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Home My WebLink About2042 CIMA CT; ; CB044102; Permit11 09 2004 City of Carlsbad 1635 Faraday Av Carlsbad CA 92008 Plumbing Permit Permit No CB044102 Building Inspection Request Line (760) 602 2725 Job Address Permit Type Parcel No Reference # Project Title 2042 CIMA CT CBAD PLUM 2164910300 Lot* 0 Construction Type NEW HENCHY RESIDENCE WATER HEATER REPLACEMENT Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 11/09/2004 MDP 11/09/2004 11/09/2004 Applicant PACIFIC EXPRESS INSTALLATION P 0 4056 CARLSBAD 92018 760 421 0380 Owner HENCHY TRUST 03 1604 2042 CIMA CT 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 $0 00 Balance Due $2700 5073 11/09/04 0002 01 02 COP 27 00 Inspector FINAL Date Clearance NOTICE Please take NOTICE that approval of your project includes the Imposition of fees dedications reservations or other exactions hereafter collectively referred to as fees/exactions You have 90 days from the date this permit was issued to protest imposition of these fees/exactions If you protest them you must follow the protest procedures set forth in Government Code Section 66020(a) and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3 32 030 Failure to timely follow that procedure will bar any subsequent legal action to attack review set aside void or annul their imposition You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes nor planning zoning grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave Carlsbad CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date Address (include Bldg/Suite tt)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total tt of units Assessor s Parcel tt Existing Use Proposed Use Description of Work #of Stories # of Bedrooms tt of Bathrooms Name Address City t fpr Ownen State/Zip Telephone tt Fax tt Name Address City State/Zip Telephone # Name { Address City State/Zip Telephone tt rv\*T* +& *~ ** *$&&>*'** i r^-it' (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 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 exemption. Any violation of Section 7031 5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]) Iu.SrWlia.4vA4 fO PC* </fifiQ> diUU^ 6. Name State License tt Address License Class O City State/Zip Telephone tt City Business License tt 1 f-4 i Designer Name State License tt Address City State/Zip Telephone Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations C] 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 |~| | 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 compensationjnsurance carrier and policy number are Insurance Company ^An^t. Ltf)/u)p±t\iff*J\jM.. ^c\ \V\(J Policy No 1 "75 fc^-/H " J Expiration Date_fVli/tr^ MUTED(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 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 workers compenioljon coverage Is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollar* (SIQp^nni In addAlon to the post of compensation damages at provided for in Section 3706 of the Labor code interest and attorney s fees SIGNATURE t <zJ&i fr\TVto 0 DATE I hereby affirm that I am exempt from thfrtontractor 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) 0 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 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 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 / type of work) PROPERTY OWNER SIGNATURE DATE. ^QOTL|fE|rHlsiSfQT!P!«FOB Al»WJ^/Ofi!V7W<^MlUP!NO%PBMI^ONtT^iif^3>AjW s^-jsu v tRaPf* M t j ' 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 constructed within 1 000 feet of the outer boundary of a school site? Q YES D 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 iiJ?irfi%'%TRucfiiSMJL^M^QM?iNCYj_j;g>i£] mtt«a,i.MUi^wI!i!s*j*fi J!,y „_ ^,~t*~^ < 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 SfBs&FWQAWTSi!