HomeMy WebLinkAbout2071 TRUESDELL LN; ; CB962279; PermitPERMIT APPIJCATION
CI ty of Carl shed lui I ding Dep9rt.nt
20~ L• P•I-Dr .• Carlabad, CA 92009 (619) 418·1161
PLAN CHECK NO. 9 C ;J.,J.. 7
P.'IT. VAi,. ___________ _
I. PmMrt I Yi'I! Pl.AN CK OEPOsrr. ________ _
VAUI>. DY ___________ _
from Us, I (,tt hack) aive cot.le,of Permit-Type: _______ .__ ___ _ l>ATe
...... -...... --.... --. ----. -. -----. -... -.. -.. -....... ---.. .
ror llaidcntlal rrujcns Only: l'rom List 2 (:1tt back) give
c,,.tc ur Structure-Type: -------~;...l.l,. __________ _
Net tau/Gain of Dwelling Units _________________ _
2. PIIUJf.cr tNmnMA·nuN FOil OFFiru USE ONI.Y
AJtlrcss 2071 Truesd e ll Ln. Du,IJmg ur Suite No.
tlrarcs1 Crou Street f .
I.tr.AL Otscltli' I ION Lot No. SuixhV1s1un Name/Number 01111 No. Phase No.
ClltCR OF.IDW IF SUOMII IE.O: , □ 2 F.nr.rgy Cales □ 2 Struqural Cale, □ 2 Soil~ tkport O I Addressed ~nvelope
A.5SESSOn'S PAI\CEL EXISTING .lJ.S&... oEscntmoN oF woiufJa t e r Heat e r Repl acement:7!0 Gallon rnoposrn USE
SQ. Ff. # OF STORIF.S # OF BEDI\OOMS II 01' IIATIIIIOOMS J. WN IACI n.RSJJN (j.1]1llc1c11Uro11\ avphcanl)
NAME (last name lirst-Fvy, uav i a ADDI\ES~071 T r uesd e ll Ln.
c rr,Car l s bad
c n.P Cajon srA-rfA
Suite B
DAY TEt.EPMoNW0-4 4 77
s. PltoP£Jt IY OWNEI( Dav id NMIE (last name liMfvy' ADDl\~71 Tr uesd e ll Ln.
c n~rlsbad STA~ ZIP c~008 DAY TEI.F.PIIOra9-7065
6. UJR'l1tACIOll A & J F t I NMIE (last name lir1(J .o s er' n c • ADDRES}3 706 Hig hway 8 Bus ine s s , S uite B
cr~l Cajon STAT~ ZIP CODE91 977 DAY TELEPIION~ 90-44 77
STATE I.IC. J,301 20 LICENSE CIA5S C-3 6 CITY 8USINF.SS UC. *200 354
OESIGNtll NAM£ (last name hrst) ADOllESS
CITY STATE 7.11' CODE DAY TELEPIIONE STA11'. I.IC. If.
1. W<JIIRFJls WMIIF'.NsAlloN
Workers' Compensauun Declarauon: I hereby alhrm that I have a cerulicate ol consent 10 scll-msure issueJ by the 01rcctor ol lmlus1n~I
Relations, or a cenilicate of Workers' Compensation Insurance by an admitted Insurer, or an exact copy or duplicate thcrror ccrtilicd
by the Director of the Insurer thereof lilcd with the Building Inspection Ocpa~ent (Sectlon 3800, Lab. C).
tNSUIVINCE-COMPANfarrner s l'OIJCY NY2 0 0 7 -5 6 -5l EXPlllATION DATE 5 -1 -97
Ccrt,hcate ol hempuon: I ceruly that m the performance ol the work lor which 1h1s permit ,s 1ssucil, I shall not employ any person III a11y ma1111cr
so as 10 become subject to the Workers' Compensation Laws or Catiromia.
SIGNATIJHE DATE
A. OWRmt-bUIIDEll OF.CLAlt\liON '
Owner-Ouuiler 1.kclaralion: I hcre6y aihrm Dial I am uempl lrom Die Cohlfaclon ucense Law lor Die lollowmg reason:
0 I, as owner of the property or my employees with wages H their sole compensation, will do the work and the~ sl\'Ucturc •~ not h11endcd or
offered for sale (Sec. 7044, Business and Professions Code: The Contractor's Ucense 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 Improvement~ are no1 Intended
or oHercd for sale. tr, however, the building or lmprovt!ment Is sold within one year oC completion, the owner-builder will have the burden
or provina that he did not build or Improve for the purpose of sale.).
