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Home My WebLink About219 CHESTNUT AVE | 221 CHESTNUT AVE; ; CB972609; PermitBUILDING. PERMIT 09/16/97 08: 45 . Page 1 of l Job Address: 219 CHESTNUT AV Suite: Permit Type: PLUMBING • Parcel No: 204-150-02-00 Lot#: Valuation: 0 Occupancy Group: Reference*: Description: WATER HEATER REPLACEMENT Permit No: CB972609 Project No: A9703314 Development No: Construction Type: NEW 9224 Q9/l?/$JtSa01sQl I3S3UED Appl/Ownr : REEVE GEORGE 219 CHESNUT AVENUE CARLSBAD, CA 92009 *** Fees Required *** - *** Apr/Issue: 09/16/97 Entered By: JM 602 864-1003 Fees Collected & Credits *** Fees: Adjustments : Total Fees: Fee description 27 27 ,/00 ,00 ... .op" • , Enter "Y" for Plumbing .Issue Fee . Each Water Heater and/or Ventv ' . * PLUMBING TOTAL ; ; . "-' ,' . ! ' k :. /-Total Credits: Total Payments : -Balance Due:, :' , „ Units, 'Fee/Unit y ~ . ^ .-,. - :'i • '' 7", oo, .00 . 00 27,00 Ext fee 20. 7, 27. 00 00 00 Data Y PE™£,HS?,PIRfD ® ACCORDANCE WTHUB.C 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 FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. ' Plan Ck. Deposit Validated By Date Address (include Bldg/Suita *)Butlneu Name (tt thi* address) Legal Ouciiptlofl Lot No. Subdivision Mima/Number SEE ... Unit No.Phase No.Total t of units Assessor's Parcel Existing Usa Proposad Usa Description of Work spue**3«::isS- SO. FT.tot Storlai f of Badrooms if of Bathrooms Telephone #m1^706-B HWY 8 BUS. EL CAJON,Y JOHbTSON 602-864-10rA-RT,SBAD CA. (Sec. 7031.5 Business snd Professions Code: Any City or County which requires a permit to construct, alter. Improve, demolish or repair any atructura, prior to Its issuance, also requires the applicant for such permit to file e signed statement that ha I* 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 eny applicant for a permit aubjects the epplicant to a civil penelty of not more than five hundred dollars 1*5001). •p m,iv £ UTT3 FJ. CAfTOMi—£5 nwi o DUO. i>m..x-'"1-'>-"•''Aanfr J FOSTER State License * ,^,License Class IW~. Stste/ZIp Telephone* .City Business License * 1200354 Designer Name State License t Address City State/Zip Telephone ^ _ ^Workers' Compensation Declaration: I hereby efflrm under penalty of perjury one of the following declarations: Q I have and will maintain a certificate of consent to self-Insure for workers' compensation ta provided by Section 3700 of the Lebor Code, for the performance of the work for which this permit Is Issued. O 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 X'ssued. My worker's compensation Insurance carrier and policy number tie: Insurance Compeny TTlTTT1lTT_rl TT-TC-TTRTUJT'E _ : _ --'- Po"°v No. M2Q07-56-51 _ Expiration DatCONTINUOUS (THIS SECTION NEED Wf'BreOMPliEtEDlF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*100) OR LESS) Q CERTIFICATE OF EXEMPTION: I certify that In the performance ot the work tor which this permit Is Issued, I shall not employ any person In any manner ao as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to tecure-workers' compensation coverage la unlawful, and shall subject in employer to criminal penalties and civil fines up to one hundred thousand dollars 1*100,000), In addition to the cost of compensation, damagea as provided tor In Section 3706 of the. Lebqr code. Interest and attorney's fees. SIGNATURED . . DATE 7. ' UWNtH-BUILUtH UtULAHAtlUNSIK':V: I hereby affirm that I am exempt from the Contractor's License Lew for the following reaaon: Q t, as owner ot the property or my employees with wages aa their sole compensation, will do the work and the atructure la not intended or offered for sale (Sec, 7044, Business and Professions Code: The Contrector's License Law does not apply to an owner of property who builds or Improves thereon, end who does such work himself or through his own employees, provided thet such Improvement* ere not Intended or offered for eele. 