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Home My WebLink About1355 NIGHTSHADE RD; ; CB040148; Permit\\ City of Carlsbad \"- 1635 Faraday Av Carlsbad, CA 92008 013-2004 Plumbing Permit Permit No: CB040148 Building Inspection Request Line (760) 602-2725 Job Address: 1355 NIGHTSHADE RD CBAD Permit Type: PLUM . Status: ISSUED Parcel No: 2156413100 . Lot #: 0 Applied: 01/13/2004 Construction. Type: NEW Entered By: KMT Reference #: . Plan Approved: 01/13/2004 Issued: 01/13/2004 Project Title: MONGOVEN RES-REPLACE WATER Inspect Area: HEATER Applicant: Owner: A&J FOSTER, INC. MONGOVEN TRUST 08-05-98 STEB 13706 HWY 8 BUS 1355 NIGHTSHADE RD EL CAJON CA 92021 CARLSBAD CA 92009 619-390-4477 . Plumbing Issue Fee . . . $20.00 Fixture or Trap 0 $0.00 Building Sewer 0 . $0.00 Roof Drain 0 . $0.00 Install/Repair Water Line 0 . . $0.00 Water Heater and/or Vent I . . $7.00 Gas Piping System 0 $0.00 Vacuum Breaker 0 . . $0.00 Other Plumbing Fees . $0.00 Master Drainage Fee . $0.00 Sewer Fee . $0.00 Additional Fees $0.00 TOTAL PERMIT FEES $27.00 Total Fees: $27.00 Total Payments To Date: $0.00 Balance Due: $27.00 3030 01/14/04 0002 01 02 COP 270D ExPIRED. PERMET PERMIT H1S EXPIRED INACCORDANCE WITH U.S.C. SECTION i06.4.4 DATE SIGNATURE PERMIT APPLICATION :CITY OF CARLSBAD BUILDING DEPARTMENT 1635 FaradayAve., Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO.___________ EST. VAL. Plan Ck. Deposit Validated By Date________________________________ 1355 Nightshade Rd. Address (include Bldg/Suite U) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total U of units SFR. - Assessor's Parcel U Existing Use Proposed Use 215-641-31-00 Description of Work SQ. FT. #of Stories U of Bedrooms U of Bathrooms Iviongoven, uarn i.i Nigntsnaae KU. .arisDaa •A. 9UO9 /bU—..t1—b9 Name Address - City State/Zip Telephone II Fax U Arlen FOsterAmeredith galrn 13706-B Hwy.8 BUS. El Cajon, Ca. 92021 (619)390-4477 Name • Address City State/Zip Telephone U Name - Address City State/Zip' (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 7a 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 ($50011. Name Address City State/Zip T'elephone# State License II 630120 License Class C-36 City Business License U 1210836 Designer Name Address City State/Zip Telephone State License U KI.. 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 workers' compensation as provided by Section 3700 of thal Labàr Code, for the performance of the work for which this permit is issued. • I have and will maintain workers' compensation, asrequired by Section 3700 of the Labor Code, for the performance of the work for which this permit is sued. My worker's compensation insurance carrier and policy number are: Insurance Company State rp Tn, Policy.No.467...01 6000713 Expiration Date 04-01-04 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$1001 69-LESS) 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' compensation Average Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($1 , 0 ad itio the cos Co_tion, damages as provided for in Section 3706 of the Lpbor c de, mt rest and attorney's fees. SIGNATURE _• DATE I hereby affirm that I am exempt from the Cdhtractor's License Law for the following reason: - 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). 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: I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO I (have / have not) signed an application for a building prmit for the proposed work: I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number): 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 I address I phone number I contractors license number): 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): 4 PROPERTY OWNER SIGNATURE DATE - S rkm On N 01 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? 0 YES 0 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 0 NO Is the facility to be constructed within 1:,000 feet of the outer boundary of a school site? 0 YES 0 NO IF ANY OF THE ANSWERS ARE YES, AFINAL 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. LB I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 30970) Civil Code). LENDER'S NAME N NE LENDER'S ADDRESS____________________________________________________ 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 Citr of Carlsbad to enter upon the above mentioned property for inspection purposes. I 4LSO 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 commenced ays from t date u permit or lithe building or work authorized by such permit is suspended or abandoned at any time after the work Is commen'e a ri 18 action 1 gr4AgMform Building Code). DATE /0 - APPLICANT's SIGNATURE I WHITE: F-4-*" YELLOW: Applicant PINK: Finance ' -