HomeMy WebLinkAbout1277 FOREST AVE; MULTI-PERMIT FILE; CB062711; Permit09-21-2006
City of Carlsbad
1635 Faraday Av Carlsbad, OA 92008
Plumbing Permit Permit No: CB062711
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Reference #:
Project Title:
1277 FOREST AVCBAD
PLUM
1561100700 Lot#;
Constmction Type:
MACPHERSON RES RELOCATE
GAS METER
0
NEW
Applicant:
MACPHERSON'S CONSTRUCTION
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
09/21/2006
KG
09/21/2006
09/21/2006
Owner
MACPHERSON STEVEN&MARGARET REVOCABLE TRUST 02-08
P 0 1482
CARLSBAD OA 92018
619 507-6521
1277 FOREST AVE
CARLSBAD CA 92008
Plumbing Issue Fee
Fixture or Trap
Building Sewer
Roof Drain
Install/Repair Water Line
Water Heater and/or Vent
Gas Piping System
Vacuum Breaker
Other Plumbing Fees
Master Drainage Fee
Sewer Fee
Additional Fees
0
0
0
0
0
1
0
$20.00
$0.00
$0.00
$0.00
$0.00
$0.00
$7.00
$o;oo
$0.00
$0.00
$0.00
$0.00
TOTAL PERMIT FEES $27.00
Total Fees:$27.00 Total Payments To Date:$27.00 Balance Due:$0.00
Inspector?
FINAL
Date
L ^PROVAL,
ff-fS'OC'Clearance:
NOTICE: Please take NOTICE that approval of your project Includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter coBectively
refened to as "fees/exactions.' You have 90 days from the date this permit was Issued to protest Imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth In Government Code Section 66020{a), and fie the protest and any other required Information with the City Manager for
processing In accordance with Carlsbad Municipal Code Section 3.32,030. Failure to timely follow that procedure wl bar any subsequent legal action to attack,
review, set aside, void, or anmi their Imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacfty
changes, nor planning, zoning, grading or other sImBar application processing or service fees In connection with this project. NOR DOES IT APPLY to any
fees/exactions of which vou have orevlouslv been given a NOTICE similar to this, or as to which the statUe of limitations has Drevtousiv otherwise expired.
PERMIT-APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
1. PROJECT INFORMATION
FOR OFFICE USE ONLY
PLAN CHECK NO
EST. VAL.
ONLY ^ ,
Plan Ck. Deposit
Validated By.
Date
Address (include Bid
rV-vr; /
^uite f)
> /?n (
Business Name (at this address)
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total rf of units
Assessor's Parcel 9 Existing Use Proposed Use
\ /}
2. 1
Iptlpn of Worlu
MLaITON (If different from ap^cant)
#of Stories 9 of Bedrooms f of Bathrooms
Name
3. iAPPUCANT
Address
Q Contractor Q Agent for Contractor □ Owner
City
□ Agent for Owner
State/Zip Telephone 9 Fax 9
Name
(>4.
Address City State/Zip Telephone #
OWNER
Name Address City State/Zip Telephone 9
5. CONTRACTOR - COMPANY NAME
(Sec. 7031.5 Business and Professions Coda: Any City or County which requires a permit to construct, alter, Improve, demolish or repair any structure, prior to ItsIssuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provlslorts of the Contractor's Licertse Law[Chapter 9, commending 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 violatipn of Section 7031.5 by any appilcanCfor a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$B(301).
Address City State/Zip Telephone # '_ License Class ^ — CL(Ty) City Business License i jl-jdlP "ID ^ 7Name
State License 9
TelephoneDesigner Name Address City State/Zip
State License 9
WORKERS' COMPENSATIONWorkers' Compensation Declaration: I hereby affirm under penalty of perjury orte of tfie following declarations:
□ I have and will maintain a certificate of consent to self-insttre for workers' compensation as provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
□ I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit IsIssued. My worker's compensation insurance carrier and policy number are:Insurance Company Policy No. Expiration Date
(THISJSECnON NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [»100] OR LESS)0^ CERTinCATE 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 Caltfomia.WARNING: Failure to secure workers' companion coverage la unlawful, and shaS subject an employer to criminal penalties and dvH fines up to one hundredthousand dollars ($100,000)^ addWoMo thay^st of compensation, damages as provided for In Section 3706 of the Labor coda. Interest and attorney's fees^SIGNATURE X C Mr, /IfuJ'/
7. OWNER-BUILDER DECLARATIONI hereby affirm that I am exempt from the Contractor's LIcanse 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 Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who doessuch work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or Improvement issold 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).
□ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: TheContractor'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 Ucense Law).
»/wD ui ulti utoor ccrae, imer
DATE
□ I am exempt under Section . Business and Professions Coda for this reason:
1.
2.
3.
DATE
I personally plan to provide the major labor and materials for construction of the proposed property Improvement. Q YES I Ino
I (have / have not) signed an application for a building permit for the proposed work.
I have contracted with the following person (firm) to provide the proposed construction (Include name / address / phone number / contractors license number):
4. I plan 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 / contractorB license number)B. I will provide some of the work, but I have contracted (Wred) the following persons to provide the work indicated (Include name / address / phone number / type
OT VrOrKJ.^
PROPERTY OWNER SIGNATURE
COMPLETE THIS SECTION FDR NON-ftSSIDBi/TIAL BUILDING PERMITS ONLYIs the applicant or future building occupant required to submit a bualneaa plan, acutely haiardous matedals registration form or risk management and preventionprogram ufMjer Sections 25506, 25533 or 25534 of the Presley-Tarmer Hazardous Substance Account Act? n YES n NOIs 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 ,CK)0 feat of the outer boundary of a school site? □ YES □ 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 THEREQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
5._ . .CONSTRUCTION LENDING AGENCYI hereby affirm that there is a consuuction lending agency for the performance of the work for wWch this permit Is Issued (Sec. 3097(1) CIvU Code).
LENDER'S NAME LENDER'S ADDRESS
fl. APPLICAfTT CERTIFICATION ^
^ and state that the above information Is correct and that the Information on the plans Is accurata. I agree to comply with allor^BrtvTI''^r relating to building constnjction. I hereby authorize representatives of the City of Carlsbad to enter upon the above mentionedagree to SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIESJUDGMENTS, 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 excavations over B'O' deep and demolition or construction of structures over 3 stories In height.
provisions of this Code shall expire by limitation and become null and void If the building or worke,tnv^™ 11° days from the date of such permit or If the builtflng or work authorized by such permit Is^pe^d ^Z^ZJdat any time after the work Is commep^^^^perlo^f WJ^ys (Section 106.4.4 Uniform Building Code). auspenueu or aoanoonea^APPLICANT'S SIGNATURE A lhA\ ' 7/// DATE ^
WHITE: File YELLOW: Applicant PINK: Rnance
City of Carlsbad BIdg Inspection Request
For; 11/14/2006
Permit# CB062711
Title: MACPHERSON RES RELOCATE
Description: GAS METER
inspector Assignment:
Type: PLUM .Sub Type:
Job Address: 1277 FOREST AV
Suite: Lot 0
Location:
APPLICANT MACPHERSON'S CONSTRUCTION
Phone: 7608226526
Inspector:
Owner: MACPHERSON STEVEN&MARGARET REVOCABLE TRUST 02-08
Remarks:
Total Time:Requested By: STEVEN
Entered By: JANEAN
CD Description
24 Rough/Topout
^
Act Comment
.Comments/Notices/Hoids
Associated PCRs/CVs Original PC#
Inspection History
Date Description Act Insp Comments
4?^
03/01/1999
City of Carlsbad
Mechanical Permit Permit No: CB990785
Building Inspection Request Line (760) 438-3101
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
Project Title:
1277 FOREST AVCBAD
MECH
1561100700
$0.00
Lot#:
INSTALL 3K AC W/30 AMPGIRUIT
Status: ISSUED
Applied: 03/01/1999
Entered By: JM
Plan Approved: 03/01/1999
Issued: 03/01/1999
Inspect Area:
Applicant:
ACTION AIR COND.& HEATING-S.D
2517 BS. SANTA FE
VISTA,, CA 92083
619-727-4152
Qwner.:-____^
MACPHERSOft-SXEVEN q2
Total Fees: $44.00 / Ardt^ Payments $0.00 \ V^^^^alan)^ Due:
loj $lj5.00
$9.00
$^0.00
$0.00
$0.00
$0.00
$0.00
$20.00
Mechanical Issue Fee
0 INCORPORATED
1952
$44.00
Install/Fum/Ducts/Heat Pumps Fee
Fireplace Installation Fee \
Exhaust Fan Fee \
Installation/Relocation Vent Fee
Hood Fee
Boiler/Compressor to 15HP F
Other
TOTAL PERMIT FEES
permit has EXPlREDlTJACCORDANUE WITH U.B.C.
