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Home My WebLink About2719 YORK DR; ; CB980740; PermitB U I L D I N G 03/11/98 12:54 P E R M I T Permit No: CB98074 Project No: A9800969 Development No: Page 1 of 1 Job Address : 2719 YORK RD Permit Type : PLUMBING Parcel No: 167-392-42-00 Valuation: 0 Suite: Lot#: 4884 03/11/98 0001 01 C-PRHT Construction Type: 02 Occupancy Group: Reference#: Status : 27-00 NEW ISSUED 03/11/98 03/11/98 RMA Description: REPAIR BROKE WATER LINE UNDER : SLAB-RE-ROUTE OVERHEAD Appl/Ownr : HASAN , DONNA 2719 YORK RD CARLSBAD CA *** Fees Required *** Fees: Adjustments: 92008 760 Applied: Apr/Issue: Entered By: 729-3566 Fees Collected & Credits o a edits : Total Fees: Tota nts: .00 .00 27 .00 .Ba Due: *** Fee description Enter 'Y" for Plu i Each Install/Repair 1Jn1 Fe~/Uni t Ext fee Data 20 .00 Y 7.00 FIN AL APP P~OVAL INSP.---OAfC:--- \ cLEARANCE-----:::: CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 .,, FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. 1!/(17 lfD CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Pal mas Dr., Carlsbad CA 92009 EST. VAL. _________ _ (760) 438-1161 1. PROJECT INFORMATION 87;q '/oRK Address hnclude Bldg/Suite I) {3qf<l'S84Q Business Name tat this address) Legal Descnpt1on Lot No. Subdivision Name/Number Unit No. Phase No. Total I of units Assessor· s Parcel I EJCisting UH Proposed Use Description of Work SQ. FT. ttof Stories I ol Bedfooms II of Bathrooms .2. Name Address City State/Zlp Telephone II ,3. APPLICANT O Contractor O Agent for Contractor • ~Owner O Ag.int for Owner Fax II Name Address City State/Zip Telephone II 4. PROPERTY OWNER .5A»1 ~ lbn,-,~ 1-f~ • Address Name >10J J City State/Zip 72 ~c -,3Stl Telephone II s. CONTRACTOR • COMPANY NAME (Sec. 7031.5 Business and Professions Code: Any City or County which requirH e permit to construct, alter, iml)fov,, demolish or repair any structure, prior to Its issuance, also requires the applicant tor such permit to file • signed statement that he is licensed pursuant to the provisions of the Contractor's License L..w (Chapter 9, commending with Section 7000 of Division 3 of the BusinHs end ProfHsions Code) or that he Is exempt therefrom, and the basis for the alleged exemption. Anv violation of Section 7031.5 by any applicant tor a permit subjects the applicant to a civil penalty of not more then five hundred dollars ($5001). Name Address City State/Zip Telephone II State License I _________ _ License Class _________ _ City BuaiONI Uc-■ I _______ _ Designer Name Address City State/Zip Telephone State License I _________ _ 6. WORKERS' COMPENSATION Workers' Compenution Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 I have end will maintain a ce"ificete of consent to self-Insur, for workers' compensation H provided by Section 3700 of the Labor Code, for the performance of the work tor which this permit is issued. 0 I have and will maintain workers' compensetion, es required by Section 3700 of the Labor Code, for the performance of the work for which this permit Is issued. My worker's compensation insurance cenier end policy number ere: Insurance Company_____________________ Policy No. Expiration Date. _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS IUOOJ OR LESS) 0 CERTIFICATE OF EXEMPTION: I ce"ify that in the performence of the work for which this permit Is issued, I aheH not employ any person in any manner ao es to become subject to the Workers' Compen1■tlon Laws of California. WARNING: Failure to HC:UH worllen' compenaetlon C0"8r■ge Is unlawful, end ehall eubject en employer to c:rimklal peneltln end clYII flnea up to -hundfed thousend dollera ($100,000), In eddltJon to the cost of c:omp■N■tlon, c1a,.,.... ea pro¥idecl for In Section 3706 of the labor c:ocle, lnt-t and en--,·• fNa. SIGNATURE_______________________________ DATE _________ _ 7. OWNER-BUILDER DECLARATION •• ;.-•:~.·--···. '····~;.,.-,.;r•.··'·· .,.·.·qr;r. .