The URL can be used to link to this page

Home My WebLink About2323 CARINGA WAY; 16; CB052406; Permit06-28-2005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB052406 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 2323 CARINGA WY CBAD St: 16 PLUM 2152402707 Lot#: 0 Construction Type: NEW GLUMET RES NEW H20 HEATER Status: ISSUED Applied: 06/28/2005 Entered By: SB Plan Approved: 06/28/2005 Issued: 06/28/2005 Inspect Area: f Applicant: ARS 3TE 100, sICY RIDGE DR SAN DIEGO CA 92121 858-677-5455 Owner: JOSIMOVIC MIHAJLO&KATICA 52710 AVENIDA MARTINEZ LA QUINTA CA 92253 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 EXPIRED PERMIT ** * PERMIT HAS EXPIRED IN ACCORDANCE WITH C.K?P SECTION 106.4.4 AS AMENDED BY C.M.C.18.04.030 DATE<*Uf,Ufr SIGNATURE T * 02 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 lees/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 j FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated Address (Include Bldg/Suite *)Business Name (at this address) Legal Description Lot No.ision Name/Number Unit No.Phase No.Total # of units Asses:Proposed Use #of Stories It of Bathrooms Name ' APPCiCANt D e£ttttttr ,? Address State/Zip Telephone *Fax* Name *> :jSS50:lNiTRACTOB-COMPANY.NAMEt '4 * & > * (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 ,Any violation of Section 7031.5 by any applicant^or a permit subjects the applicant to Acivll penalty, of rto{ more than five hun/lred dollars [$50011.hundre m Name State License #License Class City State/Zip City Business License # Telephone tt Designer Name State License # 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. M 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 fW\06lA ClgA _ ' _ Policy No. ^^l^&kH-^ "CM Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS WOO] OR LESS) Q 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 Iba^Workers' Compensation Laws of California. WARNING: Fallurtflo secWe workers' compensative coverage li unlawful, and shall subject an employer to criminal ^penalties and civil tines up to one hundred thousand dollars ( a/OCX SDp), In addition tb the cosvoi,coroetnation, damages as provided for in Section 3706 of the ^bof code, Interest and attorney's fees. SIGNATURE XljE./LOOX-^'-' •/7 \ CjflA-&\ _ DATE 7. ........ OWNER-BUILDER DECLARATION ' - -•-.--% **' ^¥"1 -J.4Sf*t: '£?"•- *_» fvW -'*,+• «->*/* ,-. r ,;i I hereby affirm that I am exempt from the Contractor's License Law for the following reason: [~1 t, 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). G 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). rj 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. D YES DNO 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. * r«OMPl*WtfliS^E_T^ 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 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. ;8p:C^STRUCTipW«lNllGE|lCV.v < - - Wi ' • '<' - ' ' 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 _ * ^ .'•<* Of( . ' ...... 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 stories in height. EXPIRATION: Every permit issued Mmefcullding 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 ckrntnencedj within 1 80 days from the date ofAuch permit or if the building or work authorized by such permit Is suspended or abandoned at any time after the work is comrrWiceoVtorla period of 180 days (SeottnVlpel^WJniforrn Building Code). APPLICANT'S SIGNATURE l\J 0) \XjJi \Ls£^- /( 1 /T/X^A. _ DATE~~T rWHITE: File YELLOW: Applicant PINK: Finance iviJiiViUKAlNDUM OF INSURANCE 11/15/04 PRODUCER AON RISK SERVICES, INC. OF ILLINOIS . -AON CENTER 200 EAST RANDOLPH STREET CHICAGO, ILLINOIS 60601 D/B/A Ami Risk Insurance Services of Illinois. CA License #0095623 INSURED American Residential Services LLC & Additional Entities Listed Below THIS MEMORANDUM IS A MATTER OF INFORMATION ONLY. THIS MEMORANDUM DOES NOT AMEND, F.XTE.ND OR ALTER THE COVERAGES AFFORDED BY THE POLICIES 3ELOW. COMPANIES AFFORDING COVERAGE COMPANY A Zurich American insurancv: (.'ninpcmy COMPANY B COMPANY C COMPANY D COVERAGES NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE 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, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR A A A A B A TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCURRENCE AUTOMOBILE LIABILITY ANY AUTO GARAGE LIABILITY EXCESS LIABILITY UMBRELLA FORM WORKERS COMP & EMPLOYER'S LIABILITY THE PROPROETOR/ PARTNERS/ EXECUTIVE OFFICERS ARE: INCLUDED PROPERTY POLICY NUMBER GLO 2938645-01 BAP2938646-OI(AOS) BAP2938647-OI (VA) TAP2938648-01 (TX) See attached for evidence of coverage WC 2938643-01 (AOS) POLICY EFFECTIVE DATE (MM/DO/ YY) 04/01/2004 04/01/2004 01/01/2003 POLICY EXPIRATION DATE (MM/DO/YYV) 01/01/2006 01/01/2006 01/01/2006 LIMITS GENERAL AGGREGATE I'KODUCTS -COMP/OP AGG !'(• RSONAL & ADV INJURY EACH OCCURRENCE PIKE DAMAGE (any one tire) MGD GXP (;uw IMC person) COMBINED SINGLE LIMIT BODILY INJURY {per person) UODILY INJURY (per accident) PROPERTY DAMAGE AUTO ONLY (euch accident) ( >THER THAN AUTO ONLY EACH ACCIDENT AGGREGATE EACH OCCURRENCE AtKiKEGATE X WC Statutory limits EL EACH ACCIDENT t-L DISEASE- POLICY LIMIT IJL DISEASE - EA EMPLOYEE $5,000,000 Included in Above $3,000,000 $3,000,000 $1,000,000 15,000 $5,000,000 $1,000,000 $1,000,000 $1.000.000 This Memorandum is issued as a matter of information only to authorized viewers fur their internal use only and confers no rights upon any viewer or' this Memorandum. This Memorandum does not amend, extend or ulter the coverage described below. This Memorandum may only be copied, printed and distributed within an authorized viewer mid may only be used and viewed by an authorized viewer for its internal use. Any other use, duplication or distribution of this Memorandum without the consent of Aon Risk Services is prohibited. "Authorized viewer" shall mean an entity or person, which is authorized by the insured named herein to access this Memorandum via Aonline. The information contained herein is as of the date referred to above. Aon Risk Services shall be under no obligation to update such information. The Memorandum of Insurance serves solely to list insurance policies, limits and dates of covcraec. Anv modifications hereto UK not authorized.