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Home My WebLink About1005 DAISY AVE; ; CB980122; PermitBUILDING PERMIT 01/19/98 14 45 Page 1 of 1 Job Address. 1005 DAISY AV Suite Permit Type- PLUMBING Parcel No 214-422-12-00 Lot# Valuation 0 Occupancy Group Reference* Description- WATER HEATER REPALLCMENT Permit No. Project No Development No CB980122 A9800184 Appl/Ownr *** MASON JAMES 1005 DAISY AVENUE CARLSBAD CA 92009 Fees Required ****** Construction Type. Status Applied Apr/Issue• Entered By. 760 438-7858 Fees Collected & Credits NEW ISSUED 01/19/98 01/19/98 JM * * * Fees 27 00 Adjustments .00 Total Fees: 27.00 Fee description 3200 01/21/98 0001 01 02Total Credits- Total Payments Balance Due Units Fee/Unit 00 27 00 Ext fee Data 27.00 Enter "Y" for Plumbing Issue Fee > Each Water Heater and/or Vent ->7.00 20 00 Y 7 00 CLEAHA: APPROVAL 111 «N ,.„ NiOIC. CITY OF CARLSBAD 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 FOR OFFICE USE ONLY PLAN CHECK NO EST. VAL Plan Ck Deposit Validated By Date / If t^Cx^ in 05 Daisy Ave. Address (include Bldg/Suile It BusineM Name (tt thi» address) Lagil Description Lot No Subdivision Name/NumberSFR Unit No Phase No Total * of units Assessor's Parcel I Existing Use Proposed Use Description of Work SO FT mTER HEATER REPLACEMENT 5.:7CONTACT PERSON (If tBffaientiroi^ippilcan...,*»«*•» Mason, James 1005 Daisy I of Stories I of Bedrooms * of Bathrooms Nime Address 3 "VteAPPUCANT i u Q ConM PETRT.T.Y .TOHNSON/KRISTY FOSTER City State/Zip Telephone «Fax * 13706-B HWY Name Address City State/Zip Telephone 8 A "Name2Address City State/Zip Telephone f (Sec 7031 5 Business and Professions Code Any City or County which requires e 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 6 by any applicant for a permit subjects the applicant to * civil penalty of not mo{B^hap,.f,lve hunriwl dgJIsis^BOOl) T TroypKR PTJTMRTTJG 13706-B HWY 8 BUS. EL CAJON CA. N>me State License I 630120 Address License Class C-36 City State/Zip .-,r>QTr telephone * City Business License * Address City State/Zip Telephone X N/A Designer Name Stale Ucerua * M »* WORKERS! COMPWSATIOMtftfjft^ffl ' Workers' Compensation Declaration I hereby efflrm under penalty of perjury one of the following declarations Q I have and will maintain a certificate of consent to aalf-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 O I nave and will maintain worker*' compensation, a* 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 ore: Policy No.,N2007-56-51 CONTINUOUS Expiration DateInsurance Company FARMER INSURANCE (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*100) OR LESS) Q CERTIFICATE OF EXEMPTION I certify that In the performance of the work for which this permit Is laaued, I ahell not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California WARNING Failure to aecure workers' compensation coverage la unlawful, and shall subject en employer to criminal penalties and civil fines up to one hundred thousand dollars (* 100,000), In addition to the cost of compensation, damages as provided for In Section 3706 of the Labq/ code. Interest and attorney s fees SIGNATURE DATE 7.OWNER BUILDER DECLARATION,^/;'. I hereby affirm that I am exempt from the Contractor's License Law lor the following reason: Q I as owner of the property or my employees with woges 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 Conlnctor's License Law doaa 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 aale If, however, the building or Improvement is sold within one yeir of completion, the owner-builder will have the burdon of proving that he did not build or Improve for the purpoae of sale) Q I, as owner of the property, em 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 build* or Improve* thereon, end contract* for such projects with contractor(s) licensed pursuant to the Contractor's License Lew) n I sm exempt under Section Business end Professions Code for this reason: 1 I personally plan to provide the major labor and materials for construction of the propoaed property Improvement. Q YES QNO 2 I (have / have not) signed an application for a building permit for the proposed work. 3 I hsve 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 I contractors license