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HomeMy WebLinkAbout1703 EVERGREEN CIR; MULTI-PERMIT FILE; CB931363; Permit12/21/93 11:25 Page 1 of 1 B U I L D I N G P E R M I T Job Address: 170 3 EVERGREEN CR Suite: Permit No: CB931363 Project No: A9301953 Development No: Permit Type: PLUMBING Parcel No: -467 100 2-3---&0 Lot#: Valuation: -zJ).;' O~D 7-b 0~ Construction Type: NEW Occupancy Group: Reference#: Description: REPLACE WATER HEATER Appl/Ownr : FOSTER, A & J., INC. 2819 CENTRAL AVENUE SPRING VALLEY, CA 91977 619 697-4151 Status : ISSUED Applied: 12/21/93 Apr/Issue: 12/21/93 Entered By: DC *** Fees Required *** *** Fees Collected & Credits *** --------------------------------------------Fees: Adjustments: Total Fees: Fee description 27.00 .00 27.00 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 > * PLUMBING TOTAL CITY OF CARLSBAD 1 7.00 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 20.00 Y 7.00 27 .00 • PERMIT APPUCATION PIAN CHECK NO. City of Carlsbad Building Department 207S Las PalllBS Dr., Carlsbad, CA 92009 (619) 438-1161 EST.VAL.~~~--------~ PIAN CK DEPOSIT ________ _ VAIJD.BY __________ ~ I. P£RMII IYPE A -Li COmmerc1al B -Cl Industrial C -D Residential []Duplex UNew Bu1ld1ng U lenant Improvement [] New Building D Tenant Improvement D Apartment D Condo i Single Family Dwelling D Addition/ Alteration a Demolition [] Mechanical Cl Pool D Relocation C Mobile Home D Electrical D Plumbing D Spa D Retaining Wall O Solar O Other DATE 2. PRUJECr INFORMATION FOR OFFICE USE ONLY Address 1703 Evergreen Circle Budding or Suite No. Nearest Cross Street il:GAL DEsCRIJYI JON t 0. Su&hvts1on Name/Number Unit No. Phase No. WAT&t IIW~ l!lB?f AS!BNT CHECK BEWW IF SOBMI 11 Eb: D 2 Energy Cales D 2 Structural Cales D 2 Soils Report D 1 Addressed Envelope ASSEssoR·s r@c•1. \fEFTE-1<. ~~~'kErvl ets..Jt DESCRIPTION OF WORK w ATt: g:: PBOPQSED USE SQ. IT. # OF STORIES 3. WN IACI PERSON (I[ different from appUcan[) NAME Julie Sarrrnons ADDRESS1703 Evergreen Circle CI1Y carlsbad Si}TE ca ZIPCODE92008 DAY TELEPHONE 729-2277 4. APPUCAN I NAME DCONIRACIOR 4tt:ENI FORWNIRACIOR DOWNER DAGENI FOR OWNER Shelly Andrews ADDRESS 2819 Central Av. Cl1Y Spring ValleJilTATE ca ZIP CODE 91977 DAY TELEPHONE 697-4151 NAME Julie Sammons ADDRESS 1703 Evergreen Circle cITI Carl sbad STATE Ca 6. UJNIRACiuk NAME A&J Foster Inc. Spring ValletTATE ZIP CODE92QQ8 ADDRESS ZIP CODE 2819 91977 DAY TELEPHONE 729 2277 Central Ave. CI1Y ca DAY TELEPHONE 697-4151 IJCENSE C!ASS DESIGNER NAME STATE UC.