HomeMy WebLinkAbout2126 PINE CREST WAY; ; CB033482; PermitCity of Carlsbad
12-16-~003 '
1635 Faraday Av Carlsbad, CA 92008
Plumbing Permit Permit No: CB033482
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
2126 PINE CREST WY CBAD
PLUM Status: ISSUED
12/16/2003
MOP
12/16/2003
12/16/2003
Parcel No: 1563320500 Lot#: O Applied:
Construction Type: NEW Entered By:
Reference #: Plan Approved:
Issued:
Project Title: BENTLEY RESIDENCE Inspect Area:
WATER HEATER REPLACEMENT
Applicant:
A&J FOSTER, INC.
STE B
13706 HWY 8 BUS
EL CAJON CA 92021
61 9-390-44 77
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
TOT AL PERMIT FEES
Total Fees: $27.00
Inspector:
Owner:
BENTLEY DONALD P&SUSAN-HARUMI
0
0
0
1
0
0
0
2126 PINECREST WAY
CARLSBAD CA 92008
Total Payments To Date: $0.00
$20.00
$0.00
$0.00
$0.00
$7.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$27.00
Balance Due:
EXP;~_ED f ERr~sT
$27.00
PERMIT;.• · :''.1:C'r1:D IN ACCORDANCEWIJM llijq.,
SECTION 10J.4.4 1726. D; L 1 03 0002 01.
DATE Ct! !':\Vl':::\ SIGNATIJFU:. ",~u.,J ' CGp
FINAL APPROVAL
Date: ------Clearance: ______ _
NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collec1ively
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 pro1est 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 capacity
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any
. i h . . . . n f Ii i . • •
02
27 .(ii)
FOR OFFICE USE ONLY
PERMIT APPLICATION PLAN CHECK NO. ____ _
CITY bF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
EST. VAL. __________ _
Plan Ck. Deposit _________ _
Validated By ___________ _
Date ______________ _
Address {include Bldg/Suite 11) Business Name (at this address)
Legal Description Lot No. Subdivision Name/Number SFR Unit No. Phase No. Total # of units
Assessor· s Parcel II Existing Use Proposed Use
156-332-05-00
Description of Work SO. FT. #of Stories # of Bedrooms # of Bathrooms
••· .. 1 r•"', "•~~!:.~r: .. ~.~~.t.~mt"f '~~F.J~cerren~,,,,,., ... ,,J·,,. •••· l''i"i"'''ID!l •t~J'SWlifl'"''"''~~"i"""m'~•,•~•••,•·\.t"'"·'"'•"''°"•l;,;,, .. ,ifi'i'~~•!l'!!l'"'"'!ml"'''•"11"'••0•1"""'••'•lfflil!!l"•"l"·"""!l!l1•1'·1·~•i'•• •,·"'"'."''"'" "•'1"'"••••1;""" ·•·•••••""'" ,.,,,. "'"r!P.CO "'"'"'"C~JJ!Dr::D<lQ!'a"'i . [I!~r&r'ltfif.r." ·;n·ri'"'lh:11nt)'l(•,mH,'''"· -:,.,•,.,,,CJ1r,,,1,,._,,,,, ,.l:(f .". ,,,.,.,.,,,,1,, •. ..;',Is,1'""'"'"""1!'•· ..• ·t,l•.,!!;!,c•;;('>Ci• r••····••-'.,."''"'"""""'·,:v-"'"J;',b"!Yt','7'iilif'· ·,4:,--1.•;·•:·1,,..,:;:;.:, , .. ,., '"""'"'"·li•i'''r',•1c:1·:--,i1 ..,,,,... Ben't 1e'y'tn'ona:Ld ·· "· "'· --'""2r 26'""'p'inecrest··""way"'" '""''far!'sb'aa' ..• .,..,, .. ..,, rJ;,'.7'"""''·· 2b'"o'S ••'-"'; 6'tr::12·9·: o'§".3'·""'' .,, ,,,
Name Address City State/Zip Telephone # Fax #
Arlen Foster~meredith galm 13706-B Hwy.8 Bus. El r....ajon, Ca. 92021 (619)390-4477
Name Address City State/Zip Telephone #
l~'l'~ili"~~)3'.Q~~"tl;:t\MjiA)«~~·ijtiill:tt'i\\m:u~I~]fij~l•\(\J;i~~l~!~~illii~llrnrn:r:ul!fflffimill1;~[~11'.i\~l\!1!wl~ill!1]i~Jt~!t.t~(\(lff1:ffimi1rii!~ilrail~~,irii\lnil~1~~fJi~!~[~)~\i;i~l~i~~f'.l~ni!lii!llMiill~!il~J.i\]jj~i~i/;r,~IB~1]tillWi:i,t"J!fu]i~(Ji/(i
Bentley, Donald 2126 Pinecrest Way Carlsbad Ca. 92008 760-729-4093
Name Address City S.tate/Zip Telephone #
iS'/;;~;iCON[i'Llfi ~tr:O:Bi~ltQ,dMl'IANOO:NAlY(E•~i,Jllfi~ID~[~~lf.i$/]~~~Jilllfiliii~~pJ!1!~.~~mllil:~!f:t!lliiji;);ii'iIB(ilifr•tirt~'1t:ili!l!wl~•'ii~w\~~-Tu.~lllm:t~:fili!f:t1Jiil!U1liiu\1iit~i!:i:"&trf
(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 Fost er PJ 11robing J 3706 B Hwy 8 Bus EJ Ca ~on CA 92027 ( 67 9), 390 4477 Name Address ity State/Zip elephone #
State License# 630120 License Class C-36 City Business License# 1210836
Designer Name Address City State/Zip Telephone
State License II [:ilq A · .