number) _^______________________^_^_____^_________^____________^___^__^_____________ 5 I will provide some of the work, but I have contracted (hired! the following parsons to provide the work indicated (include name / address / phone number / type of work) PROPERTY OWNER SIGNATURE DATE COMWj-TiTHIS SECTIONS fVO/VVtfW^JMilBUIUJlNQiEEBWIIS^^ jiSbSiP'^! iH , Is the applicant or future building occupant required to submit * business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 26505, 2S533 or 25534 of the Presley-Tanner Hezardous Substance Account Act? Q YES Q NO Is the applicant or future building occupant required to obteln a permit from the air pollution control district or air quality management district? Q YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q 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 8. •'•.CONSTRUCTION LENDING AGENCY ff*- 1 fflfilrWffiS, ^^^MM^m^&^^^m^i^mkMMm^md ' *l 1 « , i I hereby affirm that there Is a construction lending egency for the performance of the work for which thla permit Is Issued (Sec 3097(1) Civil Code) LENDER'S NAME _ _ LENDER'S ADDRESS 9 ^«5^r^8*n^^APPLICANT CERTIFICATION.') ••' ,sW .HfciVWiW* ';«KVW-'^iliSvJ.VwV£^ '< I certify that I have read the application and state that the above information Is correct end that the Information on the plans Is accurate I agree to comply with all City ordinances and State lawa relating to building construction I hereby authorize repreaantetlvea of the City of Carlsbad to enter upon the above mentioned property lor 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 6'0* 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 nofocommenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time sftar thq vyork is commenced jfy • period of 180 d^ys (Section 106.4 4 Uniform Building Code). APPLICANT S SIGNATURE WHITE File YELLOW. Applicant PINK Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB980122 FOR 02/13/98 DESCRIPTION: WATER HEATER REPALLCMENT TYPE: PLUM JOB ADDRESS: 1005 DAISY AV APPLICANT: MASON JAMES CONTRACTOR: OWNER: REMARKS: C/TEMPE/438-7858 OR 603-6904 SPECIAL INSTRUCT: AM PLEASE TOTAL TIME: CD LVL DESCRIPTION 25 PL Water Heater/Vents PHONE: PHONE: PHONE: INSPECTOR AREA PLANCKtf CB980122 OCC GRP CONSTR. TYPE NEW STE: LOT: 760 438-7858 INSPECTOR ACT COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS COMMERCIAL CERTIFICATE OF INSURANCE Issue Date (MM/DD/YY) GENCY ame & ddress ALLAN MENDOZA 8880 RIO SAN DIEGO DR. #700 SAN DIEGO, CA 92108 This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policies shown below. _9a OIST. 5JL ,AGENT_3Zfi_ SURED une & Idress A&7 FOSTER INC. 13706 B HWY 8 BUSINESS EL CAJON, CA 92021 COMFMRunm COMPANYUTTER COMPANY UTTER COMPANY UTTER COMPANIES PROVIDING COVERAGE: A TRUCK INSURANCE EXCHANGE B FARMERS INSURANCE EXCHANGE C MID CENTURY INSURANCE COMPANY fERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDINGANY 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 REDUCEDBY PAID CLAIMS. TYPE OF INSURANCE • OEMEML UAWUTY COMMERCIAL GENERAL LIABILITY - OCCURRENCE VERSION CONTRACTUAL MCOENTAL ONLY OWNERS & CONTRACTORS PROT ftUTOMMUUUUTT ALL OWNED COMMERCIAL AUTOS SCHEDULED AUTOS HRED AUTOS NOHOWNEO AUTOS GARAGE UABJUTY DURonis lUlUTY HHIWCItt CUWUMIIUI «n EMPLOYERS' UAKUTT POLICY NUMBER N2007-56-51 POLICY EFFECTIVEDATE (MM/DD/YY) 5-1-97 POLICY EXPIRATIONDATE(MM/TXW) UJTU-JUNULWS UNTIL CANCELLED POLICY UMTS GENERAL AGGREGATE fflODUCTSCOMP/OPS AGGREGATE PERSONAL «,ADVERTISING HJURY EACH OCCURRENCE FK DAMAGE (*y m Fin) MEDICAL EXPENSE(Anyompnon) COMBINEDSWGLE LMT BODILY INJURY (PER PERSON) BODLYMJURY (PERACQDENT) PROPERTY DAMAGE GARAGE AGGREGATE LMT STATVTMT EACHACCDENT DISEASE-EACH EMPLOYEE DISEASE-POLICY LMT $ S $ * /$ $ $ $ $ s$ $ $ 1 ,000,000 $1,000,000 $1 ,000,000 PTKM OF OMMTIOKnflHICUSfflBTRICT10«SBPECUl ITEMS: RE: ALL OPERATIONS TIF1CATE HOLDER ime ' CITY OF-SAN 1 • BUILDING DEPT dress • 9601 RIDGEHAVEN CT 2ND FLOOR • SAN DIEGO, CA 92123 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE MREOF. THE ISSUING COMPANY WIL ENDEAVOR TO MAI 30 DAYS WHITEN NOTICE TO THE CERTIFICATE HOLDERNAMED TO THE LEFT. BUT FAILURE TO MAJl SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UAWUTY OFANY KM) UPON THE COMPANY. US AGENTS OR REPRESENTATIVES. AUmOKEDKPOESEMAmf