SECTION 106.4^
SIGNATURE.DATE
Inspector:
FINAL APPROVAL
Date:Clearance:
NOTICH; Please take NOTICE ttiat approval of your prolect indudes the "Imposition* of fees, dedications, reservations, or ottier exactions tiereafter oollecflvety
toferred to as "fees/exacUons." You have 90 da^ from the ctete this permttwas Issued to protest imposition of these fees/exactions. If you protest fliem, you must
foBow the protest procedures set forth In Government Code Section 66020(a), and file the protest and any other required tnformatlon with the City Manager for
processing In accordance wkh Carislad lilunldpal Code Section 3.32.030. FaJure to timely follow that procedure wffl tar any sutaequent legal action to attack,
review, set aside, void, or annul their Imposltioa
You are heretiy FURTHER NOTIRED that your right to protest the specBied fees/exaotlons DOES NOT APPLY to water and sewer connection fees and capactiy
changes, nor planning, zoning, grading or other similar application processing or service fees In connection with this project NOR DOES IT APPLY to any
fees/eoractions of which you have prevloiBly been given a NOTICE slmBar to this, or as to which the statute of limitations has prevlousiv otherwise expired.
CFTY OF CARLSBAD
2075 Las Palmas Ihv, Carlsbad, CA 92009 (760) 438-U61
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(760) 438-1161
(0^
1. PROJECT INFORMATION
Address (include Bldg/Suite ff)
Lsgal Description
FOR OFFICE USE ONLY^
PLAN CHECK NO. 71>5
EST. VAL.
Plan Ck. Deposit
Validated By
Date
Business Name (at this address)
Lot No.Subdivision Name/Number Unit No.Phase No.Total # of units
Assasaor's Parcel # Existing Use
IVDS.TAU-M-1 O o-f *^.0 kV
Description of Work SO. FT. 'of Stories
!iL'* 5oNTACf PEFiSbN (If diHemnt ftotti appiicani) " v j ' ' " i '
Proposed Use
r \ArxJtT
# of Bedrooms ff of Bathrooms
Name Address ^ City
S4'TTApi>UdANf--^n goritrabtofT';'□7lgennoFebTrtractoP'''IIl Owner : □ Ageni lbr Owner ■'gTIc^i, 12.^2. AgV3feofir wAV ■ ^/StA
Name
•^TEVE (Vy^PHEtgSOt^
Address City
l-ZTT-i Psty£. C-f
ov
State/Zip Telephone ff Fax ff
q2C&e> -7Z7"HfS2-
-R
State/Zip Telephone '
CjA 6?l<f- ^7- CpSZ-^
Name Address City State/Zip Telephone#
(Sac. 7031.B Business and Professions Code: Any City or County which requires a permit to construct, alter, Improve, deniolish P''";Issuance, alio 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, commending with Section 7000 of Division 3 of the Business and Professions Code! or that he is exernpt therefrom, I"" ®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 hur^d dol ars ($5001).C\rT-iO60) t^\Q, iZ/s^/a ca /Z/- V/s ^'' ' — ^ «-.j 1 ~ ritu State/ZioAddressCity State/Zip Telephone #Name
State License #Scf] &QS License Class City Business License #
City State/Zip TelephoneDesigner Name Address
State License » ^^"f'TSOfT - ,
'b.' FWorkers'xompensatioN ^ .Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations.□ 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. ,5] I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit isissued. My worker's compensation insurance carrier and policy number are: i c- qCX / IInsurance company Policy No. /5QQ-2-/5-^^ Expiration Dateil^:i:i
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS l»1001 OR LESS)□ 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 asto become subject to the Workers* Compensation Laws of California. . . jWARNING-' Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundredTusTd don'^ioyo^ the cost of compensation, damages as provided for In Section 370^6 of th^abor c^e. Interest end attorney s fees..qioNATURE' — —T—— ——ZTTTTrTTTT" r!7P-OWNferi-BUILbERbECURAii(oN^^'iV--^-?'-■ T'"'""'''--'-; \ ^ : - •I hereby affirm that I am exempt from the Contractor's License Law for the following reason. „ a < .
