HomeMy WebLinkAbout2519 VIA ESPARTO; ; CB950192; PermitBUILDINl~ P E R M I T Permit No: CB~5U1q ~
Project No: A9500255
Develc•pment No:
UL /OJ/q5 15 :0;,
Paoe 1 of 1
Job Address: 2519 VIA ESPARTA
Permit Type: PLUMBING
Parcel No: 1h7-4U0-04-00
Valuaticn: O
Construction "'ype : NEW
Occupancy G~oup :
Description: GAS REPAIR
Appl/Ownr : BEST SERVICE
5360 EL ARBOL
CARLSBAD,CA 92008
Fees Required
Fees:
Adjustments:
Total Fees :
Fee description
Enter "Y" for Plumbing
Gas Piping System
1r. PLUMBING TOTA L
Suite:
Lot#:
Reference#:
019
0580 02/03/95 0001 01
C-PRMT
Status:
Apol1en:
Apr/Issue:
En tered By:
438-3989
02
27-00
ISSUED
02/03/95
02/0319"'
DC
o edits: .oo
.00
27.00
Tota ayrn~nt..,:
Bala ue:
e /Unit
CITY OF CARLSBAD
Ext fee Data
2 0 . llO Y
7 .00
27.00
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
• P~ APPLICATION PLAN CHECK NO.
City of Carlsbad Building OepartEnt
2075 Las Palaas Dr., tarlsbad, CA 92009 (619) 438-1161 ESf. VAL. __________ _
t. PERMI'I 1YPE
PLAN CK DEPOSIT. ________ _
VAUD.BY __________ _
DATE
From List 1 (see back) give ccxle of Permit-Type: ____________ _
For Residential Projects Only: From List 2 (see back) give
Ccxle of Structure-Type: _____________________ _
Net Loss/Gain of Dwelling Units
2. PRQJF.C'f INFORMA110N FOR OFFICE USE ONLY
Address 2-,5 I Cj J/ilr £:$"fM.:f# Building or suite No.
Nearest Cross Street
LEGAL DESCRIPTION Lot No. SubchV1s1on Name/Number Unit No. Phase No.
CHECK BEWW IF sOBMI 11 Eb:
□ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report D 1 Addressed Envelope
ASSESSOR'S PARCEL EXISTING USE PROPOSED USE
DESC,;;.ON~ WORK ,t;_
SQ. . 19-:S q,A-1'1'-#OFSTORIES # OF BEDROOMS # OF BA TIIROOMS
3. WN IACI PERSON (if dillerenl from applicant)
NAME (last name first) ADDRESS
C:::~r -:::,~1e,e,, ADDRESS p.J'? ~ C-( ~
STATE(;,/¢-ZIP CODE 2.-LJ O ff DAY TELEPHONE
/Mtt-fC J ~ /-ADDRESS
STATE (!_,,,</. ZIP CODE U ~ t DAY TELEPHONE
ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
STATE UC. #4-95'27::L LICENSE CLASS C -P -6--Y & CITY BUSINESS UC.# LTD/ B
D£SICN£1l NAM£ (last name brst) ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE STATE UC.#
1. WoRKERS' COMPENSAlioN Workers' Compensation beclarat1on: I hereby affirm that I have a cerubcate of consent to self-insure issued by the Director of lndustnal
Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified
by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C).
INSURANCE COMPANY POLICY NO. EXPIRATION DATE
Ceruhcate of Exemption: I certify that m the performance of the work for which this permit 1s issued, I shall not employ any person many manner
so as to become subject to ,e Workers' Compensation Laws of California.
8_s~;~~1t(f~~TE Z -3--ef 5
Owner-Builder Declaration: I hereby albrm that I am exempt from the Contractor's License Law for the following reason:
□ 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 Ccxle: 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
Ccxle: 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 am exempt under Section _______ Business and Professions Ccxle for this reason:
(Sec. 7031.5 Business and Professions Ccxle: 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, commencing with Section 7000 of Division 3 of the Business and Professions Ccxle)
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 ($500)).
SIGNATURE DATE
COMPLETE tAls sECl'ioN FOR NON-RESIDENTIAL 0011.biNC PERMITS oNLY:
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?
□ YES □ NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
□ YES □ NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
□ YES □ NO
IF ANY OF TI-IE ANSWERS ARE YES, A FINAL CERTIFICATE OF ocx:uJ>ANCY MAY Nar BE cyiUED AFl'ERJULY 1, 1989 UNU.S.5 nm APPUCANT
HAS MET OR IS MEETING nm R.EQUlR.EMENTS OF nm OFFICE OF EMERGENCY SERVICES AND nm AIR POlLUTION OONTilOL DISI'RlCT.
9. coNS'i R0Cl1ON LENDING AG£NCV
I hereby affirm that there 1s a construction lending agency tor the performance of the work for which this permit 1s issued (Sec 3097{1) CIVIi Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPIJCANI CERIIFICAIION
I cemly that I have read the apphcauon and state that the above information 1s correct. 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 AL'iO AGREE TO SAVE INDEMNIFY AND KEEP 1-WlMLFSS nm QTY OF CARLSBAD AGAINST AIL UABII.ITIF.S, JUDGMENTS, CDSTS
AND EXPENSES WIDCH MAY IN ANY WAY ACDUJE AGAINST SAID QTY IN OONSF.QUENCE OF nm GRANTING OF 1lilS 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 Ccxle shall expire by limitation and become null and void if the
building or work authorized by such permit is not commenced within 365 days from the date of such permit or if the building or work authorized by
such permit is suspended or abandon t any time after t work is ommenced for a pericxl of 180 days (Section 303(d) Uniform Building Ccxle).
APPLICANTS SIGNATURE .A:.~,,-,,..~ kilet~ DATE: ___ _