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Home My WebLink About2904 CORTE JARDIN; ; CB970554; PermitBUILD IN GT PERMIT 03/11/97 16 27 Page 1 of 1 Job Address 2904 CORTE JARDIN Permit.Type PLUMBING Parcel Wo- 255-144-54-00 Lot# .' Valuation 0 Occupancy Group Referenced Description. WATER HEATER REPLACEMENT .. Appl/Ownr . .MITCH**!, JEFF 2904 CORTE JARDIN CARLSBAD, CA 92009 *-** Fees Required *** 27 0 Permit No- CB970554 Pro-feet No A9700723 Development No• Suite. 3236 03/12/97 0001 pi 02 Construction Typ~ePRM1NEW 2;'°° Status ISSUED vApglied: 03/11/97 Apr/Issue 03/11/97 Entered By. JM V5f9 633-8009 Collected & ,Credits Adjustments Total Fees• Fee description Enter "Y" for" Plum^i Each Water,Heater a f. PLUMBING-'TOTAL ** * 00 ,00 27. 00 Ext fee Data 20 00 Y 7 00 27.00 FINAUAPPROVAL DATE. CLEARANCE CITY OF CARLSBAD 2075 Las Palmas Dr * Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION City of C«rlsbad Building Department ZO/5 Las P«IBM Dr., Carlsbad, CA 9Z009 (619) 438-1161 I'M)Mil l»rr. rrom hst 1 (we Iwck) give code of Pcrmil-lypc Fur Residential t'roicils Only From List 2 (sec back) give ( i*le of Siruclure-lypc Net loss/Gam of Dwelling Unils PLAN CHECK NO PIAN oc I)IJ*)MT VA1JI1 I1Y DATE FOR OFFICE USIi ONLY Addrcss Building or Suite Notorht- Nrarrst Cross Street [F.r,AL&C5clUMIoN Lot No Subdivision Name/Number SPft. "Unit No Phase No UIKLK UKIXJW If bUUMIi I tUI 1l'Vjf\ Ul..!**"* II |J \SLMT) | I I LjL/ j D 2 Fnrrgy dies D 2 Structural Calcs D 2 Soils Report d 1 Addressed Envelope ASSESSOR'S EXISnNG USEDESCRIPTION OF WORK SQ rr OF STORIES ( OF BEDROOMS IIATIWOOMS in uiiieicni irom applicant) NAME (last name firsi) fy") |ir^UJT~> , Q. CITY STATE ADDRESS ZIP CODE DAYTTirPIIONE T~KPTTTOTrr DCONTTlACTUIl NAME (last name first) CITY -ff_ rOK LON I IIAC IUU — LJUWNEU — UAUbNi1 I Oil UWNLU ADDRESS | 3-700, _& f-h^Ux <3 STATED 7IPCODE DAY TO I PHONE Ux NAME (last name first) CITY STAITc^A- ZIP CODE ADDRESS ^GH C-S-J £_£_> DAY TEI I PHONE 6 CUNTRAC.IUH NAME (last name first) cirv -* CV STAIE ZIP CODE ADDRESS / DAY ' & STATE 1 1C LICENSE C1ASS Cll^ BUSINFSS LIC # DESIGNLR NAMt (last namclirsfT ADDRESS STATE 7IP CODE DAY TELTPHONC STATE 11C ft 7~WnnKrjm" CDMIM^tJATTON ' Workers' Compensation Declaration I hereby allirm that I have a certificate ol tonsent to sell insure issued by the Director ol liulustiihl Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab C) INSURANCE COMPANY <£?ih.rrvl\J>TOLICY NO PI RATION DATE _ Ccriilicate ol bxcmption I ccrtily that in the pertormance ol the work lor which this permit is issued, I shall not employ any pcison in any manner so as lo become subject lo the Workers' Compensation Laws of California SIGNATURE __________ DATE _ \ _ 8 OWNOl UUllJjIvR DI'XJVMIATIUN " • Uwncr-uuilder Declaration. 1 Hereby allirni mat I am exempt Irom Uie Lonlraclon License Law lof Uie lollowing reason D I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure h not intended or • offered for sale (Sec 7044, Business and Professions Code The Contractor's License Law docs not apply lo an owner of property who builds or improves thereon, and who docs such work himself or through his own employees, provided that such improvement'! arc not intended or offered, for sale If, however, die building or improvement is sold within one year of completion, die owner-builder will have the burden of proving that he did not build or improve for die purpose of sale ) D I, as owner of llit property, am exclusively contracting with licensed contractors to construct die project (Sec 7044, Business and Professions Code The Contractor's License Law does not apply to an owner of property who builds or improves dicrcon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law) D 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, improve, demolish, or repair any structure, pnor to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of die Contractor's License Law (Chapter 9, commencing with Section 7000 of Division 3 of die Business and Professions Code) or dial he is exempt therefrom, and the basis for the alleged exemption Any violation of Section 7031 5 by any applicant for a permit subjects die applicant lo a civil penalty of not more than five hundred dollars [S500]). SIGNATURE DA1E COMPLE'lli T^llii btL'llUN HJR NON RESIDENTIAL BUILDING PERMITS ONLY. Is the applicant or future building occupant required lo 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? D