HomeMy WebLinkAbout2802 JACARANDA AVE; ; CB960614; Permit~-if 1{1 l I
_/96 18:47
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B U I L D I N G
1Job Address: 2802 JACARANDA AV
Permit Type: PLUMBING
P E R M I T
Suite:
LcJt#:
Pe.rmit No: CB9606 .. 4
Project No: A960nar,B
Development No:
6852 04/03/96 v')Ol 01 t ~·
C Pr~T Construction Type: N~W :: -0
Parcel No: 255-103-14-00
Valuation: 0
Oc.:cupancy G.roup: Referenre#: StattlS: ISSUED
Applied: 04/02/q6
Apr/Issue: 04/02/96
Entered By: RMA
t,19-436-8849
Descr1pt1on: REPLACE WTER HEA1ER
Appl/Ownr : DILWORTH, GARY
2802 JACARANDA AV
CAARLSBAD CA N 92009
*** Fees Required
Fees:
Adjustments:
Total Fees:
Fee description
Enter "Y" for Plumb1
Each Water Heater an * PLUMBING TOTAL
***
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
.00
.oo
27.00
***
Ext fee Data
20.JO Y
7 .00
27.00
Pl!RMIT APPIJCATION PLAN CHECK NO.
City of C.rlst.l luilding D-rt-,t
207'5 Ln P■l-Dr., C.rl-, CA 92009 (619) 4311-1161 EST.VAL.==--=-------
I. Prmrr I YPH PI.AN CK D
VAUD. BY_....t.:.~--~..--.--
DATE Frum Usr I (see back) give code-of Pennil-Type: ___________ _
For Residential Projects Only: From Ust 2 (see back) give
Code or S1ructure-Type: ________ ...:,J,:,b:._ _________ _
Net Loss/Gain of Dwelling Units
2. PRUIECT INFORMATION FOR OPPICE USE ONLY
Address 2802 Jacaranda Ave. 8u1iding or Su1le No.
Nearest Cros.1 Street L Ji' r.5 lrfcOS c·r ~utXJlvas1on Name/Number ' • LEGAL DtscRJM ION 0mt No. Phase No.
CHE'.CK Bf.WW 1¥ SUBMii llb: □ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ I Addressed ~nvelope
ASSF.SSOB'S PABCJ;I. EXJSDNG USE PBOPPSED USE
DESCRJPTION OF WORK water Heater Replacement 50 Gallon
SQ. FT. II OF SIDRIES II OF BEDROOMS II OF BATilH0OMS
3. WN IALi PERSON (U diiierenl from apphcani)
NAME (last name first) Dilworth, Gary ADDRESS 2802 Jacaranda Ave
CITY _ _[' rl hrln STATE CA ZIP CODE 92009 DAY TELEPHONE 436-8849 ◄. APPUCAN"f ucoNIRAClUR 9tG£m0RWNIRACI0R DOWNER DAGEN I FOR OWNER
NAME (last name first) carol Foster ADDRESS 13706 Highway 8 Business, Suite B
STATE CA ZIP CODE 92021 DAY TEJ.EPHONE 390-44 77
S. PROPER Ii OW rut
NAME (last name first) Dilworth, Gary
STATE CA
ADDRESS 2802 Jacaranda Ave
CITY ,Jee~ sbad ZIP CODE
6. WNik
9200~ DAY TEI.EPHONE 436-8849
A & J Foster, Inc. 13706 Highway 8 Business, Suite B NAME (last name first) ADDRESS
CITY El cajon STATE CA ZIP CODE DAY TELEPHONE 91977
C-36
390-4477
STATE UC. II
D£SIGN£1t NAME (last name Urst)
fi10l 20 LICENSE CLASS
ADDRESS
CITY BUSINESS UC. II 1200354
•..
CITY STATE ZIP CODE DAY TELEPHONE STATE UC. II
7. WOIOOJtS' OOMPENSA I ION
Workers' Compensation Declarauon: I hereby alimn that I have a cert1l1cale ol consent toself-1nsure issued by lhe Director ol inJustnai
Relations, or a certificate of Worken' Compensation Insurance by an admilled insurer, or an exact copy or duplicate thereof certified
by the Director of the insurer thereof filed with the Building Inspection Depa~ent (Section 3800, Lab. C).
