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Home My WebLink About2804 VIA RICARDO; ; CB950916; PermitB U I L D I N G P E R M I T Permit No: CB95091o Project No: A9501299 Development No: 07/10/95 08 :24 Page 1 of 1 Job Address: 2804 VIA RICARDO Permit Type: PLUMBING Suite : Lot#: Parcel No : 1 67-3 30-18-0 0 Valuation: o Con s truction Type: VN Occupancy Group: Reference#: Status : ISSUED Description: GAS LINE TEST Appl/Ownr : BOBS PLUMBING P .O. 1815 CARLSBAD, CA. 92008 *** Fees Required Fees: Adjustments: Total Fees: Fee description *** 27.00 .00 27.00 *** Enter "Y" for Plumbing Issue Fee > Gas Piping System > * PLUMBING TOTAL 619 729-3 686 Applied: 07/10/95 Apr/Issue : 07/10/95 Entered By: MDP Fees Collected & Credits *** Total Credits: Total Payments: Balance Due: Units Fee/Unit 7.00 .00 .00 27.00 Ext fee Data 20 .00 Y 7.00 27 .00 2645 07/10/95 0001 01 02 C-PRMT 27-00 CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 • PERMIT APPLICATION PIAN CHECK NO. t'~--~ L-6 City of Carlsbad Building Department 2075 Las Palaas Dr., tarlsbad, CA 92009 (619) 438-1161 EST. VAL. __________ _ t. PERMIT 1YPE PLAN CK DEPOSIT ________ _ VAIID.BY. ___________ _ DATE From List 1 (see back) give code of Pennie-Type: ____________ _ For Residential Projects Only: From List 2 (see back) give Code of Structure-Type: _____________________ _ Net loss/Gain of Dwelling Units 2. PROJECT INFORMATION Addr~<804- FOR OFFICE USE ONLY Bualdang or Suite No. Nearest Cross Street ~ CAQ:l)o LEGAL DESCRIPTION Lot No. SubchV1s1on Name/Number Unit No. Phase No. CHECK BEWW IF sUBMI I I Eb: □ 2 Energy Cales D 2 Structural Cales D 2 Soils Report O 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK G,,A..~ SQ. FT. # OF STORIES # OF BEDROOMS # OF BATHROOMS 3. WN IACI PERSON (at daflerenf from apphcant) NAME (last name first) ADDRESS CITY STATE ZIP CODE ◄. APPllCAN I ~ON IJtACIOR LI AGEN I FOR CON I RACIOR DAY TELEPHONE DOWNER □AGENIFOROWNER NAME (last name first) --:8,--o g's YUJly~/lr~ CITY STATE ZIP CODE DAY TELEPHONE s. PROPERTI OWNER NAME (last name first) Wu~~K-ADDRESS~ 8 04~/4iu~O · CITY STATE ZIP CODE 9 ~ DAY TELEPHONE -i.. '29 • 3/:, fJ6 6. OON"i'RAciOR NAME (last name first) ADDRESS CITY ~ STATE ZIP CODE DAY TELEPHONE STATE uc. #5::/3 S'"'a3ucENSE cIASs C -3-'-CITY BUSINESS uc. # ast name arst CITY STATE ZIP CODE DAY TELEPHONE STATE UC.# 1. WoRKERS' OOMP£NsA'i1oN Workers' Compensauon Deciarauon: I hereby aihnn chat I have a certificate of consent to sell-insure issued by ihe Director ol 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 Certahcate of Exemption: I certify ihat m ihe performance of ihe work for which thas pennat as issued, I shall not employ any person m any manner so as to bec~om subj= the W.o kers' Compensation Laws of California. SIGNATURE_ fi__W/J:.____ 1 -1 o --9£ s. OWNER-BO Owner-Builder Deciarauon: I hereby afhnn that I am exempt from the Contractor's License Law for the iollowmg 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 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.). 0 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 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, 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 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 ($500]). SIGNATURE DATE COMPLETE fflls SECTION FOR NON-RESIDENl1AL BUILDING PEllMl1's 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 of the Presley-Tanner Hazardous Substance Account Act? □ YES ONO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ YES ONO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ YES ONO IF ANY OF nm ANSWERS ARE YF.S, A FINAL CERTIFICATE OF cxx:uPANCY MAY NOf BE ISSUED AFTER JULY l, 1989 UNLESS 1lIE APPUCANT HAS MET OR IS MEETING nm RF.QUIREMENTS OF nm OFFICE OF EMERGENCY SERVICES AND nm AIR POILUTION OONTilOL DISllUCT. 9. OONS'IR0CIION LENDING AGENCY I hereby afhnn ihat there as a construction lending agency for the performance of ihe work for which Chas pennat as issued (Sec 3097(1) CIVII Code). LENDER'S NAME LENDER'S ADDRESS 10. APPUCANI CEitliFICAllON I ceruly that I have read ihe apphcauon and state that the above inlormauon 1s correct. I agree to comply with all Clly ordinances and Stale 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 1U SAVE rNDEMNIFY AND KEEP HARMLESS THE CI1Y OF CAR1.SBAD AGAINST AIL UABllJTIES, JUDGMENTS, CDSTS AND EXPENSES WI-OCH MAY IN ANY WAY Aa:RUE AGAINST SAID CI1Y IN OONSF.QUENCE OF nm GRANTING OF nos 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 within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or aban n at ny time after t e w k • commenced for a period of 180 days (Section 303(d) Uniform Building Code). APPLICANTS SIGNATURE DATE: 0 ! / _ WIQSIPYYQ IMSPlt;l'IOI 1 OATS Z,fi_ O ____IS t!fSPICTOlt_J_[_/?U-0 ________ _ PEJUCIT e <jS--,9/? , PWIC:Jt e JOI ADDUSS dftJL/ ~;f~ ---- TIMZ U.IVI: TIMZ co t.Vl. c6l ------------ PIiia-Ti •1111•• OUalI Pl'tOII -~aAJ // :> - t.&AVI:: ACT CCNNEMTS Co -------