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HomeMy WebLinkAbout1004 LANDS END CT; ; CB050325; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 02-02-2005 Plumbing Permit Permit No: CB050325 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 1004 LANDS END CT CBAD PLUM Status: Parcel No: 2145311300 Lot#: 0 Applied: Construction Type: NEW Entered By: Reference #: Project Title: Applicant: A&J FOSTER, INC. STE B 13706 HWY 8 BUS EL CAJON CA 92021 619-390-4477 BLOUGH RES REPLACE H2O HEATER 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 Plan Approved: Issued: Inspect Area: Owner: BLOUGH ROBERT&KATHLEEN 1004 LANDS END CT CARLSBAD CA 92009 ISSUED 02/01/2005 KG $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: EXPIRED PERMIT $27.00 0924 02/02/05 0002 01 Inspector: PERMIT HAS EXPIRIEO IN f,CCOROANCE WITH C.B.C. CGP SECTION 106 4.4 AS AMENDED BY C.M.C.18.04.030 OATE :zln i.iX" _ SIGNATURE_.,o .. W=----- 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 '1ees/exactions." You have 90 days from the date this permit was issued to protest 1mposition 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 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO., _____ _ CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. _________ _ Plan Ck. Deposit ________ _ Validated By __________ _ Date. _____________ _ Address (include Bldg/Suite #) Business Name (at this address) Legal Description 13 00 214-531--Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Re lace Water Heater Existing Use Proposed Use Description of Work SO. FT. #of Stories # of Bedrooms # of Bathrooms 2 · ,:·1 · ~0••1·Acr,P•ii•oN"11f1•·1•fir•n~li""'' ·· illiudlt/11•~ '"'"""'". •"i!'•""''~''•""' .. ""''""'""""'·-~'""~·,·••'''''' ,.,,,,,,,11>.•,-l.p. )Jtl ~~1•·• ·· J,!,; ,.., .... , ., •. ·, ·.·, ., ' ,. >\,:;",::;;"' --~":. ""' .. , ', ' •'""Ai; .. -J ' Fo'ste'r i'nt'.':•f 31ot5· t11gt\-W!y'10';1'Utt-;f'!W"1Pllllllli.~W~~iBffl!lffl~('jjJ!11i:&'ii,-:\'s,;a(i!i;o11,1c'is~1~!')[',!!&i';1R~A?1.,,1;,,;,,lN!,,;)i,!'FJ;,a,,;+.,?i!,-,, :;af!,,,J-!! ,,:,!·;,,:-H'S! .~t:.:..:~el'.ICAN1',!i9J~W~~f~~·:r~:l>:,~,iij.n11w/i'fl,'U~-~;11;i],~;~11:;.;;;;fa~.t,~f~!!!?,;: li'•i ••.. 7: .. ~ ' .:~:.~ ~)lOP~R\'l(;~wc~~G~'R :!!~5~ii,1•ii;;~!9'•:EN't!l·ffl::~lil-Q't:.f.!lis111111:tilll~;;;~;~;;~1\'iil~ii1i~ir.,,; ,,, ( ;, '·•,',c,• ,,:,, Name Address City State/Zip Telephone # tB'~ :<,,,i:C:OM~RA:8JUlli~1ti:P·M·i:tANii:1•Mi:~ii1~~:1!~!f.!-•~tr~~:~:~~:~t~~~;~i'::rn1:;1~:~1iir~m~1JPj~mi~;1■•"ii~1~1~'1~,~g!..:ir:.;~aH._aJllllllll!Ual:l!IYaif:;;~:1~~~:~i!!t•;iJ~;~W~~;i1ir:~~w~~ii~:: (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 thereft11A''1 Mdo:llibl!J.bt4f'J'or the alleged exemption. Any violation of Section 7031 .5 by an'£_ ~l}ljr;:a~ for a ~r~~gutji:B5 l!l~t©9 ii()ii\iltalty of not more thar\ 'fl,Jll"'lfo'ri'dred dollars [ $ 5001). A & J Foster Inc. 1397Uti HIQ way · 12'0836 Name Address C-36 City State/Zip Telephone # State License # ____ 6_3_0_1_2_0 __ _ License Class _________ _ City Business License # _______ _ Designer Name Address City State/Zip Telephone State License # _________ _ :,~;·;!:,:'.~1??f0:Rj(S1lS:t~d.O.M.ij~$AiilQ'~!if!ili!L~li!f,ii~~f~i~f~l~~it~1;'kJi!i~:mr1r:fftt~if!:\;:f1%:ii!JJ~t;:~i!:it~lt~:1m~TiTu!i~l[\!