pursuant to the Contractor's License Law).□ I am exempt under Section Business and Professions Code for this reason:
1. i personally plan to provide the major labor and materials for construction of the proposed properly improvement. □ YES DNO
2. I (have / have not) signed an application for a building permit for the proposed work.3. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license
4. I nian 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
6""TwiiXvVdr.'ome°orthe"rork^but I have contracted (hired) the foiiowing persons to provide the work Indicated (include name / address / phone number / type
of work):
DATE
'' f.Et4Mlt8'bNLVffliTr'WT^rr1ff'V5^T tpIT-f i-fs-iThf'f:-v h -„ the appiicant or future building occupant required to submit a business plan, acutely hazardous materials registration ^rm o^r risk management and preven o-i'-proOfom-urHJar-Bootlcna 2550B, 2E533 or,2PS3A of the Presley-Tenner Haiaidous Substance Account Act? U U -i m rjn
:■ (athebliilStp futur. building occupant required to obtain a permit from the air pollution control district or air quality management districts □ YES □Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ YES □ NO „ no .c MooTiwrt thf
IF ANY oV'tHE answers ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THEREQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION^NTROL D^TRICT.^ ^ .. -
• ! Vhtr.by .fflrm:th.t there Is a construction iending agency for the performance of the work for which this permit is Issued (Sec. 3097(1) CIvi) Code).
LENDER'S, NAME;LENDER'S ADDRESS
'''(9F.v'Ai^UeANf:cfeRttfidATi5M:!^f^Z-l"''f"^^ .... -: , c:,Glfy thaVl hava^read the application and state that the above Information t'o'em^^'u^on^hVaVovT mentionedCity ordinances aruf State laws relating to ^rn^slru^ ND'^iyiFT AND KMP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES,5;fSE,iScrs?^AN''oTrP^^^^ 1^|?hZy1n'a°NY^^WA% Se^GaTn^T S^^ c" IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.OSHA: An OSHA permit is required for excavations over B'O" deep and demolition or construction of structures over 3 stories in height.
or abandoned at any time after thework is conimeMeif^ a period of 180 days (Section 108.4.4 Uniform Building Code). f qAPPLICANT'S SIGNATURE -7A
City of Carlsbad Inspection Request
For: 3/5/99
Permit# CB990785
Title: INSTALL 3K AC W/30 AMPCIRUIT
Description:
Inspector Assignment:
Type:MECH Sub Type:
Job Address: 1277 FOREST AV
Suite: Lot 0
Location:
fivPPLICANT : ACTION AIR COND.& HEATING-S.D.
Owner: MACPHERSON STEVEN K&MARGARET A
Remarks:
Phone: 7607293191
Inspector:
Total Time:
CD Description
44 Rough/Ducts/Dampers
Act Comments
b£-
Requested By: STEVE
Entered By: CHRISTINE
Inspection History
Date Description Act insp Comments
«
BUILDING PERMIT Permit No: 06980422
02/13/98 09:10 Project No: A9800538
Page 1 of 1 Development No;
Job Address: 1277 FOREST AV Suite: 4051 02/13/96 0001 01 0-
Permit Type: ELECTRICAL iv^
Parcel No: 156-110-07-00 Lot#:
Valuation: 0 Construction Type: NEW
Occupancy Group: Reference#: Status: ISSUED
Description: CONVERT FROM OVER HEAD TO Applied: 02/13/98
: UNDERGRND ELEC. UPGRADE lOOA TO 200AMPS Apr/Issue: 02/13/98
Entered By: JM
Appl/Ownr : MACPHERSON STEVEN 760 729-3191
1277 FOREST AVENEU
CARLSBAD CA 92008
■AAA Fees Required *** a** F^s^ Collected & Credits
Fees: 35 <00^ (2^ {_ /d\ /^^Adjustments: /' '^■--^Tbta-l^-predi't s: .00Total Fees: /'35 , O.Os^/J To bail/^aymept's : .00/ (■\ ^C)ue\ 3 5.00Fee description / ^ 'x. /' KUnit's "V^jF^e/Uhit Ext fee Data/ / ///'x .'-^V ^ \VV'—j _ j ^ ^"—Y
Enter "Y" for Eleotrid-Xssue-E;ee^ \ \ 10.00 Y
Remodel/Alter Per/ANfP-fY^T / X ^ jy-*' .2 5\ 2 5.00T' I \ y' 'f/'. r-x 1X.' I ,/X iV y&\' >/,/ I
\ /\ WsXv's / /\ ^y\// vy-^' /\ INCOnTOnATcD , T\ I ' ■' l&o? ■■ \ X /\ CY'nVC /\ C- ■-1 ' ? _ . ^ \ - /
X ■■'//r Xi'v-''
FINAI- A^PROVi^
J r:;
CLEARAK.
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
-PERMIT /APPLICATION
CITVOF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(760) 438-1161
1. PROJECT INFORMATION
Add
FOR OFFICE USE ONLY
PLAN CHECK NO.
EST. VAL.
