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HomeMy WebLinkAbout1744 CATALPA RD; ; CB040276; Permit03-10-2b04 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB040276 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 1744 CATALPA RD CBAD PLUM 2155160400 Lot# Construction Type JAMES RES-REPLACE WATER HEATER 0 NEW Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 01/27/2004 KMT 03/10/2004 03/10/2004 Applicant A&J FOSTER, INC STEB 13706HWY8BUS EL CAJONCA 92021 619-390-4477 Owner CARROLL JAMES G&KAREN C 1744 CATALPA RD CARLSBAD CA 92009 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 01 0 0 $20 00 SO 00 SO 00 SO 00 SO 00 S700 SO 00 SO 00 SO 00 SO 00 13000 $000 TOTAL PERMIT FEES $27 00 Total Fees $2700 Total Payments To Date $2700 Balance Due:$000 Inspector 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 trie 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 tees 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/exacliorjs of which you have previously been oiven 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 NO EST VAL Plan Ck Deposit Validated By Date Address (include Bldg/Suite tt\Business Nama (at this address) Legal DescrigtionJ2V5-£Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor's Parcel o Proposed Use Description dt Work .CONTACT PERSON (if 'different' from applicant) SO FT #of Stories it of Bedrooms # of Bathrooms Za ,UUN IA gtr ' tilb»q-?flfV/</77 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 IChapter 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 sujj^cts tfte applicant^o^a civil penally Of notrnore than five hundred dollars Address License Class City Telephone #State/Zip i eiepnone City Business License # |5U CTX -JJrt Designer Name Address City State/Zip Telephone State License # 6 WORKERSXCOMPENSATION, '". " ' >< .">"'.'** '!"V"~* * - C;, '*>* " ^'"fW" f '' : /V^"- * \ Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations O 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 Hf 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 Insurance Company ~f\O^^_ V^CViOO Policy No ^ fo / ""O/QCQQ / / 3 Expiration Date [THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [S100] 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 t^Ec^MArorkers'xyfnpensiflflH^ovecage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dallarsXdOQ OOfiJfin a£fitjfln[to lln i infill n»|dpnpiiiinii damages as provided for in Section 3706 of the Labpi code, interest arid attorney's fees SIGNATURE t-"*'»™"' ' * " S *- —— — DATE a —"*•-' / o/ 7. * OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for tha following 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 ha did not build or improve for the purpose of sale) l~1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec 704*, 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 ' 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 ["") YES nNO 2 I {have / have not) signed an application for a building permit for 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 1 have hired the following person to coordinate, supervise and provide the rrajor 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 NO COMPLETE THIS SECTION FOR /Vpfl/-fl£S/D£VrMi BUILD1NG>ERMITS ONLY<1 ^^j f «, tV, 'j.iUlk- '- £ & --J -. **> > 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 the air pollution control district or air quality management district? Q YES Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? C] YES l~l NO IF ANY OF THE ANSWERS ARE YES, AiptNAL 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, . CONSTR1JCTION LENDING AGENCY^ • " ^i. /*-'c -''V^vy; ; , , ' ," «f *,--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 " ',' , C ^ ,"" * ", * - '-.J, *," ."^,3^, ' " H% >- VA. ^> "V I.*'"1 ' L~ L." »A ' ' i *\'j '. 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 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 EXPIRATfON 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 commencedjwthm 180 days from the dateji such permit or if the building or work authorized by such permit is suspended or abandoned at any time alter the work is commencgd1lo7a/§gflocf pf 1 §g^f8ys (SeSjJrTlOB^ 4 Uniform Building Code) APPLICANT'S SIGNATURE DATE YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 05/17/2004 Permit# CB040276 Title JAMES RES-REPLACE WATER Description HEATER Inspector Assignment JM 1744 CATALPARD Lot Type PLUM Sub Type Job Address Suite Location APPLICANT A&J FOSTER, INC Owner CARROLL JAMES G&KAREN C Remarks PEBASE«IKSPEeffiriNiTiHEiBI Total Time CD Description 25 Water Heater/Vents Act Comment Phone Inspector Requested By JAMES CARROLL Entered By CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 03/29/2004 25 Water Heater/Vents CO JM SET SCREWS IN EXHAUST DUCT COMPENSATION I N SUR AN>C£ POLICYHQLDER COPY PO B0X'807) SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION "'INSURANCE ISSUE DATE 04-01-2003 -CONTRACTORS STATE LICENSE BOARD SD\ WORKERS-COMPENSATION UNITp o ^ox '26000 ^ * * v,,v * *. SACRAMENTO CA 95826 1 * \ % GROUP 000467 * * POLICY NUMBER 0000713-20O3 CERTIFICATE,ID. 4 * ~ - CERTiFlCATE-E^FHRES 04-01-2O04 * * O4-O%2QO3/04-01-2004 f y! , t / % \ LICENSE NUMBER- LICENSE #630120V **INCEPTION-DATE- 04-01-2003" * This is to certify that we have issued a vahd Workers' Compensation insurance policy in .a form approved by the California Insurance Commissioner to the employer named below for the pplicy period indicated.i i ^ > "" s s , , s , f This policy is not subject to cancellation by the, fund except upon1 10 days' advance written notice to the employei- We will , ^*- "^ ~* , also give you f§ days^-^yance notice should this policy be cancelled prior to ^ts /vorrnat .expiratioa • ' ' - ' ' " ' This ceftiftpate p'f ^nsu^arffee is np^ art insur|nce pohcy and doe,s not ame'nd. extend/'or*alter the qoverag^ afforded by the Moticjes/is^d nCTgtirt*"Notwitt>stanc|int| any requirement. terr% ,OF cdndftioir of -any ^ntfact 'br^otheE,document with resp|ct;^i Which this^xerttficate of |nsjurancsr^may%e'^ssued ,or may >eFtam, Ahe mSurancVaftordedlbyl the ^"™ policies d^schb^a herein is subject to all tfie ^emis^^exSI'tjSiians1 and .condition^, g* such polices , £ , * % * AUTHORIZED RePRESENTATlVe - , , - -^ , . ,^ PRESlDEIsfr'-.X'''-',"^ -V» r- ' \ '^ ? - - V v '•• i " ' •* "" " -( - * ' t *'' • \ ^ '. "•-' • ', Lift INCLUDING DEFENSE, CO^ji: $/,900lo6p.Op PJ ^^/ -"-"-- •<. ' + ^1 -v,,0 j.'^ ](>-r,'^., ^'ft-V^.V TT^\ . ->'- " ,/^;5:V^V^V;?i^^lK^^^;x : TIHiS DOGDIWENT HAS-A:Btl.UE-PATTERNED BAGICGROUN