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Home My WebLink About2904 LANCASTER RD; ; CB054289; Permit.J t City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 12-21-2005 Plumbing Permit Permit No: CB054289 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2904 LANCASTER RD CBAD PLUM Status: Parcel No: 1674613300 Lot#: 0 Applied: ISSUED 12/20/2005 LSM 12/21/2005 12/21/2005 Construction Type: NEW Entered By: Reference #: Plan Approved: Issued: Project Title: KESERMAN RES-REPLACE WATER HT Inspect Area: Applicant: A&J FOSTER, INC. STE B 13706 HWY 8 BUS EL CAJON CA 92021 619-390-4477 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 TOTAL PERMIT FEES Total Fees: Inspector: $27.00 0 0 0 0 1 0 0 Owner: KIESERMAN RONA L 2904 LANCASTER RD CARLSBAD CA 92010 $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 Total Payments To Date: $27.00 Balance Due: EXPIRED PERMrj, PERMIT HAS EXl'IRt:!l ltl f,CCORDANCE WITH ' !• '·, SECTION 106.4.4 AS AMENDED BY C.M.C.18.04 . Cc,; DATE x;.l:>o~o(p SIGNATURE....:cc¼f=--- FINAL APPROVAL Date: Clearance: $0.00 NOTICE: Please take NOTICE that approval of your project includes the "lmposttion" 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, 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 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 f hih h rvi I inNTI iilr hi wi h ha hrwi / FOR OFFICE USE ONLY IPIF.RMrf APPUCAT~ON PLAN CHECK NO. _____ _ CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. __________ _ Plan Ck. Deposit ________ _ Validated By __________ _ Date__,. ____________ _ Address (include Bldg/Suite 1/) Business Name (at this address) Le,.I DescrlJ>/ion J t, 7 -'-f lP J -3 -au Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Existing Use Proposed Use 1 .. Description of Work SQ. FT. #of Stories # of Bedrooms # of Bathrooms (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construc1, alter, Improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that l:>e Is licensed pursuant to the provisions of the Contractor's License Law !Chapter 9, commending w ith Section 7000 or Division 3 of the Business and Professions Code) or that he ls exempt -therefrom, and the basis for the alleged ex mption. Any violation of Section 7031.5 by any applicant for a permit subje ts the applicant to a civil penalty of not more than five hundred dollars ($5001). <. J ~o +e---wi c ~ (, H< t, 1 ~ '£ /c.., i 'L,.'" ( Ct -3~u Lf) Name State License # & 3 1J 1'2..:::. Address License Class _c_-__ S_b ____ _ City · · State/Zip Telephone # City Business License # /Z..I u8 3b Designer Name Address City State/Zip Telephone State License # __________ _ '.6;~WPBKERS~_qQM~l\l.SAIIlP.fi.~f.':.~m:"~!~l!~1;...u..l:a., • .:,,i;JllffiiU.;o.;i,.;i]~~~::r~;~~~~~-~~~~5~~ Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 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 ior which this permit is issued. R... 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 ~d. My worker's compensation insurance carrier and policy number are: , _ -/ Insurance Company 5T"'l±'1' (:J,._,, ~ Policy No. DQ{)""L)Y '2,uu -1 Expiration Date <./_lo.>'- (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) O CERTIFICATE OF E){EMPTION: 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: Foiluro to secure workers' compens11tion covero e ls unlawful, and shell subject on employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,00 , a • ion to th st of nso~on, damages as provided for in Section 370Ei of the Labo\ code, Interest and attorney's fees. SIGNATURE DATE / 7:,-l Cf --0C" l17!~·n:1JmN1;°8(~.WJ~_a@iRW:8':1J~l~~,~~r. ~W!·· ~ft;~'l:fl;~'i-4'~~~-:r.-1!.~~-=~~™~~'!Biit;r:f~fh~"~~ I hereby affirm that I am exempt from the Contr or's License Law for the following reason: O 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 end 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). O 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 on owner of property who builds or improves thereon, and contracts for such projects with contractorls) licensed pursuant to the Contractor's License Law). O 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. 0 YES ONO 2. I (have / have not) signed an application tor a building permit for the proposed work: 3. I hove contracted _with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license numberl: 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): ____________________________________________________________ _ Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk managem·ent and prevention program under Sections 26505, 25533 or 25634 of the Presley-Tanner Hazardous Substance Account Act? 0 YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O 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. . ,0 ~-rii'c''ofii'sif:AtJi:';r.~iON,ii1E"';;:l,,Tij·W-t:!fl•'l~~l r.u;~t~1,;f,;°•,, .. , .. ,,,,.,,::,,;f~~,"\~~~~,~~1i:~R·~~•!!1'llffii~~l~~~~~~~~sl~~~~ ~--;,rJ,.,... t.=.c..-, ... , ..... '-' .. ~"'·"•"-~'~"·'!,~ .. ,~k't,\!: . ..; m~ ..... t~Yi1.U~~~~Jfrmt:tiuMJ~,.!~W(~1.i,;i~!l~ii~1t:ii1,;in~1~u!.Gi ~li;i,M!i!IW'A:..!!ii ~ .IW~tt~ .IQ>! ~~ ~ • --'.~ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued (Sec. 3097!il Civil Code). LENDER"S NAME _______________ _ LEND ER'S ADD RESS;,;;:;;;;;;;;;:;;;:;;;;;;;;;:;;;;;;:;:;:;;;::;;;::;:;;;;;;:;;;,:;;;;:;;:;;;;;_;;;;;;;;;:;;;;;;;;;~;:;;;;;;;;;;;;; ,~!~t'.li'.M~fi~tifA1iJtu::~~Bl'ii1K(~~rn:mi~mn;~~ir1:i~:,i,Ul:li1~~~'f.bt.~~~ "· .-, •· ;1 'i:L;J..~~ ., · -ii,~~~ 1 certify that I have read the applicatlon1and state that the above information Is correct and that the information on the plans Is accurate. I egree t o comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Cit\t of Carlsbad to enter upon the above mentioned property tor inspection purposes. I A LSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO EXPENSES ~HICH 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. El(PIRATfON: Every permit Issued by the building Official under the provisions of this Code shall expire by limilation and become null and void If the building or work authorized by such permit Is no! commenced within 160 days from !he date of such permit or if the building or work authorized by such permit ls suspended or abandoned al any lime afler the work is commenced p · of 180 (Secti .4.4 Uniform Building Code). APPLICANT'S SIGNATURE J DATE PINK: Finance