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HomeMy WebLinkAbout1369 CORVIDAE ST; ; CB021177; Permit04-17-2002 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB021177 Building Inspection Request Line (760) 602-2725 Job Address Permit Type '-'arcel No Reference # Project Title 1369 CORVIDAE ST CBAD PLUM 2156911100 Lot# 0 Construction Type NEW HERSHEY - REPLACE WATER HEATER Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 04/17/2002 JM 04/17/2002 04/17/2002 Applicant A & J FOSTER 2819 CENTRALAVE SPRING VALLEY 619697-4151 Owner HERSHEY STEVEN&LISA FAMILY TRUST 10-29-99 1369 CORVIDAE ST CARLSBAD CA 92009 5311 04/18/02 0002 01 02 CGP 27.00 Total Fees $2700 Total Payments To Date SO 00 Balance Due S2700 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Dram Install/Repair Water Line Water Heater and/or Vent Gas Piping System Vacuum Breaker Other Plumbing Fees Master Drainage Fee Sewer Fee Additional Fees 0 0 0 0 1 0 0 $2000 $000 $000 $000 $000 $700 $000 $000 $000 $000 $000 $000 TOTAL PERMIT FEES $2700 t'JK J» 3 FIRED PERilT 3? V K&S EXPIRED IN ACCORDANCE WITH U.B.C. i 103.4.4 SIGNATURE. Inspector 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 You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 1 -PROJECT INFORMATION 1369 CORVIDAE STREET FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date Address (include Bldg/Suite it)Business Name (at this address) Legal Description Lot No sft?•division Name/Number Unit No Phase No Total ff of units Assessor s Parcel #15-691-11-00 Existing Use Proposed Use Description of WorkWater 2 CONTACT-REEritjKiDn-i Heater Replacement SO FT CORVIDAE ST Name Address 3 'V: APPLICANT " rjfcdnlractor ';• Q Agent for ContractCL /'Q Owner _DArlen Foster/Carol Tester 1370 6^B Hwy.8 #of Stories Carlsbad City LAgerit for .Qwnei, ".'•'•BUS . El Cajoi it of Bedrooms CA. 92009 State/Zip IV "Car ' 92021 » of Bathrooms 760-929-0214 Telephone # Fax '(619)390-4477 # Name 4 ^PROPERTY OWNER n HERSHEY, STEVE Address City -.A; -, ... " ;•;• -,"'•= ,-, --~i ••1369 CORVIDAE ST Carlsbad Address City State/Zip *' 92'009 State/Zip Telephone # 760-929-0214 Telephone #Name 5 CONTRACTOR - COMPANY NAME ' ,• ,. : ; " •''•... ••' ••!' \ (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 therefrom, and the basis for the alleged exemption Any violation of Section 7031 5 by any applicant for a permrt subjects the applicant to a civil penalty of not g9)r§.U15n V/*Ti|ff<?r'!(i|df"aAS/l'4>'f)°"A & J Foster Plumbing 13706-B Hwy.8 Bus. El Cajon Name State License ft 630120 Address License Class C-36 City State/Zip -, ^-i .-. Q^slephone City Business License # Designer Name Address City State/Zip Telephone State License ft _ N/A _ 6 WORKERS' COMPENSATION -; i - ' .. "" '", _• . "'•," "".', ", "'••. " : ' ' ;.. ." > I ;;f; , W ~ -': '•""-•••..•-.. H '^ •-{'" " " ,:"j - -• •':• r> ""'I: ' Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations [3 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 OX 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 worker s compensation insurance carrier and policy number are nr\r\nTi -\ r\ A m m04-01-02insurance company State Comp.Ins.Pollcy No nr\r\nTi -\467-01 0000713 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) Q 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 n i iiMjwilliii compensation c^geijfffe is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($10000<n^ in foMmnto tircost of cytfpeiyarfon damages as provided for in Section 3706 of the Labor code interest and attorney s fees SIGNATURE £f*6*&«S ') •^^£1^^ _________ DATE APR 18 200? 7 : OWNER BUILDER DECLARATION S '"" " '" . '' " •-•.••• I hereby affirm that I am exempt from the Contractor s License Law for the following reason Q 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) Q 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) ' Q I am exempt under Section __ Business and Professions Code for this reason 1 2 3 I personally plan to provide the major labor and materials for construction of the proposed property improvement O YES I (have / have not) signed an application for a building permit 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) 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 COMPLETE THIS SECTION FOR NONRESIDENTIAL BUILDING PERMITS ONLY 1" , f ' _; - Is the applicant 01 future building occupant required to submit a business plan acutely hazardous materials registration form or risk management and prevention program under Sections 255O5 25533 or 25534 of the Presley Tanner Hazardous Substance Account Act? I I YES I I NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district' [~| YES d] NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? G YES [] 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 'CONSTRUCTION LENDIN'G AGENCY ' ":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(i) Civil Code) LENDER S NAME LENDER S ADDRESS 9 :.."': APPLICANT CERTIFICATION ,,,«,-"' '".-.. ;, ,- ;': ^".- '"^'-,.'-;sr " - ""• ^ ~ "",. " 7" ". F7-; " .'•• • ;. " ', ""JV" -'---;,-:••••-•-;••• V '"., ' V": • 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 CitV 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 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 within 180 days from the dateofsjich permit or if the building or work authorized by such permit is suspender) or abandoned at any time after the work is commenced fgf^JeiJjj^of 180 dgy^Sectioff^TO 4_4/Jmform Building Code) APPLICANT S SIGNATURE DATE 1 WHITE YELLOW Applicant PINK finance