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Home My WebLink About2611 COLIBRI LN; ; CB013525; Permit11-13-2(101 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB013525 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 2611 COLIBRI LN CBAD PLUM 2155351500 Lot# Construction Type 0 NEW REPLACE GAS PIPE TO POOL HEATR Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 11/13/2001 RMA 11/13/2001 11/13/2001 Applicant PIPES PLUMBING 1145LAWST SAN MARCOS CA 92069 760 434-3067 Owner ANDERSEN KIM&SUSAN 2611 COLIBRI LN CARLSBAD CA 92009 4245 11/13/01 0002 01 02 CGP 27.00 Total Fees $2700 Total Payments To Date $000 Balance Due $2700 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 0 1 0 $2000 $000 $000 $000 $000 $000 $700 $000 $000 $000 $000 $000 TOTAL PERMIT FEES $2700 Inspector FINAL APPROVAL I/IL Date Clearance NOTICE Please take NOTICE (hat 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 capactiy 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 1 PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK EST VAL Plan Ck Deposit Validated By x Date // // *hn tsi'Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor s Parcel tt <tt O ' Existing Use Proposed Use Description of Work SQ FT #of Stories tt of Bedrooms tt of Bathrooms 2 , CONTACT PERSON (if different from applicant) Name 3 APPLICANT 25" Address ontractor CD Agent for Contractor City Owner CD Agent for Owner State/Zip Telephone tt Fax # Name 4 PROPERTY OWNER Address City State/Zip Telephone tt Address City State/Zip elephone #Name 5 CONTRACTOR - COMPANY NAME "' (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 ($5001)~ Name State License tt Address License Class City State/Zip Telephone tt City Business License # // f jpfyf"? Designer Name Address City State/Zip Telephone State License tt 6 WORKERS' COMPENSATION Workers Compensation Declaration I 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 H_ 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 f^/| P_Otf)ff)PS~0 $fll .T/F • ^f'^^^o^v No C _ffi ID&933 Expiration DateZfe1.. Jf// D( (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) f~l 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 compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100.000) ip'addition totKe cost of compensation damages as provided for in Section 3706 of the Labor code, interest and attorney s fees SIGNATURE ^—y^^^ <2Jf&Zdt DATE 7 ••-. OWNER-BUILDER DECLARATION " I hereby affirm that I am exempt from the Contractor s License Law for the following reason CD 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) CD 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) CD 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 l~l YES l~lNO 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 COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY 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? CD YES CD NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? CD YES CD NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? CD YES CD 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 8 ' CONSTRUCTION LENDING AGENCY 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 9 APPLICANT CERTIFICATION 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 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 pariod of 180days (Section 106 4 4 Uniform Building Code) APPLICANT'S SIGNATURE ^^^t^Hf^y^ tZ&eKJ&Wr DATE WHffE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 11/14/2001 PermiW CB013525 Title REPLACE GAS PIPE TO POOL HEATR Description Type PLUM Sub Type Job Address 2611 COLIBRI LN Suite Lot 0 Location APPLICANT PIPES PLUMBING Owner ANDERSEN KIM&SUSAN Remarks AM PLEASE - GATE ON WEST SIDE OPEN Total Time CD Description 23 Gas/Test/Repairs 29 Final Plumbing Act Comments Inspector Assignment Phone 7604343067 Inspector Requested By MIKE Entered By CHRISTINE C * I Associated PCRs Inspection History Date Description Act Insp Comments Now 13 01 09:05a Pipes Plumbing 760-471-2865 p.2 ACOBD CERTIFICATE OF LIABILITY INSURANCE D"E^T PNUUUCbK , ALL COMMERCIAL INSURANCE SERVICES, LLC t 6790 TOP GUN STREET #3 L SAN DIEGO CA 921 21 , PHONE 858/642-0200 FAX 858/642-0205 — "HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION >NLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE iOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR U.TER THE COVERAGE AFFORDED BY THE POLICIES BELOW COMPANIES AFFORDING COVERAGE COMPANY Agency L,c# OC64552 A LLOYD'S OF LONDON INSURANCE INSURED COMPANY PIPES PLUMBING B CONNECTICUT INDEMNITY 1145 LAW STREET „„,.„...«,SAN MARCOS CA 92069 COMPANY ^ ^^ COMPANY D COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, 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 ACL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS UTR TYPE OF INSURANCE POLICY NUMBER 'SmiSSHSrtf fMK(»Sm$C?!< L|MITS GENERAL LIABILITY ACAC10012979CA07 JUL 1 01 JUL 1 02 (GENERAL AGGREGATE s 2,000,000 X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG * 2,000,000 CLAIMS MADE X OCCUR PERSONAL & ADV INJURY » 1,000,000 A X OWNERS & CONTRACTOR SPROT EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any One Fire) J 50,000 MED EXP (Any One Person) $ 1,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND CAP1 06933 0 EMPLOYERS LIABILITY " THE PROPRIETOR/ ,Nr,PARTNERS/EXECUTIVEOFFICERS ARE EXCL ! COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) * BODILY INJURY (Per accident) PROPERTY DAMAGE 1 AUTO ONLY EA ACCIDENT S OTHER THAN AUTO ONLY EACH ACCIDENT J AGGREGATE $ EACH OCCURRENCE * AGGREGATE S S EC 31 00 DEC 31 01 X ««™£, OTH EACHACCIOFNT S 1,000000 DISEASE POLICY LIMIT $ 1,000,000 | DISEASE-EACH EMPLOYEE % 1,000,000 OTHER 72SBAKN6514 JUL 1 01 JUL 1 02 C DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS PROOF OF INSURANCE CERTIFICATE HOLDER PROOF OF INSURANCE Attention ACORD 25-S (1/95) Certificate # 16577 CANCELLATION, SHOULD Mff~Of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THEEXPIRATION DATE THEREOF THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYSWRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TODO SO SHALL IMPOSE NO OBLIGATION OR UABILrTY OF ANY KIND UPON THE INSURER IT SAGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE -^7 * / J-~:l/^fe^z, xfcr -?^ £^*£.-t- Mafk Rubin 0822037