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Home My WebLink About2236 CORTE ANANAS; ; CB043719; Permit09-29-2004 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB043719 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 2236 CORTE ANANAS CBAD PLUM 2552710500 Lot# Construction Type HOWELL RESIDENCE WATER HEATER REPLACEMENT 0 NEW Status ISSUED Applied 09/29/2004 MDP 09/29/2004 09/29/2004 Entered By Plan Approved Issued Inspect Area Applicant A&J FOSTER INC STEB 13706HWY8BUS ELCAJONCA 92021 619 390 4477 Owner HOWELL LIVING TRUST 04 26 00 2236 CORTE ANANAS CARLSBAD CA 92009 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Dram 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 $2000 $000 $000 $000 SO 00 $700 $000 $000 $000 $000 so oo $000 TOTAL PERMIT FEES $2700 Total Fees $27 00 Total Payments To Date $0 00 Balance Due $2700 SECTION 1u "RED IN ACCORDANCE WITH U B,C SIGNATURE,2205 09/29,04 0002 01 <P CGP " 27 00 Inspector FINAL APPROVAL Date Clearance NOTICE Please take NOTICE that approval of your project includes the Imposition of fees dedications reservations or other exactions hereafter collectively 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 protest 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 fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired PERMIT APPLICATION i • CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 1 PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date Address (include Bldg/Suite it\Business Name (at this address) Legal Description - an I ot No Subdivision Name/Number Unit No Phase No Total # of units Assessor s Parcel tt Existing Use Proposed Use DescnptioH of Work SQ FT #of Stories # of Bedrooms # of Bathrooms City Owner ' Q Agent for Owner City State/Zip Telephone ttName 5 CONTRACTOR - COMPANY NAME , , , . „ •••' ' ,J. „',. •. ..-V 7 ; j , ''„. (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 e^iemptior^ Any violation of Section 7031 5 by any applicant for a permit subjectsJhe applicant to a cjvil penalty of not morejhan five h.und: Name State License ti Address License Class C'tV State/Zip City Business License # elephone # iich this permit \s 4/05. Designer Name Address City State/Zip Telephone State License tt 6 WORKERS COMPENSATION , " , ,? """ Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations |~] 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 ->SJ 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 msurajjce earlier and policy number are - _ '"•«=£ I/ *-•$ i Insurance Company i. V iCJLT'^—' a \ 8 JV^l Policy No J ./ vJO'vJ / \fc/"Vx^"l' Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [*100I OR LESS) |~| 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 secure workers compensntion coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100 000) injxWTtTonfw the cosvpfcompeffWfon damages as provided for in Section 3706 of th^TjaJ)^r cod* /nje/esj and attorney s fees SIGNATURE XV^^L^ /) . ^—-^S^fl^ DATE 7 OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor s^jdcense Law for the following 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 ona year of completion the owner buijder will have the burden of proving that he did not build or improve for the purpose of sale) fJ3 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 1 I personally plan to provide the major labor and materials for construction of the proposed property improvement l~l YES I~|NO 2 I (have / have not) signed an application for a building permit for the proposed work 3 1 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 NON RESIDENTIAL BUILDING PERMITS ONLY,, V • ' '" ' ;.' " 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 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? O YES (H NO Is the facility to be constructed within 1 000 feet; of the outer boundary of a school site? d YES QH 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 8 CONSTRUCTION LENDING AC.ENCY • 1 ... ' ' ' > ' ' ... • ' , 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 i LENDER S ADDRESS 9 APPLICANT CERTIFICATION ! ~~ j' """ " "' , _' .. ~ ,"' : ',''""''' 'L ., !" > ••• 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 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 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 commencedjj^irrl 80 days frijrn the c^gte^^such permit or if the building or work authorized by su«h permit is suspended or abandoned at any time after the work is commeni APPLICANT S SIGNATURE :orm Building Code) DATE WHITJXFile YELLOW Applicant PINK Finance COMPENSATION INSURANCE FUND flPRIL 7, £004 PO BOX 420807 SAN FRANCISCO CA 94142 0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE POLICY NUMBER 1732576 - CERTIFICATE EXPIRES 4-1-05 r CITY OF CflRLSBflD ftTTNs BUILDING DEPftRTMENT 1635 FflRftDftY AVE CflRLSBftD Cft 92008 JOB: ALL OPERflTIONS 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 30 This policy is not subject to cancellation by the Fund except upon $H days advance written notice to the employer 30 We will also give you "j^jN days' advance notice should this policy be cancelled prior to its normal expiration This certificate of insurance is not an 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 document with respect to which this certificate of insurance 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 A LI T H O R I Z E D R E S f. N TAT I V T PRESIDENT EMPLOYER'S LIfiBILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,080 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICftTE HOLDERS' NOTICE EFFECTIVE 04/07/04 IS flTTACHED TO ftND FORMS ft PART OF THIS POLICY. EMPLOYER R & j FOSTER, INC P 0 BOX 2758 EL CfiJON CO 92021 (REV 303) THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND