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Lpncter s Name ' rf (J ft- >£.'II finder s Address[STRUCTKEEP HON WHETHER SPECIFIED HEREIN OH NOT I ALSO AGREE TO SAVE\RMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES JUDGMEi v* O'"--i; o 5
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$X\LJ I hereby affirm that there is a construction lendingagency for the perlormance of the work for winch tnis permil is issued (Sec 3097 Civil Code; IA / - - ^ I1 HAVE CAREFULLY EXAMINED THE COMPLETED ' APPLICATION ANCERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATIONDECLARATIONS ARE TRUE AND CORRECT AND 1 FURTHER CERTIFYISSUED TO COMPLY WITH ALL CITY COUNTY AND STATE LAWS CIII!
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n Every permit issued by the Building Official under theexpire by limitation and become null and void If theby such permit is not commenced within 180 days tromif the building or work authorized by such permitat any time after the work is commenced for a periodjrovisions of thiBuilding or worthe date of sucrs suspended oof 180 days* AN OSHA PERM!!5 0 DEEP AND CSTRUCTURES OV\ 1r IS REQUIRED FOR EXCAVATIONS OVE>EMOt_ITION OR CONSTRUCTION OFER 3 STORIESIN HEIGHT3
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moc (DESCRIPTION OF WORKWater heater replacementDESIGNER S ADDRFSS1 LICENSE NO 1Not Valid Unless Machine Certified1OWNER E MAILING ADDRESS1022 Daisy Ave.DESIGNER1 DESIGNER S PHONE18/fB3/'B5B56S 'fQiOQ1I hereby a'firn tM 1 am exempt Iron ine Ccr.tr at 1to- s License law for tr-e 'ollowmrj reason (Sec 7031 T; ,Business a/id Professions Code Any city or r,oun:y wnitn ;ftQjires a sennit to consruct alter .mprovf; demohsn or 1r-:pdir any struttu'e pcoi to its issuance a-vi requ-res h^e ap ,olicant Jo? sucn oenirt to Me a signed stdtemert that ne isIOWNE H S NAMF:Tern KasteckiOWNER s PHONECONTRACTOR S ADDRESS2819 Central Ave. S.V. 92077| LICENSE NO !1 443348 1T)r
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SUBDIVISIONASSESSOR PARCEL NOLCONTRACTORArlen Foster1CONTRACTOR PHONE »697-4151im JSjl 1 hereby affirm that 1 am licensed under_ provisions of Chapter 9 (commencing withSection 70JO) of Division 3 of the Businessimd Professions Code and my license is infull force anfUaUecU ,-,-./-u NO 443348 cia-, ._.C361JOB ADDRESS AV ST RO NEAREST CROSS ST1022 Daisy Ave. Baticruitos Dr.DATE Of APPLICATION12/16/85BUSINESS L|£fc&ld£ T11646 WLVALUATION \ U*x.r\ "°^^ \ m
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