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Home My WebLink About1003 DAISY AVE; ; CB970809; PermitBUILDING PERMIT Permit NO CB970R09 04/08/97 09 45 Project No A97C105U Page 1 of 1 Development No Job Address 10Q3 DAISY AV Suite *' Permit Type PLUMBING Parcel No 214-422-11-00 Lot* Valuation 0 Construction Type NEW Occupancy Group. Reference* Status ISSUED Description: WATER HEATER REPLACEMENT Applied 04/0,8/97 Apjr/Issue 04/08/97 Entered By: JM V 619 438-17OT77 04/09/97 0001 01 02Appl/Ownr FITZGERALD, THOMAS 1003 DAISY AVENUE CARLSBAD, CA 92009 *** Fees Required *** Fees. Ad3ustments * Total Fees': r Fee description Enter "Y" for Plurnbi Each Water"Heater an * PLUMBING TOTAL C-PfiMT 27,00 Collected $ Credits APPROVAL * ** 00 ,00 27 00 Ext fee Data 20.00 Y 7 00 27 00 CITY OF CARLSBAD 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161 FPOt'l PJFOSTER INC FfiX 461 5443 PHONE NO PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr , Carlsbad CA 92009 (619) 438-1161 1003 Daisy Ave ftpr 07 1997 03 06PM P4 FOR OFFICE USE ONLY, PLAN CHECK NO . EST VAL Plan Ck Deposit. Validated By Date Address (Include Bids/Suite »)'Business Name (at this address) Legal Description Let No Subdivision Nairn/NumberSr R Unit No Phase No Total * of unit! Assessor's Parcel *Existing Use Proposed UBB Description of Work WATER HEATER REPLACEMENT CONtACT PEftSON (If different frFitzgerald, Thomas SO FT Hal Stoilet n of Bedroom*» of Bathrooms FitzgeraJd, Thomas N«m« Address Cl»y State/Zip Telephone ISec 703 1 B Business snd Professions Coda Any City or County which requires * permit to construct elter Improve, demolish Of repair my structure, prior to Its Istusnce also require) the applicant tor such permit w (He « stoned statement that ha la licensed pursuant to the provision* of the. Contractor's Ueerrae Law (Chapter 9 commending with Section 7000 of Division 3 o> the Business and Profession* Cods) or that ha Is exempt therefrom and the basis for the alleged exemption Any violation of Sectlan 7031 6 by any applicant for « pormlt subjects the applicant to a clvllpenalty of not more "than Jive hund<adxlollars4*C001) A " Name tion Any violation of Sectlan 7031 6 by any applicant for « pormlt subjects the applicant to a clvllpenalty of not more "than Jive hund<adxlollars4*C0.T FOSTER PLUMBING 13706-B HWY 8 BUS _ EL CAJOJfT C% gZ021 "398-1117 ' ' ~" - .-. - - . Stale License if 630120 Address License Class C-36 City Stete/zip ]_ 2 Q 0 3 ^'"P*10"* * City Business license # ^^____ Designer Name 5i«te License *N/A City State/Zip Telephone $£&mNmtGaaamaam®HBSWjnt &8SWU) .s. <Worker* Compenaation Declaration I hereby affirm under penalty of perjury one of the following declarations D 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 tor which this permit Is Issued rfD I have end wilt maintain workers compensation as reautred by Section 3700 of the Labor Cede for the performance of the work for which trti permit Is issued My worker s compensation insurance carrier and policy number are , ~_ Insurant* Company FARMER INSURANCE P.,BcvNo N2QQ7-56-51 ^ration Pet.5"1"97 (THIS SECTION NEED NOT BE COMPLETED IP THE PERMIT 18 FOR ONE HUNDRED DOLLARS 1*100] OR USE) Q CERTIFICATE OF EXEMPTION I certify that In tha performance of the work for Which this permit Is Issued, I shad not employ any person In any manner so as to become tubject to tha Workers Compensation Lews of California WARNING Failure to secure worker* compensation coverage Is unlawful and shad avrtajeet an employer to Criminal penalties and civil fines up to one hundred thousand dollars ($100 000), In addition to the cost of eomponsntion damages as provided for In Section 3706 of the Ubo/ coda Interest end attorney s fees SIGNATURE .7 OWNER BUILDS DECLARATION "* A*'-'****?