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 tor tha purpoae of aale). Q I. as owner ot the property, am exclusively contracting with licensed contractor* to construct the project (Sec. 7044, Business and Professions Code: The Contractor'* License Liw doe* not apply to an owner of property who build* or Improve* thereon, and contract* for *uch project* with contrector(a) licensed pursusnt to the Contractor's License Law). O I *m exempt under Section Business end Profession* Code for thl* reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property Improvement. O YES QNO 2. I (have / have not) signed en application lor a building permit for the proposed work: 3. I have contracted with tha following person (firm) to provide tha proposed construction (include name / address / phone number / contrsctors 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 / eddress I phone number / contractors license number): 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): PROPERTY OWNER SIGNATURE DATE NO Is the applicant or future building occupant required to aubmlt • business plan, acutely hazardoua material* registration form or rlak management and prevention program under Sections 25505, 25533 or 26634 ot the Presley-Tanner Haiardoua Substance Account Act? Q YES Q NO Is tha applicant or future building occupant required to obteln a permit from the air pollution control district or air quality management district? Q YES Q Is the fscllity to be constructed within 1,000 feet of the outer boundary of * school site? Q YES Q 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. •£-?CQNS!THU(^N.ttm>ra^^ . j t. .-.. I hereby affirm that there Is a construction lending agency, for the performance of the work for which this permit I* Issued (Sec. 3097(1) Civil Code). LENDER'S NAME _____ _ _ ' ' LENDER'S ADDRESS ^^mm-^^mmi.}4gmmmf^^mmmis^m^^^^mm^^^&i, *>; ?/ • I certify that 1 have read the application and state that the above Inlormatlon I* correct and that the Inlormatlon on the plans Is accurate. I agree to comply with all City ordinances and State lawa relating to building construction. I hereby authorize repreeentetives of the City of Carlabad 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 excavation* over 5'0" deep and demolition or construction ol structure* over 3 itorie* In height. EXPIRATION: Every permit Issued by the Building Official under the provision* of this Code (hall expire by limitation and become null and void if the building or work authorized by such permit Is not commenced within 366 days from tha date of such permit or If the building or work authorized by such permit Is suspended or abandoned at any time after tjja, work \s commenced for • period of 180 diya (Section 108.4.4 Uniform Building Code)., APPLICANT'S SIGNATURE WHITE: File YELLOW: Applicant PINK: Finance COMMERCIAL CERTIFIG^EW 1BSURAHCE Issue Date (MM/DD/YY) JENCY .me ' ALLAN MENDOZA & ' 8880 RIO SAN DIEGO DR. #700 dress ' SAN DIEGO, CA 92108 This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter thecoverage afforded by the policies shown below. . COMPANIES PROVIDING COVERAGE: 99.DIST..AGENT 17fi 3URED me • A&J FOSTER INC. • 13706 B HWY 8 BUSINESS lress • EL CAJON, CA 92021 COMPWffuna coupwrunw COMPANYunu A TRUCK INSURANCE EXCHANGE B FARMERS INSURANCE EXCHANGE C MID-CENTURY INSURANCE COMPANY •cauemturn* Q ERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINGANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE 101 tf mUl UillUTY COMMERCIAL GENERAL UABUTY -OCCURRENCE VERSION CONTRACTUAL • NCOENTAL ONLY OWNERS & CONTRACTORS PROT. ATTTOMOIBF UABUTY ALL OWNED COMMERCIAL AUIOS SCHEDULED AUTOS HRED AUIOS NON-OWNED AUTOS GARAGE LUBUTY nunn 11 IMMITV WvAWU UHfUUTiOl An EUPLOYERr UABAOT POLICY NUMBER N2007-56-51 OF OPEMTIOMS/VUnClK/RISTWCTIOWSPICIAl ITEMS: RE: ALL OPERATIONS POLICY EFFECTIVEDATE (MWDD/YY) . 5-1-97 POLICY EXPIRATIONDATE (MMAXVYY) OGNTINUOUS UNTIL CANCELLED POLICY LIMITS GENERAL AGGREGATE PRODUCTSCOMP/OPS AGGREGATE PERSONALS ADVERTISING MJURY EACH OCCURRENCE FBE DAMAGE (Any one Fn) MEDICAL EXPENSE(Anrompenon) .COMBMEO SMGLELMT BODILY NJURY (PER PERSON) BOOLYKURY(PERACCOENT) PROPERTY DAMAGE GARAGE AGGREGATE HIT STATUTORY EACHACCOENT DISEASE-EACH EMPLOYEE DISEASE-POLICY IMT $ $ $ $ $ $ $ $ $ $ $ $ $ 1 ,000,000 $1 ,000,000 $1 ,000,000 ' IRCATE HOLDER (1flpkw o CANCELLATION mrrv nP-oaN^mlv SHMO "" v « "^ DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. ie • CITY OF -SAN dfiGO- THEISSUMOJMPANYWUEMKAVORTOMAiaMYSWIWENNOnCETaM • BUILDING DEFT NM*D m THE LEFT. BUT FAILURE TO MAI. SUCH NOTICE SHALLWPOSE NO OBLIGATION OR UAHUTYOF ress • 9601 RIDGEHAVEN CT 2ND FLOOR ANY »O UPON THE COMPANY. ffS AGENTS OR Kffl^AnvtS. • SAN DIEGO, CA 92123 . , ^ 13SI