HomeMy WebLinkAbout1650 BASSWOOD AVE; ; CB951485; PermitBUILDING PERMIT u+ %!Jb Permit No: CB951485
10/18/95 12:34 Project No: A9502172
Page 1 of 1 Development No:
Job Address: 1650 BASSWOOD AV Suite: I
Permit Type: PLUMBING m.0 1O/lE,:'gg o(j9: 01. $2
27 gzj Parcel No: 205-060-23-00 Lot#: ?-.:?f;g*r c 2 .~ : :
Valuation: 0 Construction Type: NEW
Occupancy Group: Reference#: Status: ISSUED
Description: GAS REPAIR Applied: 10/18/95
Apr/Issue: 10/18/95 Entered By: DC Appl/Ownr : LIPTON, EDWARD 619 438-9470 1650 BASSWOOD AVENUE CARLSBAD, CA 92008
Fee description
Enter "Y" for Plu
Gas Piping System * PLUMBING TOTAL
----------------_-
*** Fees Required *** .......................
Fees : Adjustments: Total Fees:
I i FINAL APPROVAL
INSP. 17 %DATE 1~-~--4~.:
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICAllON
City of krlsbmd WLdinO Deputmt 2075 Las Pal- Dr., Culrbd, U 92009 (619) 438-1161
PLAN CHECK NO. 1
FOR OFFICE USE ONLY
I Code of Structure-Type;
Net WGain of Dwelling Units
2 PRCUECXINFoRMAnoN
J6sO Building or Suite No.
Subdinsion NamdNumber Unit No. Phase No.
0 2 Energy Calcs
DESCRlPnON OF WORK
SQ. fT. # OF BEDROOMS # OF BATHROOMS
0 2 Structural Calcs 0 2 Soils Report 0 1 Addressed Envelope
USE
111 airrerent from aDDiicantJ ._ NAME (last name firit) ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
NAME (last name first) ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
STATE LIC. # LICENSE Mss CITY BUSINESS LIC. #
-NAME (last name ImtJ A[)DRESS
STATE LIC. # c1n STATE ZIP CODE DAY TELEPHONE
~~ ~ ~ Workers' Compensation Declaration: I hereby attirm that 1 have a certiticate ot consent to felt-insure issued th e Director ot Industrial Relations, or a certificate of Worken' Compensation Insurance by an admitted insurer, or an exact copy orbYduplicate thereofcCnifKd by the Director of the insurer thereof filed with the Building Inspection Department (Seedon 3800, Lab. C).
INSURANCE COMPANY POLICY NO. EXPIRATION DATE
Certiticate of Exemption: I cemty that in the pertormance ot the work tor which this permit u issued, I shall not employ any person in any mannec so as to become subject to the Worked Comparwtion Laws of California.
SIGNATURE DATE
uwner-Muilaer uecmrauon: I netr~ y attirm tnat I a m exempt rrom me c;o ntractors ucense mw roc me toilowing reason:
I, as owner of the propaty or my employees with wages as their de compensadon, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractofs License Law doa not apply to an owner of property who builds or improves thereon, and who doa such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improwment is sold within one year of compkdon, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sak.).
I, as owner of the property, am exclusively contracting with licensed contracton to construct the project (Sec. 7044, Business and Professions Code: The Contractofs License Law does not apply to an owner of property who builds or impvcs thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law).
I am exempt under Section
(Sec. 7031 .S Business and Professions Code: Any City or County which requires a permit to amstma, alter, implrovr, demolish, or vir any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed punuant to the provisimns of the Contractor's license Law (Chapter 9, commencing 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 appiicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [SOOI).
0
0
0 Business and Professions codc for Mu reason:
S#;NAlURE MTB
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 Sections 25505,25533 or 25534 of the Praley-Tanner Hazardous Subtance Account Act?
Is the amlicant or hrture buildinn occumnt reauired to obtain a Dennit from the air wlludon conad dtraia or air aualitv manasement d~w? OYES 0 NO
OWNER-BUILDER VERIFICATION
Attention Property Owner:
An ‘owner-builder’ building permit has been applied for in your name and bearing your signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary delay in
processing and issuing your building permit. No building permit will be issued until this verification is
received.
1. I personally plan to provide t
improvement (yes or no)
r labor and materials for construction of the proposed property
C
2. I (have/have not) signed an application for a building permit for the
proposed work.
3. I have contracted qith the following person (firm) to provide the proposed construction:
Address City
Phone Contractors License No.
4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise,
and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following persons to provide the
work indicated:
Name Address Phone Type of Work
Signed: Property Owner
Date:
2075 Las Palmas Drive - Carlsbad, California 92009-1 576 - (61 9) 438-1 161 @