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Home My WebLink About2388 ALTISMA WAY; B; CB951203; PermitBUILDING PERMIT Permit No: CB951203 09/06/95 11:26 Project No: A9501787 Page 1 of 1 Permit Type: PLUMBING 3527 0?/06/?5 0001 01 02 Parcel No: 215-240-18-01 Lot#: C-FWT Valuation: 0 Construction Type: NEW Occupancy Group: Reference#: Status: ISSUED Description: REPLACE WATER HEATER Applied: 09/05/95 : A & J FOSTER INC Apr/Issue: 09/06/95 ~ ~. Development No: I Job Address: 2388 ALTISMA WY Suite: B 27.00 Entered By: RMA Appl/Ownr : KROTT, ELAINE 619-431-9464 . Credits *** .oo .oo 27.00 Ext fee Data 20.00 Y 27.00 7.00 CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATlON City of Carlsbad Buildinn Departrnt 2075 Las Pal88 Dr., Carlsbad, CA PZOOP (619) 438-1161 E From List 1 (see back) give code of Permit-Type: ______.______.______"...".----------------.."--------- For Residential Proiects Only: From Ijst 2 (See back) & Code of Structure-Type: <m Net WGain of Dwelling Units I 2 PRQlEcFINFORMAnoN FOR OFFICE USE ONLY AddresS Nearest Cross Street 2388 Altisma Way #B Bulldrng or Sulte NO. ON Lot No. Subdivision NamdNumkr Unit No. Phase No. 0 2 Energy Cab 0 2 Structural Cab 0 2 Sails Report 0 1 Addressed Envelope "SPbG USE PROPQSED USE DESC~FWJNOFWOM Water Heater Replacemnt 40 Gallon SQ. FT. # OF STORIES # OF BEDROOMS # OF BATHROOMS NAME (last name first) Kj-ott, Elaine CITY A (11 onerent trom appllcantl ADDRESS 2388 Altisma Way #B -y WVallev STATE ZIPCODE 91977 DAY TELEPHONE497-4151 NAME (last name first) Elaine -0tt ADDRESS 2388 Altism Way #B STATE ZIPCODE 930"~ DAY TELEPHONE A?, -9pc;p , -. NAME (last name first) A & J Foster, InC. ADDRtSS 2819 Central Ave. CITY spring valley STATE CA ZIPCODE 91977 DAYTELEPHONE 697-4151 STATE LIC. #- LICENSE CLASS 0 ?c CITY BUSINESS LIC. X -E [last name nntJ CITY STATE - ZIPCODE - DAY TELEPHONE - STATE LIC. # - rm Workers' Compensatmn Lleclaratlon: 1 hereby attlrm that I have a certltxate ok consent to selt-msure Issued by the Olrector Ot Industmi 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 ceruhcate 01 Exemption: It 1s issued, 1 Shall not employ Xnnp person any manner so as to become subject to EXPIRATTONDATE q 7 96 SIGNATURE DATE U-N wner-Buuaer wlarauon: I nereDy attmn mat I am exempt trom me Contractors ucense law for tne tollowrng reason: 0 1, 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 dm not apply to an owner of property who builds or improves thereon, and who dm 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 haw the burden 0 I, as owner of the property, am exclusivelycontractingwith licensed contractors to construct the project (Sec. 7044, Business and Professions of proving that he did not build or improw for the purpose of sale.). Code: The Contractor's License law dm 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). 0 I am exempt under Section Business and Professions Code for this reason: any smeture, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish, or repair 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 aiieged 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 [$5001). SlGNAlllRE MTB Is the applicant or future building occupant require3 to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presiey-Tanner Hazardous Substance Account Act? Is the applicant or future building occupant required to obtain a permit fmm the air pollution control district or air quality management district? Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? IFANYOFTHEANSWERSAREYE$A~~~~~~OFOOCUPAN~MAYNOTBE~APIWJULYl.l989~THE~~ HAS MET OR IS "DIG 'IHE RIQm OF THE OFFICE OF EMERGENCf SERVICES AND THE AIR FQLWTION CONTROL DN'IUCT. YES 0 NO nm 0 NO om 0 NO that tnere IS a con~tructzon lendlng agency tor the perlormance 01 the work tor wntch thls permit IS ~ssued (SeC 3UY7(lJ Clnl Wel. LENDER'S NAME LENDER'S ADDRESS relating to building construction, I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection 1 eertlty that 1 haw read the appllcatlon and State that the above lntormatmn IS correct. I agree to comply wlth all Uty ordtnances and State lam purposes. IAlsoAG~TOSAVE~~ANDI(EFP~THE~OFCARISBADACAINSI'AU.IIAB~JUDG~OOSIS ANDEXPWSFSWHIMMAYINANYWAY~~ACAIN~SAID~INCONSEQUEN&OFTHEGRAN?WGOF~~. OSHA: An OSHA permit is required for excavations over 5'0" deep and demolition or construction of StNCNreS 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 from the date of such permit or if the building or work authorized by such permit is suspended or aban ed for a period of 180 darj (Section 303(d) Uniform Buil g Code APPLICANTS SIGNATURE DATE: &L -.& WHITE File YELLOW: Applicant PINK: Finance r3 City - " of Carlsbad 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 lor the performance of the work for which this permit is issued. A. workers' compensation as provided by section 3700 of the Labor Code, ~OI I have and will maintain workers' compensation, as required by section 3700 issued. My workers' compensation insurance carrier and policy nur~~bcr are: ea 8. of the Labor Code, for the performance of the work for which this permit is INSURANCE COMPANY POLICY NO. EXPIRATION DATE: i' '/$. 2L( -14 j@ttdt/rrta* '& qY$2585- """""_ IC, """""""""""" A """"""""""""""" """""""---"-------"--"--"-- ,5: / - 92L. ITHIS SECTION NEED NOT ~~COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) 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 C. workers Compensation laws of California. Warning: Failure to secure workers' compensation coverage is unlawful, and shall be subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000). in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, Interest and attorney's fees. March 3, 1995