Plan Ck. Deposit
Validated By,
Date y/.7/^A
ress Imdude BIdg/Suits #)Binlnns Name (at tMi addreas)
Legal Descnptton Lot No.SubtflvWon Nama/Numtwr Unit No.Phase No.Total # of umts
Assessor's Parcel #EsistlnB Use Proposed Uss
:z ^CONTACtNRSblilrtdmatont frainaiipiieaiiii
»or mofm # Of DodroOfllS 9 orpillBIXMia 3
le 9 Fa/#
« of Bathroc^
StatafZip Tstaphone iName Addraea Qty
O. APPUCANT 'QContraotor D Agent to Comiactof ■'D Owln^'!0 Agent for Owinir-
Name Address Qty State/Zip Telephone #
^ PROPERTY OWNER ^ '
Name Addrsss Oty StateAlp Telephone #
B. CONTRACTOR - company tiAue " ' I''-. .11 '--T/T"" ' '
(Sec. 7031.5 Business and Professions Coda: Any City or County which requires a permit to construct alter. Improve, damolish or repair any structure, prior to Its
Issuance, also requires the eppVcant for such permit to fie a signed statemarw that he is Icsnsed pursuant to the provisions of the Contractor's License Law{Chapter S, convnending with Section 7000 of Division 3 of the Business and Profeaslona Code) or that he Is exampt therefrom, and ths basis for tha allegedexemption. Any violation of Section 7031 .B by any applicant for a permit aul^ects the applicant to a dvli penalty of not more then five hundred dollars 1*500)1.
Name
State Ucensa f
Address
Llcetae Class
City State/Zip
Qty Business License #
Telaphorte f
Designer Name Address City State/Zip Telephons
Stats LIcenss #
6. WORKERS'C0MPBI8ATI0N ..-i-
Workers' Compensation Declaration: I hsraby affirm under penalty of perjury one of the following declaratiohs:
□ i have and will maintain a certificata of consent to sstf-lnsura for workers' compensation as provided by Section 3700 of ths Labor Coda, for the performance
of the work for which this psrmit is issued.
□ I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for tha performenoa of the rvork for which this permit Is
issued. My worker's compensation irauranca osrrier and policy number are:insurance Company ^ Policy No. Expiration Date
(THIS SECTION NEED NOT BE COMPLETB) IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*100) OR LESS)
□ CERTIFICATE OF EXEMPTION: I certify that in the performance of the work tor which this permit la Issued, I she* not employ any person in any menner so as
to become subject to the Workers' Compensation Laws of CatHomls.
WARNINQ: Falure to securs workers' eompenaetlon covaraga Is onlawlid. and ahal aii^aet an amployar to criminal parwIUaa and eM Ones iqi to one handradthousand dollars (*100.000), In addWIoii to the coat of compeiMailun. daiaagii as provided for In Saotian 3706 of the Labor code, huaiaal and attomay's faea.
SIGNATURE ^ DATE
7.OWNER^UUBl DECLARATION _I hereby affirm that I am exempt from the Contractor's Lioense Law for the foSowing reason:
1, as owner of the property or my employeas with wages as their sole oompensatlon, will do tha work and tha stnioture Is not intandad or oNarad for sale(Sec. 7044, Business and Professions Coda: The Comractor'a Lioense Lew does not apply to an owner of property who faullda or brvrovae thereon, and who doessuch work himself or through lUs own employees, provided that such impruvaiueiaa are not Intended or offered for stia. U, however, the buHdbiB or Impcovement Issold within orre year of complatiorb tha owner-builder wN have the burden of proving that ha dU not buHd or Improve (or the purpose of aaie).
□ I, as owner of the property, am exdusivsly contracting with loensed eonlractuia to oonatruct the project (Sec. 7044, Businasa and Code: ThsContractor's Ucanae Law does not apply to an owner of property who buMs dr hnprovas thereon, and conuaeta for auch projaeta with contracteria)
pursuant to the Contractor'a Ueertse Law).
□i am exampt under Section , Businasa and Proiassloiis Code for this reason:
plan to provide the major labor and materials for construction of the proposed property Improvement. B''yeS □no
A (t(av Aisvs not) signed an appHoation (or e building permit for the proposed work.