# 639] 29 ADDRESS C 36 Cl1Y BUSINESS IJC. # J 2QQ354 Cl1Y STATE ZIP CODE DAY TELEPHONE STATE IJC. # 7. WOIUMlS' WMPRNSKIION Workers' Compensation Declaration: I hereby alHrm that I have a certificate of consent to self-insure issued by the Director of lndustnal Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the insurer thereof filed with the Building Inspection Department (Section 38001 Lab. C). INSURANCE COMPANY ):.:2 ;;;;, I Owner-Bu1lder Declaration: I hereby affirm that I am exempt from the COntractor's Llcense Law for the foliow1ng reason: D 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.). D 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 Llcense 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). CJ I am exempt under Section -------Business and Professions Code for this reason: (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 Llcense I.aw (Chapter 9, commencing 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 [$500]). SIGNATIJRE DATE COMPtf: IE t'HIS SEGI ION FOR NON-RESIDEN'IIAL BUILDING PERMI IS ONLY: 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? CJ YES CJ NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? CYES CNO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? CJ YES CJ NO IF ANY OF Till!ANSWERS ARE YES, A FINALCER11FICATE OFoa::!JPANCY MAY Nill BEJSSIJED AFrnRJULY I, 1989 UNIJ'.SS TIIEAPPIJCANT HAS MET OR IS MEETING 1llE REQUIREMENTS OF 1111! OFFICE OF EMERGENCY SERVICES AND 1llE AIR POILUTION CXJNTROL DISl1IICT. 9. WNSJHOCIION IENDJNG AGENCY I hereby afhrm that there 1s a construction lending agency for the performance of the work for which this permit 1s issued (Sec 3o97(1} C1vU Code). LENDER'S NAME LENDER'S ADDRESS 10. APPilCAN I CEkIIFICAliuN I certify that I have read the application and state that the a&ive 1nformat1on 1s correct. I agree to comply wuh all City orillnances and State laws relating to building construction. I hereby authorize representatives of the City of C'.arlsbad to enter upon the above mentioned property for inspection purposes. I AlSO AGREE TO SAVE INDEMNIFY AND KEEP IIARMIBSS 1llE CTIY OF CARISBAD AGAINST AIL IJABIIJ1lES, JUDGMENTS, CDSTS AND EXPENSES WIIlCII MAY IN ANY WAY A£Il!UE AGAINST SAID CTIY IN OONSEQUENCE OF TIIE GRANTING OF 11IlS PERMIT. OSIIA: 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 365 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 for a period of 180 days (Section 303(d) Uniform B ilding e). .. z 0 ;:: "' "' "' ~ " w 0 "' i[ l "' w 0 ~ 5 .. ii: w z ! z 0 ;:: "' .. z w ~ '" 0 " .. "' w ~ "' 0 'l ... 0 I hereby affirm that I am licensed under provisions ol Chapter 9 (commencing with Section 7000) of Division 3 of the Business •nd Professions Code, and my license ts m 1 "1110"0 "''"11"°1.8 .C36_ lie No ___ q_q_~_.J_•'±_ C1.1\1 _ hereoy atk,n rhat I am ese'TIP1 lrorr The Cc1··ac Tors License Law lo• 'he lolow,ng reason ,Ser 7031 5 Bus•ness and Profes1 ons Code A~'I :,ly or ~o,rn:y wh,c;s ·e ou,res a perm,t to cons:·,cr. alw ·rnpro-.e. demo,s,1. or ·e~a,r any struc•u:e prio· 'O ,ts ssua1ce alsc requires i~e ap pl,cant 1or sue~ ;ierrn,1 'o 1,1e a s,q1ed ~Tatemert tha: 1e s licensed oursuan: to tne pravis,on> cf tne conrracwr o License Law ·Cha;i'er g co,,.menc,ng