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Home My WebLink About1694 CHESTNUT AVE; ; CB983513; PermitPermit No: CB983513 Project No: A9804570 Development No: BUILDING PERMIT 10/13/98 13:33 Page 1 of 1 Job Address: 1694 CHESTNUT AV Suite: Permit Type: MISCELLANEOUS Parcel No: 205-130-30-00 Lot# : Valuation: 0 Construction Type: VN Dccupancy Group: Reference*: Status: ISSUED description: REWIRE HOUSE, INSTALL GAS LINE Applied: 10/13/98 : RE-ROOF AND NEW WATER SERVICE Apr/Issue: 10/13/98 Entered By: MDP Appl/Ownr : CONATY TIM 909 699-2562 43320 CORTE BARBAASTE 2180 10/13/98 0001 01 02 TEMUCLA CA 92059 C-PRMT 79=00 *** Fees Required *** *** Fees Collected & Credits *** Fees : Adjustments : Total Fees : Fee description Miscellaneous Fee Miscellaneous Fee Miscellaneous Fee 79. 00X . j*b79: oo / f'-' / • -x s- #1 / •~\r; ./•• #2 .';• #3i ••• -A ' * MISCELLANEOUS TOTAL ^ , - •- ' rfotal/creditsY\ Total Payments: \ . Balance; Due :. \ '•'"'..-, Units FeeSUnit* .-...> - • 20.00 .-;•'•., <:->~\"> ' '"• ''•'. : > 25.06;;"" ~"••-?, . ~"r: 34,00'" •••/. ;'• , i.r j- ' •'/ '.. r ' 79 . 00 . 00 .00 Ext fee 20 25 34 79 . 00 .00 . 00 .00 Data ELEC ROOF PLUMB FINAL A INbP- ".CLEARANCE, 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 1 . P FOR OFFICE USE ONLY PLAN CHECK EST. VAL. Plan Ctc. Deposit Validated By Date Address (include Bldg/SuitB *)Business Name (it this address) Legal Description Lot No.Subdivision Name/Number /7 Unit No. Phase No. Total * ot units Assessor's Parcel »Existing Use / / Proposed Use Description of Work I 2. CONTACT PERSON (If dttferent from appUcantl sef. FT.tot Stones'» of Bedrooms » of Bathrooms \ & Name Address City ;3. APPLICANT E3"6ontractor D Agent for Contractor O Owner"'"I'D Agentfor Owner State/Zip Telephone f. r- Fax» Name 4. PROPERTY OWNER )utA/T~W Lg) Address City State/Zip Telephone <r Name ' I Address City State/Zip Telephone * 5. CONTRACTOR - COMPANY NAME " " """ """ —-^^-^••^ • - -y • •-;—' "™**^""~" "r-1 (Sec. 7031.5 Business end 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 epplicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Lew (Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he Is exempt therefrom, end the basis tor 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 then five hundred dollars (55001). r. Ce>. Name ' State License if 3 3-t <-<.&£• Address License Class City State/Zip Crtv Business License t /• Telephone I ^non^ Designer Name Address City State/Zip Telephone State License # ___^__^___^^___ 6. WORKERS'COMPENSATION "" - - - ---.- - Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0^1 have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, tor 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: Insurance Company ->r*^fir (*j&ry\.0 j/J$ f=V^/D Policy No-A^*? —f>/ f~i-^jf ~~ "f Expiration Date ' *~ i C (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*1001 OR LESS) Q 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 as to become subject to the Workers' Compensation Lews of California. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), In addition to the cost of compensetton, damages as provided for hi Section 3706 of the Labor coda. Interest and attorney's faas. SIGNATURE DATE ..• .... -iTf,-: •- .7. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law tor 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 tor aale (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 are not Intended or offered for Mia. 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 build or Improve tor the purpose of aala). D I. as owner of the property, em exclusively contracting with licensed contractors to construct the project (Sac. 7044, Business and Professions Code: The Contractor's License Lew does not apply to an owner of property who builds or improves thereon, end contracts for euch projects with contractorU) licensed pursuant to the Contractor's License Lew). 