Hieve'MntTactrt vvm the foRowing person (flmi) to provide the proposed construction Ondude name / eddrass / phone number / conUautuia Bcanae number):^
L
4. i plan to provide portions of the work, but I have hirad the foOowiriB person to coonSnata, auperviae and provide the major work Bnduds nama / address / phonelujmber / contractors license txiitdter):
B. i win provide some of tha work, but I have oonuacted (hired) the foRowing persona to provide the work indteated Nndude nama / addrsss / phone nundier I type
of work):
property owner SK9*ATURE
'DATEcoMpletbthis sEOTtoi< FoirtfcMMteiaMnMi fcuabliW ppiMtTi ''■'t
Is the appNoam or future buMng occupam raqulrad to submit a business plan, acutely haiartinus metariala raglauatluit form or risk irwnagamant aixi prevention
program laxJer Sections 2B50B, 25533 or 28534 of the Praelay-Tanner Haiardous Subatanca Account Act? □ YES □ NO
Is the applicant or future buHdbig occupant required to obtain a permit from the air poluben ujntiul dlsukit or air quality management dixtrlctf □ YES □ NO
is t^ faclDty to be ixjtauucted within 1,000 feet of tha outer boundary of e sohool site? □ YK □ NO
IF ANY OF THE ANSWBtS ARE YES, A PMAL CSITIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MOTIHa THE
REQUIRHiarrS of the office of EMBIQBICY KRVICES AND T« AIR POLLUTION CONTROL DtSTRICT.
is, COftSTTOCTiONLtiiDWd AOdWiY''' V'"' ^ - -r .
I hereby affirm that there is a construction landing agamy for tha parformance of the work for which this permit is issued (Sec. 309751 ChrO Code).
LENDER'S NAME I LBiDER'S ADDRESS i
«. ' APPUCANTCERTIFICATlSli ■■■. u.. v , j,....-y.,—,, ^'T ■ fI certifv that i have r^ tha application and state that tha above informatioo is oorract and that the hifurineUwi on the plans is accurate, i agree to comply with allCity wdmanc^^State laws relating to bidding construction. I hereby authoriza rapraaentativas of tha City of Cartsfoad to enter upon the above mentionedproperty for inspection purposes. I ALSO AGREE TO SAVE, INDBHNFY AND KS> HARMLESS THE CITY OF CARLSBAD AGAINST Aa UABIUTIESJUDGMENTS, COSTS AND EXPSiSES WHICH MAY M ANY WAY ACCRUE AGAMST SAID CITY W CONSEQUENCE OF THE GRANTMG OF THIS PERMIT.OSHA: An OSHA permit is required for excavations over B'O* dasp and damoStion or construotloii of atnotures over 3 stories in height.
by tha BuUding Official WHler the provisions of this Code shall expire by limitation and become null and void If tha bidding or® commenced within 365 days from the date of such permit or if ths building or work amtwrlzad by such pemnit is suspendedj. 1 . ^.1. gf ,gQ (Section 106.4.4 Uniform Building Coda).
APPtiCANrS SIGNATURE
work authorized by such permit is
or abandoned at any time after the
DATE > -/ ^
WHITE: File YELLOW: Applicent PINK: Finance
>
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB980422 FOR 03/03/98
DESCRIPTION: CONVERT FROM OVER HEAD TO
UNDERGRND ELEC. UPGRADE lOOA TO 200AMPS
TYPE: ELEC
JOB ADDRESS: 1277 FOREST AV STE:
APPLICANT: MACPHERSON STEVEN
CONTRACTOR:
OWNER:
REMARKS: C/STEVE/
SPECIAL INSTRUCT:
INSPECTOR AREA PD
PLANCK# CB980422
OCC GRP
CONSTR. TYPE NEW
LOT:
PHONE: 760 729-3191
PHONE:
PHONE:
INSPECTOR
TOTAL TIME:
PERMIT# TYPE
CB961929 RAD
LVL DESCRIPTION
EL Service Change/Upgrade
—RELATED PERMITS—
CD
33
STATUS
EXPIRED
ACT COMMENTS
h'f (JAk—
DATE DESCRIPTION
022398 Service Change/Upgrade
***** INSPECTION HISTORY *****
COMMENTSACT INSP
AP NF
Permit No: CB973163
Project No: A9704041
Development No:
0508 10/21/97 0001 0:
fc 60-00
BUILDING PERMIT
10/21/97 12:53
Page 1 of 1
Job Address: 1277 FOREST AV Suite:
Permit Type: MECHANICAL
Parcel No: 156-110-07-00 Lot#:
Valuation: 0 ConstruGirl"on Type: VN
Occupancy Group: Reference#: Status: ISSUED
Description: INSTALL NEW F.A.U. UNIT Applied: 10/21/97
: Apr/Issue: 10/21/97
Entered By: MDP
Appl/Ownr : JDK MECHINipAL 619 596-9674
1057 WALNUT
SANTEE, CA. 92071
*** Fees Required *** F^e-s^Collected & Credits -kkk
Fees:
Adjustments:
Total Fees:
4 4 ,4o
/X
Fee descr
, 0 :
/44/:oAPj'^ . TotirlX^ymmtX
/ _^c|:&SLan|X^e :\iption ^ Data
~V 15 . 0 0 YX#5%)i0/21/97 000:^0^0 02
. 00
. 00
44 . 00
/ / n ,
O
Enter 'Y' for Mechaniea-lr;5lssu«.:^e;^>
Install Furn/Ducts/He-atliP.Lunps
Other 1
MECHANICAL TOTAL'
INCORPORATED
1952
r
''ilo
~?^^^0 0 ELE^^^'OO
44 . 00
OVAL\k
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION
\
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad OA 92009
(760)438-1161
1. PflOJarriNFOMMATION
FOR OFFICE USE cmV
PLAN CHECK NO
EST. VAL.
