Loading...
HomeMy WebLinkAbout2653 VANCOUVER ST; ; CB032893; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB032893 Job Address: Permit Type: Parcel No: Reference #: Project Title: Building Inspection Request Line (760) 602-2725 2653 VANCOUVER ST CBAD PLUM 167 4420900 Lot #: 0 Construction Type: NEW SURRY RES-NEW WATER HEATER Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 10/21/2003 RMA 10/21/2003 10/21/2003 Applicant: A&J FOSTER, INC. STE B SURRY ANTHONY T REVOCABLE TRUST 11-20-00 13706 HWY 8 BUS EL CAJON CA 92021 619-390-44 77 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 TOTAL PERMIT FEES 0 0 0 0 1 0 0 504 S EL CAMINO REAL ENCINITAS CA 92024 $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 Total Fees: $27.00 Total Payments To Date: $0.00 Balance Due: $27.00 FINAL APPROVAL DATE7(-:J:</4trcLEARANCE __ _ SIGNATURE ~ PER". ' SECilv • , 7110 10/22/03 0002 01 02 CGP 2'"'-00 MIT FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. {!/J(2J~_5 Cil Y OF~CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. _________ _ Plan Ck. Deposit _________ _ Validated By __________ _ Date _______________ _ t 1. ~,,,rp·,to~ect:.1Nf.dR.MA TIQ N;:r:}'.'.!f1?1='·::;~r~~ilf;}].Jtf:~;;,, . ~.};:~1/:~~i~~ji~f:J· ~!-":CT:~~IJ;~©l~!,)jlj~~Gmilr;;~J~iiilti~' 2653 Vancouver St . Address (include Bldg/Suite #) Business Name (at this address) legal Description lot No. Subdivision Name/Number SFR Unit No. Phase No. Assessor's Parcel # Existing Use Proposed Use 167-442-09-00 Total # of units Description of Work SQ. FT. #of Stories # of Bedrooms # of Bathrooms Water Heater Replacerrent 12 •• '. ••• c~i~~~l;R~t~~itint'trom,i>~6gt1~tt~~11~~~i~fiT.littti,!~~[~~Y~af~~~~'~oliijii't1rt6~1f1:~~89'}Gi,>JL1, Name Address City State/Zip Telephone # Fax # l3,x;ic;~c:~!t~:~~rwig:iJt9~~9J!C{fflf~~,~~iTlr~I~i\i::tt\QW~~,!~~t~J~e~~1~~i;i~:;~1g{It~Pf~~b':flil4?r·Wt1'' Name Address City State/Zip Telephone # ;4 __ ;~i:_ pflOPeRri ·-0w~rRr:l~Jiitf~:ir=;.1:J.~g:1j~Jdt~~~m~~fili:'.~;:L~at{:~':[;~J~~tr1~1~rir1[ill~~1~1J~~~[ITk~:ttl~~iit~~~~~~i1~~1ni1~t~~~~f fJ~~r~~~·~~~:;~;t11~~i(\, Surry, Ant hony . 2653 Vancouver St. Carlsbad ca. 92008 760-717-2409 Name Address City S.tate/Zip Telephone # l's. ·! .. ,..CQ~(r.R'8~WR~i~CP,M.PA~~NA~J;,i~.J~m::;;~&~1P~.~;,;'jp1';1~;:;G~Z!~~~A'it~;~~v~¾l,~~~~1'~~'1J'~S~~~";,~i[f~~~:c:,:~;~~~~ (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 1$500)). A & ,J Easter PJ rnnhi og 1 3706 B Hwy 8 Bns EJ Ca@on CA 92021 ( 619) 390-4477 Name Address ity State/Zip Telephone # State license# 630120 license Class C-36 City Business license# 1210836 Designer Name Address City State/Zip Telephone State License # N q A • 16.: rf~ ,WOfiJ(E'.FU~;~cOM.~~NS-Arf.1'1N. ,~r=_,~:~£fJ!1~·:~~\~J-~~ ;;~~fil~~t~;i'~]~~~re~:~~~~~J~!i~;~r~~·;,~,i!~~J~~~~~~(~~~~f~~~~~t~~~{~;~}Ji'.L;P~:t'~!: ~~:~ ·,;H2~;:1·L~:;:•¼t➔ -~ Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 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 of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company State Comp Tns Policy No. 467-01 0000713 Expiration Date 04-01-04 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 DR LESS) 0 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 verage Is unlawful, and shall subject an employer to crlmlnal penalties and clvil fines up to ona hundred , O ensation, damages as provided for in Section 3706 of the La o code I te est and attorney's fees. SIGNATURE DATE.::':::~c==f.~'s:;;.':==::: 'i :;;;~~~iO)V~1fij;_~t1jµl5ER}PE¢~~,fRAii:10N ,h·~:rt;?:" ,·-~-~~!~~af8i~~IiJ~!Plii:i;;~1~~!fjifJ~~~~IE!!l~i~?P.!~ffi"iiJ~~~5,ij~raf~iRJ.iTu~Jill:'07~~~~~~tkl~:r,~-;~,r!~~~~;"?:ttE.rflt:i~~:ri:~~ I hereby affirm that I am exempt from the ontractor's license law for the following reason: 0 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 l aw does not apply t o an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements ere 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 l aw 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). 0 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. 0 YES ONO 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 _________ _ i co M P.L.E;;TE1i'i::H 1s:'~~p'f1qli(tFif B:~l)>tJik'fslfi'E1•(ft4f e,fJ1tbJN<U>e~MJif~'.1'.i;i:ii!iY~~lli:1/C.W,i~1!J.1~1Illt!;t'lif'llfili§•~~,;1·~ir'; ~~llit~l~il:' df ~;,t1.;;)L~:1i!fr"li Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk managem·ent and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? O YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O 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. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued (Sec. 3097(1) Civil Code). LENDER'S NAME N t);fE LENDER'S ADDRESS ________________________ _ ,9T~,.~;:~·[~e.PitcANi~CER~n.fJ1C~T!0ii:]~~~1::~~~¥lfi~~J~t~?l'.~Jitt~;J,i¥}.J.~t~ilf;ID!tt~~~~lr$i'lfYJ!~~~i)~~Jti~l~~~:;;g1w-;-~~J~~[~~:1;!l~:;:~~7:i~~tfji:~jr~l~i I certify that I have read the application and state that the above information Is correct and that the Information on the plans Is accurat e. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Clt\t 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 lhe 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 lhe date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time afler the work Is commence R riod of 180 days (Se tic W6.4.4 Uniform Building Code). /{ ! 10 / /'<1--, APPLICANT'S SIGNATURE --t.=-~~-4:i~.....-½~h--:-a~~~~~~---------DATE _......__.,__-'"i)rD .... ~c..;<<7-'--1./'---" L(-!___L__"--------1 l PINK: Finance City of Carlsbad Bldg Inspection Request For: 07/20/2004 Permit# CB032893 Title: SURRY RES-NEW WATER HEATER Description: Type: PLUM Sub Type: Job Address: 2653 VANCOUVER ST Suite: Lot 0 Location: APPLICANT A&J FOSTER, INC. ---> Inspector Assignment: J 'W\ Phone: 7607294191 Inspector: Owner: SURRY ANTHONY T REVOCABLE TRUST 11-20-00 Remarks: SIDE GARAGE DOOR WILL BE OPEN FOR INSP. Total Time: CD Description 25 Water HeaterNents Act Comment Requested By: MR SURRY Entered By: CHRISTINE ££ _______ _ Associated PCRs/CVs Inspection History Date Description Act lnsp Comments