~~!f~~t;fii~fj~!111lil~IB1i1i]if;\~~i~~li:~\ii~!8!1'~j!ij!t~~~~iifi:~1,t~:~i!ifJ Workers' Compensation Declaration: 1 hereby affirm under penalty of perjury one of the following declarations: O 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. ~ I have and will maintain ~ork~rs' compens~tion, as-r~quired by Section 3700 of the Labor C9!J.1ic.1~j~",arformance of the work for wtQ:OG&~Jlit is issued. My worker's compensation 1nfilateeFUV\8d and pohcy number are: 1 T.j"l. Insurance Company______________________ Polley No._____________ Expiration Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) O CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit ls 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' co thousand dollars ($100,000). In addlf a I, and shall subject an employer to criminal penalties and :!f1!112!@05Jp to one hundred am rovlded for In Section 3706 of the Labor code, Interest and attorney's fees. SIGNATURE DATE j]!i!i~:!IIPJIVNtR~itd~iRi~~d~RA: :,IO"i\lil~~\iji'.liilti!~i!l.1~:ii~~illM~i~~if.i:i:!1rnir:mf.:···· I hei'eby affirm that I am exempt from the Contractor's Licen 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 sate !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). O 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). D 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. D YES ONO 2. l (have/ have not) signed an application for a bulldlng permit for the proposed work. 3. I have contracted with the following person Uirm) 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): __________________________________________________________ _ Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk manegem·ent end 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 pollutlon control district or air quality management district? 0 YES D NO Is the facility to be constructed within 1,000 feet of the 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;~;~t(!:Cillli,1t~ttfail)'ij\(e_jijij1(Q!iq'ijij,{~~!ii~l;t!il~\::~,1:;J,~](;1::,1~~]!;~;:i~:~r:u~~rllllM1':l.,11;r1?:ii~~\-~~\~!~l-~i~~-~(liil~li!l!i~-~i~\!~~ri1tm?-1rn1h;iJiij!:!:1•iil'.:}li:;: i/'i!':t-i:1:;:;.,;: 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'~:.li!:f{A!ill~li$::tt&IIJ(Gj)]Q■l)l:i!~i'.m:1:w11:::;1J:li;:ifljl~!~~'!if!::]~1f~~~:i1iit1~i~j,,i)~~'iliilfli!ii\ilaili!imt1iTi1:~1iWtlil·•·fillil~-•i■IN■?~m1!(,::1;•:11i~~,ti:1T:tW:~::i~tiillii~li!}; 1 certify that I have read the appllcation·and state that the above information is correct and that tha 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 Citt of Carlsbad to enter upon tha 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 ls required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. EXPIRATrON: Every permit issued by t~e building Offlclal under the provisions of this Code shall expire by limltation and become null and void 1f the building or work authorized by such permit Is not commenced within 180 days from the date of ch permit or lf the building or work authorized by such permit is suspended or abandoned at any time after the work Is commenced f pe of 180 (Sectl • 6.4.4 Uniform Bulldlng Code). J APPLICANT'S SIGNATURE PINK: Finance OATE ----+F...,fa~o./--',,,12-'l2""00 .... s-