wrth Swt,on 700G ~1 ",·,•s,o~ 3 o< !he Bus:~e,, and Prules;,cr,, vuGe1 or r~a: rs ex- e'npt there1rorP and tr>e bas,s Jar the allegea e,enm•,on An1 v,ola1io~ of Se(l1on 7G31 5 by an applicant ror a pe,m1t scb 1ects 'he applicant to a civrl penalty of nol more thdn 1:ve sun a-ed col'ars 1$50~., I. ;,5 owner of lhe praperl)'. o-m·1 employees ·,,,:h wages as !heir sole co"lpensar,on will do the wor1, and l'le sr·uc ture 1s no1 ,ntended or altered for sa•e (Sec (04~ B;s,ness a~c Proless1ons Coae The Contractor's License ~aw ~oes not ;ipply to dn owner of properly who bu11ds or ,mproves thereon and ;,,ho does sue~ "Ork himself or throug~ hrs owr employees O'ov1ded Iha! sue!, 1m~rovements are not intend- ed or of1ered lor sale 11, however. 1he bJild1~g or ,m~rove- menl 1s sold w,tn1n one year of comp,et,on The owner·Du,lder w,11 'lave the burden of proving thal he d,d not buira or ,m- prove for :he ourpose 01 sale1 · I as owner or the prope·ty am exclus,vely conlrac,ng w1lh licensed contractors lo construe! the pro1e~r !Sec 7044 Busmess and Profess.ans Co~e The Contractors License Law does not app!y to an owner of property who bu1 ds or ,m proves !hereon. and who contracts for each D<Oreos w:th a contractor(s) 1,cense pursuant lo the Conrractor s Lrcense Law) As a homeowner I am ,mprov1ng my home and roe follow ,ng cond,11ons exist I The worl< ,s being Derlormed prior to Sale 2 I have lived ,n rny home for :welve monrhs prior to complel10~ or th,s wore have ~01 cla1r,ec %s exemption durirg the lasl three years B & PC X I hereby affirm 1ha1 I ha,e a cert1•,cate ol consent to se f. nsure. o, a ce'11f1ca1e of Workers Con,pessatron 1n :~:;: ~~J :e-tTC6~16e98o,ra· Labor Code! co""" Maryland casualty )?;'PY IS f,leG .,.,,th the c,ty Certified COP\' ·s hereby lurn,shed CERTIFICATE OF EXEMPTION FROM ','/ORKEPS COMPENSATION INSURANCE 1Th,s section oeed nol be completed ,f the ;:,ermrt ,s lor one hundrea do·,ars rS1001 or less) _ I cert,'y thal 1n the performance of the work ror wh,c~ •.his perm,'. ,s rssued. I shall not employ any person ,n any manner so as 10 t>ecome subJect to the Workers Com pen· sal1on Laws ol Cal,forn,a NOTICE TO APPLICANT· It. after makong th,s Cert1f1cate of Exemption. you should become sub1ect to the Workers l Compensation prov1s1ons of the Labor Code. you must forthwith comply with such prov,sions or th,s perm t shall be deemed re,oked i[ I hereby affirm that there 1s a construction 'ending aqenc,-for the pertormance ot the work for wh,ch th,s per m,1 ,s ,ssued (Sec 3097. ~ Lende· s Name lenuer s Address USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. CARLSBAD BUILDING DEPARTMENT Carlsbad. California 92008-1989 (619) 438-5525 APPLICATION & PERMIT JOB ADDRESS AV.ST.AD, NEAREST CROSS ST. DATE OF APPLICATION BUSINESS LICENSE :t VALUATION ! 