Plan Ck. Deposit.
Validated By
Date
. Addrau (ineiudg BIdg/Sulta f)
la~)~l yC^Vg
Builnwi Nama (at thii addreaa)
Legal Deacriptlon Lot No.Subdhriaion Nama/Numbar Unit No.Phaaa No.Total # of units
Assasaor'a Parcel #Existing list Propoaad Use
--f . 1r5°-,55^Sr.CS.
li "COHTACtPtBfcbttB*dmaiai«'lnimiiip^^
\ O ✓v.r e \/-oA/v> • fxa •) I i ^iQlDo^ f
* of Bedrooms # of Bathrooms
Name
3. AmJCANT^""^ ContTBOtof
It- cXa
Address
G Agent for Contrseibf
aty
'D oWfiW -'G Ag^ forOwnir
State/Zip leiepfKMie f Fax 0
Name
4. PROPERTY OWNER
yv\r PvJ ee-< o>0
Address
' r •-r ' -
Cttv Telephone 0
ia"Tl
Address
StstaiZip
• -n*" *. n L^w'' r J. -
aty Stata/Zip
11 -H n —'-r '-W IT'
Nime
E. contractor-conIi<anyNAhI£~
TsAphone «
iV 7 ipn-eyee
(Sec. 7031.5 Businexs and Professions Code: Any City or County whioh raquhes a permit to oonstniot, alter, improve, damoBsh or repair any structure, prior to Its
Isauance, also requires the appBcant for such permit to fHe a signed statement ttiat he Is icenaed pursuant to the provislona of the Contractor's Licensa Law
(Chapter 9, comrtMnding with Section 7000 of Dhriaion 3 of the Business and Professions Codel or that he Is exempt therefrom, and the basis for the alleged
exemption. Any violation o^ Secdon 7031.6 by any appHcsnt for s permit subiects the sppEcent to a dvl peraity of not mora then five hundred dollars (IBOOl).
Name
State License 0 ~7 O *1^ 6
Address
Licatae Class C '^O
Oty Stata/Zip
City Buslnesa Licerae #
Telsphone f
Designar Name Address Oty State/Zip Telephone
State License 0
e. woRKBis'coMPeuATioN ' "" "IT'-—7
Workers' Compensation Dederation: I hereby affirm under penalty of perjury one of the foRowing dedaratlens:□ I have end will maintain a certificate of consent to self-insure for workers' compensation as provldsd by Section 3700 of the Labor Code, for tha performance
of the work for which this permit Is Issued.
□ I have and wlll maintain workers' compensation, as required by Section 3700 of the Labor Cods, for tha performance of the work for which this permit Is
issued. My worker's compensation bmjrancs carrier arxl policy number ere:
Insurance Compeny Pdloy No.Expiration Date
SIGNATU
(THIS SECTION Nffi} NOT BE COMPLETED IF THE PEtWIT 18 FOR OffE HUNDRB) DOLLARS 1(1001 OR LESS)
CERTTRCATE OF EXEMPTION: I certlfytfnt In the performance of tfie work for wlkcli thie permit is Issued, I sfwl not employ any perann In any menrter so as
to become subject to the Workers' Comperaatlon Lews of CeBfomia.
WARNING: FeOure to secure workers' compensation coverage Is uniawfuL and ahaH subject an en^loyer to obiilnaf penaWee and oM Ones up to one hundredthousand doBors ((100,000), bi^addhian^ the cost of corapensatlcn, damagsa as provldsd for bi Sactlon 3706 of tha ■■*»» coda, Intareat and atloniey'a faaa.
