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Home My WebLink About2015 CORDOBA PL; ; CB960177; Permit7/,- BUILDING PERMIT 02/01/-»6 13 41 Paae 1 of 1 Job Address 2015 CORDOBA PL Peimit Type PLUMBING Parcel No 207-240-10-00 Valuation ° Permit No CB960177 Project No A9600280 Development No 0 1 Lot#Constructlon Status ISSUED HEAaER REPLACE APPl/Ownr AJACKS MAINT 7631 LEMON AVE LEMON GROVE, CA 91945 *** Fees Required *** Entered By MDP "9 589-8888 ** Fee:27 2700 1 I, -Fee description *" •* Enter Y for Plumbirw ^ss^ue^ Each Water Heater and/^r Tfttvt * PLUMBING TOTAL ' » ^' ! • f i -j «J * * 'Total treSots T&tai1 Payments ^ , t r Balance Due, " t J Units Fee^/Uatt 00 00 27 00 Ext fee Data 20 00 Y 7 00 27 00 //if !> , " FIWAL APPROVAL CITY OF CARLSBAD 2075 Las Palmas Dr Carlsbad CA 92009 (619) 438 1161 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Palmas Dr Carlsbad CA 92009 (619) 438 1161 T PERMIT TYPE From List 1 (see back) give code of Permit Type For Residential Proiects Only From List 2 (see back) give Code of Structure Type Net Loss/Gain of Dwelling Units PLAN CHECK NO - f~? "^ EST VAL PLAN CK DEPOSIT. VALID BY ~ DATE 2 PROJECT INFORMATION FOR OFFICE USE ONLY Address Nearest LEGAL DESCRIPTION Lot No Subdivision Name/Number Unit No Phase No CHECK BELOW It SUBMITTED D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D 1 Addressed Envelope ASSESSOR S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK SQ FT # OF STORIES # OF BEDROOMS # OF BATHROOMS 3 UUN l AUI FEKbON (it different rrom applicant) NAME (last name first) CITY STATE ADDRESS ZIP CODE DAY TELEPHONE 4 APPLICANT U CONTRACTOR [J AGENT FOR CONTRACTOR U OWNER D AGENT FOR OWNER NAME (last name first) ADDRESS CITY STATE ZIP CODE DAY TELEPHONE 5 PROPERTY OWNER NAME (last name first) CITY CftflTfi&QKACJIUR A 3SH 1 &K/V , nn t-H D ZIPCODEa^D{ffSTATE DAYTELEPHONE CITY STATE LIC # STATE j[0'\ ZIP CODE CENSE CLASS DAY TELEPHONE CITY BUSINESS LIC # DESIGNER NAME (last name tirst) CITY STATE ZIP CODE ADDRESS DAY TELEPHONE STATE LIC # 7 WORKERS^ COMPENSATION Worker? Compensation Declaration I hereby affirm that I nave a certificate ot consent to self insure issued by the Director or Industrial 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) INSURANCE COMPANY POLICY NO EXPIRATION DATE Certificate otExemption 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 SIGNATURE DATE 8 OWNER BUILDERDECLARATION Owner Builder Declaration I hereby arnrm that I am exemptirom the Contractors License Law tor the lollowing reason 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 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) I 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 COMPLETE THIS SECTION FOR NON RESIDENTIAL BUILDING 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? 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 district? D YES D NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? D YES D NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1 1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT 9 CONSTRUCTION LENDING AGENCY I hereby attirm that there is a construction lending agency tor the performance ot the work tor which this permit is issued (Sec 3097 (i) Civil Code) LENDERS NAME LENDERS ADDRESS 10 APPLICANl UhRllMCAlION I certify that 1 have read the application ana state that the above information is correct 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 CTTY OF CARLSBAD AGAINST ALL LIABILITIES JUDGMENTS COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SATO 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 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 buildmg or work authonzgdjiy such permit is not commenced within 365 days from the date of such permit or if the building or work authonzed by sucjipppnit is ^usBWdedor Abandoned at affy)time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code) DATE File YELLOW Applicant PINK. Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB960177 FOR 02/21/96 DESCRIPTION WATER HEATER REPLACEMENT TYPE PLUM JOB ADDRESS 2015 CORDOBA PL APPLICANT AJACKS MAINT CONTRACTOR OWNER REMARKS MW/AFTER 3 PM SPECIAL INSTRUCT PHONE PHONE PHONE INSPECTOR AREA PLANCK# CB960177 OCC GRP CONSTR TYPE VN STE LOT 619 589-8888 INSPECTOR TOTAL TIME CD LVL DESCRIPTION 25 PL Water Heater/Vents ACT COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS A«OKl». CERTIFICATE OF INSl PRODUCER Roger Combe Robert F Driver Co Inc 1620 Fifth Ave San Diego CA 92101 IN4UBSO " • Ajacks Mainttnance Svs Inc 7t>31 Lemon Avenue Ltmon Grove CA 91945 JRANCE niST0" THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANDCONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATEDOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THEPOLICIES BELOW COMPANIES AFFORDING COVERAGE u^s^ A 1IG Insurance Company %££" B TIG Insurance Company [™NY C TIG Insurance Company ^£NY D Calif Compensation COMPANY c LETTER C COVERAGES THIS 13 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PfcRIOD INDICAfED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCUMENTWITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OH MAY PERTAIN THE INSURANCE AFFORDED BYTHE POUCIE8 DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OK SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN RfcDUCED BY PAID CLAIMS co LTR A B C D • - - - TYPE OF INSURANCE GENE "X~ 1 HAL LIABILITY COMMfcffcJAL GENERAL LIABILITY JCLAIMSMAOE F^f 1 OCCUR OWNER S 1 CONTHACTER S PROT AUTOMOBILE LIABILITY— — i ANY AUTO x~ 1C X ALL OWNED AUTOS SCHEDULED AUTQ8 MIRED AUTOS NON OWNED AUTOS GARAGE LIABIU1Y EXCESS LIABILITY X OM6RELLAFORM OTHtR THAN UMBRELLA FORM WORKER 6 COMPENSATION AND EMPLOYERS LIABILITY OTHER POLICY NUMBER 31361157 31361157 XMM9300416 W94A111314 POLICY EFFECTIVE DATE (MWDD/YY) 12/31/95 12/31/95 12/31/95 10/01/95 POLICY EXPIRATIONBATE (MM/DD/YY) 12/31/96 12/31/96 12/31/96 10/01/96 LIMITS GENERAL AQ0REWU-E PRODUCTS-CQMP/OP AGQ PERSONAL &AOV INJURY EACH OCCUFHhNCE FIRE DAMAGE (Any a flre) MtD EXPENSE (Any one p fson) COMBINED SINGLE LIMIT BODILY INJURY (Per perao ) BODILY INJURY (Per a Want) PROPERTY DAMAbE EACH OCCURRENCE AQaflEGATE STATUTORY LIMITS EACH ACCIDENT DISEASE POLICY LIMIT DISEASE EACH EMPLOYEE * 2 000,000 « 1 000 000 * 1000000 s 1000000 « 50 000 » 5,000 t 1 000 000 S $ S « 1 000 00( s 100000L « 1,000 OOCr« i ooo oor s 1 000 OOt DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Job All Maintenance Senvices Operations of The Named Insured * 10 days nonet, of cancellation for nonpayment of premium CERTIFICATEHOLDER CANCELLATION " "" "" " SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 0E CANCELLED BEFORE TH6 EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL tNDEAVOfl TO MAIL _3Q DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION Qfl LIABILfTY OF ANY KIND UPON THE COMPANY ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPHE9ENTAT Roger Combe, (y/90)>AC5HETCORPORA.TION 1990