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Home My WebLink About2409 JACARANDA AVE; ; CB020115; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 01-10-2002 Plumbing Permit Permit No:CB020115 Job Address: Permit Type: Parcel No: Reference #: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 2409 JACARANDA AV CBAD PLUM 2550703100 Lot #: 0 Construction Type: NEW BROCK RESIDENCE WATER HEATER REPLACEMENT Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 01/10/2002 MDP 01/10/2002 01/10/2002 A&J FOSTER, INC. STEB BROCK KARIN S TRUST 05-03-99 13706 HWY 8 BUS EL CAJON CA 92021 619-390-4477 Total Fees: $27.00 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Drain Install/Repair Water Line Water Heater and/or Vent Gas Piping System Vacuum Breaker Other Plumbing Fees Master Drainage Fee Sewer Fee Additional Fees TOTAL PERMIT FEES Inspector: 2409 JACARANDA AVE CARLSBAD CA 92009 Total Payments To Date: $0.00 0 0 0 0 1 0 0 FINAL APPROVAL Balance Due: $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 Date: l,hsfa ? Clearance: $27.00 NOTICE: Please take NOTICE that approval of your project includes the ulmpos!tion" 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 wtth 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 capactiy 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 vou have oreviouslv been aiven a NOTICE similar to this or as to which the statute of timitations has oreviouslv otherwise ev"ired. FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. (92__" \ l .S--- CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. __________ _ Plan Ck. Deposit ________ _ Validated By __________ _ Date _______________ _ •1 . ..-PROJECT INFORMATION 2409 Jacaranda Ave. Address (include Bldg/Suite #I Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units SFR Assessor's Parcel # Existing Use Proposed Use 255 070-31-00 Description of Work SO. FT. #of Stories # of Bedrooms # of Bathrooms Water Heater ReP.laceme nt ,2. CONTACT PERSON (If different from applicant) , , .. Brock Karin 2 409 Jacaranda Ave. 11-1..~ ~ Carlsbad Name Address City APPLICA.Nl\ }{ G] Cantraoto~ "E]]°Agent for Contractor ·•□ Owner ·, 0 Agent for Owner Arlen Foster/Carol Foster 13706-B H wy.8 Bus . El Cajon, Name Address City 4. PROPERTY OWNER Brock Karin Name ' 2409 Jacaranda Ave. Carlsbad Address City 6:' CONTRAC'(OR.~'COMPANYJfiAME • , I, l • ' CA . l , 92009 760-753-2059 Ca. State/Zip Ca. 92021 State/Zip I ' 92009 State/Zip V Telephone # ( 619,) 390-44 77 Telephone # 760-753-205 9 Telephone # Fax II (Sec. 7031 .6 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior 10 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 Coda) 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 then five hundred dollars 1$50011. 619 390-4477 eme City State/Zip Telephone # State License # ..._6,._3_..Q......,_] .,_2...,Q,__ ____ _ City Business License # 1 210836 Designer Name State License # --N,._,/...,A1-1.~------ ,6: W'oRKERSI COMPENSATION Address City Workers' Compensation Declaration: I hereby atrirm under penalty of perjury one of the following declarations: State/Zip Telephone 0 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. ,,0 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 ,;;sued. My worker's compensation Insurance carrier end policy number are: Insurance Company State Comp Tns Policy Nc467-0l 000071 3 Expiration Date 04-01-02 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESSI 0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit Is issued, I shell not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall 1ubject an employer to criminal penalties and clvll fines up to one hundred thousand dollara ($100,000), In addition to the cost of compensation, damages as provided for In Section 3706 of tha Labor code, Interest end attorney's feos. SIGNATURE_______________________________ DATE -----._-"--,.;-c;-·~--,;--j ,. owf.Jilii:iiOJ[rfei'i DECirARATION ' ' iii>' ,. 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 as their sole compensation, will do the work end the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to en owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements ere 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 salel. 0 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 Lew does not apply to an owner of property who builds or Improves thereon, and contracts for such projects with contrector(sl licensed pursuant to the Contractor's License Law). 0 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. 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 numberl: 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): ______________________________________________ _ 6. 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 (COMfLEIE'Tf!!S secj lo FOil l',-;;.O~f',..:R::ig:;;5::,0::EN=nA::i.:--,B~\J:-JL:-:D::::IN:i;,G;::l!;:,E~Ri=:M~IT;;;S;;,OITN;::L ,,.;.;;;;;:;;;;;:.;;;;..---;;;;-:;---~ Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management end prevention program under Sections 25605, 25633 or 26534 of the Presley-Tanner Hazardous Substance Account Act? 0 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 7 0 YES O NO Is the facility to be constructed within 1,000 feet 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. 8 ,CONSTRlJCTio;m:E,NOtNG GE~ ,, lP · ,i , I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is Issued (Sec. 3097(11 Civil Codel. LENDER'S NAME t-X)NE 9, ~cA~il'ceiJ11i'ic,rrlo • .;.../. ,l: ·:lllol, ' •-, ~ 1 , , t · 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 ell City ordinances and State laws relating to building construction. I hereby authorize representatives of the Cit\t 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 6'0" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit Issued by the building Ofliclal under the provisions of lhls Code shall expire by llmilallon and become null and void if lhe building or work authorized by such permll ls not commenced wllhln 180 days from lhe dale of such permil or II lhe building or work authorized by such permll is suspended or abandoned al any lime afler the work Is commenced for a period of 180 days (Seclion 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE --------------- WHITE: Filo YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 01/15/2002 Permit# CB020115 Title: BROCK RESIDENCE Description: WATER HEATER REPLACEMENT Type:PLUM Sub Type: Job Address: 2409 JACARANDA AV Suite: Lot 0 Location: APPLICANT A&J FOSTER, INC. Owner: BROCK KARIN S TRUST 05-03-99 Remarks: AFTER 1 :00 PM 1111 Total Time: Inspector Assignment: Phone: 7607532059 Inspector: Requested By: KAREN BROCK CD 25 Description ~ Rmments Water HeaterNents /v ___ +--..,,,,_::::.....,,-1-ir:J1-~.----:r-------- Associama PCR, f---1:--_._--~.-£------------ lnspection History Date Description Act lnsp Comments