit04-29-2008 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB080789 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # PC# Project Title 1941 ALGARDCBAD PLUM 2151700323 Lot# 0 Construction Type NEW CHAMPAGNE RES REPLACE WTR HTR Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 04/29/2008 KG 04/29/2008 04/29/2008 Applicant FAST WATER HEATER COMPANY 12601 132NDAV NE KIRKLAND WA 98034 4258143124 Owner CHAMPAGNE LORI R 1941 ALGA RD#A 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 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 APPRVAL 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/axactions 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 From1 Fax #760-602-8558 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 04/23/2008 13-41 tt011 P 002/005 400686 PLAN CHECK NO.. EST VAL PlanCk Deposit Validated By 1941 ALGA RD Addnsss (Include Bldg/Sulte #)Business Name (at this address) Legal DeserfpBon Lot No SLttflvislon Name/Number Unit No Phase No Total* of units Assessors Pares! #Eidstmg Use Proposed Use Description of Work SO. FT Remove/Replace Electric Water Heater # of Stories S of Bedrooms # of Bathrooms Telephone # KIRKLAND. WA 98034 Name Address § FAST WATER HEATER COMPANY Address CBy Telephone* MITCHELL. LAURA & ROWDY Name Address City Telephone* (Sao 7031.5 Business and Professions Code Any City or County which requires a permit to construct, alter, Improve. oemoOsn or repair any structure, prior to Its Issuance, also requires the applicant for such permit to file a signed statement that he te licenced pursuant to the previsions of tha Contractor's License Law (Chapter 9, commendms with Section 7000 of Division 3 of the Business and Professions Code] or that he Is exempt therefrom, and the baste for the alleged exemption Any violation of Section 7031 6 by any applicant for a permit subjects me applicant to a civil penalty of not more (nan fiv» hundred dollars ($5001) FAST WATER HEATER COMPANY 12601 132ND AVE NE KIRKLAND. WA 98034 800-454-8955 Name Address City State/Zip Telephones State license #877489 License Class C36 Crtv Business License « 1222302 Designer Name Stele License* Address City State/Zip Telephone # I hereby affirm under penally of perjury one of the foilWorkers' Compensation t D I have and will maintain a certificate of consent to self-Insure for workers' oompenssBon as provided by Section 3700 of the Labor Code, for the perfbmance of the work for vihlch tnte permit Is Issued. , X I have and win maintain worker's compensation, aa required by Section 3700 of the la^r Code, for trepefforaiance of the werk for which fills permit Is Issued My worker's compensation Insurance carrier and policy number are Insurance Company California State Fund Policy No. 1761660 Expiration Data 12/1/08 (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 Ihe performance of tha work for which this permit Is Issued,1 shal not employ any person 61 any manner so as to become subject to me Workers' Compensation Laws of Cafifomla WARMW3- Failure to secure wortere' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and eMI Hnes up to one hundred thousand doOare<$1oo,OOI», In addition to th« cost of compensation, damages am provided far bi Section 3706 of the Labor Cods, Interest and attorney's fees. SIGNATURE e3**J**t*Jfr~A*#f' DATE 4/29/08 I hereby affirm that I am exempt from the Contractor's License Law for the following reason. Q L as owner of the property or my employees wNh wages as their sole compensation, wBI d the work and Die structure to 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 a; Improves thereon, end who does eueh work himself or through ha own employees provided that such Improvements am not Intended or offered for sale. If, however, *e building or Improvement Is sold within one year of compieflon, the owner-builder will have fiw burden of proving ft it he did not build or Improve for the purpose of sale}. D I, as owner of the property, am axdurivety contracting wHhtamsed contractors to coramict trw project (Sec. 7044, Budness and Professions Code. The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, end contacts for such projeoto with contractors) licensed pursuant to the Contractor's License law) D I am exempt