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HomeMy WebLinkAbout1640 CORMORANT DR; ; CB012388; Permit07/16/2001 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No.CBOl2388 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 1640 CORMORANT DR CBAD PLUM 2156500411 Lot# 0 Construction Type NEW LAIBSON RES/ NEW WATER HEATER Status ISSUED Applied 07/16/2001 Entered By CB Plan Approved 07/16/2001 Issued 07/16/2001 Inspect Area Applicant A&J FOSTER, INC STEB 13706HWY8BUS EL CAJON CA 92021 619-390-4477 Owner LAIBSON JERRY&IRIS TRU 1640 CORMORANT DR CARLSBAD CA 92009 0002 01 CGP 02 27.00 Total Fees $2700 Total Payments To Date $000 Balance Due $2700 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Dram Install/Repair Water Line Water Heater and/or Vent Gas Piping System Vacuum Breaker Other Plumbing Fees Master Drainage Fee Sewer Fee Additional Fees 0 0 0 0 1 0 0 $2000 $000 $000 $000 $000 $700 $000 $000 $000 $000 $000 $000 TOTAL PERMIT FEES $2700 Inspector FINAL APPROVAL 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 "fees/exactions" 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 Carlsbad Municipal Code Section 3 32 030 Failure to timely 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 specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 •I PROJECT INFORMATION ' ~" """..• .......:,.,..,....... '1640 CORMORANT DR'CARLSBAD'CA 92009 <Suite> <Name> FOR OFFICE USE PLAN CHECK NO EST VAL Plan Ck Deposit Validated By £. Date "7- \lf- ONLY P? -nl** i Address (include Bldg/Suite #) <Legal Descr> Legal Description <Assessor No> Assessors Parcel # WATERHEATER INSTALL Description of Work Business Name (at this address) <Lot> Subdivision Name/No> <Unit> <Phase> <Total> Lot No Subdivision Name/Number <Existmg Use> Existing Use <SQ FT> <Stones> SQ FT # of Stories Unit No Phase No <Proposed Use> Proposed Use <Bedrooms> # of Bedrooms Total # of units <Bathroom> # of Bathrooms Vs. ., CONTACT PERS6N"(if different from applicant)' <Name> <Address> Name 3 APPLICANT;NetClerk Inc Address D Contractor fi7l Agent foriContractor a Owner 720~Dubuque Ave <City> ST <ZiD> City O Agent for Owner South State/Zip SanFr.CA 94080 r .....:;; .;:!: <Phone> <Fax> Telephone* 8883301777 Fax* Name 4 PROPERTY OWNER JERRY LAIBSON Address 1640 CORMORANT DR City State/Zip Telephone* " CARLSBAD CA 92009 <Phone> Name Address City State/Zip Telephone* 5" CONTRACTOR-COMPANYNAME " '"^. .•'••'.• ~ ^ ""'vK'., ' (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 Foster Incorporated PO Box 2758 El Cajon QA 92021 6193904477 Name State License # 630120 <Name> Designer Name Address License Class C36 <Address> Address City State/Zip Telephone* Citv Business License # 1210836 <City> ST <Zip> <Phone> City State/Zip Telephone State Licence # 6 WORKERS' COMPENSATION Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations l~l 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 0 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 P0|ICy No 00506395 Expiration Date 05/01/2002 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) l~l 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- • /TV 0 in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code interest and attorney's fees SIGNATURE •***9*-' DATE 07/11/2001 7 OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason I I 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) I 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) I I I am exempt under Section Business and Professions Code for this reason 1 I personally plan to provide the major labor and materials for construction of the proposed property improvement l~l 2 I (have / have not) signed an applicant for