HomeMy WebLinkAbout1310 CHUPAROSA WAY; ; CB961113; Permit06/19/96 11 36 B U I L D I N G P E R M I
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Job Address 1310 CHUPAROSA WY Suite
Permit Type PLUMBING
Parcel No 156-110-53-00 Lot#
Valuation 0
Occupancy Group Reference*
Description REPLACE WATER HEATER
A & J FOSTER
Appl/Ownr HAGLCR, JACK
1310 CHUPAROSA WY
CARLSBAD CA 92008
Permit No
Project No
Development No
Construction Type
Status
Applied
Apr/Issue
Entered By
CB961113
A9601590
619-729-5726
NEW
ISSUED
Ob/19/96
06/19/96
RMA
*** Fees Required ****'**'Fees S- Credits * A <r
Fees
Adjustments
Total Fees (jjtoiiii^ T^\,&V .i?.*-, \1 »!>
Enter "Y" for Plumbing Issue Fee'. >
Gas Piping System ' • ••>
* PLUMBING TOTAL 7 .GO-M
00
00
27 00
Ext fee Data
20 00 Y
7 00
27 00
8118 06'19/% OOOi OJS C2
C-PRrfT 27.00
DATE
CITY OF CARLSBAD
2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161
1 e &9&K ERMTT APPLICATION fiT^lJ
City of Carlsbad Building Department mj %**M
M75 Las PalM Or . Carlsbad, CA 92009 (619) 438-1161 ^qffipr
1 FrKMI 1 IYPE •>
From Nst 1 (we Iwck) give code of Permit
For Residential Proicits Only From List 2
C <xle of Structure Type
Type
(see back) give
SFR
Net loss/Gam of Dwelling Units
2. PROJECT INFORMATION
PLAN CHECK NO
EST VAL
PIAN CK DEPOSIT
VALID BY_ ^
HATE
FOR orncE use ONLY
Address 1310 Chuparosa Wy
Nearest Cross Street FloreS Dr
Building or Suite No
IFGAL DESCRIPTION Lot No Subdivision Name/Number Unit No Phase No
C1IFCK BUXJW IF SUBMITTEDI 1 I \_>I\ LI I my »» II (JU UIT1I I I L.L/ .
D 2 Enrrgy Gales D 2 Structural Gales D 2 Soils Report D 1 Addressed Envelope
ASSESSOR S PARCEL ^MSTW i USE_PROPOSED USEDESCRIPTION OF WORK Water Heater Replacement
SQ FT # OF STORIES OF BEDROOMS # OFBATMIKXJMS
3 UJN l At.l FLH^JN u> uillerenllrom applicanNAME (last name first) Hagler, Jack
CITY Carlsbad SAE
, ,., n <->v,i-i^=T-/-,c3a TAK?ADDRESS 131° Chuparosa Wy
Z'' 92008
4 APFUCANI UUJNIHALIUK UjAOhN I HJH
NAME (last name first) Carol Foster SUlteB
CITY El Cajon STATE CA ZIP CODE 92021 DAY TEI.EPHONE 390-4477
5 PHOPLH IT UWNLH• nwi &*i\ • • \-»*» i VL**. _ __ -I
NAME (last name first) Hagler, JacK ADDRESS 1310 Chuparosa Wy
CITY Carlsbad STATE CA ZIPCODE 92008 DAYTEIFPHONE729-5726
6 CJONTRACTOR
NAME (last name first)
CITY El Cajon
a r TA & J Tnr±HC
STATE CA ZIP CODE
ADDRESS
91977
STATE UC # 630120 LICENSE CIASS
13706 Highway « ^Business,
390-4477
1200354
DAY TELEPHONE
C-36
UESTtiNtR NAME (last name Iirsl)
CITY BUSINESS UC #
ALJUKtSS
CITY STATE ZIP CODE DAY TELEPHONE STATE LIC #
7 WORKERS' COMPENSATION
Workers' Compensation Declaration Inereby aHirmtnanhave a certincate ol consent to sell insure issued by the Director ol Indusmil
Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified
by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab C)
Farmers on,,rvx,n N2007-56-^».mAnoN DATE 5~1"97
INSURANCE COMPANY POLICY NO
Certmcate oTExempiion I certify that in the performance ofihe work Tor 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
^^lyrcEJJj....OlJj2nlJffl DATE i/VJ ^ / ' ^ !8 OWNER BUlLUtH UKXxXkATION / <•
Owner Builder Declaration 1 hereby allirm that I am exempt irom the lantractors License Law lor me following reason
O I as owner of the property or my employees with wages as their sole compensation, will do the work and the structure it 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 die 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 thereon, and contracts for such projects
with contractor^) licensed pursuant to the Contractor's License Law)
D 1 am exempt under Section Business and Professions Code for this reason
(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, commencing 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])
SIGNATURE DATE
IHIJj SECTION FOR NUN HEalUtN IIAL UUILUINU PtHMlla ONLY
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or nsk management and
prevention program under Sections 25505, 25533 or 25534 of the Presley Tanner Hazardous Substance Account Act?
Q 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 district?
Q YES D NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
O YES D NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS 11 IE APPLICANT
HAS; MET ORIS MEETING THEREQUIREMENTS OP THE OFFICE OF EMERGENCY SERVICES AND THE AIR POIJ U1TON CONTROI DI?1TUCT
9 UUNb I HUtTI IUN LkNUUNU AUKNUY
rheteby allirm that there is a construction lending agency lor the performance ot the work lor which this permit is issued (bee 3097(0 Cmi Code)
None
LENDERS NAME LENDER'S ADDRESS
10 APPLICANT U-H'linCA'lTDTr ,______,
i cemly that 1 have read the application and state that the above mlormaiion is correct 1 agree to comply with all City ordinances and State laws
relating to building construction I hereby authorize representatives of the City 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, UABUXnES, JUDGMENTS, COSTS
AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT
OS1JA. An OSHA permit is required for excavations over S'O" deep and demolition or construction of structures over 3 stones 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 365 days from the date of such permit or if the building or work authorned bysuch permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code),
APPLICANTS SIGNATURE $(. r~^ i^ ^,VA DArE|=P~\ ^V
f
City of Carlsbad
Building Department
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations
I have and will maintain a certificate of consent to self-insure for
A 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
B of the Labor Code, for the performance of the work for which this permit is
issued My workers' compensation insurance carrier and policy number are
INSURANCE COMPANY POLICY NO. EXPIRATION DATE
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED
DOLLARS ($100) OR LESS)
I
i ji
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.
m C workers compensation laws of California. K
r\ Dqte
Warning. Failure to secure workers' compensation coverage is unlawful, and shall be
subject an 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 Labor Code, Interest and attorney's fees.
March 3, 1995
2075 Lag PalmRS Dr • Cnrhbnd CA P?OOR-1«V7n • (RIP) -nn 11 m - FAX fO1<V> 'inn nncH