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Home My WebLink About2812 CHATSWORTH WAY; ; CB032086; Permit07-30-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB032086 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: References: Project Title: 2812 CHATSWORTH WY CBAD PLUM 1674801938 Lot#: 0 Construction Type: NEW ESPARZA RES-NEW WATER HEATER Status: ISSUED Applied: 07/29/2003 Entered By: CB Plan Approved: 07/29/2003 Issued: 07/29/2003 Inspect Area: Applicant: A&J FOSTER, INC. STEB 13706HWY8BUS EL CAJON CA 92021 619-390-4477 Owner: ESPARZA RAYMOND&DONNA FAMILY TRUST 09-28-95 2812 CHATSWORTH WAY CARLSBAD CA 92008 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 0 0 0 0 1 0 0 $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $27.00 Total Fees:$27.00 Total Payments To Date:$0.00 Balance Due:$27.00 PERMIT HAS- SECTION 10U.4 JEJ5& :DWICCQ. •JANCEWITHL.J.C, 0727 07/30/03 OQ02 01 02 \£^%^4A^K_Moa&cift Inspector: FINAL APPROVAL Date:Clearance: NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK HO.0$/SI3/M EST. VAL. Plan Ck. Deposit Validated By •/• Date ~7 / *> , ,atsworth way Address (include Bldg/Suite tt)Business Name (at this address) Legal Description Lot No.Subdivision Name/NumberSFR Unit No.Phase No.Total tt of units Assessor's Parcel tt167-480-19-38 Existing Use Proposed Use Description of Work Water Heater SQ. FT.#of Stories tt of Bedrooms # of Bathrooms Replacement CONTACT PERSONI (if different from applicant)• x, ' * ' ,'/-,» • ' „ ' v ", -,-'•Esparza, Ray 2812 Chatsworth way Carlsbad "CA." 92008 " ^60-720-2812 Name •3. APPLICANT' JO Contractor „„...Arlen Foster/Carol Foster Address City D Agent for Contractor --, O Owner -Q-A.gent for Owner -113706-B Hwy.8 Bus. El Ca'jon, State/Zip Telephone #Fax if "Ca. 92021 (619)390-4477 Name 4. PROPERTY OWNEREsparza, Ray Address City State/Zip 2812 Chatsworth Way Carlsbad Ca. 92008 Telephone tt 760-720-2812 Address City State/Zip Telephone ttName 5. CONTRACTOR - COMPANY NAME - '„ , ••-"", - ,',".;*,'- .... (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 [$5001). A & J Foster Pi nmhi ng 1 ^Vflfi-R H Name " Address State License tt 630120 License Class M\r ft RiiQ C-36 •R" r^-i^n ^A cn(pl (5iQ)3QQ-4477 City State/Zip ' telephone # City Business License # 1210836 Address City State/Zip Telephone NUA Designer Name State License # 6- WORKERS'COMPENSATION , '• ,"',., " ,' > • , J:~. Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Q t 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. S 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 issued. My worker's compensation insurance carrier and policy number are: Insurance Company Statt^ fr^mp TTIQ | Policy No. 4^7—01 0000713 Expiration Date Q4_Q]^_Q4 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS) Q CERTIFICATE OF EXEMPTION: 1 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 secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000)^p**kligon to the c^t of cQ^fsation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE J^^gjl&rtJ fl,—~ L/^^feS DATE / ^^/^-^ I hereby affirm that I am exempt from the Contractors License Law for the following reason: Q 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 the purpose of sale). Q 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 contractor(s) licensed pursuant to the Contractor's License Law). Q 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. l~l YES f~lNO 2. I (have / have not) 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 COMPLETE THIS SECTION FOH'/tfD/tf-fl£5/0BY7Mi.BUH.DlNG PERMITS ONLY > , , _ "'* 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? O YES LU NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? d YES QH NO Is the facility to be constructed within 1,000 feat 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. 8, CONSTRUCTION LENDING AGENCY - . ..'•''"".'" 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 NAME M r>]E! LENDER'S ADDRESS 9, APPLICANT CERTIFICATON "---",.'"-,' ""","','" -, -. >' - ,'."•-' - ' !I certify that I have read the application jand 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 CitV 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 commerjcecLjttitljin180 days frofn the dflajfeuch permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is cornmencgjWSFajg^W qjlfjfl^ays (Sectl^no^^Jaiiorm Building Code). APPLICANT'S SIGNATURE DATE 7/30 WHITJTFile YELLOW: Applicant PINK: Finance so POLICYHOLDER COPY CO M PE NS ATIO N INSURANCE FUND P.O. BOX 807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 04-01-2003 CONTRACTORS STATE LICENSE BOARD WORKERS COMPENSATION UNIT P 0 BOX 26000 SACRAMENTO CA 95826 SD GROUP: 000467 POLICY NUMBER: 0000713-2003 CERTIFICATE ID: 4 CERTIFICATE EXPIRES: 04-01-2004 04-O1-2003/04-01-2004 LICENSE NUMBER.- LICENSE #030120INCEPTION DATE: 04-01-2003 D.O.: SD This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon lo days' advance written notice to the employer. We will also give you 10 days' advance notice should this policy be cancelled prior to its .normal expiration. - This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the ' policies described herein is subject to alt the terms, exclusions and conditions of such policies. AUTHORIZED REPRESENTATIVE . ' , PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,OOO.OO PER OCCURRENCE. EMPLOYER LEGAL NAME A & J FOSTER, INC 13706 HWY 8 BUSINESS ST #B EL CAJON CA 92021 A & U FOSTER, INC PRINTED:03-17-2003