a building permit for the proposed work YES NO I hi,aye contracted with the following person (firm) to provide the proposed construction (include name / address/ phone number / contractors license number) gName> <Address> <WorkPhone> <State License> 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/ contractors license number) <Name> <Address> <Work Pnone> <State License> 5 I will provide some of the work but I have contracted (hired) the following person to provide the work indicated (include name / address / phone number / type of work) <Name> <Adaress> <Work Phone> <Work Type> PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOR NON-RESIpENTIALBUiLDING PERMITS ONLY ' "" " "" ' '";" r™r-:M-: "L "-' 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 Sect ons 25505 25533 or 25534 of tha Presley-Tanner I lazardous Substance Account Act? l~l YES l~l NO DYES NOIs the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district' Is the facility to be constructed within 1 000 feet of the outer boundary of school site7 l~l YES l~l 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 n™"~ -,,..-,-,, ^ ^, -,„ -— . -, , .... ...^ 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 ;•"' APPLICANT CERTIFICATION : ~T£r' ... ;;•;. . T^; ' ' . -~ 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 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 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 Even/ 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 07/11/2001 City of Carlsbad Bldg Inspection Request For 07/23/2001 Permit# CB012388 S^*^Title (LAIBSON\*ES/ NEW WATER HEATER Description Type PLUM Sub Type Job Address 1640 CORMORANT DR Suite Lot 0 Location APPLICANT A&J FOSTER, INC Owner LAIBSON JERRY&IRIS TRUST 09-07-82 Remarks AM PLEASE Inspector Assignment Phone 7604386806 Inspector Total Time CD Description 25 Water Heater/Vents Act Comments Requested By JERRY Entered By CHRISTINE Associated PCRs Inspection History Date Description Act Insp Comments CERTIFICATE OF LIABILITY INSURANCQftK, Ryfeitt Rfeucy Inc. CA $212.2 . ..jr / flsvid FOB tor O'S/63/01 AMATTCW ©lrmFQPn&ftT*ON 0JII.V ftHlJ C«N1Bf:»S MO 8te.Mff$i WPQS THIS. CSHWJCAW HOLtE* fHIS CEOT STCATI! CO«$ «<J* .W^NS, HCTFMD ORM.T ea. TW eo W!yMJ€; Ai*ortoto BY TT«E POLICIES wio** Co C<x "*&ra-,'SfS rh n !?^_ rn U [""I ' 01/11/01 01/.U/02 (fifine DWACE lWr«r» Utf ? excluded 01/11/0'% * 3., 000, 000 • CSwraSP'400 i 1,000,0*6 L~ T 6**ee J£_ ^l] OB/01/01 ••I t>,omss • ffogyUMP; J S 1, 00D,^03 &bieiBfhcw or<WKMigi>K«eAnQifWOieiJHM«w50M «»*D »l*MI«Jrinnkr«r'iK)H^iv4>Qifl »W . State of California CONTRACTORS 5tA.lft UCINSf BOARD ACHVIUCINS1 1^,^630120 A 6 J FOSTER IMC 10/31/2001 720 Dubuque Ave , South San Francisco, Ca 94080 Government Services 888-330-1777 Fax 877-846-5888 Permit Application ID# 92454 Mail To: Carlsbad Building 1635 Faraday Ave Carlsbad CA 92008 Phone Fax 7606028558 Email C o n t Company A & J Foster Incorporated Address P° Box 2758 City El Cajon State /ZIP CA 92021 Phone 6193904477 Fax 6193904448 Email Cr Credit Card Number Expiration Date Card Holder Name ractor Information Worker's Comp Carrier State Comp Ins Fund Worker's Comp No 00506395 Exp 05/01/2002 State Contractor's License 630120 Exp 10/31/2001 License Class / Type c36 Exp Exp Business License # 1210836 Exp 08/31/2001 edit Card Information Visa I I Mastercard | | Other [•] check Project Information Homeowner Name JERRY LAIBSON Project Address 1640 CORMORANT Valuation 155 Job Description WATERHEATER INSTALL Homeowner Phone Number DR CARLSBAD CA 92009 Residential | | Commercial | | Notes Payment Check Permit Type Paper Agent Authorization ORG |~| NOT |~~| AA Type R34_5/25