DATE
7. ^...OMiEtAUUSLDEQjOtA'nON - - - , : ■ • frF:'wrar'.I hereby affirm tharlam exempt from the Contrector's License Law for the folowing reason:
□ I, es owner of the property or my smployeea with weges as their sole comperaetion, wa do the work end the structure Is not intended or offered for sale(Sec. 7044, Business arxl Profeasioru Code: The Contractor's Lioanse Law does not apply to en owner of property wtxi builds or Improves ttrereon, and who doessuch work hlnwelf or through his own smployees, provided that such Improvements sre not Intended cr offered for sale. If, however, the buildlt« or (mprovemsnt lasold whhln one year of completion, the owner-buMar wN have the burden of proving that he dM not build or Improve for the purpose of sale).
□ I, as ownar of the property, am exclusively ccouacting with Hcenssd umuautuis to construct the project (Sec. 7044, Business and Coda: ThsContractor's License Law does not apply to an owner of property wtx) bulds or knproves thereon, and conuacls for euoh projects with contraotorls) Hcsnsed
pirrsuant to the Contractor's Ucense Law).
□I am exempt under Section . Business srxf Professions Code for this reeson:
1. I personalty plan to provide the major labor end mstsrials for construction of the proposed property Improvement. □ YK GffO
2. I (hove / hove not) signed en application (or a budding permit for tfM proposed work.
3. I have contracted with the following person (firm) to provide the proposed constnmtion (Include name / address / phone number / contractors Ucense number):
4. I plan to provide portions of the work, but I have hired the folowing person to coonSnsts, supervise end provide the niajor work Undude name / address / phonsnumber / contractors Ucense rxtrrdwr); ;
5. I will provide some of the wofk, but I have contracted (hired) the following persons to provide the work Indtoetadenciude name/address/phone number/type
of work):
DATEPROPERTY OWNER SIGNATURE
icoMPLtTE THIS sarrioii for /touHtetoiaifTiAi huiUriiio rtiMtTt --—~~
la the opplioant or future buUrSng occupant requkad to submit a buakrees plan, acutely hazardous materials reglauatlun form or risk management and prevention
program under Sections 25606, 26533 or 2B534 of tfw Presley-Tarvier Hazartlcus Substance Armoum Act? G YES G NO
Is the spplicent or future boBding occupant raqukad to obtain a permit from the ah pollution contrd rUstrlct or eir quality management (flstrlct? Q YES Q NO
lithefacffitytoboconstructad within 1,000 feet of ths outer boundary of a school she? G YES G NO .ff Afl^OF THE ANSWERS ARE YES, A FWAL CtdfinCATE OF OCXRIPANCY MAY NOT BE ISSUED UNLBS Tf« APPUCANT HAS MET OR IS MBTUM THEREQWREMBITS OF THE OFHCE OF BUBWENCY SERVICES AMD THE AIR POtUmOHCOfiTROL DISTRICT. ttAU mtr oh « hianiia THEIs.' coWsTRucTiofJ Lttibiiki AoaiiSY ^ y,'!' .... ,
I hereby affirm that there It a construction larxllng agency for the performance of the work for which this permit Is Issued (Sac. 3097(1) Chrll Code).
LENDER'S NAME LENDBCS ADDRBS
1b: ■ applicant tSmRCATiOll »- ,il ,
appTicatlon and state that the above brformetion Is correct and that the Information en the plans Is eeourata. I agree to comply with sHaty ortflnancM and State laws raiating to buUdkig construction. I hereby authorize representatives of the City of Carlsbad to enter upon the above mentlonodpurposes. I ALSO AGRB TO SAVE. INDBmnFY AND KEB HARMLBS THE OTY OF CARLSBAD AGAINST ALL UABIUTIESJUDGMENTS, COSTS AND EXPBISES WHICH MAY M ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF TWS PERMIT.OSHA: An OSHA permit is required for sxcavatioru ovw^B'O' deep and demoUticn cr construction of structures over 3 stories bi height.
the provisions of this Code shal expire by inUtstlon and become null wrd void If the buDdlng orwithin 3B& days from the date of such peniilt or If the buUdbig or work authorized by such permit is suspendediced for s period of 180 days (Section 106.4.4 Uniform Building Code).APPUCANTS SIGNATURES^ ' ; o>j
WHITE: Fie YEaOW: AppUcam PINK: Fbwnce
work authorized by such permit is
or eberxloned at
VNSCHEPTJT,ED BUTLDTOG iNSPFmnM
DATE
PERMIT * CPA-i -T, t
JOB ADDRESS
DESaUPTION
inspector
PLAN CHECK#
TIME ARRIVE:TIME —/
CODE DESCRIPTION ACT COMMENTS
/)-o/
- (eS^