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Home My WebLink About2640 CAZADERO DR; ; CB031795; Permit07^2-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB031795 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 2640 CAZADERO DR CBAD PLUM 2153003301 Lot* Construction Type KHAZRA RES-NEW WATER HEATER 0 NEW Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 07/02/2003 RMA Applicant A&J FOSTER, INC STEB 13706HWY8BUS EL CAJONCA 92021 619-390-4477 Owner KHAZRA MOOJAN 4823 OCEAN VIEW BLVD LA CANADA FLT CA 91011 8750 07/02/03 0002 01 02 27. Plumbing Issue Fee Fixture or Trap y 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 $000 $000 $000 TOTAL PERMIT FEES $2700 Total Fees $2700 Total Payments To' Date '' '' * $0 00. Balance Due $27.00 PERMIT HAS EXPIRED IN ACCORDANCE WITH ILB& SECTION 106.4.4 SIGNATURED : ^ 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 tothis. or as to which the statute of limitations has previously otherwise expired PERMIT APPLICATION CITY Or* CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 1 "PROJECT INFORMATION^2640 Cazadero Dr. FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan^Ck Deposit Validated By Date Address (include Bldg/Suite f)Business Name (at this address) Legal Description Assessor's Parcel # 215-300-33-01 Description of Work Lot No Subdivision Name/NumberSFR Existing Use SQ FT ' #of Stories Unit No Phase No Proposed Use # of Bedrooms Total tt of units # of Bathrooms Water Heater Replacement 2 , CONTACT PERSON (if cjiffetan Khazra, Moo^an Name 3 APPLICANT "KTContraator Arlen Foster^Carol Name 4 PROPERTY, OWNER > Khazra. Moo^an t frormapplicantl " } J^r'" V «v 2640 Cazadero Dr. Address Q'AgenitffoT Contractor*' [D^OwSeF' Foster 13706-B Hwy.8 Address 2640 Cazadero Dr """Carisfead^""1'^ City Bus. El Cajon, City Carlsbad Ca SV" f 2ttJ9 * State/Zip Ca." 92021' State/Zip '."' 92009 rt26-43f-9338 ' ' Telephone # Fax # (619)390-4477 Telephone # 626-437-9338 Address City State/Zip Telephone #Name 5 .CONTRACTOR - COMPANY, (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 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 [35001) a K. .T T^Q+«ar piTrmh-mrr 1, 37G6-B Hwy, 8 Bus. El Caion CA. Q?n?i (fii Q) 300-4477 Name State License #630120. Address License Class C-36 3ty State/Zip Telephone # City Business License # _121.0.8 36 Designer Name State License # 6 Address City State/Zip Telephone Workers' Compensation Declaration I hereby affirm 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 as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued •Q 1 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 policy NO Afi7_m nnnmi Expiration Date — fll — issued My worker's compensation insurance carrier and policy number are Insurance Company g-^-Sj. COlTlp. IllS . __ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 15100] OR LESS) D 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 secuj»-*'orkws' compensatio^o»rfrage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($10j>tf6o)^g^RlditjpnJ|^ffiQ cost op&mQejgaJion, damages as provided for m Section 3706 of the La$>or cqde, interest and attorney's fees DATE the Labor code, intere "7/2.70^SIGNATURE 7 . OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Confractor's License Law for the following reason CD 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 one year of completion, the owner-builder will have the burden of proving that he did not build or improve for tha purpose of sale) d 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 contractors} licensed pursuant to the Contractor's License Law) CJ 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 O YES QNO 2 3 I personally plan to provide the major labor and materials for construction of the proposed property improvement O I (have / have not) signed an application for a building permit for the proposed work 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 1 have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work) ,_.-,.,,-.-,.-, .-^-_m, PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION f^NON-RESIDENTlAL 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 Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES CH NO Is the facility to be constructed within 1 ,000 feet of the outer boundary of a 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 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 ADDRESSLENDER S NAME 9, . APPLICANT Cl I certify that I have read thfl application and state that the above information is correct and that the Information on the ptans is accurate I agree to comply with alt 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 AMY 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 permil is not commencerjwithm 180 days from the datMjf such permit or if the building or work authonzed by such permit is suspended or abandoned at any time after the work Is commencpertor gi^iod^of 1jjp*fays (SegjSn KN^* 4 Uniform Building Code) APPLICANT'S SIGNATURE DATE . _ / / / File YELLOW Applicant PINK Finance SD POLICYHOLDER COPY ^^^^/v*nus O IA\| E PO BOX 807, SAN FRANC!SCO,CA 94142-0807 COMPENSATION -, < <- , INSURANCE FUND CERTIFICATE OF WORKERS''COMPENSATION INSURANCE ISSUE'DATE 04-01-2003 •- , - ,GROUP ^> -, > 000457:" * • " , ' POLICY^ NUMBER , i*/ 0000713-2003 ? , ; - -, . " v -CERTIFICATE JD' X"-4 ' , v t " ''*,'."..,-- "- '" , r - CERTIFICATE EXPIRES" 04-01-2004 " ; '- ,,' 1 * * ' \ v , ' fv% ' ' f "' ;' 04-Q172003/0'4-01-2004 ' ' C6NTRACTORS STATE LICENSE BOARD «, SD ' ' / * *-* LICENSE NUMBER ^LICENSE #630120 ^ - f WORKERS ^-COMPENSATION, UN IJ-;*' lS ^ ««<"V ' - ^ ' INCEPTION DATE 04-01-2063 - SACRAMENTO: CA',95826* ^f'V^;*^"^'*''**' /V ^ ,-c ' This is to "certify" that1'we have'issued a valid vWqrkers'r Compensation insurance policy in^a'f6rm~approved by'the f C •* , California Jnsurance Commissioner tb^the^ employerjhamed bejqw for the (Sol icy, period indicated ^.P"""- £• - 'JiA ,<r ~ - N " ,""-tThis policy is ,not'subject to cancellation by^the Fund except upon* 10 day's1, advance (written notice "to Jne"*employer- " , ', V f * We will also5 give you \Q days' advance-notice "should this'policy be^cancelled prior to rts^norrhal''expiration i I , "• ,,- ' s ^This ceFtificate^of, insurance is'not'an insurance'policy r ancLdpes not ame^dr ex tenet or'alter" the coverage ^af forded" • /' „, -by ,the policies listed herein Notwithstanding'any requirement'^,terni xor conditiort of any cpntract-,or^6ther ^document >'<• v' ^ '~-> ^' with respect to which this "certificate of'insurance mayr be' issued or may pertain, the "-insurance afforded by, the • ' *'"- " ! - policies described herein is subject-to alf the/ter*ns, excfusibns.'and conditions^of such',"-1'-"—* ""* ^ c -' • ,'Si^i.V *-''^" ,-v:T v f'= ^U'1 * ^^-^ ^^, v^-,"^r^' ', l >-Vi^ l>?.' 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