^^ Vs^t'i^ -4* ^ •* * t 1 ^ J 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 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 5 0 deep and demolition or construction of structures over 3 stones 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 for a period of 180 days (Section 106 4 4 Uniform Building Code) APPLICANT S SIGNATURE DATE WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 11/19/2004 Permit* CB044102 Title HENCHY RESIDENCE Description WATER HEATER REPLACEMENT Type PLUM Sub Type Job Address 2042 CIMACT Suite Lot 0 Location APPLICANT PACIFIC EXPRESS INSTALLATION Owner HENCHY TRUST 03 16 04 Remarks WILL BE HOME FOR INSPECTION Inspector Assignment Phone 8589670391 Inspector Total Time CD Description 25 Water Heater/Vents Act Comment Requested By VIVIAN Entered By CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 11/08/2004 21 35 FAI 17804210385 From Kelly Hartley At Mart* Maddcete* Associates • PACIFIC EXPRESS10 urai«iiw«0001 A£m& CERTIFICATE OF LIABILITY INSURANCE PA8£!P37 ra PHOOUCtt Maxes Haddocks s. Associates Insurance services me 1*03 Wright Place Suite #2SO Carlsbad CA 92008 Phone 760-804-0402 rax 76O-804-0942 RJ3UKS) Pacific Express installation& 5<«vie*s, Ine17§ Roymar Roaa |Hoeeanside CA 92054 OATE(MWWIWYY) 03/01/04 ~ THIS CERTIFICATE IS ISSUED AS A HATTER OBSESS™1 ONLY AND CONFERS NO RHSHT3 UPON THE CERTIFICATE HOLDER tSBCER-nnCATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW INSURERS AFFORDING COVERAGE INSURE interstate insurance Grp iHSUrenp The Hartford V. IMWIHTPC State compensation Ins runt INSURER P NAJC* P COVERAGES THE Ml ICE 'OFIwa*AN(TLin^MlOWHAVFTr^l«JB>T9TILlW^^ NOWTOOTANDWB «NY RCQUIPbMCNT TtRM C* CONDITION If- /»IY CONlftACT C* oTI ER DOCUMENT WITH RCsfta TO WHIU 1 II US CEPDFI^fE MVBt W4LCD W km PgPTAIN THEIN'illHWNl.EAi=F-iPDinflYTterOLnE,DESrB|B9M€ReNI SUOJCTTO*" THETERMS exflUSIONSAW)rONDmONSCiP<!OCH P<J| 1 IF^ ftMRECATF 1 IMITb SHRMVN M«,Y HAVE BEEN REDO CH "V PAir CLAIMS INSIf PUDTLTRKWSE A B C X X TYPE OF INSURANCE GENERAL LIABILITY X v. JMMFR M iCNBW. 1 l"UILnY " 1 CLAIMj M«£>C |x"| OCCLfc * Effl. AGGREGATE LMT APPLIED pel X~] POLICY I | 5§2f | | 1 OC. »in X — — OKOeiLE UABIUTY ANYAIJTO UtOWNRJAimMi F i«DUFDALm:« ^ICEDAIfTO NOM-OWNLDAIJTO"! 6AKAOEL1ABUTY A(JY ALT') EXC Zl i grow 1 J CLAII>lSMADE OETJlIC riBLE BCTrtfllON * WOtSXBW COMPENSATION AW) EMPLOYERS LIABILITY ANT PROPWfc I OWRMmfeK/CxEUJTTVEOfTicEWMaecR ext-LLcmi 1 yw *s-aibcun*v SOCIAL PROVISIONS lukM OTHER ••" PWCV^UM^ ^gUGMtW ^A^,feJ!?tevT ^ CLP6251320 72UECOS8557 1732214 01/20/04 10/13/03 03/17/04 01/20/05 10/13/04 03/01/05 E* M ft-CURREMd- PREMIoEi Ifc jcujWICO) MEP LW (Any orw pmn) PERSOIW«.«AOvlNJJRV (XfERALASCRewATt PROW n- COMP^AW gC»«INEO SINbLt LIMIT (£ a VI nl) BOOILY INAWV (Par porcen) HODILV INJURY (Put &ud>*iU Pft^WTY OMUHSf IPera *mt) AUTO OWH PAATIOFNT OWEK mw K^1- . AUTOlTNir ALL BATH OCCURRENC5 ACGPECATF — ' I WCSIAIU I "" OIH-ITORUMTS 1 cs EI EACH ACCIDENT Fl IMSEA«ie EA.PMPi.uYeE E L WSbAA PCtlCY LIMIT (1,000,000 $50 000 *1,000 *1 000,000 *1 000,000 »1,000 000 * 300000 * t « % — $ $1000000 t 1000000 $ 1000000 DESCRIPTION OF OPGRMlftwV LOCATION* / VEHICLES 1 EXCLUSIONS ADDS! BY ENDORSaNENT/ SPEtlAI, PROVBIONC Lowe s Companies Inc and any and all Subsidiaries ace named as Additional Insured with respect to General and Auto Liability of the above Named Insured *10 day notice of cancellation due to non payment of pr«aium applies CERTIFICATE HOLDER CANCELLATION LOWESCO 9HOULP AW W THE ABOVE B5SCRD6D POLICES 66 CANCELLED BB=OBE THE EXPIRATION PATE THEREOF THE ISSLJ1HG INSURER tWLLewSMOR TO MAR. *30 DAYBWRtTTSM NOTICE TO Tt* CSrnFICATE HOLOSft KAMED TO TOE LBT BUT FAILURE TO CK> SO SHALL IMPOMIWOBLKWTKJNO«UAS(UTYOFANVKWDUPONT>ffirj6UKbA(reAOer<r5aft RB^E8EMTATTVE», tUmOROBO REPKEtENTATTVE (j^ynu D Thomas, CIC ACORD 25 (2001/08) 6 ACORD CORPORATION 1988