HomeMy WebLinkAbout1373 CASSINS ST; ; CB971223; Permit'W ex**
Permit No: CB971223
Project No: A97'01591
Development No:
BUILD. ING PERMIT
05/13/97 14:^
Page 1 of J
Job Address : HL J 5(!T CASSINS ST Suite:
Permit Type: PLUMBING 491605/13/97000101 02
Parcel No: 215-691-55-00 Lot#: C-PRMT 47-00
Valuation: 0 Construction Type; NEW
Occupancy Group: Reference*: Status: ISSUED
Description: GAS AND ELECTRIC LINE TO BBQ
Appl/Ownr : UNLIMITED LANDSCAPE INC
11374 CAMINITO CORRIENTE
SAN DIEGO, CA 92128 "
*** Fees Required ***
Applied: 05/13/97
Apr/Issue: 05/13/97
Entered By : JM
619 485-1600
Collected & Credits
Fees :
Adjustments:
Total Fees:
Fee description
Enter "Y" for Plumb
Gas Piping System
Other
* PLUMBING TOTAL
47
A * *
.00
. 00
47. 00
Ext fee Data
20.00 Y
7. 00
20.00 ELECTRICAL
47,00
PROVAL
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 CA 92009
(760)438-1161,^a,
Address (include Bldg/Suite *)
FOR OFFICE USE
PLAN CHECK NO.
EST. VAL.
Plan Ck. Deposit
Validated
Date
Business Name lit this
Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total * of units
Assessor's Parcel Use Proposed Use
Description of Work
^ E COWTACt^PERSdN ft drfferi
SOFT #of Stories * of Bedrooms * of Bathrooms
Name
»;• APPLICANf \Sliomrictor TJ Aoeht for Cohtractor
Name Address City State/Zip Telephone *
(Sec. 7031.6 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 ha 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 civH<penalty of not more than five hundred dollars ($500)).
CA
Name
State License f License Class
City State/Zip Telephone *
City Business License » //<?«? 5g> Cf
Designer Name
State License f
Address City State/Zip Telephone
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.
Q 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: y
Insurance Company Oft ( (JQ (\L f~\ PoHcy No. QtyGlftM ttfitf Expiration Date *K // A? 7
(THIS SECTION NEED NOT BE COMPLETED'IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ff 1001 OR LESS) ' '
D 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 aa
to become subject to the Workers' Compensation Laws of California.
WARNING: Failure to secure workers' compensation coverage to unlawful, and shal subject an employer to criminal penalties and cM fine* up to on* hundred
thousand dolars (rrOO.OOO). In addMgnfchtta cost of compensation, damages as provided for hi Section 3706 of the La\or code, interest and attorney's fees.
SIGNATURE j^J I J^CL t^AL/ / / 7"f i DATEULXXjLt-l—*« ;r-'i "sw*j|'s
ntractor'a ucenseI hereby affirm that I am exempt from the Contractor's Dcohse Law for the following reason:
Q I, as owner of the property or my employees with wages as their sol* compensation, will dp the work and the structure Is not intended or offered for sale
(See. 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 Ms own employees, provided that such improvements sre not intended or offered for sale. If, however, the building or improvement is
sold within one yeer of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale).
O I. •* owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Profession* 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!*) licensed
pursuant to the Contractor's License Law).
D I am exempt under Section Business snd Professions Cods for this reason:
1. I personally plan to provide the major labor and materials for construction of the proposed property Improvement. Q YES QNO
2. I (neve / 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 neme / address / phone number / contractor* 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 neme / address / phone number / type
of work): -
PROPERTY OWNER SIGNATURE DATE
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention
program under Section* 25505, 26533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? O YES Q NO
Is the applicant or future building occupant required to obtain a permit from the air p<rftutlon control district or air quality management district? O YES D NO
Is the faeility to be constructed within 1,000 feet of the outer boundary of a school site? D YES Q 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 is issued (Sec. 3097(1) Civil Code).
LENDER'S NAME _ LENDER'S ADDRESS _ ,
"
I certify that I have read the application and state that the above information is comet and that the information on the plan* I* accurate. I agree to comply with all
City ordtoanc** and State law* relating to building construction. I hereby authorize representatives of the Ch> of Cartsbed 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 structure* over 3 stories in height.
EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shaH 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 buHding or work authorized by such permit i* suspended
or abandoned at any time after tbe-work la commenejaAjor ajjeriod of \80 days (Section 106.4.4 Uniform Building Code).
JL JLL ^7. DATEAPPLICANT'S SIGNATURE
PINK'
PRODUCER'
TANENBAUM-HARBER OF CA. INC.
11610 IBERIA PL., SUITE 200
SAN DIEGO, CALIFORNIA 92128
(619) 487-8839
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY
A CAL COMP INSURANCE COMPANY
INSURED
UNLIMITED LANDSCAPE, INC.
11374 CAMINITO CORRIENTE
SAN DIEGO, CA 92130
COMPANYB
COMPANYc
COMPANY
D
.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
COLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE
DATE (MM/DIVVY)
POLICY EXPIRATION
DATE(MM/DD/YY)LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
' | CLAIMS MADE | | OCCUR
OWNER'S & CONTRACTOR'S PROT
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
PERSONAL * AOV INJURY
EACH OCCURRENCE
FIRE DAMAGE (Any one tire)
MED EXP (Any one person)
AUTOMOBILE LIABILITY
AT. 7 AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
COMBINED SINGLE LIMIT
BODILY INJURY(Per perron)
BODILY INJURY
(PerMCktont)
PROPERTY DAMAGE
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
EACH OCCURRENCE
AGGREGATE
WORKERS COMPENSATION AND
EMPLOYERS1 LIABILITY G968143954 8/01/96 8/01/97
Hffiflflfel
ium-ER
EL EACH ACCIDENT
' THE PROPRIETOR/
I PARTNERS/EXECUTIVE
I OFFICERS ARE:
$ 1,000,OOC
INCL
EXCL
EL DISEASE • POLICY LIMIT 1,000,OOC
EL DISEASE • EA EMPLOYEE $ 1,000,OOC
OTHER
DESCRIPTION OF OPERATtONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
CITY OF CARLSBAD
2075 LAS PALMAS DRIVE
CARLSBAD, CA 92009
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT! CB971223 FOR 07/07/97 INSPECTOR AREA PD
DESCRIPTION: GAS AND ELECTRIC LINE TO BBQ PLANCK! CB971223
OCC GRP
TYPE: PLUM CONSTR. TYPE NEW
JOB ADDRESS: 1373 CASSINS ST STE: LOT:
APPLICANT: UNLIMITED LANDSCAPE INC PHONE: 619 485-1600
CONTRACTOR: PHONE:
OWNER: PHONE: //
REMARKS: R/DENISE/485-1600
SPECIAL INSTRUCT:
TOTAL TIME:
—RELATED PERMITS— PERMIT! TYPE STATUS
CB971225 PATIO ISSUED
CD LVL DESCRIPTION ACT COMMENTS
23 PL Gas/Test/Repairs
39 EL Final Electrical
***** INSPECTION HISTORY *****
DATE DESCRIPTION ACT INSP COMMENTS
051597 Gas/Test/Repairs AP PD
051597 Underground/Conduit-Wiring AP PD CONDUIT