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Home My WebLink About2165 CHESTNUT AVE; ; CB930784; Permitr, it T T n T N r PERMITBUILDING P E R n x 08/10/93 13:39 Page 1 of 1 suit*31 Job Address: 2165 CHESTNUT AV - Permit Type: PLUMBING Parcel No: 167-080-44-00 -otff- Valuation: ° Construction Type: NEW Referenced- Description^ °WATER HEATER REPLACEMENT Permit No: CB930784 Project No: A9301136 Development No: 3450 og/lc,/93 000i 01 02 ,>PRHT Status: ISSUED Applied: 08/10/93 Apr/Issue: 08/10/93 Entered By: MDP Appl/Ownr : A J FOSTER INC. 2819 CENTRAL AVE SPRING VALLEY, CA, 91977 *** Fees Required *** 619 697-4151 F«?*ss Coiiected & Credits *** Fees : Adjustments: Total Fees: Fee description 27. oc; ;:ot:ai Credits t Total Payruents: Balance Due; ., Units Pee/Un;t Enter'"Y" for Plumbing Issue Fee > Each Water Heater and/ur Vent > * PLUMBING TOTAL , 00 .00 27, 00 Ext fee Data 20.00 Y 7. 00 27. 00 &srCITY 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 1. PERMIT TYPE A - U Commercial U New Building Q Tenant Improvement B - D Industrial D New Building D Tenant Improvement C - g Residential D Apartment D Condo [^Single Family Dwelling D Addition/Alteration D Duplex D Demolition D Relocation D Mobile Home D Electrical g Plumbing D Mechanical DPool D Spa D Retaining Wall D Solar DOther__ 2. PROJECT INFORMATION Address Building or Suite No. 2165 Chestnut Ave. Nearest Cross Street El Camino Real LEGAL DESCRIPTION Lot No. Subdivision Name/Number PLAN CHECK NO.&l "? _ EST.VAL PLAN CK DEPOSIT -71.°" VALID. BY yUv/^/-' DATE ^jl? / Si1 t FOR OFFICE USE ONLY Unit No.Phase No. CHECK BELOW IF SUBM1 11 tlJ: D 2 Energy Calcs O 2 Structural Calcs D 2 Soils Report P 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK HEATER REPLACEMENT # OF STORIES 3. rJUNTALrr PEKSUJM in aitierent rrom applicant.) NAME Pat Reyes Cota ADDRESS CITY Carlsbad,STATE CA. ZIP CODE 2165 Chestnut Ave. 92008 DAY TELEPHONE 452-3212 4. APPLICANT QCON1HAC1OK dAGENl i-OK CON 1KACTUK LJUWNEH LJAUEN 1 hOK OWNER NAME Michelle Medina ADDRESS 2819 Central Ave. CITY RnHnrr Vallev. STATE CA. ZIP CODE 91977 DAY TELEPHONE 697-4151 5. PROPERTY OWNER NAME ADDRESS CITY Carlsbad, STATE CA. ZIP CODE DAY TELEPHONE 6. CONTRACTOR NAME A&J Foster, Inc. CITY Spring Valley, STATE CA. STATE LIC. # ADDRESS 2819 Central Ave. ZIP CODE 91977 DAY TELEPHONE 697-4151 LICENSE CLASS C-36 CITY BUSINESS LIC. # 1200354 DLSIGNERNRME N/ACITY STATE AUURtSS ZIP CODE DAY TELEPHONE STATE LIC. # 7. WORKERS' CJOMPEN^AIION Workers' Compensation Declaration: I hereby attirm that I have a certificate or consent to self-insure issueobytne Director oflndustriaT 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 Republic Demnity POLICY NO. PC949585 EXPIRATION DATE 5/1/94 Certificate of Exemption: 1 certify that in the performance ot the 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. SIGNATURE 8. uWNER-BU r__^_^^ ^___^_^^___ Owner-Builder Declaration: 1 hereby attirm that 1 am exempt from the Contractor'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: (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 9. CONSTRUCTION LENDING AGENCJY 1 hereby attirm that tflere is a construction lending agency tor the performance ot the work tor which tms permit is issued (Sec 3097(1) Civil UodeJ. LENDER'S NAME NONE LENDER'S ADDRESS 10. APPLICANT djRTU-'KATlON I certify that 1 have read the application and state that the above information is correct. I agree to comply with all City ordinances and titate 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, 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 stories 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 authorized by such 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 DATE:P. It-_ WHITE: File YELLOW: Applicant PINK: Finance