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HomeMy WebLinkAbout1374 CASSINS ST; ; CB023436; Permit11-14-2002 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB023436 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 1374CASSINSSTCBAD PLUM 2156914700 Lot# Construction Type KLIEN RES-REPLACE WATER HEATER 0 NEW Applicant A&J FOSTER, INC STEB 13706HWY8BUS EL CAJONCA 92021 619-390-4477 Status Applied Entered By Plan Approved Issued Inspect Area Owne'r KLEIN EARL R JR&JOYCE M 1374CASSINSST CARLSBAD CA 92009 ' ISSUED 11/14/2002 RMA 11/14/2002 11/14/2002 t*j.Jnn-U/14/02 27-00 Total Fees $2700 Total Payments To Date $000 Balance Due $2700 Plumbing Issue Fee / Fixture or Trap / Building Sewer Roof Dram Install/Repair Water Line Water Heater and/of Vent Gas Piping System Vacuum Breaker Other Plumbing Fees Master Drainage Fee Sewer Fee Additional Fees $2000 ' "$0 00 $000 ,$000 $000 $700 $000 $000 $000 $000 $000 $000 TOTAL PERMIT FEES $2700 PERMIT HAS EXPIRED IN ACCORDANCE WITH U.B.C, SECTION 106.4.4 DATE ^i-eAo'^ SIGNATURE Inspector — FINAL APPROVAL Date Clearance NOTICE Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions" You have 90 days from the date this permit was issued to protest imposition of these fees/exactions If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3 32 030 Failure to timely follow that procedure will bar any subsequent legal action to attack, review, sel aside, void, or annul their imposition You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired, PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK EST. VAL. Plan Ck Deposit Validated By Date. 1374 CassinsSt Address (include Bldg/Suite if)Business Name (at this address] Legal Description Lot No SFR Subdivision Name/Number Unit No Phase No Total ft of units Assessor's Parcel # 215-691-47-00 Description of Work Existing Use Proposed Use SO FT #of Stories # of Bedrooms # of Bathrooms Water Heater Replacement COWTACT PER^OH^iCdiffSrebtlrarh^EP&tl -$*;. .^uUEarl Klein 3374 Cassins Name Address 4 I APPLICANT1 ^'Contractor 'Arlen Foster/Carol Foster X706 City Bus.^^6-6 l!wy.8 Bus. El Cajon,Ca. State/Zip 92021 Telephone ft C619) 390 Fax Name i4, PRQ>ERTYt OWNER Earl KlPin Address City State/Zip Telephone # Cassins 'StT ffi""'Varlsbad ^"ca^^gfeor "" '7^-436-8870' Address City State/Zip Telephone ftName 5 »; CONTRACTOR --"COMPANY,NAME-*~5^l\iJF?I<T." 1 r^iT*. :£U;uS?r"'LA (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 permit subjects tha applicant to a civil penalty of not mote than five hundred dollars l$5QQJl A K, T pnc-h^r" p"| i-rrnhi Name State License J* 6301 20 ng 1 V7nfi-R Hwv.8 B Address License Class C— Jo us. El Canon CA. y/u/i \. oiy } jyu-4^/ / City State/Zip Telephone # City Business License # -1210836 Designer Name State License ff M/A 8." rWOHkERStCOMPENSATlON Address ••y«<% ^r*^''*"r '^.ir,,vr; City State/Zip Telephone Workers' Compensation Declaration 1 hereby affirm under penalty of perjury one of the following declarations C] 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 .J~l 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 vssued My worker's compensation insurance carrier and policy number are Insurance Company gtiat.P CO^D... In^_. Policy No 467—01 0000713 Expiration Data 04—Ul—U J (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 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^rfflrejHtf kers' cotrjpensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (^BOTg^ljgjgd.dj^n/uyie cost o£compensation, damages as provided for in Section 3706 of the Labof cpde, interest and attorney's fees SIGNATURE **^^ _" * ^~? *"*" DATE j ' II *— 7 DOWNER-BUILDER DECLARATION» V/*- . kc fct, , Y/^MlV A{5£4l> -IKX^ tJ,J £%* ?'f"L"#***'"\~ T fy >* * N .'* * '-'-,"* V * I hereby affirm that I am exempt from the Contractor's License Law for the following reason 0 1, 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 thsreon, and contracts for such protects with contractorts) licensed pursuant to the Contractor's License Law) Q 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 f~l YES QNO 2 f (have / have not) signed an application for a building permit for the proposed work 3 I have contracted with the fallowing person (firm) to provide the proposed construction (include name / address / phone number / contractors license number) 4 1 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 SECTION FORl/VO/V^ES/DBYTM^B^^ Vf~» v 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? Q YES Q NO Is the applicant or future building occupant required to obtain a permit from ths air pollution control district or air quality management district? Q YES Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES fj 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 58.,* ^CONSTRUCTION L'ENDjNG AGENCY "? ^ /l (^" ' ," &»t&W'4?FrS" V£ ? <"?* v, »^£ A^U1- fes'< £. * "^ 'f,^ .' < ', - f„ , , 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 bDME LENDER'S ADDRESS I certify that 1 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 1 hereby authorize representatives of the City 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 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 the building or work authorized by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced forjy^flfjjcf 180 dayg J^ection 4fij^<4 Uniform Building Code) APPLICANT'S SIGNATURE DATE n//g WHITE FileXXELLOW Applicant PINK Finance AUG-21-2002 WED 04=58 Ptt A & J FOSTER PLUMBING FAX NO. 619 390 4448 P, 02/07 POLICYHOLDER COPY STWTE p ° BOX 420807, SAN FRANCISCO, CA 94142-0807 COMPENSATIONI N SU«ANC• PUN D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE MAY 14, 2002 "COUTRACTORS STATE LICENSE BOARD WORKERS' COMPENSATION UNIT p O BOX 36000 SACRAMENTO CA 95fl26 GROUP, 00046? POLICY NUMBER: 711-2002 CERTIFICATE ID: 6 CERTIFICATE EXPIRES: 04-01-300* 04-0,1-2003/0^-01-2003 COMTR L1C tt 630120 INCEPTION! 4-1-02LOS ANQEUB3 DO This la to certify thai wo have issued a valid Worker's Compensation Insurance policy in a form approved by the CaliforniaInsurance Commissioner to the employer named balow for lh« policy period Indicated This policy is not subject to cancellation by tno Fund except upon 10 days advance written notice to the employer We will also gfva you 10 days advance notice should this policy be cancelled prior to its normal expiration Trite certificate of insurance Is not an Insurance policy and does not amend, extend or alter the coverage afforded by (he policies listed herein. Notwithstanding any requirement, term or condition or any contract or other document with rsepeot to which this certificate of insurance may be issued or may perlsln the insurance afforded by the policiesdescribed herein is subject to all the terms, exclusions, and conditions, of such policies AUTHORIZED REPRCSEHTATtVC EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS- §1,000,000 PER OCCURRENCE EMPLOYER A fe J FOSTER, INC 13706 HWY B BUSINESS ST EL CAJON CA 92021 SCIF 10265 IEPF-UI CGI