0 I am exempt under Section Business end Professions Code tor 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 (have / have not) signed an application for a building permit tor 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 end provide the major work {include name / address / phone number / contractors license number): 5. of work): 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 PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOR NON^£SID£NTJAL BUILDING PERMITS ONLY '••:~rr"^~~' "• •-*•""-'•• -<-~ --?-<™r-—s*^-*'i"rr* .--.-.. -.*•• - • • Is the applicant or future building occupant required to submit a business plen, acutely hazardous materiala registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES O NO Is the epplicant or future building occupant required to obtain a permit from the eir pollution control district or air quality management district? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school she? Q 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. £. CONSTRUCTION LENDING AGENCY ~ """" '"'' '"""'"•".""''' •«•"•"•<<"-•--•••— - - ------ ••,-••• I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME ^/iQ- LENDER'S ADDRESS ^/^^ IS. APPLICANT CERTIFICATION " -,-,.-.-,,-,-.:_,-.,.^.,_..,.,, ....^ ;...,_,,.,..„,,,._,.,,.,,,,,, ^.^,;T^f,^,, : I certify that I have read the application end 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 laws relating to buildipg construction. I hereby authorize representatives of the City of Carlsbad to enter upon the above ment.oned property for inspection purposes. I ALSO AGW.E TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES JUDGMENTS. COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF TH.S PERMIT OSHA: An OSHA permit is required for excavations over 5'0" deep end 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 ,s not commenced within 365 days from the date of such permit or if the building or work euthorized by such permit is suspended or abandoned at any time after tbe\wprk is-comr/iepced forywiod of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE f /MUrf /^H^^^, DATE /d ~' WJ/TE: IWi;: File YELLOW: Applicant PINK: Finance City of Carlsbad Inspection Request For: 2/26/99 Permit# CB983513 Title: REWIRE HOUSE, INSTALL GAS LINE Description: RE-ROOF AND NEW WATER SERVICE Inspector Assignment: DH 1694 CHESTNUT AV Lot Type: MISC Sub Type: Job Address: Suite: Location: APPLICANT : CONATY TIM Owner: NORTH COUNTY COMMUNITY FOUNDATIO Remarks: Phone: 9093023126 Inspector: Total Time: CD Description 19 Final Structural 29 Final Plumbing 39 Final Electrical 49 Final Mechanical Requested By: TIM Entered By: CHRISTINE Act Comments Af Date Inspection History Description Act Insp Comments 2/11/99 19 Final Structural 10/30/98 34 Rough Electric 10/23/98 21 Underground/Under Floor 10/23/98 23 Gas/Test/Repairs 10/23/98 24 Rough/Topout CO DH FILL KNOCK OUT HOLES IN PANEL PROVIDE PLANS/TEMPERED GLASS FRONT DOOR AP DH AP DH AP DH AP DH so COMPENSATION Y'N S U R A N C E FUND P.O. BOX 807, SAN FRANC!SCO,CA 94101-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 01-01-98 POLICY NUMBER: 229-98 UNIT 0014351 CERTIFICATE EXPIRES: 01-01-99 CONTRACTORS STATE LICENSE BOARD ATTN: WORKERS' COMP. UNIT BOX 26000 SACRAMENTO CA 95826 '• JOB: LIC #321486 'CLASS'S*^ INCEPTION DATE:,01-01-9! ., I?W .,-;.% D.O.: SAN DIEGO ' ; ^> 'Vn ,' A:jv|* This is to certify that we have issued a valid Workers' Compensation insurance policy in'a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. ;., <r V* This policy is not subject to cancellation by the Fund except upon 10 days' advance written notice to the employer. We will also give you 10 days' advance notice should this policy be cancelled prior to its normal expiration. ;This certificate of insurance is not an insurance uolicy'and does not amend, extend or. alten the coverage afforded by. theApplicies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate'Of insurance 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. PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE. STANDARD EXCLUSION: INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY. •>% ^'-•:-:;,- EMPLOYER LEGAL NAME CONATY CONSTRUCTION COMPANY 43320 CORTE BARBASTE TEMECULA CA 92592 CONATY, GRANT TIMOTHY THIS DOCUMENT HAS A.BLUE PATTERNED BACKGROUND. PRINTED: 12-18-97 P0409: "^ SCIF 10265 IREV. 2-95)