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HomeMy WebLinkAbout1011 DAISY AVE; ; CB980504; Permit1/0/^350 BUILDING PERMIT 02/17/98 14 21 Page 1 of 1 Job Address 1011 DAISY AV Suite Permit Type. PLUMBING Parcel No- 214-422-15-00 Lot* Valuation 0 Occupancy Group Reference* Description WATER HEATER REPLACEMENT Permit No Project. No Development No. 4156 02/18/98 0001 01 C-PRMT CB980504 A9800t>49 02 27-00 Appl/Ownr *** SIKES WILLIAM 1011 DAISY AVENUE CARLSBAD CA 92009 Fees Required **** * * Construction Type. Status Applied Apr/Issue Entered By 760 603-0975 Fees Collected & Credits NEW ISSUED 02/17/98 02/17/98 JM * ** Fees 27.00 Adjustments. ' .00 Total Fees • 27 6.0. Fee description Total Credits. Total. Payments Balance Due. Units '"'•'.Fee/Unit 00 00 27 00 Ext fee Data Enter "Y" for Plumbing Issue Fee > Each Water Heater;and/or Vent " >7 . 0 0' 20 00 Y 7 00 FINALAPPROVAL DATE CLEARANCE. CITY OF CARLSBAD 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 If^^'Ti^fWrWfffl-Ti'fflPil FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date 1011 Daisy AVP. Address (include Bldg/Suita f)Business Name (et this address) Legal Description Lot No Subdivision Name/Number SFR Unit No Phase No Total f ol units Assessor s Parcel Existing Us*Proposed Use Description of Work SO FT wiV^msasttOte1011 Daisy Ave. fol Stories f o( Bedrooms * of Bathrooms ''^3-0975 Name Address City State/Zip Telephone 0 Fax „ Q SHELLY jQMpriM/KRTSTY FOSTER Name Mtor^ioiii.ffl.^^ 5R 13706-B HWY 8 BUS. EL CAJON, CA. HZUZL iss City State/Zip TelephoneAddress i ni i AVP.CARLSBAD CA. 9200 Address City State/Zip Telephone (Sec 7031 5 Business and Professions Code Any City or County which requires • permit to conttiuct, liter. Improve, demolish or repair any structure, prior to Its Issuance, also requires the applicant (or such permit to (lie i signed ataternent thit he to licensed pursusnt to the provisions of the Contractor's License Law IChapter 9, commending with Section 7000 of Division 3 of the Business »nd Professions Code] or that he la 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 I *J5J?PJ) , , -r T™-.mTm ™-nvra-™r! 1 ^7nfi-B HWY R BUS. EL CAJON CA. 92021 390-^ " ., rt 01 — O — F*&iName Stati License f 630120 Address License Class C-36 City State/Zip City Business License 1 1200W' Designer Name State Uctnae 1 N/A Address City Stste/Zip Telephone SiCOMPENSATIOHM<i^ira^ V^i^' „' • . Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations Q I have and will maintain a certificate of consent to self Insure for workers' compensation as provided by Section 3700 of the Labor Code !oi the performance of the work for which this permit Is Issued Q. I have and will maintain workers' compensation, aa required by Section 3700 of the Labor Code, (or the performance of the work for which this permit Is Issued My worker's compensation Insurance carrier and policy number are: Insurance Company FARMER INSURANCE Policy No.N2007-56-51 Expiration Oate CONTINUOUS (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*100) OR LESS) Q CERTIFICATE OF EXEMPTION I certify that In the performance of the work for which thla permit I* laaued, I ahall not employ any person In nny 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 en employer to criminal penalties end civil fines up to one hundred thousand dollars 1*100,000), In addition to the cost ol compensation, damages as provided lor In Section 3706 ol the Lebq/ code, Interest and attorney s lees SIGNATURE DATE. 7. OWNER BUILDER DECLARATION *4£ I hereby affirm that I am exempt from the Contrector's License Law lor the following reason: Q I as owner of the properly or my employees with wages as their sol* compensation, will do the work and the structure Is not intended or offered for sale (Sec 7044 Business and Professions Code The Contrector'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 (or aele If, however, the building or improvement Is sold within one y**r of completion, the owner-builder will have the burden of proving that he did not build or Improve (or the purpose of tale) [3 I as owner of the property, am exclusively contracting with licensed contractora to construct the project (Sec 7044, Business and Professions Code The Contractor's License Law does not apply to sn owner of property who builds or Improves thereon, and contracta for such projects with contractor(s) licensed pursuant to the Contractor's License Lew) n I am exempt under Section Business and Professions Code for this reason; 1 I personally plan to provide the major labor and materials (or construction of the proposed property Improvement Q YES QNO 2 I (have / have not) signed an application for a building permit (or 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 / comractois 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) . DATEPROPERTY OWNER SIGNATURE .COMELE7&JHIS SECT10N-FOH VnV-»^.