HomeMy WebLinkAbout2322 LA COSTA AVE; A; CB970144; PermitI ~ .. r •
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FINAL APPROVAL
INSP. d?z>;C!?IJATE ;z · 2--i · fl
CLEARANCE ____ _
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
-
FOR OFFICE USE ONLY
PERMIT APPLICATION PLAN CHECK NO. q]D I V'-j
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(619) 438-1161
EST. VAL. _________ _
Plan Ck. Deposit ____ ...,.. ___ _
Validated !y •r M:
Date I/. 1 'J,.,f 7
Address (include Bldg/Suite II Business Nama (at thia address)
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total I of units SFR
Assessor's Parcel I Existing Use Proposed Use
Description of Work SO. FT. lot Stories I of Bedrooms I of Bathrooms
WATER HFATER REPLACEMENT
"'-'"'~·-c· ONTACT PERS-ON 11' ctlfJereni ,;,;;.,ep11,li~tf~ •~~t ~'I\', '"'l"l"l~"1/it''·"·''· i~~~~L•J.\;_~.,:.m:,'•i ....... ,, Staunton~ B:i.11 ., .... LjL:,('ta o'st:i AVI='."'" 'tt.ti''CARrnB
Name Address City Telephone I Fax #
~~1:~~~~~~~7~t;?ro~~~'l"-'3r~~~~Y{~,A~~~~""q~(f
Name Address City
~,~fo~iwNt
Staunton, Bill ,. ~322 La c~~~' Ave. 0t~AJJ
Name Address City
~c_o~c:r:oe ~couwmwiiPffl:'IPl5Wtlrill&1
,,~ '.f90-4•,f=l-7
State/Zip Telephone I
CA . "LUU~
State/Zip Telephone I .,, ,t•
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, Improve, d•molish or repair any structure, prior to its
issuance, also requires tha applicant for such permit to file e 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 tha applicant to a civiLe!nalty of n.9.t more 1?J~~!_ hundr~<g'ijliafJ15J>OH,
A & J FOsrER PUJMBING 13706-B HWY 8 BUS. EL CAJUN CA. -
Name Address City State/Zip 12003'!:l'.!fPhone I
630120 C-36 State License I __________ License Class__________ City Buaineaa License I _______ _
Oesigner Name Address City State/Zip Telephone
State License # __ N"--'-/.C.A"-------
tt::;i;,WO.RXERS: COMPENSATIO~,:.W:!"..:' ~J:,......_. ,t'"'" .. :°:J!,,, • .rJ.~ ,,,,..,_';i;Tj
Workers' Compensation Declaration: I hereby effirm under penalty of perjury one of the following declarations:
0 I have end 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 p•rmit is Issued.
:fl I have and will maintain workera' compensation, ■a requlr•d by Section 3700 of the Labor Cod•, for the performance of the work for which this permit la
Issued. My worker's compensation insurance carrier and policy number ar•: N2 00?-S6-51
Insurance Company FARMER INSURANCE Policy No. -------------5-1-97 Expiration Date _______ _
1 TH IS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1•1001 OR LESS)
0 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• Compenution Laws of California.
WARNING: Fallur• to aecure•work•ra' compensation coverage 11 unlawful, and shall aubJ•ct an employ•r to criminal penaltlea and dvll fines up to one hundr•d
thousand dollars ($100,000), In eddltlon to the coat of compenaetlon, dameges II provided for In S•ctlon 3706 of the~ cod•. lntarest and attorney's f•es.
SIGNATURE _______________________ -'-------DATE
1, OWNER-BUILDER DECLARATION ···, '!'· ·,.··f.;;,.: :1:. '._.,.f'·E.':'.~l i.,,~•-·" .. "f.'f:c.~:li•, ~-.. ·-... --,s:
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
0 I, as owner of the property or my employees with wages es their sole compensation, will do the work end the atructure Is not intended or offered for sale
(Sec. 7044, Business and Professions Coda: The Contractor's License Law does not epply 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 Hie. If, however. the bull ding or improvement is
sold within one year of completion, the owner-buUder will have the burden of proving that h• did not build or Improve for the purpoH of 11le).
0 I, as owner of the property, am exclusively contracting with licensed contractors to con1trucf the proJ•ct (Sec. 7044, Bualneaa and Professions Code: The
Contractor's Uc•nae Lew does not apply to an owner of prop•rty who build• or Improves ther•on, and contracts for such proj•ct• with contractor(a) licensed
pursuant to the Contractor's Ucenae Law). ·
0 I am exempt under Section ______ Business and Professions Code for this re11on:
1. I personally plan to provide the major labor and materials for construction of the propoHd property lmprov•ment. 0 YES ONO
2. I (have / have notl 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 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 _________ _
~~.:nt!S -SECTJOfi...FQR NO~~t!,!UJi!N.G ~IJ..LP~i.iui~ ' l!~ ~~!.:.:.2Ji:ii~:~;.:. ?;?.~
la the applicant or future building occupant required to submit a busineas plan, acutely hazardoua materials registration form or risk management and prevention
program under Sections 25505, 25533 or 25534 of the Presley-T1Mer Hazardous Substanc• Account Act7 0 YES O NO
Is the applicant or future building occupant requir•d to obtain a permit from the air pollution control district or air quality managemant district 7 0 YES O NO
Is the facility to be constructed within 1,000 fHt of the outer boundary of a school site? 0 YES O 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.
&{,''.,CONSTRUCTION LENDING AGENCY ' ''a.T' W, ,._ ' ?.l;t"", · . \i..itt· " · ~-;;:~· ,...1 ,.
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit 11 i11ued (Sec. 3097(i) Civil Codel.
LENDER'S NAME ______________ _
9; ' APPUCANT CERTIFICATION
:E~OER'S AOORESS:::;--:--::,;::;;;;;;;:-;:-:_;:;;;;,;;;;::::;:;:;;;,;::;:;:;,;:::;:;;:c:::;:;;;:;:--.:;'!.:-~:;:.,.-:.------
' .
I certify that I have reed 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 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 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 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 aher th work is commenced for a period of 1 BO days (Section 106.4.4 Uniform Building Code).
YELLOW: Applicant PINK: Finance
,·
PERMIT# CB970144
DESCRIPTION: WATER HEATER
TYPE: PLUM
CITY OF CARLSBAD
INSPECTION REQUEST
FOR 02/21/97
REPLACEMENT
STE:
INSPECTOR AREA
PLANCK# CB970144
OCC GRP
CONSTR. TYPE NEW
LOT: JOB ADDRESS: 2322 LA COSTA AV
APPLICANT: BILL STAUNTON
CONTRACTOR:
PHONE: 619 944-0814
OWNER:
REMARKS: MW/STOMPTON/944-0814
SPECIAL INSTRUCT:
TOTAL TIME:
CD
25
LVL DESCRIPTION
PL Water Heater/Vents
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PHONE:
PHONE:
INSPECTOR _:p...,._ ________ _
ACT CO~ENTS
.p{l£vJt---
***** INSPECTION HISTORY*****
DATE DESCRIPTION ACT INSP COMMENTS