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Home My WebLink About1520 JEANNE PL; ; CB973133; Permitii B U I L D I N G P E R M I T Permit No: CB97l1J3 Project No: A970399$ Develnpm~nt No: 10/20/97 11:49 Paqe 1 of 1 Job Address: 1520 JEANNE PL Permit Type: MECHANICAL Parcel No: 207-130-22-00 Valuation : 0 Occupancy Group: Description : INSTALL 75000 : ELECTRIC Suite: Lot#: Reference#: BTU FURNACE-NO 0430 10/2.0/97 0001 01 C-PRHT 02 24-00 Construction Type: NEW Stc1tus: ISSUED Applied: 10/20/97 Apr/Issue: 10/20/97 Entered By: RMA Appl/Ownr : COASTAL AIR MECHANICAL 12860 WARHORSE ST 619 484-0321 SAN DIEGO CA 92129 *** Fees Required Fees : Adjustments: Total Fees : Fee description Enter 'Y' for Mech Install Furn/Ducts * MECHANICAL TOTAL *** Fe .00 .JO 24.00 *I<* Ext fee Data 15.00 Y 9.00 24 .00 EXPIRED PERM\l PEll!,\11 ~ EXPIRED IN ACCORDANCE~ u.a~ SECl\ON 106.4.4 ( ~ S\GNA'TURE ~~._,.,.._ DA'TE-__..__.- ...,. .. ' FINAL APPROVAL iNSP. ___ DATE __ CLEARANCE -------~ CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION FOR OFFICE USE ONLY LJ 3 PLAN CHECK NO. q:J 3 > CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Pal mas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. _________ _ Plan Ck. Deposit -----,,.....,,----- Validated By.,......,.?G__,J_a__,~µ.:A-:....1 __ _ Date ( i) I ~r '-1, :::::+-- Address (include Bldg/Suite #I Business Name let thil address) Legal Description Lot No. Subdivision Name/Number Unrt No. Phase No. Total I ot units Asses r's Parcel # '.s: oo::> 1/rtl.-Existing Use Proposed UH ork SO. FT. lot Stories I of Bedrooms # of Bathrooms 2. CONTACT PERSON Iii dlffon,nftii,,n .;..ianii Name Address City State/Zip Telephone# Fax# :3. APPLICANT . (iJ"Eontr~r 0 Agent for Contr,d:or . □ 6wrief · · 0 Agimi ioi iiwner ··· ·-9z.lZ.'/ '6/P-</~Y--o3Z-/ z>&V/p /1/ELSo / z t!'J~ W-4/t#dR.SE Sr , 5". 7), Name Address ' City State/Zip Telephone I 4. 7:/:RTYll't.NE#. /SM vbW'.,ve /2. ~~ (!;,. 9'zo()~ . ~Tl'£- Name Address City State/Zip Telephone II 6. CONTRACTOR~ COMPANY NAME !Sec. 7031.5 Business and Professions Code: Any City or County which rBQUlres • permit to construct, ■her, Improve, demolish or repair env structure, prior to Its issuance, also 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 end Profusions Code) or that he Is exempt therefrom, and the b11is for the alleged exe'!!etion. Anv violatiJr of S•~,!?n 7031.5 by any applicant for• permit subjects the ep.Bflcant to• civil penahy of not more than five hundre dollars 1$50011. ~,4sr,,tL /Me ff/fe,,L#,./,ML-~ · ~,.e,t/e,,es-6 .5r s. lJ. 9Z/c9 ;, -cHs2-/ Name State License I / Address City State/Zip Tel~one I ~ <ii Of Ucense Cless e 2.-0 City Bu.inn• Ucen■e , / ;;l, 0 'i ':l. 'tf Designer Name Address City State/Zip Telephone State License I _________ _ 6. WORKERS' COMPENSATION : "; . r ·'"' Workers' CompenHtion Declaration: I hereby affirm under penetty of perjury one of the following declarations: O I have and will maintain a certificate of consent to ■elf-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, es required by Section 3700 of the Labor Code, for the performance or the work for which this permit Is issued. My worker's compensation insurance carrier and policy number are: Insurance Company____________________ Policy No .. ___________ _ Expiration Date _______ _ ION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS lt100I OR LESS) CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is iuued, I shall not employ eny person In any manner 10 as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to~• workers' compensation coverage la unlawful, and ahall aubject an ■mpk,yM' to c:nmlnal penahlu and clvU ffnea up to one hundred thouHnd dollara ($100, O ,, ip~ to the coat of compenutlon. damages• pro. vlded for In Sa. ction 370·6·•· '. tho. ~-. -~• Interest and attorney. ·• fffs. SIGNATURE , ~ DATE ~!_ C 7. OWNER-BUILDER DECLARATION .~ ' " , · : . ·,.·~ i·,· '.'~•···-·: :· .. ,,,.;:1·•~,T''r"'•·;·••:'.: .•. ,,,,,~n '" , .. -,: ' I hereby affirm that I am exempt from the Contractor'• License Law for the following reason: O 1, as owner of the property or my employHs with wages es their sole compensation, will do the work and the structure ill not Intended or offered for Hie (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 dou such work himself or through his own employ■es, provided that such Improvements are not intended or offered for sale. If, however, the building or Improvement la sold within one year of completion, the owner-builder will heve the burden of proving 1h11 he did not build or Improve for the purpon or Hlel, D I, as owner of the property, em exclusively contracting with licensed contractora to construct the project (Sec. 7044. Buslneu and Profusions Code: The Contractor's License Law doa1 not appJy to an owner of property who builds or Improves thereon, and contracts for auch project■ wh:h contractorl•I licensed suant to the Contractor's License Law). ~ I am exempt under Section ______ Buslne11 and Profession■ Code for this reason: 1 . I personally plan to provide the major labor and materials tor construction of the proposed property Improvement. 0 YES ONO 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 m■tor work Clnclude name / addreu / phone number/ contractors license number): ____________________________________________ _ 6. I will provide some of the work. but I have contracted lhired) the followmg persons to provide the work indicated llnclude name/ addre11 I phone number/ typa of work):. ______________________________________________________ _ PROPERTY OWNER SIGNATURE _____________________ _ Is the _applicant or future building occupant required to submit a business plan, ■cutely h■zardous material■ r.eglatratlon form or riak management and prevention program under Sections 26505, 25533 or 26534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES D NO Is the applicant or future building occupant required to obtain• permit from the air pollution control district or air quality management district? 0 YES O NO Is the facility to be constructed within 1,000 feet 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 POU.UTION CONTROL DISTRICT. ta. -coNSTAuCTioN i..ENDiNG AGENCY .. , ,_ .. , -·,"' '"'':""· ··:·,..· •·-.. ---,·~:---~·: ;0·':""';:-":or::r·:•?~~ ... ,.-~ ... , .. ,.., .,., · ,,,..,,-·•-•-.... ,. -•" ~ ... , : :"---,.,m .. , · 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 ADDRESS _______________________ _ 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 egree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Cltt of Carlsbad to enter upon the above mentioned property for Inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CrTY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CfTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. 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 It the building or work authorized by such permit is not c enced in 365 days from the date of such permit or If the building or work authorized by such permit is suspended or abandoned at any time after the wo I comme for a ~d of~ days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE /(___e_.f'~ DATE /,:J-.;2tJ ·-f?,Z WHITE: File YELLOW: Ap~icant PINK: Finance