The URL can be used to link to this page

Home My WebLink About1754 COTTONWOOD AVE; ; CB040041; Permit01-06-2004 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB040041 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 1754 COTTONWOOD AV CBAD PLUM 2155033725 Lot# 0 Construction Type NEW SARAZEN RES-NEW WATER HEATER Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 01/06/2004 RMA 01/06/2004 01/06/2004 Applicant A&J FOSTER, INC STEB 13706HWY8BUS EL CAJON CA 92021 619-390-4477 Owner SARAZEN FAMILY LIVING TRUST 11-26-92 3603 W FOX RIDGE LN PALOS VERDES PENINSULA CA 90274 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 Total Fees $2700 Total Payments To Date $000 Balance Due $2700 2594 01/08/04 0002 01 0? CGP 27 = 00 pr..- ;JT HAS EXPIRED IN ACCORDANCE WITH U 8.C $i.UtON 106.4.4 DATE_nU,(friA- SIGNATURE, PERMIT APPllCATDON CITY OF'CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 1 PROJECT INFORMATION 1754 Cottonwood Ave. 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 Subdivision Name/Number SFR Assessor s Parcel it Existing Use 215-503-37-25 Description of Work SQ FT #of Stories Water Heater Replacement 2 CONTACT PERSON (if different from applicant) > : * •, ".:-t ;',*,;, V>* ''',.:.',; Sarazen, David 1754 Cottonwood Ave. Carlsbad Name Address City 3 APPLICANT jjp Contractor D 'Agent? for Contractor ' 'Q Owner "' Q-Agent^orlOwner, ,. Arlen Foster/ meredith qalm 13706-B Hwy.8 Bus. El Canon, Name Address 4 PROPERTY OWNER , ' ' f ,. « ,t Sarazen, David 1754 Cnttnnwnnd Name Address City '\ '" ..-*•* .... .. '- AVP> Carl PiharJ C City Unit No Phase No Total tt of units Proposed Use it of Bedrooms ""CA." 92009 ' State/Zip Ca. 92021 State/Zip -.a q?nnq " State/Zip ff of Bathrooms '760-271-6488 Telephone ff Fax ff (619)390-4477 Telephone ff 760-271 -64RR Telephone ff 5 CONTRACTOR'-COMPANY NAME"" ! .. i ' ',. <• .„ , '>". ",'-..4'- , I •' „" ,\.'--" L.. ^.~ . /..;.,? * 13»1\ ...™,' ','^: .'- • i, (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 I $500]) A & J Foster Plumbing 13706 B Hwy.8 BUG.—El Canon CA. g 92021 (61%)390 1477Name Address J <3ty State/Zip Telephone ff State License tt ?0 License Class (".—City Business License # 1 71 Designer Name Address City State/Zip Telephone State License ff M. i\L\^ * ^ 6 'WORKERS' COMPENSATION !' •• / "" " ' " J •• "' ' *'":•. ,7^T"- " ^'i'U 1 •' ' a "T">:.. / Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations [~1 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 £1 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 ued My worker's compensation insurance carrier and policy number are Insurance Company g^--,^.^ «"nmr-i TTT- P°I|CVNo 467 01 0000713 Expiration Date Q^ QT_ Q^State Comp.Ino. (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) n CERTIFICATE OF EXEMPTION I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California WARNING Failure tospaar& workers' compensatiagco»erage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($>0t£oOO>{>SradditioiL^d'the costafcompansation, damages as provided for in Section 3706 of the Labor code, interest and attorney s fees^^r * JCr I !r^ f—^—^P^^^^^' II ^""7 / f \. it SIGNATURE £_^^C^.-^e*<~S / J . , 'S r*L%es^ DATE / / Q /Oj~Ljf. 1—f i ^^—i 7 OWNER-BUILDER DECLARATION , ". , - , !, .:^ ,-• ** < -.•- - -' I hereby affirm that I am exempt from the Contractor's License Law for the following reason PI 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) f~l 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) I I 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 l~l YES f~lNO 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 n<ime / 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 NON-RESIDENTIAL BUILDING PERMITS ONLY,: *;' '" T "*V f 1, 5'J* " "' 1't *™L" • , 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? d YES Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? CD YES Q 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 LENDING AGENCY '' ''"••/,- " ,: ""_,"" !,-, V"" '' ""*•. '" '' "' "i: "'.. ', •. - j : ' "« 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.CERTIFICATlbYi I certify that I have read the application jand 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 forjexcavations over 5'0 deep and demolition or construction of structures over 3 stories in height EXPIRATION Every parmil 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 commejjpwfTwlhjn 180 daystom the^teteXf such permit or if the building 01 work authorized by such permit is suspended or abandoned at any time after the work is comrne>rfe<djor sggfiod/f '^fflays (Secjffn 106> 4 Uniform Building Code) APPLICANT'S SIGNATURE DATE sure iWHUTE File YELLOW Applicant PINK Finance SD POLICYHOLDER COPY COMPENSATION I N S U'R A N CE PO BOX 807, SAN FRANCISCO,CA 94142-0807 F'LJESID CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE 04-01-2003 CONTRACTORS STATE LICENSE BOARD WORKERS COMPENSATION UNIT P 0 BOX 26000 SACRAMENTO CA 95826 SD GROUP 000467 POLICY NUMBER 0000713-2003 CERTIFICATE ID 4 CERTIFICATE EXPIRES 04-01-2004 04-01-2003/04-01-2004 LICENSE NUMBER LICENSE #630120 INCEPTION DATE 04-01-2003 Do so This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the 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 -)Q days' advance notice should this policy be cancelled prior to Us normal expiration . ^ : . . This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the 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 terjns, "exclusions' and .conditions of such policies' ' , ' k AUTHORIZED REPRESENTATIVE •> PRESIDENT , ' EMPLOYER'S .LIABILITY LIMIT INCLUDING DEFENSE COSTS. $l',OOO^OOO 00 PER OCCURRENCE EMPLOYER.LEGAL NAME A & J FOSTER, INC 13706 HWY 8 BUSINESS ST #B EL CAJON.CA 92021 A & °J FOSTER, INC PRINTED <>3-17-2003 p04og