1703 Evergreen Circle valley St. 3/15/86 LOT I BLOCK j sueo1v1s10N I ASSESSOR PARCEL NO. CONTRACTOR Arlen Foster Plumbing OWNER"$ NAME CONTRACTOR"$ ADDRESS Julie samnons 2819 central Ave. OWNER"S MAILING ADDRESS 1703 Evergreen Circle DESIGNER DESCRIPTION OF WORK Water Heater Replacement 0Es1GNER's AOOREss ----------~-~~~---------------~-~--~---- FLR ELEV GRADING PERMIT ISSUED NO STORIES TYPE CONST 8177 CONTRACTORS PHONE• 697-4151 LICENSE NO. 443348 DESIGNER'S PHONE LICENSE NO. ace GP EDU ace LOAO Fl RE SPFI ZONE PLAN I.D. # 311~_/_ PERMIT NUMBER BUILDING SO FOOT~GE CENSUS TRACl I c;p LAND USE ! PARi<;ING SPACE. RES ur,.,1Ts l ID ~ D IRE:OEVE.LQPMENT AREA ,r ..,o Not Valid Unless Machine Certil,ed OTY[ ' PLUMBING PERMIT· ISSUE ~.,fi ii OTY MECHANICAL PERMIT· ISSUE SUMMARY/ACCOUNT NUMBER EACH FIXTURE TRAP ~ I INSTALL FURN DUCTS UP TO 100 000 BTU 001-810-00-00-8221 BUILDING PERMIT 001-81 0-00-00-82 tO OVER 100 000 BTU SIGN PERMIT EACH BUILlllNG SEWER 1. ~AC~lliR HEATER AN-~ oRVENT __ _ ·--~·---- - --------- E. ACH GAS SYSTEM 1 TO 4 U UT L f TS :;>.LU. UU EACH GASSYST[',I J OR MO Rf r ',1E.1AL-F REPL-ACr: ---------r--EL-ECTRICAl -----001-810·00-00·8223 i-------·-f----------------- =: $2 .50 r-+:~:~~: ~~::::::or~:-~~5T:P3 HP --·----b-~-,,:/:_-_-_·_,.-===+~-:;~·~ccA-T~=L-c',-H:-c'-u-CM_K--Bl=-N-G _-_-=:=~::r~~~:-~~:::~: --,-- - -+ ----- - - - -----·--.-------+------·-----j EACH INSTA~ ALTE.R. REPAIR WATER PIPE. --i --- - -VEN~FAN SINGLE 9ucT ---- --I-_M_E_CH_AN_IC_AL - -____?~~8_2_0-~00_·8_2~4 _ _, ___ _ EACH VACUUM BREAKER MECH EXHAUST H DUCTS MDBILEHOME 001-810-00-00·8225 -------------t--------,---+-- -~-T~_s_o,_~NER -----------~'------jf----jf-R_E_L_D_C_A_TTIIOONNy-1' A ~NACE·HEATER ____ -r----:;c---- r=-J '': ccoc _''_' ', ~ ----::_-_~,-, -_t--$-10-.-_-oo 1·.'1 ~ - MOBILEHOME PARK INSP -----+-------~ n S0~AR .. 001 ·81 0-00-00-8226 - TU!Al Pi lJ\lBINl. TOT kl MECHANICAL /!/ STRONG MOTION 880-519-92-33 FIRE SPRl"JKLERS 001-810-00-00-8227 i ------ PUBLIC FACILITIES FEE 332:..§j 0-QQ·00-893_0 ~--- NEW :OLN:~::l~:,\:~:~;T . ISSUE __ s= __ -!! QT~h~T~O-LA_R~S_S_U_E ______ ,(4/"c-1{,.cc_e_\-+, ----_--_-11-__ -__ SC_HOCJL ~E-E-·-DISTRICT __ -_--_-- ---~-·--_ -_ -----=---~ 1PH !PH j + lsTnRt.c;E1r,r;kc.; I QTY I I I Ex1sr BL uc ~A AMP.sw~~K R-_------_;;;----------J Roe~ :;·oRA:;L --I I ~ Carlsbad ----------- --,----------- Encinitas ----- 1 1 PH -----~1~ · cur·,,_P _____ -------cr"~----+-----'-----!.1--San [)1egu1t~ ______ -.-- : ~----------tf----:~~:~~~:--~-!~J:~'E~:-~~;~:~oR_A_'.:,,~;,~F\~H~C,.,_H_1_u_,_T ____ ·_-_+--_-_-_ __ -.~-----,-----+-P-"_'\ l'l VI 'F_ ~==1==---=--L"'·l-~:~:CN~"sca;~;~"~CACX~----,-,-,-,-,-o.-o-o-_.-,-,-_.-,---,-6-_2-_~------------------------------_ I '>---+-~~-~~-:-C-2.L-:---:--------t--------,.----j---·---. ·--- - ---------+------------ 1 _ -~lMPOC[UP¢CY'30UAY? __________ ~--·--____ J____ ~ M_F_F _______ _880·=9_2_-57_ j---'----·riJTAL Ell(.THl(.Al ----r--~--.