* r> * I hereby affirm that I am exempt from the Contractor s Licensft Law for the following reason n I ss owner of the property or my employees with wages »s their sola compensation, will do the Work end the structure la not intended or offered for sale (Sec 7044 Business and Professions Code The Contractor * license Lew does not apply to an owner el property who bunds or Improves thereon, em) who does tuch work himself or through his own employee* provided that such Improvements ere not Intended or offered far eels If however the building or Improvement I* sold within on* y»«r of completion tho owner bulldar win have the burden of proving that he did hot build or Improve for the purpose of sate) O I si owner of the property em exclusively contracting with licensed contractors to construct the project (Sec 7044 Business and Professions Code The Ccntreetor e License Law does not apply to an owner of property who builds or Improve* thereon end contracts for eueh projects with comraetor(s) licensed pursuant to the Contractor's Uoense Law) 0 ' «rn exempt under Section Business am) Professions Code for this reason* 1 I personally plan to p'ovide the mafor labor and materials for construction Of the proposed property Improvement Q YES ON" 2 I (nave / have not) signed an application for a building permit for the proposed Work 3 I have contracted with the following parson (firm) to provide the proposed construction (include name I address / phone number / contractors license number) 4 I plan to provide portions of tha woik but I have Mred the following person to coordinate, supervise end provide the major work (Include name I address I phone number / contractors license number) ____^ _„__«_ .^ __.—_^^—______ 5 i win provide some or the work but I havn contracted (hired) the following persons to provide the work Indicated (include name I address / phone number / type at work) ^ _ PROPERTY OWNER SIGNATURE DATE Is lh» applicant or future building occupant required 10 submit a business plan acutely hazardous materials registration form or risk management and prevention program under Sections 25BOS 25533 or 2E534 of the Preilsy Tanner Hazardous Substance Account Act? Q YES Q NO la 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 OOO feet of the outer boundary of a aohool site? Q YES Q NO IF ANV OF THE ANSWERS ABE 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 LENDER S ADDRESS, , k t w v ;\t '_. i .1 i I hereby affirm 1h9t there is 9 construction lending agency for the performance of the woik rgr which this permit Is Issued (Sec 3O97II) Civil Code) LENDER S NAME SU ' APPUCANT CEfcTinCAHOM ujr. f^Vl J| I certify that I have read the application and state that the above information is correct and that the Information on the plans la accurate I agree to comply with all City oidinanees and Srain l»ws relating to buildmp. construction I hereby authorize representatives of ttia City of Carlsbad to enter trpon the abovo mentioned property