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Home My WebLink About1805 CANYON PL; ; CB991618; PermitBUILDING PERMIT Permit No: CB980799 03/18/98 11:20 Project No: A9801054 Page 1 of 1 Development No: Job Address: 1805 CANYON PL Suite: Permit Type: PLUMBING Parcel No: 205-080-86-00 Lot#: Valuation: 0 Construction Type: NEW Occupancy Group: Reference*: Status: ISSUED Description: CONNECT WATER SERVICE LINE Applied: 03/18/98 : FROM EXISTING 2ND WATER METER TO RESIDEN Apr/Issue: 03/18/98 Entered By: RMA Appl/Ownr : BRINKS PLUMBING & WATER RESTOR 619 282-1771 7969 ENGINEER RD STE 216 SAN DIEGO CA 92111^ *** Fees Required *** & Credits *** fifeu Sl55_Q3/18/9e-500i-9i—02— Fees : Adjustments: Total Fees : Fee description Enter " Y" for Plu: Each Install/Repa 27s C-PRMT 27.00 . 00 . 00 27. 00 Ext fee Data 20.00 Y 7. 00 FINA CLEARANCE. PPOVAL DA, 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. PROJECT irefs tOJECT INFORMA&<? Zl TION FOR OFFICE USE ONL PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated By Date iffi Address (include Bldg/Suite *)Business Name lit this address) Legal Description Lot No.Subdivision Nairn/Number Unit No.Phase No.Total * of units Assessor's Parcel f Existing Use Proposed Use Description of Work 12. CONTACT F SQ.FT.fof Stories I (If different from appgcant) f of Bedrooms f of Bathrooms Name Address 3. APPLICANT Et Contractor D Agent for Contractor : Q Owner Citv State/Zip «?,/?. Telephone * Fax * •Jl Name 4. PROPERTY OWNER !h f "/» A//^ Address City State/Zip Telephone » W Z, City .•atr*t~r * »•• r . State/Zip Telephone *Name Address S. CONTRACTOR - COMPANY NAME " "~""'" " ~ ~ *~""""""' ™"~~ (Sec. 7031.5 Business end Professions Code: Any City or County which requires a permit to construct, altar, improve, demolish or repair any 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 and Professions Codel 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). ^£."1/1 £5 r(i)m&ina «#* /e'Xff&Z f^£SJS>^477fAJ "?94> 3 ^s/g/sref/Z, /&/'••*£?/<£. £& M. Name State License * Address License Class A City State/Zip City Business License f Telephone *-I7-7/ State/Zip TelephoneDesigner Name Address City State License * /tr"/T _ 6. " WORKERS' COMPENSATION .................... " ....... ' ". ....... '. ' ......... "*' * "TT''''''^'''''^^^^'^^ ";:::. :•;,•••;: I <•*""• ::"vr; ' :-' :' Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: O 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. JS 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 C?/)r/ £&Hj0 - _ ; _ Policy No. l~ 3 7 V // S^/3 Expiration Date ^T'^R • (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*100} OR LESS) O CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit la issued, I shall not employ any person in any manner ao as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage to unlawful, and abaft subject an employer to criminal penalties and chril Unas up to one hundred thousand dollars 1*100,000). hi addition to the cost of compensation, damages as provided tor hi Section 3706 of the Labor code. Interest and attorney's fees. SIGNATURE _ • _ DATE _ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D \as owner of the property or my employees with wages as their sole compensation, will do the work and the structure Is notJntanded or offered for sale (Sac. 7M4, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who buHds oMmproves thereon, and who does such worVhimself or through his own employees, provided that such improvements are not intended or offered for sale. If-bewever, the building or Improvement Is sold within onavear of completion, the owner-builder will heve the burden of proving that he did not build or improve taMfte purpose of sale). D I. as ownenafthe property, am exclusively contracting with licensed contractors to construct the projepHSK. 7044, Business and Professions Code: The Contractor's LicenseHaw does not apply to an owner of property who builds or improves thereon, apavcontracts for such projects with contractors) licensed pursuant to the Contractors License Lew). O I am exempt under Section Business and Professions Code for this i QNO1 . I personally plen to provide tnVmajor labor and materials for construction of theproposed property improvement. O YES 2. I (have / have not) signed an application for a building permit for the proposes work. 3. I have contracted with the following pe>sqn (firm) to provide the prpposed construction (include name / address / phone number / contractors license number): 4. I plen to provide portions of the work, but I have hire*^e>o1iowing person to coordinate, supervise and provide the major work (include name / address / phone number / contractors license number): _ JS<^ 5. I will provide some of the work, but I have contracted (hiredMnvfollowing persons to provide the work indteated (Include name / address / phone number / type of work): _ /_ _ ^v^ _ DATE trials registrar PROPERTY OWNER SIGNATURE COMPLETE THIS SECTION FOR Is the applicant or future buildii program under Sections '. Is the applicant or future><jilding occupant required to obtain a permit from the air pollution Is the facility to beictfnstructed within 1,000 feet of the outer boundary of a school site? IF ANY OF THEyCNSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE required to submit a business plan, acutely haze? 6533 or 25534 of the Presley-Tenner Hazardous Substance A form or risk management and prevention D NO REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. S," COJJSTRUCTION LENDING AGEniCV '" " "'*" "' ' "*" "' ~""^"T'™7-•«'-«-^--'*-' '- -• ---' -=--- I herqbv affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(0 Civil Code)7 ODER'S NAME A)'"<4 LENDER'S ADDRESS D YES Ttrol district orItrsquadty management district? D YES D NO D YES D NO "^ MET OR IS MEETING THE "APPLICANT CERTIFICATION ' r;"B:" : ' i^™'. ..... • ":: ;-r"— -• •••- -nT~~^T-1>^m*^ •^•l-, . • -. -- , , • j -,„ -., -,- - -„..- • ^ ., 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 agree to comply with all City ordinances and State laws relating to building 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, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY 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 if the building or work authorized by such permit is not commenced within 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 ttw wgdrfcommenced for a period of 1 80 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB980799 FOR 03/20/98 INSPECTOR AREA DESCRIPTION: CONNECT WATER SERVICE LINE PLANCK* CB980799 FROM EXISTING 2ND WATER METER TO RESIDEN OCC GRP TYPE: PLUM CONSTR. TYPE NEW JOB ADDRESS: 1805 CANYON PL STE: LOT: APPLICANT: BRINKS PLUMBING & WATER RESTOR PHONE: 619 282-1771 CONTRACTOR: PHONE: OWNER: PHONE: REMARKS: C/BILL/619/894-5851 INSPECTOR SPECIAL INSTRUCT: FIRST INSPECTION OF THE DAY IF POSSIBLE OR 619/282-1771 TOTAL TIME: CD LVL DESCRIPTION ACT COMMENTS 22 PL Sewer/Water Service ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP COMMENTS V