«/>fArn^/,'Hj^ifli^p|pfipM|j^^ ..;jt' sjp'^v'. Vi i i , Is the applicant or future building occupant required to submit e business plan, acutely hazardoua materials registration form or risk management and prevention ptogiam under Sections 26605, 25S33 or 26634 of the Presley-Tanner Hazardous Substance Account Act? Q YES Q NO Is the applicant or future building occupant lequlred to obtain a permit from the alf pollution control district or air quality management distiict? Q YES Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of •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 I hereby affirm that there Is a construction lending agency for the performance of the work for which thla permit Is lasued (Sec 309711) Civil Code) LENDER S NAME LENDER'S ADDRESS 9. ' APPLICANT CERTIFICATION j,. . '•&'& •-fi#3$$J&l 'S^Vl^^ft^S^^^^ : i, 1 certify that I have reed the application and state that the above Information Is correct and that the Information on the plans Is accurate I agree to comply with ell City ordinances and State laws relating to building construction I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property lor 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 GHANT1NQ OF THIS PERMIT OSHA An OSHA permit Is required for excavatlona over 6'0* deep and demolition or construction ot structures over 3 stories In height EXPIRATION Every permit Issued bvsthe Building Official under the provisions of thla Code ahall expire by limitation and become null end void if the building or work authorized by such permit Is,noY commenced within 366 deys from the date/of such permit or If the building or work authorized by such pormit Is suspended or abandoned at any time alter t^e yfok. is cqmm»nc$3 tor/9 period ot I BO days/Section 106.4.4 Uniform Building Code) APPLICANT S SIGNATURE DATE WHITE File YELLOW Applicant PINK Finance UNSCHEDULED BUILDING INSPECTION DATE ^/A//7£) INSPECTOR PERMIT # 7/)U^&(-r PLAN CHE£K#*• / "~~ JOB ADDRESS \O ( ( DESCRIPTION TIME ARRIVE: TIME CODE DESCRIPTION ACT COMMENTS JSURED lame & ddress COMMERCIAL CERTIFICATE OF INSURANCE Issue Dale (MM/OD/YY) tO SAN DIEGO DR. #700 > CA 92108 .DIST..AGENT_32fi_ A&7 FOSTER INC. 13706 B HWY 8 BUSINESS EL CAJON, CA 92021 This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policies shown below. COMPANYurns COMPANY UTTH SB" COMPMff UTTW COMPANIES PROVIDING COVERAGE: A TRUCK INSURANCE EXCHANGE B FARMERS INSURANCE EXCHANGE C MID CENTURY INSURANCE COMPANY 0 VERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDINGANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE SEVERAL UANUTY COMMERCIAL ONSMl UABUTY -.OCCURRENCE VERSION CONTRACTUAL WOOENTAL ONLY OWNERS & CONTRACTORS PROT kvrouontf uuun ALL OWNED COMMERCIAL AUTOS SCHEDULED AUTOS •WED AUTOS NOftOWNEO AUTOS GARAGE UABUTY WMEUAlUUin WOUIU CQMKIUinNI UO EMPLOYERS' UABIUTT POLICY NUMBER - N2007-56-51 POLICY EFFECTIVEDATE (MM/OO/YY) 5-1-97 POLICY EXPIRATION DATE (MM/DOW) OQfcrrlfrtXXJS UNTIL CANCELLED POLICY LIMITS GENERAL AGGREGATE PROOUCTSCOMPfflPS AGGREGATE PERSONAL &ADVERTISING MJURY EACH OCCURRENCE FflE DAMAGE (Any mfin) MEDICAL EXPENSE(Any or* person) COMBWEOSINGLE LMT 600LY MJURY (PER PERSON) BODLY MJURY (PfflACODENT) PKKRTY DAMAGE GARAGE AGGREGATE HIT STATUTORY EACHACCDENT DISEASE-EACH EMPLOYEE DISEASE-POLICY LMT $ s $s$ s $ $ s $$ $ $ 1 ,000,000 $1 ,000,000 $1 ,000,000 RE: ALLOPERM1CNS HHCATtMOUK me • CITY 5, • BUILDING DEPT dress • 9601 RIDGEHAVEN CT 2ND FLOOR • SAN DIEGO, CA 92123 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WU. ENDEAVOR TO MAI 30 DAYS WRflTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAIURE TO MAI SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UABWTYOF ANY KM) UPON TIC COMPANY. (IS AGENTS OR REPRESENTATIVES. 1251