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Home My WebLink About1746 CEREUS CT; ; CB030712; Permit03-10-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB030712 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 1746CEREUSCTCBAD PLUM 2155170300 Lot#: 0 Construction Type: NEW SCHMAD RES- REPLACE H2O HEATER Status: ISSUED Applied: 03/10/2003 Entered By: RMA Plan Approved: 03/10/2003 Issued: 03/10/2003 Inspect Area: Applicant: A&J FOSTER, INC. STEB 13706HWY8BUS EL CAJON CA 92021 619-390-4477 Owner: SCHMAD PAMELA J 1746CEREUSCT CARLSBAD CA 92009 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Drain 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 $20.00 $0.00 $0.00 0064 /03 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0002 01 CGP 02 27.00 TOTAL PERMIT FEES $27.00 Total Fees:$27.00 Total Payments To Date:$0.00 Balance Due:$27.00 PERMIT HAS EXPIRED IN ACCORDANCE WITH U.B.C, SECTION 106.4.4 HATF \[fl\lf± SIGNATURE /A/J. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 !l7 WROjECT "INFORMATION" FOR OFFICE USE ON PLAN CHECK EST. VAL. Plan Ck. Deposit Validated By Date 3 / / Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total # of units Assessor's Existin9 use Proposed Use Description of Work Vv ,2. CONTACT PERSON, i . . I W Heot4e/ SQ. FT.#of Stories # of Bedrooms # of Bathrooms Name Address City 3, APPLICANT. iQCantractor Q Agent for Contracto? 0 Owner' £Hisg~Brrt"fortOwrier *j~ State/Zip Telephone # Fax it Name PROPERTY OWNI Address J Name 5, C§\ (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 the applicant to a civil penalty of not more than five hundred dollars Name State License tt Address License Class <-" City •' State/Zip City Business License # Telephone # Designer Name Address City State/Zip Telephone State License # 6. "WORKERS' COMPENSATION * * * '* ' "7 „"? " "<' " ~"«~ * ^"K-TN-- -T ---v,-. ^ Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: W] 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 olthe work for which this permit is issued. fl 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 fSfrg-nMTVMU Policy No. "?| 0" /.Ou £- Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS TOR ONE HUNDRED DOLLARS [$100] OR LESS) [3 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 coverjoe is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,OOr^0Midkion to tbe^ost of •rffensation, damages as provided for in Section 3706 of the^Latjor; code. Interest and attorney's fees. SIGNATURE ^ ^" ~* DATE - 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). 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 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). PI 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. O YES QNO 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 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): . DATE_ -a, ^ ? PROPERTY OWNER SIGNATURE ; - COMPLETE THIS SECTION, fQtPNON-RESIDENflAL SOlCDrNQ PERMITS QNtY^V^'l'* /"""*. "t 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? O 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? O YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? l~l YES f~l 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. 8V,", CONSTRUCTION LENDirlGjAGENW'rv;- '^[ 7-'" .^."'l"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 A/O/Vc^ . LENDER'S ADDRESS |9. APPLICANT CERTIFICATION ' ' " I " *•'f ' '*","' \~*s~s , -'r," -** t '„ > "r-%, 1 "'-,"'•"/ I certify that I have read the application and stata 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 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 witbjf*Mfidays from jhe^late of^^^ermit or if the building or work authorized by such permit Is suspended or abandoned at any time after the work is commenced foj^D^io^^BO Jayj^pection 1Qg<C4 yp^rni Building Code). APPLICANT'S SIGNATURE DATE WHITE: File^ YELLOW: Applicant PINK: Finance AUG-21-2002 WED 04:58 PM A & J FOSTER PLUMBING FAX" NO; 619 390 4448 P. 02/07 POLICYHOLDER COPY1 ,~ -* V "" P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807' FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE COMPENSATION I N * \J* A N C B MAY 14, 2002 CONTRACTORS STATE LICENSE BOARb WORKERS' COMPENSATION UNIT P O BOX 26000 SACRAMENTO CA 95B26 GROUP: :--., 000461POLICY NUMBER: 71J - 2002CERTIFICATE ID: 6CERTIFICATE EXPIRES: 04-01-200) 04-0.i.-2003/0l-01-2003 CONTR LIC ft: 630120 INCEPTIONi 4-1-02 LOS ANGELES DO This Is to certify that we have issued 9 valid Worker's Compensation Insurance policy In a form approved by the California Insurance Commissioner to the employer named below for Ih» policy period indicated. This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer. - - ' / We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration. This certificate or insurance Is not an Insurance policy and does not amend, extend or alter the coverage afforded by (lie policies listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be Issued or may pertain, the Insurance afforded by the policies described herein Is subject to all the terms, exclusions, and conditions, of such policies. AUTHORIZED REPRESENTATIVE EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE A & J FOSTER. INC, 13706 HWY 8 BUSINESS ST SL CAJON CA 92021 4- SCIF10265