5-1-96
rt1 1cate o xempllon: certJ at m l e pe onnance o l e wor or w nol emp oy any person m any manner
so as to become subject to the Worken' C.Ompensation Laws of California.
8_sg,;~~-~~~j~ DATE /.j /0/tJv ,
□
□
□
Owner-Builder DeclaraUon: I hereby alhnn ffiat I am exempt irom the Corifradofs Ucense Law Jor lhe loilowmg reason:
J, as owner of the property or my employees with wages as their sole compensation, wlll do the work and the sft'Ucture Is not inlended or
orrered for sale (Sec. 7044, Business and Professions Code: The Contractor's Ucense 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 orrered 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 sale.).
I, as owner or lht property, am exclusively contracllng with licensed contractors to construc1 the project (Sec. 7044, Business and Professions
Code: The C.Ontractor's Ucense Law does not apply to an owner or property who builds or Improves thereon, and contracts for such projects
with contractor(s) licensed pursuant to the Contractor's Ucense Law).
I am exempt under Section _______ Business and Professions Code for this reason:
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct. alter, improYet demolish, or repair
any structure. prior to its issuance, also requires the applicant for such pennit to file a signed statement that he is licensed pursuant to the
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 alleged exemption. Any violation of Section 7031.5 by any applicant for a pennit
subjects !he applicant to a civil penalty of not more lhan five hundred dollan [SS001).
SIGNA11JRE OATH
CoMPLEIE IRIS St'.ClloN FOR NON-RESlbE.N ttAL B0lWlNG PE:RMlt'S ONL'l:
Is the applicanl or future building occupanl required to submit a business plan, acutely hazardous materials registration fonn or risk management and
prevenlion program under Sections 25505, 25533 or 25534 of the Presley.Tanner Ha1.ardous Substance Account Act?
□ YES □ NO
Is the applicant or fiuure building occupant required to obtain a pennit from 1he air pollution control district or air quality management disllict?
□YES □NO Is the facilicy 10 be constructed within 1,000 feet or the outer boundary of a school site?
□ YES □ NO IF ANYOf Till!ANSWERS ARE YES, AflNALCER11flCATHOf oa:tlPANCY MAYNar BE ISSUED AFil!IUULY I, 1989 UNLESS TIIE APPUCANT
HAS MET OR IS MEIITING nm Rl!QlllREMENTS OF TIii! Ol'l'ICI! Of EMERGENCY SERVICES AND TIIE AIR POIJ.ITJlON OONTROL DISllllCT.
9. WNSIROCIIUN umomc XCENCJ
I hereby alunn that there II a construction lending agency lor the perionnance of the work lor which tills penmt 1s assued (Sec 3097 (1) C1VJI Code).
LENDER'S NAME ·None LENDER'S ADDRESS
Id. APPUCXNI Ulti1FICXIION
I cemfy ihat I have read the application and state ffiat the above 1nlonnaUon II correct. l agree lo comply with aH City ordinances and State laws
relaling to building construction. I hereby authorize representatives or the City of Carlsbad to enter upon the above memioned property for inspection
purposes. I Al.'iO JIGREE TO SAVE INDEMNll'Y AND KEEP IIARMI.FSS Tim crlY Of CARlSBAD JIGAINST AU. IJABILITIES, JUDGMENTS, CDSl'S
AND EXPENSES WJDOI MAY IN ANY WAY Aall.UE AGAINST SAID crlY IN OONSl!QIIENCE Of TIIE GRANTING Of 11IIS PERMIT.
OSIIA: An OSHA pennit is required for excavations over S'O" deep a·nd demolition or construction of structures over 3 stories in height.
Expiration. Every permit issued by the Building Official under the f,rovislons of this Code shall expire by limitation and become null and void if the
building or work authorized by such pe'rmit Is not commenced with n 365 days from the date of such pennit or Ir the building or work authorized by
such pennit is suspended or abandoned at any time after !he work is commenced for a period of 180 days (Section 3 J(d) Unifonn Building axle).
APPLICANTS SIGNATURE ~l_cLuw t./-:0 1& DATE: __ _
T';. "'T'T f ()~H ~ ,-,· , ,, , PnH' 1·:
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