lor inspection purposes I ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AQAINST ALL LIABILITIES JUDGMENTS COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AQAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA An OSHA permit is required tor excavations over G 0* doep and demolition or construction of structures over 3 stories in height EXPIRATION Every permit l*sued by the Building Official under tha provisions of this Code snail expire fay limitation end become nun and voM If the building or work authorized by such permit is not commenced within 365 days from the date of such permit or If the building or work authorized by such permit Is suspended or abendoned at any time after the work is commenced for a period of 180 days (Section 106 4 * Uniform Building Code) APPLICANT S SIGNATURE WHITE FUe YELLOW Applicant PINK Finance DATE CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB970809 FOR 04/16/97 INSPECTOR AREA DESCRIPTION- WATER HEATER REPLACEMENT PLANCK* CB970809 OCC GRP TYPE: PLUM CONSTR. TYPE NEW JOB ADDRESS: 1003 DAISY AV STE: LOT: APPLICANT: FITZGERALD, THOMAS PHONE: 619 438-1747 CONTRACTOR: PHONE: OWNER: PHONE: REMARKS: RS/TOM/438-1747 INSPECTOR SPECIAL INSTRUCT: TOTAL TIME: 25 PL Water Heater/ Vents CD LVL DESCRIPTION ACT COMMENTS <Ti ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP COMMENTS FROM flJFOSTEP INC FfiX 461 5443 PHONE NO * t-'MHIEPS HfeUCHllO. blO-291-O.Tb Pl-IGE HO '«IGie313 Apr 07 1997 03 03PM PI IUM HT 1J>. LU IJJ II I Ol COMMERCIAL CERTIFICATE OP INSURANCE D.IU! (MMKJU»Y>) AJU c« MEWD02A0000 KJTO s/i/v 0JEGO, C/» 5/1/V6 92100 ST 9V DIST „ JLL-_ AGfM 370 IllSUtlCU INC. 13706 B UVr 0 QVSWBSS EL CAJON, CA 92021 TMs COtrtlllcslo Is Issued as a mallet til Inlormallon only inU ron(m<v nuupon (he cwlincaio hol('or This iwllilpalo doos nol aniomJ extend 01 aHoi covorege aliordod by Hio policies sl«^wn Mow COMPANIES PnoVIOIHQ COVERAUE- A IWCK INSIMNCC tXCMANGt 0 FARMERS INSURANCE CXCUANU C MID CENTURY W8UHAMCC COMPANYUIUK DVEIIADES MB , 's 10 ' iwv IIIAI mi IIH..IK s iff IMMKWMT ttwo iinnw HAVT tirrn is'ajro 10 TUT wsijnro NAMFO AJIOW rnn Tin potM Ptnido IUOK AU» nni»Mn«,TM«Mnu> ii 'it o' 'i? w i IMK on coiioinou or ANY cwnruci on OTHCR OOWIMCNT win msrtcT TO WIWK ins cttmriUU WAY et ISSUED on MW PEHIWN ti ic »isui\A«r rnfnmn.') (t» )Mt COUU-S ULbUVUtD HtntlN IS SUWtCt 10 All (HE TCRMS, [XCIUSIONS AND CONDITIONS Of $UU< PVUCIFS LIMltf, SHOWN MAY HAV^ DUN lltK'l,I.U — •« nn o.1 *>5vWvCf UKtMM UMIUU - OCCURHtlU VISION COMIMCIUAL WOOOlTALOfAY IVTWOIIli IMtHITY AUO\W(OCOUM[I)CIAIAUIOS HWOAUIOS IIOUOY/IKOAUIOS CAAAtt llABUtt VMIRIVU UXNUH flOMlM' WMflHWIIOK Ml IMHOYUC UAmin PMYMMU W200,-3,-5, TOIICY tmcTM DATE (MM/OWVY) 5/1/96 PW.IT.Y WPIRAIRlN (MIC jMM/Oim) 5/7/97 POUCY UI.HI& ottrttwi AGGWGMt WOHEOAIE «)V(h(« IKJUIIY (ACM occunniNCi MtlCAl EXPtNSt CQWW«0SIMM van txH)n^?;wf\K (Plft Pf RSOtt) WWYIHWM(TEH ACOWIII) GAM6E AQQM6AU IWH tftWi Atv«/™i Ol&EASCMCACH tMT^LOYE! WSMSf • PllwdY 1<W1 » $ I I $ $ $ $ $ * J ,000,000 * J ,000,000 r.cBic IHI of DHMuoumiiiuiiiKstffltt wwmtui mm KOLDEn ".irwr CRKCCILATIOV, SIIOUlp AW OF THE ABOVE OESCTVfiEO POUCITS AC CWfttHtO RUWf Wf IWIflMKIN OAH I Iff HI llf111? (RUNG COMTAlff WU UffiUVQR 10 MAI 3D PAYS WHimil tlOIIrt 10 lUt CinilTICAlE DOlUln HAMtOtO W UN. MIT f AW 10 MM. MlC« KOIKE SUMt tMCOSt M) OOUbAlRlN OK UWIkllV OF ANT OTD WON m Cff^M. IIS