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Home My WebLink About1064 LAGUNA DR; 22; CB012548; PermitVJ·/(j:?f;~ ,. City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 08-01-2001 Plumbing Permit Permit No:CB012548 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 1064 LAGUNA DR CBAD St: 22 PLUM Status: ISSUED 08/01/2001 JM 08/01/2001 08/01/2001 Parcel No: 15527220"05.'.1--;l. Lot#: 0 Construction Type: NEW Reference #: Project Title: SIEGEL -REPLACE WATER HEATER Applicant: A&J FOSTER 2819 CENTRAL AVE SPRING VALLEY 619 697-4151 Total Fees: $27.00 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 Total Payments To Date: 0 0 0 0 1 0 0 Applied: Entered By: Plan Approved: Issued: Inspect Area: 6216 08/01/01 0002 01 02 $0.00 Balance Due: $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 CGP 27-J0 $27.00 Master Drainage Fee Sewer Fee Additional Fees EXPIRED PERMIT TOTAL PERMIT FEES ' . '"!'!:7111.! l'."CORDAJIICi: i•,~•·q '' 8.C. . $27.00 FINAL APPROVAL Inspector: Date: Clearance: NOTICE: Please take NOTICE that approval of your project includes the ~imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fee&lexactions: 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 Car1sbad Municipal Code Section 3.32.030. Failure to dmely 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 specffied fee&'exactions DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application prooessing or service fees in oonnection with this project NOR DOES IT APPLY to any fee&'exactions of which vou have nreviouslv been niven a NOTICE similar to this or as to which the statute of !imitations has oreviouslv otherwise evnired. FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK No.C/Jj/2.5 f CITY OF CARLSBAD BUILDING DEPARTMENT 1635 F a raday Ave., C arlsbad, CA 920 08 E ST . VAL. ________ _ Plan C k. Deposit.r. 1. PROJECT INFORMATION Validated By \,, ~ .1 ± I D ate ... , r( lj O I 1064 LAGUNA DR 22 C A RLS BAD C'A 92008 <Suit'e'>" Business Name (at this address) Address (include Bldg/Suite#) <Legal D escr> <Lot> <Subdiv is io n Name/N o> <Unit> <Phase> <Total> Legal Description <Assessor No> Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units <E xisting U se> <Propos ed U se> Assessor's Parcel # WATERHEA TERINST A LL Existing Use <SQ FT> <Sto ries> Proposed Use <Bedroom s> <Bathroom> Description of Work SQ. FT. # of Stories # of Bedrooms # of Bathrooms 2. CONTACT PERSON (If different from applicant) <N am e> <Address> <Pho ne> <Fax> Name Address Telephone# Fax# 3. -AP-P-U_C_ANT ___ C __ C_o_n_tr-act-or ~ NetClerk Inc 8883 301777 Name Telephone# --~---4. PROPERTY OWNER LIZ A DEJON G E 1064 LAGUNA DR. #22 C ARLSBAD CA 92008 7 604 346 499 Name Address City State/Zip Telephone# 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 [$500]). A & J F oster Incorporate d PO B ox 2 758 El Cajon C A 9 2021 6 193904477 Name Address City State/Zip Telephone# State License # ...:6::.:3:..0:....:.1 =2-=0 ____ _ <N am e> License Class _c_3-'-'-6 _______ _ <Address> City Business License # 1210836 <City> ST <Zio> <Pho n e> Designer Name Address City State/Zip Telephone State Licence# _________ _ 6. WORKERS' COMPENSATION Workers' Compensation 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 for which this permit is issued. liZI 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 Ins . Fund Policy No. 00506395 Expiration Date 05/01/2002 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) D 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 doll,·_·i~:..~·11. in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE ~---------------------DATE ....:0::...:7c.:./=2-'-"7/c::2:..=0c.::0..;.1 ____ _ 7. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D 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). D 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 threreon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). D I am exempt under Section ______ Business and Professions Code for this reason: 1. 2, 3. I personally plan to provide the major labor and materials for construction of the proposed property improvement. □ YES O NO I (have / have not) signed an applicant for a building permit for the proposed work. I hay~ contracted with the following person (firm) to 11rqvide the:eroposed construction (include name~ ;istdr~siil phone number/ contractors license number): <N ame> <Aaaress <WorK 1-'hon e> <State License> 4. I plan to provide portions of the "{qrk, but I have hired the following person \p ~qordinate, supervise and provide the m_ajqr work (include name / address / P.h.one number t contractors license number):<N am e> <A aaress> <work Phone> <Sta te License> 5. I will P!QVide some of the work, but I have contracted (~ir~dl the following person to provide the work indicated (include name / address / ~ti.o.ne r,u.mber / type of work): <N am e> <Aad ress> <Work Phone> <W orK I ype> PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOR N':O::N::-R::E::S:::ID::E:-N:;;:T:;:;IA::;::l;;;B;:;:U;;;IL:::_;D;:::IN;:::G:;-:PE=R=M::l=Ts::-:o:;:;N:;:;LY:;;;:=--:====;._-=:.:.:.;::,;;;;;::;;;:=;;;;;::==:===~ 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? D YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management d1smct? □YES 0 NO Is the facility to be constructed within 1,000 feet of the outer boundary of school site? D YES D 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. 3087(i) Civil Code). LENDER'S NAME LENDER'S ADDRESS 9. APPLICANTCERTIFICA~:n_o_N __ 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 Stale laws relating to building construction. t hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGEMENTS, 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 period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE ~-------------------DATE ...:0::...:7c...:./=2..:.7;..:;/2::..;0::...:0=--1'-------- .. ' City of Carlsbad Bldg Inspection Request For: 09/17/2001 Permit# CB012548 Title: SIEGEL -REPLACE WATER HEATER Description: Type: PLUM Sub Type: Job Address: 1064 LAGUNA DR Suite: 22 Location: APPLICANT A & J FOSTER Owner: Remarks: Total Time: Lot 0 Inspector Assignment: Phone: 7604348945 /, (' Inspector: ::::J. \.....___...., --'=--- Requested By: LORCO Entered By: KAREN CD Description 21 Underground/Under Floor Act Comment I ;Lil Alo MTff 1~12-1£ )oc/(eD 31 Underground/Conduit-Wiring Associated PCRs Inspection History Date Description Act lnsp Comments