YES D NO Is the applicant or future building occupant required lo obtain a permit from the air pollution control district or air quality management district? D YES D NO Is the facility to be constructed within 1,000 feet of the ouier boundary of a school sile? O YES D NO IF ANY OF THE ANSWERS ARE YES, A FINAL aaiTLFICATE OF OCCUPANCY MAY NOT BE ISSUED AFITJl JULY I. 1989 UNU'.SS 11 It AI'I'IJC ANT '- OF EMERGENCY SERVICES AND THE AIR POU UTION OUN11UM-......9 (JUNSTKUUIIUN LkNDINU AtitNUY Thereuy allirm dial there is a construction lending agency lor Uie perlormancc otlhe work lor whicn diis permit is issued (Sec 3097 (i) Lwil Lode) UNDER'S NAME LENDER'S ADDRESS 10 _ 1 ccmly ihai I have read Uie application and stale that Uie above inlormavion is cortccA I agree lo comply wiili all City otUinaiK.cs and State Uws relating lo building construction I hereby authorize representatives of die City of Carlsbad to enter upon the above mentioned property for inspection purposes 1 ALSO AGREE TO SAVE INDtMNIFY AND KEEP HARMLESS THE OTY OF CARISBAD AGAINST AI 1. IJAIHIini-S JUIX'.MI Jf K, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF IIIIS PUIMIT OS! (A. An OSHA permit is required for excavations over S'O" deep and demolition or construction of structures over 3 stones 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 vl>e building or work authorized by such permit Is not commenced within 365 days from die date of such permit or if die building or work authorized by such permit is suspended or abandoned at any lime after the work is commenced for a period of 180 days (Section 303(d) Uniform IHiildmg Code) CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB970554 FOR 01/13/98 DESCRIPTION: WATER HEATER REPLACEMENT TYPE: PLUM JOB ADDRESS: ••. 2904 CORTE JARDIN APPLICANT: MITCHUM, JEFF CONTRACTOR: OWNER: REMARKS: C/JEFF MITCHUM/632-9030 SPECIAL INSTRUCT: INSPECTOR AREA PLANCK# CB970554 OCC GRP CONSTR. TYPE NEW STE: LOT: PHONE: 619 633-8009 PHONE: PHONE: INSPECTOR TOTAL TIME: —RELATED PERMITS—PERMIT* TYPE STATUS CD 25 CB930109 SPA EXPIRED LVL DESCRIPTION ACT COMMENTS PL Water Heater/Vents dp / DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS City of Carlsbad Building Department WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self-insure for A. workers' compensation as provided by section 3700 of the Labor Code, (or the performance of the work for which this permit is issued. 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 workers' compensation insurance carrier and policy number are: INSURANCE COMPANY POLICY NO. EXPIRATION DATE. (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) 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. • C. workers compensation laws of California. ** f Signature ^1 \Q&it&4 _ Date g/// /ff j- Warning: Failure to secure workers' compensation coverage is unlawful, and shall be subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for' in Section 3706 of the Labor Code, Interest and attorney's fees. March 3, 1995 2075 Las Palmas Or - Corlsbod. CA 92009-1576 • (019) <t3n-11O1 • FAX (011) 'lin rmQ«t FROM fiJFOSTER INC FfiX 461 5443 PHONE NO ?FQM ". FHRHERS IIISUFHUCG 613-291-0776 PHONE NO. : 4610313 Mar 11 199"? 12 28PM P4 . 07 I'-reu ui:ixi:i-i AGENCY COMMERCIAL CERTIFICATE OP INSURANCE Issue Dale (MMJDWYY) HBNDOZA ' 8880 RIO SAN DIBGV OK, ffOO ' SAN DIEGO, CA 92106 Tilts cerlBlcalo Is issuod as a mallot nl Inlormnlioti only and nonlois im Mgl't5 upon the cuilillcalo holder. This ceHHtoile <loos not amom). extend ui allot \ho wvciage altordod by lite policies sliqwn below. ST,D1ST ----AGENT 376 lUSURtl) Name * AiJ FOSTER INC. s, ' 13706 D IWY 0 BUSINESS Aftbes) ' GL CAJON, CA 92021 COMPANIES rnOVlDlMQ COVtnAQE; R H\UCK INSURANCC CXdlAHGL o FARMCRS INSURANCE CXGHANGC -c MIO-CENTUnY INSUHAMCC COMI'AHY a«r DVENAQES W, i* 10 WI9Y IMA1 1111 »U.«IS OF WSOWKX. LISIFO BfLlW HAVt DTHHSaJT0 10 IMF RlSUffiD NAMFD Mi<JVT f OH THt POUCY HMD WOICAKH NOl'MllKI AIOTIO. n »H/jfiiEMiKi itw/ on couomoii or AMY CONIFIACI 9n onitnowaiMtNT vwm wwa TO VKWTH 1MB ctHTincAit WAY W IS&UEP 6» MAY rauaiM, IMC wsunANrt »MmhL<) «T 1HI COIIO&S OkSOVUUl Hlltm IS SUIUtCl 10 AIL HIE URMS, tXClUSKWS AND CONOtllONS OF SUWI POllClfS. IW»^ SltO\VH M/W llAvC DltH IttKUU 1VFI 0.* ».SWW.« dWlWl 1UV1U1V - OCCUWIlCt YWSOM conwwu/i.MaDonALOMv wiitn34C«nRAcron$pnor. 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