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Home My WebLink About2840 HILLSBORO CT; ; CB043566; PermitJ N::;'#'r City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 09-14-2004 Plumbing Permit Permit No: CB043566 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 2840 HILLSBORO CT CBAD PLUM 167 4 727500 Lot #: 0 Construction Type: NEW Status: Applied: Entered By: Reference #: Plan Approved: Project Title: HUMPHREY RES-REPLACE WATER HEATER Applicant: A&J FOSTER, INC. STE B 13706 HWY 8 BUS EL CAJON CA 92021 619-390-4477 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 0 0 0 0 1 0 0 Owner: HUMPHREY MONICA 2840 HILLSBORO CT CARLSBAD CA 92008 Issued: Inspect Area: ISSUED 09/14/2004 KMT 09/14/2004 09/14/2004 $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 Total Fees: $27.00 Total Payments To Date: $0.00 Balance Due: r --: ,..,..... ... _......,~_ --.. ·,, -.. · .. :·~•·"•·,-~\. '""J'I . . . . . ,1 :<; r; .j • -. '· • e ' ' ' $27.00 .-. . •· -, Ii. :.ib i.l., k . .,;., .-~ ~ \t1 ! d 1271 09 /15/04 0002 01 Inspector: PER· ::n :c ,. . ''l1ED IN ACCORDANCE WITH U.B.C CGP SECTIOiJ I uv.'f.4 SIGN.AJliRE. -~~--- 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. 02 PERMIT APPLICA Ti ON CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLY -/ PLAN CHECK NO. O c...("!,_s-b-6 EST. VAL. __________ _ Plan Ck. Deposit ________ _ Validated By __________ _ Date ______________ _ Address (include Bldg/Suite II) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number l lo7 -L\, 1, -75 ~ ()0 Unit No. Phase No. Total # of units As;sor•s Parcel # :::;, \:: *istin\ec Descri~)gc ,t LAX. e.,c ~-FT. #of Stories Proposed Use # of Bedrooms # of Bathrooms Designer Name Address City State/Zip Telephone State License # __________ _ !61:1~1·~Wij.f.lJ'itB·sni~nM:e.Er{tsAit1A,6t'1j~;ri~~l~JI1~,ii!:1~::~~~~~~~J,~•~~~~1ittj~,~~~t:tt~.mrlt~~J~~--~~~:i~~~l'~1t~t~mtit:~h~:t:~jµ,5~1,i1~;ti1)t~~;·~r;~~~~t~~:j1l:1 Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 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 ~~e work for which this permit is issued. ~ I have and will maintain workers' compensation, es· required by Section 3700 of the Labor Code, for the performance of the work for which this permit 1s ,ssued. My worker's gi ~ens_ tion insura e carrier a policy number are: . -1 ~ ~7(o-f'')U . _ 4·11'~ Insurance Company ..,._.L..._,,_.,,,._,~"""'----'L-.... 1--"'-"':e..11--------Policy No. j . / .,,;_o J _ '-" -l Exp1rat1on Date-L V....) (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100] OR LESS) -' 0 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 secure workers' pensotlon co erage u fut. and shall subject an employer to criminal penalties and civil fines up to one hundred i;:7~:~~0;W;N,;E;:::::,:;.:::~:::~~::jo;~,t~R~~:):!];~;:~:;mi~~:~~[,i;:[:::;~.:;::;:~;j;i:~:,ri~:t1:{Z;t,:,Jie1.,:::~.~.r,,::::::lli~::1t;·,,:,:::;,;,~i.f!J•,• .· .• ·~,.,.,,..;,,., ,,_, , .... ,.,1, r , ••.•• ,., ,l..,,IM~." , .•. , ,";;,,•, ,, ::.,·:i'r!':iil!!'" ,,. ,;It. :i,Hi!,,,.,~ --•~. :tr.,-.. 1 •,,o;,~lla<L•~-i;;;;..,. ;;;;i; __ ,w,.,,""""'·ll •• """'"'"''"'Ir,!;;''"'' .i,i!l, ___ ,_, -= :.a ... ,~o;~m, • .=~!ilt-:n:,:,~J·iit: '""il'l:orl!ll,:r.i:11r~11~11llii:ll!~i!!.11ii,.. ·,~i1<•l,, -~-,:-.• -~ J!·b:'n 1 ,. U•~"'f:-f-, •.• i'l,.~,w. lij I hereby affirm that I am exempt from the Contractor's Li nse 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 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 en 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). 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 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). 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 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 __________ _ icoMJj(e~,i:~iI[Al$i:~~¢/t)('$r:,JfiQB[m'{iMBE.$.i~i&!t.14i,jifj;iijmJRGiP.llliMIJT!§~~l[~yffi',~~~~~Jl;.i~~W]:~~~~~~~~~,~~!l'~~~i~u~9.,fi,I1i~i~;7~11jj\1(~~~T.~~~~1lt.,1l~~~ Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk managem·ent and prevention program under Sections 25505, 25533 or 25534 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? 0 YES O NO Is the facility to be constructed within 1,000 feet of tha 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'?1\[~'.0,~~~:6~,t~Ui.Q~~~~eN~)[qf~~,¢~itC,jtf.{~t~~~,nir~~t~~~t[~E.J£~kft~~1~~11~~!~M~~~3.it;f}!!IIIL~~~!flii~l~~~\~:i?l~i~1111:ri~m~~~i~:tf;;~?~!~~~:t.w-r!f.f~:!~1~t:i~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(1) Civil Code). LENDER'S NAME ______________ _ LENDER'S ADDRESS ________________________ _ ,9';•\~r:\.~P,jiLtc;'i@jfJ¢"~13\tii=ji;;'i},'iJf(Ql\i~Wifl!ltt~11:li:ilf;(it~,ii~~~ri:nr[lil'Jlli!Q.~~~(li!i,\ill,t't::l'¼:.Tiit:AA[«i•if~1;ll:t"l~l,;,;tmwtB.~i!l~lll'il1ili~mr11~tt::.11.~•J.ri~::1:e~Jl!];~i 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 all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Cit\' 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. E)(PIRATC0N: Every permil issued by the building Official under the provisions of this Code shall expire by limitation and become null and void if lhe building or work authorized by such permit is not commenced with days fr~m lh date o u ermlt or if the building or work authorized by such per~it ls suspended or abandoned at any time afle r the work is commenced for 80 aY. ~ction 10 .4 · ulldlng Code). DATE 9~ J /51 N J APPLICANT'S SIGNATURE ___ __JG~~~~~~~..J.'...:.~~"..!.~~~:::=-------L/'-'1 _______ _ WHITE: Fil PINK: Finance