□ I, as owner ortli~ propeny, am exclusively con1n1c1lng with licensed contractors to consllUct the project (Sec. 7044, Uusincss and l'rofes.•iuns
Code: The Contractor's Ucensc Law does not apply to an owner of property who builds or Improves thereon, and contracts for such project,
with contractor(s) llcensed pursuant to the Contractor's Ucense Law).
□ 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, demoli5h, or repair
any sllUcture, 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 Ucensc Law (Chapter 9, commencing with Sectlon 1000 of Division 3 of the Business and Profes.,ions Co<le)
or that he Is exempt therefrom, and the basis for the alleged exemption. Any violation or Section 7031.5 by any applicant for a permit
subjects tl1e applicant to a civil penalty of not more than five hundred dollars ($500)).
SlGNAnmE DATE
COMPL.t'ft 1111S stclioN FOit NON-1\ESIDENllAL DOIIDING PEilMITS ONLY:
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration fonn or risk management and
prevention program under Sections 25505, 25533 or 25534 or the Presley-Tanner Hu.Alrdous Substance Account Act7
0 YES □ NO
Is the applicant or ru1ure build Ing occupant required to obtain a permit from the air pollution control district or air quality management tli~1ric17
□ YES ONO
Is the facility to be constn1<:1cd within 1,000 feet of tl,e outer boundary of a school she7 □ YES □ NO
IF ANY OF 111.£ ANSWEllS ARE YES, A flNAL CFJ\11F1CA'llt OF OCX:UPANCY MAY NOf 8£ IS.<;UEJJ AYI'EI\ JUI.Y 1, 1989 UNl£.'i.t; 11 IE J\l'l'IJCJ\NT
IIAS MET on IS M1!£11NG TIIE IU'.QUIRl!MafTS OF TIIE OFF1C£ OF EMERGF.NCY SERVlCES ANO TII£ Alfi l'OIJ.trllON U1N'1110l. l>IS1111Gf.
9. WNSIRUCIION LDWING XGF.RCY
I hereby aihu~ihcrc IS a construction •~nJmg agency lor Uie perlormance ol U1e work lor winch lhts permit IS IS.SU@ (Sec 3097(,) Ctv,I CoJe).
LENDER'S NAME LENDER'S ADDRESS
10. I\PPUCAN I Olli\FICXIION
I cemly ilia[ I have read ihe apphcahon and stale that the above mlormahun 1s correct. I agree to comply with all Cuy orJ111anccs and State laws
relating to building construction. I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned propcny for inspcclion
purposes. I AL'iO N:1\££ TO SAVE INDEMNIFY AND KE!? IIARM~ TIIE CITY OF CARISIW> .-.Cl\lNST AIJ. UAIIIIInf.S, JUIX:MENTS, CXlS'l'S
ANO F.Xl'ENSES WIUOl MAY IN ANY WAY Aal\UR AGAINST SAID CITY IN CDNSl!,QUENCE OF TIIE GIWfllNG OF 11US l'E.I\MIT.
@IA: An OSIIA permit is required for excavations over S'O" deep and demolition or construction or structures over 3 stories in height.
Expiration. Every permit i55ued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the
building or work authorb.cd by such P'nnlt Is not commenced witlun 365 days from the date of such permit or If the building or wo1k au1ho1i7.cd hy
such permit is suspended or abandoned at any time after the work Is commenced for a period or 180 days (Section 303(d) Uniform_ lluildv1g Co<le)n,
APPLICANTS SIGNATU~~ ====:=::::;::::;::::;:;:=;==~------=-DAI'£: 11 ·2J-~
PERMIT# CB962279
DESCRIPTION: WATER HEATER
TYPE: PLUM
CITY OF CARLSBAD
INSPECTION REQUEST
FOR 12/06/96
REPLACEMENT
STE:
INSPECTOR AREA DC
PLANCK# CB962279
OCC GRP
CONSTR. TYPE VN
LOT: JOB ADDRESS: 2071 TRUESDELL LN
APPLICANT: LEVY, DAVID
CONTRACTOR:
PHONE: 619 729-7065
PHONE:
OWNER: PHONE:
REMARKS: MW/DAVID INSPECTOR -------------SPECIAL INSTRUCT: TELL DORIS LEAK rs FIXED
TOTAL TIME:
CD
25
LVL DESCRIPTION
PL Water Heater/Vents
ACT COMMENTS
_jf .(,v,Al/
***** INSPECTION HISTORY*****
DATE DESCRIPTION ACT INSP COMMENTS