under Section Business and Professions Coda for Bits mamn 1 I personally plan to provide the major labor and materials for construcaon of the proposed property knpravement D YES D NO Z I (have/havg not) signed an appUcaSon fcr a building permit for he proposed work. 3 I have contracted with the Mowing person (firm) to provide the proposed oonsmi(aon(lrdude name/address/p^re number/contrartora Ticmisertumber)- 4. I plan to provide portions of the work, but I haw hired the following person to coordinate, supervise and provide Hie major work (Include name / address / phone number / rontractors Bcensa number) _______^_-__—____p_____^___.,^___^_^______^___^______^_____-_—_______ 5. I wig pcoride some of to work, but I have contracted (hted) the ^^ PROPERTY OWNER SIGNATURE ,.DATE. From"04/29/2008 13:43 K011 P 003/005 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave, Carlsbad CA 92008 Page 2 of 2 Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration f Sec«oiis2S605,25533or25534ofthsPreBl8y-TanriBrHazBrdouBSub3tancaAccouiSAof7 Q YES D NO Is the applicant or future bunding occupant required to obtain a permit from the air pollution control olstrlct or air quality management district? lsthetacl5tytobeiMri3tnicledvrtmin1,000(Betcfmeouteft)OOTdaryofascnoolslt»? D YES D NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTFICATE OF OCCUPANCY MAY NOT BE «S REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. D YES D NO I hereby affirm that there Is a construction tending agency for the f LENDER'S NAME a of the wortc for which thte permit la Issued (Sec. 30B7(I)CMI Code). LENDER'S ADDRESS I certify that I have read the appllceSon and state that fin above Information Is correct and that the InformaBon on the plans Is accurate. I agree to comply wHh all City ordinances and State laws relating to bunding 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 UABHJT16S, JUDGEMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAD CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA. An OSHA permit Is required far excavations of 6'0" deap 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 nuH and void If the building orworK authorized by such psrmit Is not commenced vidtWn 180 days from fte dale of such parmft or tf fte bufUng or w^auftnrb^ by such pennlt is suspend or atandoned at any lime after the work Is commenced for a period of 180 days (Section 106 44 Uniform Bidding Code) APPLICANTS SIGNATURE.. DATE.04/29/2008 City of Carlsbad Bldg Inspection Request For 06/04/2008 Permit* CB080789 Title CHAMPAGNE RES REPLACE WTR HTR Description Type PLUM Sub Type Job Address 1941 ALGA RD Suite Lot 0 Location OWNER CHAMPAGNE LORI R Owner Remarks Total Time CD Description 25 Water Heater/Vents Act Comments Inspector Assignment Phone 7608050800 Inspector Requested By LAURA MITCHELL Entered By CHRISTINE Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments From: 04/29/2008 13:44 SOU P 005/005 POLICYHOLDER COPY NB COMPENSATE 420807, SAN FRANOSCO,CA 94142-0807 INSURANCEgaatg • »fr « Ftl F^UIEMO CERTIFICATE OF WORKERS' COMPENSATION folSURANCE ISSUE DATE 12-01-2007 GROUP; POLICY NUMBER: 1761680-2007 CERTIFICATE ID- 10 CERTIFICATE EXPIRES. 12-01-2008 12-01-2007/12-01-2008 CONTRACTORS STATE LICENSE BOARD NB LIC PERMIT?: 877489 WORKERS COMPENSATION UNIT INCEPTION DATE-12-O1-2007 PO BOX 26000 DO.NB SACRAMENTO CA 95826-0026 This Is to certify that we have Issued a valid Workers' Compensation insurance policy m a form approved by tha 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 30 days 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. This certificate of insurance Is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein Notwithstanding any requirement, term or condition of any contract or other document with respect to which iHs certificate of insurance may be issued or to which rt may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions of such policy HZED REPRESENTATW6O PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS $1,000,000 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 12-01-2005 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER FAST WATER HEATER COMPANY (A CORP) NB 12801 132ND AVE NE KIRKUAND WA 88034 (REV 2-flH IB11.SO] PRINTED : 12-03-2007