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Home My WebLink About1663 CHAMISAL CT; ; CB040030; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 01-06-2004 Plumbing Permit Permit No: CB040030 Building Inspection Request Line (760) 602-2725 Job Address: 1663 CHAMISAL CT CBAD Permit Type: PLUM Status: ISSUED Parcel No: 2157300708 Lot#: 0 Applied: 01/06/2004 Construction Type: NEW Entered By: SB Reference*: Plan Approved: 01/06/2004 Issued: 01/06/2004 Project Title: HOERGER RES NEW H20 HEATER Inspect Area: Applicant: Owner: A&J FOSTER, INC. • HOERGER MYRON E&NEOMA B LIVING TRUST STEB 13706 HWY 8 BUS 1663 CHAMISAL CT EL CAJON CA 92021 CARLSBAD CA 92009 619-390-4477 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 Master Drainage Fee Sewer Fee Additional Fees 0 0 0 0 1 0 0 $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $27.00 Total Fees: $27.00 Total Payments To Date: $0.00 Balance Due: $27.00 2594 01/08/04 0002 01 02 FINAL APPROVAL DATE t/W^CLEARANCE SIGNATURE PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1. PROJECT INFORMiAtJON FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated By Date Address (include Bldg/Suite »)1663 Chamisal Ct.Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total # of units Assessor's Parcel ff Existing Use SFR Proposed Use Description of Work215-730-07-08 2. CONTACT PERSON (if different from applicant) „' Water Heater Replacement SQ. FT.#of Stories # of Bedrooms # of Bathrooms Name •3, Address City •CA. Fax if Name X Address ; City State/Zip gaOjri 13706-B awry,.8. Bus. ^ Cajon,;, ; Ca, • 92021, Telephone ff(619)390^4477 Name €EU State/Zip -92009- Telephone # -760~f 03-1886. Address i City iiPANY NAME 1863 Chajflisal Ct,' Carlsbad (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 [$5001). Name Address Plumbing _EL City State/Zip Busin<sjaUcens93>fl21 Telephone # Designer Name 630120 Address C-36 City State/ZitZlUooSOephone State License # 6. WORKERS' COMPENSATION, • ' " ,- , " .' , " „.",*..'"•"• " -. Workers' Compensati£Jvl£eclaration: I hereby affirm under penalty of perjury one of the following declarations: [_) 1 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. D 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 Policy No. Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [4100] OR LESS) Q CERTIFICATE OF Si^JBSoftOII^-tiJnfiit in the performance of the work for whiOTQms-fretoiftySiBadf 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 dollars ($10&pWl»iifcaddition tolhe cos^f afrnpensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE ^^^. ^K.. i r? S -_* DATE . l not employ any person in mattieA<l I hereby affirm that I am exempt from the Cqprfractor'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). 0 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(s) licensed pursuant to the Contractor's License Law). D 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. [D YES [UNO 2. I (have / have not) signed an application for a building permit for the proposed work. 3. I have 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 / contractors license number): __ _____ _ __ __ _ _ _ 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work): _ ___ _ _ PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOR /V0/vV?£S/O£W77/U.BUILDlNG PERMITS ONLY ;.,>,"> -,*-"., 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? Q YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES Q NO Is the facility to be constructed within 1>,000 feet of the outer boundary of a school site? f~) YES f"l NO IF ANY OF THE ANSWERS ARE YES, AJFINAL 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. 30970) Civil Code). LENDER'S NAME I LENDER'S ADDRESS 9. APPLICANT CERTIFICATION' ', I , ' '. • - - ". ' '"•"•>• '.'•-"•,' > >,.,„., ,'>>. -, - " :" I certify that I have read the af)J>MME!on 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 CitV 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, 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 5'0" deep and demolition or construction of structures over 3 stories in height. EXPIRATfON: 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 cpmmencgjUJthin 180 daysfrom the iat^ef such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is comme_j_p*(i^or1jjjj_^iod__)f tafl^avs (Secffin10§/t.4 Uniform Building Code). APPLICANT'S SIGNATURE WHJT&File YELLOW: Applicant PINK: Finance DATE City of Carlsbad Bldg Inspection Request For: 01/21/2004 Permit* CB040030 Inspector Assignment: Title: HOERGER RES NEW H20 HEATER Description: Type: PLUM Sub Type: Phone: 7606031886 Job Address: 1663 CHAMISAL CT Suite: Lot 0 Location: Inspector: APPLICANT A&J FOSTER, INC. Owner: HOERGER MYRON E&NEOMA B LIVING TRUST Remarks: Total Time: Requested By: MR HOERGER Entered By: CHRISTINE CD Description AcJ Comment 25 Water Heater/Vents Associated PCRs/CVs Inspection History Date Description Act Insp Comments SD COMPENSATION I N S U R A. N;CE ;; I. ;; '•= ,, PQLICYHQLDER COPY ; P.O. BX'807, SAN FRAIN)C!SCO,CA 94142-13807; :, j y y- CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 04-01-2003 ' J •• CONTRACTORS STATE LICENSE BOARD WORKERS COMPENSATION UNIT P 0 BOX 26000 SACRAMENTO CA 95826 SD 000467 0000713-2003 GROUP: POLICY NUMBER: CERTIFICATEJI3: < : •• 4 . . : ": igPIRES: 04-P1-2004 04-011^2003/04-01-2004 LICENSE NUMBER: LICENSE #630120 INCEPTION DATE.- 04-01-2003 D.O.: SO This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 10 days' advance written notice to the employer. We will also give you 10 days' advance notice should this policy be cancelled prior to its normal expiration, - , This certificate of insurance is not arr insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement term, or condition of any contract or other documentwith respect to which this certificate of'insurance may'be'issued or may pertain, 'the insurance afforded by the policies described herein is subject to alt the terms," excfusibns and conditions o1 such policies. AUTHORIZED REPRESENTATIVE ' , ,• , PRESIDENT , . - , - EMPLOYER'S,,LIABILITY LIMIT INCLUDING DEFENSE COSTS,' $f,OOO',OOO.OO PER'OCCURRENCE. EMPLOYER LEGAL NAME A & J FOSTER, 13706 HWY 8 BUSINESS ST EL CAJON CA 9202} A & J FOSTER, INC PR.NTED:P0409