-.. I hereby affirm that I em exempt from the Contractor's Lie-• Lew for the following rHson: 0 I, H owner of the prope"y or my emploYffS with wages H their sole compena■tion, will do the work end the structure la not Intended or offered for Hie (Sec. 7044, Busine" end Profe11ions Code: The Contractor'• License Lew don not apply to en owner of property who bullda or lmprovn thereon, end who don such work himHlf or through tlis own emploYffS, provided that auch Improvements ere not Intended or offered for Nie. If, however, the bulldlng·or Improvement la sold within one yHr of completion, the owner-builder wllf have the burden of proving that he did not build or Improve for the purpOH of Ule) . .P,l_ I, H owner of the prope"y• em exclusively contracting with licensed contrector1 to construct the project (Sec. 7044, Bueineu end ProfHalona Code: The Contractor's License Lew does not apply to en owner of prope"Y who builds or lml)fove1 thereon, end contrec:u for IIIJCh projects with contrectorla) ~ed pursuant to the Contractor's Licenae Lew). 0 I am exempt under Section ______ BuaiONI end ProfHSlons Code for this reuon: 1. 2. 3. I personally plan to provide the mejor labor end materiel• for construction of the proposed property Improvement. 0 YES ~O e , have not) signed en application tor • building permit for the propo11d work. I have contracted with the foll w~ person (firml to provide the proposed construction (Include name/ eddrNS / phone number/ contractors Ii-• number): 4. I plan to provide po"ions of the work, but I have hired the following person to coordinate, auperviH end provide the major -k (Include name/ eddraas / phone number / contractors license number>..·_----------------------------------------------- 5. I will provide aome of the work, but I have contracted (hired) the foll of work): ____________ -r--r4~----,il::-f----~-------------------~~-~--------- OATE ___ ....;,3""'/'-"/-'-'/ c ..... 9~B pera0n1 to provide the -k Indicated !Include name / ■ddrNI / phone number / type 'COMPLETE THIS SECTION FOR NON-linlDENTiAi. ilUILDiNci PERMiTii OM. Y~~~.'t....,.._, •• ,-,...,T"'f~~--;1.~~-'7l:' ~-,,.,.., ... -..... ·-· •••••• Is the applicant or future building occupant required to submit• buaineal plan, ecutely heurdoua materiela regiilli■liof! form or risk management end prell9ntion program under Sections 25505, 25533 or 25534 of the Presley-Tenner Hazardous Subet■nc• Account Act7 0 YES O NO Is the applicant or future building occupant required to obtain• permit from the air pollution control diltri_ct or air quellty management district? 0 YES O NO Is the facility to be constructed within 1,000 Ifft of the outer boundary of • 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. is.· CONSTRUCTION LENDING AGENCY ••· ,. -·•---~· •·--· ,,..-~:~-~,,...-,..,.r-·• ~-~•--·,----~----~----~~-.-.,-· 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) Clvil Code I. LENDER'S NAME ______________ _ :9, APPLICANT CERTIFICATiON ••• LENDER'S ADDRESS _______________________ _ I certify that I have read the application and state that the above information is correct end that the Information on the plans Is accurate. I egrH to comply with ell City ordinances and State laws relating to building construction. I hereby authorize reprHentltivn of the Citt of Cer11bed to enter upon the above mentioned prope"y for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO 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 for excevetions over 5·0-deep end demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Building Officlel under the pr '1ions of this Code shell expire by limitation end become null and void it the building or work authorized by such permit is not c menced within 365 days from t date of such permit or If the building or work authorized by such permit is suspended or abandoned at eny time after the wo • commenced for• d of 160 d vs (Section 106.4 .4 Uniform Building Code). DATE ___ ..3-'-0 ___,ft/;:.....;7°'._~=---- WHITE: File YELLOW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB980740 FOR 06/25/98 DESCRIPTION: REPAIR BROKE WATER LINE UNDER SLAB-RE-ROUTE OVERHEAD TYPE: PLUM RD STE: INSPECTOR AREA PY PLANCK# CB980740 OCC GRP CONSTR. TYPE NEW LOT: JOB ADDRESS: 2719 YORK APPLICANT: HASAN, DONNA CONTRACTOR: PHONE: 760 729-3566 PHONE: OWNER: REMARKS: C/SAM/714/932-7225 EARLY AM SPECIAL INSTRUCT: TOTAL TIME: CD 17 LVL DESCRIPTION ST Interior Lath/Drywall PHONE: INSPECTOR ACT COMMENTS ~-------------------- DATE 061898 061798 DESCRIPTION Rough/Topout Rough/Topout ***** INSPECTION HISTORY***** ACT INSP AP PY NR PY COMMENTS NO ADULT IN HOUSE