!'.8~1tl[~~iW:6ifJ{Eii'S.:tQUMhN.~~irfa:~11~~~:~~~~~,~~1re~Jb1~:ti~~1~H~w~11~~~j~~;~J~m~oo;~~;~~~!~~J~lli~~~11aw~:it~f~1~11~~~~i~r.~~~l~j~~wPJir~m~~ffi~lrt~;J~i~'.~~itrl!~~m~;t1m7at~i;1;m~1;·~11~::~~~i~~11(~n
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
0 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. x:::i I have and will maintain workers' compensation, a required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My worker's eompensation insurance carrier and policy number are:
Insurance Company state Comp Ins Policy No.467 OJ 00007] 3 Expiration Date Q4-Q]-Q4
(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 secur workers' compensation c rage Is unlawful, end shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars [$10 ompe ation, damages as provided for in Section 370Ei of the Labo code, nterest and attorney's fees.
SIGNATURE • DATE f --'--'"-1--'--''-'-.,_,__. __
I he;eby affirm that I am exempt from the Co ractor·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 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. 0 YES ONO
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 1 have hired the following person to coordinate, supervise and provide the major work (include name I address / phone
number/ contractors license number): __________________________________________________ _
5. I will provide some of the work, but I have contracted (hiredl the following persons to provide the work indicated (include name/ address/ phone number/ type of work): ______________________________________________________________ _
PROPERTY OWNER SIGNATURE ________________________ DATE _________ _
l¢0Me~,te!1fijf.(1'$)~e¢,j)ptJ;jifriB)!'QJiNJiJll$.iP.ir?ttl'41~r--g1~@lliG/R~iiMiftl1oJJ}~~ "f~1J,tt!~1lffl&~\}J~;!;f~Jl~ii:'!.,W~imt .. J11Ililtfii]f:,!~!5,l)J;:j@@[l~:~i~i~'illil~;1r:.:1~:t!,lik~
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk managem·ent and prevention
program under Sections 25505, 25533 or 25634 of the Presley-Tanner Hazardous Substance Account Act? 0 YES O NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES D NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE
REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code).
LENDER'S NAME [:ii NE LENDER'S ADDRESS ________________________ _
,-.,: 1; ''%,..,;;;1,;•i.<1ITi~'.ii-'i:if-;;r;;·1,;.•Ai;-ri·~iiW~,•1Yl!.', •t::11!'1:i!fi. tr1',~::f.,.J,·;&1r,1,ffi1,,;,f,im"'111~•.~:rl:'l'ill:li. :r . .:,r,,~"J!i~'\111~:nm,.!il'lh~',i1:illl:il"!!!~::!iH~.r1n~1r1r<.1h.'iir,,~.,,~d;~,"t~u:~1r,:~i~,:;;:;,,·1$•·,·:!ili,'i!llll1,l',iel:i!~,r;i!lf":;p1n1.i,.T~."~~mmrnnm,;!;,t,,,,1,i::8w11::m;n1:ii:\f' I j1;1, .1 ~i.-~~'-l".l""~ll!t-~~-"W.i~61,~"l!-~ili.l~ J.'4'~, .. ,iY.,Ut~t.ln ,1:.1 .I, 11~r.,c1,1-.1i1d1'-J~:w.a;~'il":,awlfl~-~w,,~--¥~,1 ,. !l~~lU.l:1.lis.;::-~,!!Ji.a.,..t!!t..HJ~,-~il;l~ ,:;,.i.:,,;~::u~:~i!=:b.;o~li,t!$i1:,!lilf~ct~~~lfl•,li.lll..~i;..,$,.'t~~~l,,JJJ.1~'11i;1•.;l11!./I, l.:i~!'e!~;!i,,;W~~ ... -l,J~~-'l.li P.R,il:!i111'9,Nfflij~1,V•l!-lru!llill~,.l:r,!...,il!-~'W
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 Citt of Carlsbad to enter upon the above mentioned
property for Inspection purposes. I I/I.LSD AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES,
JUDGMENTS, COSTS AND EXPENSES r HICH 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.
EXPIRATrON: Every permit issued by t e 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 comma ·cad within 180 days from the date oi such permit or if the building or work authorized by such permit is suspended or abandoned
al any time after the work is commence · d of 180 s (Se · 6.4.4 Uniform Building Code). 1 J J
APPLICANT'S SIGNATURE --L-~~~~~1~..!..il!~~::c:z::;s________ DATE 1 ~ '7 f ()::;
PINK: Finance