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Home My WebLink About1337 CASSINS ST; ; CB972308; Permitv/ BUILD 08/18/97 13:04 Page 1 of 1 Job Address: 1337 CASSINS ST Permit Type: PLUMBING Parcel No: 215-690-23-00 Valuation: 0 Occupancy Group: Description: RUN GAS LINE TO BBQ Appl/Ownr : AKS LANDSCAPING 1612 WARMLANDS DR VISTA CA 92084 *** Fees Required *** ING PERMIT Suite: Lot#: Reference#: Permit No: CB972308 Project No: A9702920 Development No: 8172 08/18/77 0001 01 02 fiflBK 27.00Construction Type": NEW Status: ISSUED Applied: 08/18/97 Apr/Issue: 08/18/97 Entered By: RMA 760 433-3252 ***Collected & Credits *** Fees: 27.00 Adjustments: .00 Total Fees: 27.00 Fee description Enter "Y" for Plumbing Issue Fee > Gas Piping System > * PLUMBING TOTAL Total Orbits: Total Payraeats : Balance DW«J Units" Fee/Unit 1 7.00 .00 .00 27.00 Ext fee 20. 00 7.00 27. 00 Data Y CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 >ERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 1. PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO. ^ 7 EST. VAL. Plan Ck. Deposit Validated By. Date ( •£.1 Address (include Bldg/Suhe *)Business Name (et this address) igal Description Lot No.Subdivision Name/Number Unit No. Phase No. Total » of units Assessor's Parcel *Existing Use Proposed Use Description of Work 2. aatim SO. FT.*of Stories * of Bedrooms f of Bathrooms (If mim from appacwtl Name Address City State/Zip Telephone * .-.,,-. r!^p~^*gf gvfjf^ Fax* State/Zip C/& Telephone * (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, attar, improve, demolish or repair any structure, prior to its issuance, also requires the epplicant 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 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 [$5001). Name State License * Address License Class City State/Zip City Business License * Telephone * Designer Name Address City State/Zip Telephone State License # 6. WORKERS'COMPENSATION ' ."""","'.' -""—-r*"7;-»- <-"?.,- »,„- „-., ,- lir - Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Q I have and 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 Code, 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 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*100) OR LESS) SL CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shell not employ eny person in any manner so as tobecome subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage la unlawful, and shall subject an employer to criminal penalties and crvH fines up to one hundred thousand dollars^* 100.000), tn addition>to\the cost of^mpensation. damages as provided for hi Section 3706 of the Labor coda. Interest and attorney's fees. SIGNATURE 7. DATE .53Wfc.33lf'OWNER-BUILDER DECLARATION -' * * ** '-"" "' * " *~" -"" —* * - ~ •-"- ^ - I hereby affirm that I am exempt from the Contractor's License Law for the following 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 sate (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 ere 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 buHd or improve for the purpose of sale). O 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 epply to an owner of property who builds or improves thereon, end contracts for such 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: 1 . I personally plan to providt the major labor and materials for construction of the proposed property improvement. Q YES QNO 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 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 / contractors license number): ___ _____ _ _^__^^______________________________^___________.___ 5. I will 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): _ . _ ' PROPERTY OWNER SIGNATURE DATE Is the epplicsnt 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? Q YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? O YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school she? O YES D 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. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit la issued (Sec. 3097(1) Civil Code). LENDER'S NAME LENDER'S ADDRESS_ ^^ tt I certify that I have reed 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 lawa relating to budding construction. I hereby authorize representatives of the City 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, 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 him the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time aftecBe work Is commenceeUor a period m 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE ~( £ - PERMIT* CB972308 CITY OF CARLSBAD INSPECTION REQUEST FOR 08/19/97 DESCRIPTION: RUN GAS LINE TO BBQ TYPE: PLUM JOB ADDRESS: 1337 CASSINS ST APPLICANT: AKS LANDSCAPING CONTRACTOR: OWNER: REMARKS: C/? SPECIAL INSTRUCT: INSPECTOR AREA PLANCK# CB972308 OCC GRP CONSTR. TYPE NEW STE: LOT: PHONE: 760 433-3252 PHONE: PHONE: INSPECTOR TOTAL TIME: —RELATED PERMITS— CD 23 PERMIT# TYPE CB971721 POOL RW970157 ROW STATUS ISSUED ISSUED LVL DESCRIPTION PL Gas/Test/Repairs ACT COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS NOTICECITY OF CARLSBAD " ^ ^^ ™ • ^^ ^^ 438-3550 BUILDING DEPARTMENT 2075 LAS PALMAS DRIVE /) " ' I ' I /DATE D ' f / I / TIME. LOCATION, PERMIT NQ;_ /A/ <? rA ( i r /^ 8 FOR INSRECTION CALL 438-3101. RE-INSPECTION FEE DUE? I I YES FOR FUkFtfER INFORMATION, CONTACT _UgJKER IJJF LL&PHONE BUILDING INSPECTOR CODE ENFORCEMENT OFFICER