HomeMy WebLinkAbout1885 CHESTNUT AVE; ; CB960628; PermitW G PER MBUILD
04/04/96 16:10
Page 1 of 1
Job Address: 1885 CHESTNUT AV
Permit Type: PLUMBING
Parcel No: 205-230-25-00
Valuation: 0
Occupancy Group: Reference*:
Description: REPLACE WATER HEATER
Appl/Ownr : H JELT , JEANNE
1885 CHESTNUT AVENUE
CARLSBAD, CA 92008
Permit No: C3950628.
Project No: A9600882
Development No :
Suite:
Lot* :£886 04/04/96 0001 01 02
Construction Typi~f%lw 2?«00
Status: ISSUED
Applied: 04/04/96
Apr/Issue: 04/04/96
Entered By: DC
619 729-2724
*** Fees Required ******Fees Collected & Credits ***
Fees: 27.00
Adjustments: ;'00
Total Fees: 27,00
Fee description
'Tot si'"- Credits:'
Total Payments: ./..
Balance Due:
;;, Units Fee/Unit
.00
. 00
27.00
Ext fee Data
Enter "Y" for Plumbing Issue Fee >
Each Water Heater and/or"Vent >
* PLUMBING TOTAL : . • '• '
20.00 Y
7. 00
27 . 00 .
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION
City of Carlsbad Building Department
2075 Las Palaas Dr., Carlsbad, CA 92009 (619) 438-1161
I. PERMIT TYPE
From List 1 (see back) give code of Permit-Type:
For Residential Projects Only: From List 2 (see back) give
Code of Structure-Type: '
Net Loss/Gain of Dwelling Units
2. PROJECT INFORMATION
PLAN CHECK NO.
EST.VAL
PLAN CK DEPOSTT_
VALID. BY
DATE
FOR OFFICE USE ONLY
Address
Nearest Cross Street
LEGAL DESCRIPTION Lot No.Subdivision Name/Number Unit No.Phase No.
CHECK BELOW IF SUBMITTED:
O 2 Energy Calcs Q 2 Structural Gales O2 Soils Report D 1 Addressed Envelope
ASSESSOR'S PARCEL EXISTING USE PROPOSED USE
DESCRIPTION OF WORK
SQ. FT.DRIES # OF BEDROOMS # OF BATHROOMS
3T UJNrAUTrtHSuN lit dillerent rrom applicant;
NAME (last name first)
CITY STATE
ADDRESS
ZIP CODE DAY TELEPHONE
4. APPLICANT D CONTRACTOR
NAME (last name first)
CITY
U AGENT FOR CONTRACTOR
ADDRESS
STATE ZIP CODE
CJ OWNER a AGENT FOR OWNER
DAY TELEPHONE
5. PROPERTY OWNER ,
NAME (last name first) H I1
v
CITY STATE ZIP CODE
ADDRESS S'O./nc. #-
DAY TELEPHONE ~ 1-7*4
t>. OUN'lttAUHJK
NAME (last name first)
CITY
STATE
STATE
LIC. #
DESIGNER NAMt (.last name tirst)
CITY STATE
ZIP CODE
LICENSE CLASS
ZIP CODE
ADDRESS •
DAY TELEPHONE
CITY BUSINESS LIC. #
ADDRESS
DAY TELEPHONE STATE LIC.#
7. WORKERS' COMPENSATION
Workers Compensation Declaration: I hereby affirm that I have a certiticate ol consent to self-insure issued by the Director ot Industnal
Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified
by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C).
INSURANCE COMPANY POLICY NO.EXPIRATION DATE
Certificate ot Exemption: I certify that in the performance ot the work tor which this permit is issued, I shall not employ any person in any manner
so as to become subject to the Workers' Compensation Laws of California.
SIGNATURE DATE
8. OWNER-BUILDER DECLAMATION
Owner-Builder Declaration: 1 nereoy altirm mat i am exempt trom tne contractors License Law lor tne loilowing reason:
CSC '. 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 for sale (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 sale. 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 for the purpose of sale.).
D I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (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 contracts for such projects
with contractor(s) licensed pursuant to the Contractor's License Law).
D I am exempt under Section _ Business and Professions Code for this reason:
(Sec. 7031.5 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 he is licensed pursuant to the
provisions 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 applicant for a permit
subjects.the applicant to a civil penalty of not more than five hundred dollars [$500]).
SIGNATURE Qiw*JL^ *-C//- DATE i-L.-
COMPLETEJTH1S SECTION FOB NON-RESIDENTIAL BUILDING PERMITS ONLY:
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 Presley-Tanner Hazardous Substance Account Act?
D YES D NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
O YES D NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
O YES D NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT
HAS MET OR IS MEETTNG THE REQIJ1REMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
9. CONSTRUCTION LhJNLILNU AGENCY
1 hereby attirm tnat tnere is a construction lending agency tor the performance ot the work tor wnicn this permit is Issued (Sec 3097(i) cmi Code).
LENDER'S NAME LENDER'S ADDRESS
1U. Ar r LJlJAN 1 LjiK 1 IT U-iA 1 ION
i certify mat i nave read tne application and state that the above mtormation is correct. 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 CTTY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS
AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SATO 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 the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code).
•PUCANTS SIGNATURE, DATE: _~"WHITE: File YELLOW: Applicant PINK: Finance
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