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Home My WebLink About1069 LIGHTHOUSE RD; ; CB972645; Permit09/19/97 14:56 Page 1 of 1 B U [ L D I N G Job,Address: 1069 LIGHTHOUSE RD Permit Type : PLUMBING Parcel No : 214-531-22-00 Valuation : 0 P E R M I T Suite: Lot#: Permit No : CB972645 Project No: A97033B4 Development No: 9345 09/19/97 0001 01 C-PRMT Construction Type: 02 Occupancy Group: Reference#: Status: Applied: 27-00 NEW ISSUED 09/19/97 09/19/97 JM Description: GAS LINE OT FIRE PIT AND : FUTURE BBQ Appl/Ownr : KEREKFFY KYLE 1069 LIGHTHOUSE ROAD CAR LSBAD, CA 92009 Fees Required *** Fees: Adjustments: Total Fees: Fee description Enter "Y" for Plu Gas Piping System * PLUMBING TOTAL 760 Apr/Issue: Entered By: 736-3488 .00 .00 27 .00 *** Ext fee Data 20.00 Y 7.00 27.00 PERMIT HAS EXPIRED IN ACCORDANCE Wi;\:l lU\,O, SECTION 106.4.4 ~ DATE ____ SIGNATUR!YJ:t....,l.,,,ai~Nca~- CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. Vy; q) CITY.OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL.-------==-- Plan Ck. Deposit -::::..-l'----r.7l,-,...,_'b/ Validated By-::;c-t-~9-c::"''----- Date, ___ -bf-+--L+-+-t------ 1. PR<ijEct INFORMATION lo E. '\ L,·,;1 lrl + 1-\o"ls: E RoA h Address (include Bldg/Suite #) '2'2... Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units ((. ta-5 i/l€N(E: S'lVV\£ Assessor's Parcel# .l..... • f'_. Existin~ Use J:NstllJ/ AS' )iN£ 10 F>'r, (lit\" ruih'.t'JjS fut f-.,-k,ir, Proposed Use .s Description of Work SO. FT. #of Stories # of Bedrooms # of Bathrooms Name • Address City State/Zip Telephone # Fax# li/\''"JlliiilicANt O Contracio, 0 Agent ior t:oni,adlor ~owrlei';; 0' Ali•nl i~f ooh6i''' l<y/c KefeJcf:.Pv 106'l Lighf-'101.\Se /?.Ml) CA(.LSMll CA 'I bO '736 -s '18 8 Name 7 Address Citv State/Zip Telephone# Address City S.tate/Zip Telephone# '.i;. • i:<iNTRAcT0R : COMPANY NAME (Sec. 7031.6 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repalr any structure, prior to its Issuance, also requires the applicant for such permit to flle a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3 of the Business and Prof8sslons 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 clvll penalty of not more than five hundred dollars ($5001). Name Address City State!Zip Telephone# State License II _________ _ License Class ________ _ City Business license I _______ _ Designer Name Address City State/Zip Telephone State License # _________ _ e. WORKERS' COMPENSATION •; > Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following 0 I have end 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 for which this permit is issued. O I have and will maintain workers' compensation, as required by Section 3700 of the Labor Coda, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company____________________ Policy No.____________ Expiration Date _______ _ ITHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$1001 OR LESS) 0 CERTIFICATE OF EXEMPTION: 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, WARNIN0: Failure to secure worker•• compensation coverage I• unlawful, and ahall subject an employer to criminal penaltlea end civil fine• up to one humlred thousand dollar, ($100,000), In addition to the cost of compensation, damagH at provided for In Section 3708 of the Labor code, Interest end attorney'• fees. SIGNATURE.______________________________ DATE _________ _ , •' .. '''OWNEFU1UILbr!R DECLAAATIbl\i <. ~ •. , -~-,~----d. · .-, -~." • ', .• ~. -~· .. :" ,··;·~:,~:'-'-i,.f~::.xti'.SJ~t.jg:Fl~:t:it_~':t~?l~fi~r[:".~~?J\ilJ!::J(J):t~Yi,J~:~0~::•t"\f:c'ViTi:f ,, I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D 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, end who does such work hlmself 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 Hie). 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 auch projects with contractor(s) licensed pursuant to the Contractor's License Law). 0 I am exempt under Section ______ Business and Professions Code for this reason: ,. 2. 3. I personally plen to provide the major labor and materials for construction of the proposed property Improvement. ~ YES ONO 1E2)ave not) signed an appUcatlon for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction !include name / address I phone number / contractors license number): 4. I plen 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): ____________________________________________ _ 6. I wm 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): DATE '1 / 19/91) Is the applicant or future building occupant required to submit a busine n, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25633 or 26634 of the Presle -ner HezardoiJs Substance Account Act1 0 YES D NO Is the applicant or future building occupant required to In a permit from the air pollution control district or air quality management di:strlct? 0 YES O NO Is the facility to be constructed within 1,000 of the outer boundary of a school slte7 0 YES D NO IF ANY OF THE ANSWERS ARE YES, AL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETIN0 THE REQUIREMENTS OF THE OFFICE MERGENCY SERVICES AND THE AIR P0LLUTION CONTROL DISTRICT. lit,. .. MHstiluctl<i!I I.EliiblNiJ Alii!Ni:V'."'·'" .,,,'.'.''7,r's:r?"'''' , , t hereby affirm that there ls a construction lending a or the performance of the work for which this permit Is Issued !Sec. 30970) Civil Code). LENDER'S NAME--------,,..-<':._____ LENDER'S ADDRESS. ______________________ _ i!C ·. Ai'l>l.lcANf CEiliiFICA'rloN "'' ,. . . ·. I'. P n.-.-.,. ''. '•·,,,, '/c·""''""'"''"''' , .. ,., . .,,,,..";, t'.'"~1'"FJ"''~~i".'/'1''trs!'r,l)''"'ft"!'J!:i~:.''"''.I''", ;' .,,.,,.,,,,,,,.~., I certify that I have read the application and state that the above information is correct and that the Information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize repreHntatlves of the Citt of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE A0AINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavation:s 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 385 days from the date of such permit or if the building or work authorited by such permit Is suspended or abandoned at any time after the wor ' e cad f riod of 180 days (Section 108.4.4 Uniform Building Code). APPLICANT'S SIGNATURE __c,~~i::~r~~~~~!-=---------------------_:__ OATE C, //Cf/ 9 /) WHITE: File YELLOW: Applicant PINK: Finance PERM'.!'.T# CB972645 DESCRIPTION: GAS LINE OT FIRE FUTURE BBQ TYPE: PLUM CITY OF CARLSBAD INSPECTION REQUEST FOR 09/24/97 PIT AND INSPECTOR AREA PLANCK# CB972645 OCC GRP CONSTR, TYPE NEW JOB ADDRESS: 1069 LIGHTHOUSE RD APPLICANT: KEREKFFY KYLE CONTRACTOR: STE: LOT: PHONE: 760 736-3488 PHONE: OWNER: PHONE: REMARKS: C/KYLE/431-9462 AM PLEASE INSPECTOR SPECIAL INSTRUCT: FIRST INSPECTION OF THE DAY PLEASE. TOTAL TIME: LVL DESCRIPTION ACT COMMENTS 8AM CD 11 23 ST Ftg/Foundation/Piers PL Gas/Test/Repairs /& ______ _ /lfF'----------------------- ***** INSPECTION HISTORY***** DATE DESCRIPTION ACT INSP COMMENTS