----1., -: ·----,-n, SCllAS r . CR~: 1 ~:::::: PAYABLE I ,,-~~~~~~~~~~~~~~~~--~.._~ ..... ~-,-~~~~~~~~~--~~~~..i..~~~~~~~~~~ .... ~~~~~~~~j,._~ $10.00 I I HAVE CAREFULL y EXAMINED THE COMPLETED ·APPL!CATION AND PERMIT" AND DO HEREBY Ei,;p1ral!on Every permit issued b)'the Building Otf1c1al under the prov,s,ons otthis I CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall ei,;pire by lim,tat,on and become null and void If !he building or work DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT IS authorized by such perm,t ,s no! commenced within l80daysfrom the date o! suet> 1 permit, or 1f the bu1ldmg or work authorized by such permit ,s suspended or * AN OSHA PERM:T IS REQUIRED FOR EXCAVATKlNS OVER 5· o·· DEEP ANO OEMOt.JTk)N OR CONSTRUCTION OF STROC:TURES OVER 3 STORIES IN HEIGHT ISSUED: TO COMPLY WITH ALL CITY. COUNlY ANO STATE LAWS GOVERNING BUILDING CON· abandoned at anv time alter the work is commenced for a oenod of 180 davs I STRUCTION. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE ro SAVE INDEMN!FY AND APPROVED BY /! I KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABIUTIES. JUDGMENTS. COSTS AND APPUCANT"S SIGNATURE JI. OWNERD CONTRACTOR~ I EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE ~ r/ 1 BY PHONE O / +-:/,' f:v_ 04' :L.:G:R:A:N:T~l~N~G:.::o~F-T~H.::IS:.;.P:E~R~M~IT:.;.~~~~~~~~~~~~~~~~~~~~~~~~~~-~n~;.::!!;:'~~-:...~'2..~~.2:l!;;!i;;;!:;:'~.-,_,;i.,.."'~-~;;,~-;.,1;,·,;;i; -,,~~~~~~~~~~.J _________ _t_~:::._':' __ :~::'._l_'I ·~17~.:._ ···11.tf'~l:;,~ __ _J SJ <I ~ C Q_ TYPE ' DATE INSPECTOR I BUILDING I FOUNDATION ' FIELD INSPECTION RECORD ' REINFORCED STEEL ' I MASONRY I GUNITE OR GROUT I REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES INSPECTION REQ IF INSPECTORS DATE CHECKED APPROVAL SUB FRAME D FLOOR D CEl~ING SOILS COMPLIANCE SHEATHING D ROOF D SHEAR PRIOR TO FOUNDATION INSP FRAME I -~ ---~-~-------- EXTERIOR LATH ' I STRUCl URAL CONCRETE:: OVER 2000 PSI ---INSULATION I PRESTRESSED CONCRETE INTERIOR LATH & DRYWALL I POST TENSIOr-..Ec-; ' PLUMBING I D SEWER AND BL/CO u PI.-/CO UNDERGROUND D WASTE D WATER TOP OUT D WASTE D WATER CONCRETE __ 1 ___ -FIE'._O WELDIN(; ,--~-~ HIL;H STRENGT'-' I BOLTS I -- S~'ECIAL MAS01'.JRY ----- TUB AND SHOWER PAN I GAS TEST I ' D WATER HEATER D SOLAR WATER r------·- Pll ES CAISSQr-.;:-· -+-----~----I------~ -~ ' I ELECTRICAL I ' I ~------1---------- ---D ELECTRIC UNDERGROUND DI UFFER -----~ ROUGH ELECTRIC I I ------------------ D ELECTRIC SERVICE D TEMPGRARY ----------------~--~---------- D BONDING D POOL I ---1---------- I ! MECHANICAL I ' ----·------~----~ D DUCT & PLEM,, D REF, PIPING -----HEAT -AIR COND, SYSTEMS ' ' VENTILATING SYSTEMS I I CALL FOR FINAL INSPEcr ON WHEN ALL APPROPRIATE I ITEMS ABOVE HA \IE BEEN APPROVED FINAL I PLUMBING I ELECTRICAL I MECHANICAL ' ~ I GAS I --i BUILDING ' I I SPECIAL CONDITIONS ' I I I ~-----,___ ____ ------~---~----