HomeMy WebLinkAbout1920 BASSWOOD AVE; ; CB951209; PermitBUILDING PERMIT Permit No: CB951209
09/06/95 08:39 Project No: A9501793
Page 1 of 1 Development No:
I Job Address: 1920 BASSWOOD AV Suite:
Permit Type: PLUMBING 3520 09/06/9s WOI. 02 02
Parcel No: 205-080-56-00 Lot#: C-PRMT 27 v $0 Valuation: 0
Construction Type: NEW Occupancy Group: Reference#: Status: ISSUED Description: REPAIR GAS LINE Applied: 09/06/95 Apr/Issue: 09/06/95
Entered By: RMA
Appl/Ownr : ARTHUR BROWN PLUMBING 619-729-4914
2697 STATE ST
*k* Fees Required ted & Credits ***
Adjustments: .oo
...................... .....................
Fees :
Total Fees: .oo
27.00
Ext fee Data
20.00 Y
7.00
27.00
----------------- Fee description ------------------
Enter "Y" for PI
Gas Piping Syste * PLUMBING TOTAL
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
/
/hIT APPLICATION
2075 Las Pel- Dr., Carlsbad, U 92009 (614) 438-1161 / City of Carlsbad Building Depertpnt
1'
/
A - U Commercial mew Building U Tenant Improvement
B - 0 Industrial 0 New Building OTenant Improvement
C - 0 Residential 0 Apartment 0 Condo Single Family Dwelling AdditiotVAlteratior
0 Duplex 0 Demolition 0 Relocation 0 Mobile Home 0 Electrical 0 Plumbing
DMechanical OPool 0 Spa ORetaining Wall OSolar nother
2. PRWFXXINFORMATION FOR OFFICE USE ONLY
Building or suite NO.
AQdress tqa #kpdood Nearest Cross Street
Lot No. Subdivision NamdNumber Unit No. Phase No.
0 2 Energy Calcs 0 2 Structural Calcs 0 2 Soils Report 1 Addressed Envelope
PaQpQsEeysE
NAME ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE CITY STATE ZIP CODE DAY TELEPHONE
-_ 2- 1 CITY STATE ZIP CODE &dJbn4 DAY TELEPHONE Tlf 9 7/
NAME ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. # m Workers' Compensation Declaration: I hereby alfirm that 1 have a certiticate ot consent to selt-insure issued by the Director ot Industrial 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).
cc/ POLICY NO&~~~~~~&~PIRATION DATE ormBnce of the work tor which this permit is issued, I shall not employ any person in any manner ceruticate ot Exempuon: 1 certny that in th-rt so as to become subject to the Workers' Compensation Laws of California.
INSURANCE COMPANY kkh z5, &
SIGNATURE DATE
Owner-Builder Declarauon: I hereby attirm that 1 am exempt trom the Contractor's License Law tor the tollowing reason:
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 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.).
I, as owner of the property, am exclusivelycontracting with licensed contractom to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law dm 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).
I am exempt under Section
(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 [SSOO]).
0
0
0 Business and Professions Code for this reason:
SICNATURE DATE
COm
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?
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
IF ANY OF THE ANSWERS ARE YES A FINALCERTIFICATE oPoQcupANCY MAY NOT BE ISSUED UrIW JULY 1.1989 UNISSTHE"T
0 YES 0 NO
OYES 0 NO
OYES 0 NO
ik =OR 1s MEE~INC THE ~urmnaas OFTHEO~~OF mm~rncx sawas AND THE AIR wiunro~ <XINTROL DISTRKII.
I hereby attirm that there IS a construction lending agency tor the peRormance ot the work tor which this permit 1s issued (Sec 3097( I) cm~ code).
LENDER'S NAME LENDER'S ADDRESS
10.
I cenitv that I have read the aDDlication and state that the above intormauon is correct. I awee to comDlv with all City ordinances and State laws relating to building constructioh: I hereby authorize representatives of the City of Carlsbad to enter upon the above mentibned property for inspection purposes. IhISOAC~TOSAVEINDEMNIFYANDKEEPHARMLESSTHE~OPCARLSBADACAZNrnAU.~~~a)61S AND EXPENSES WHICH MAY IN ANY WAY ACCRUEACAM~sA(D <TIy IN CONSEQUEN~OFTHEGRANTING OPW 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. Ewry 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).
DATE: 9/6/91
: Applicant PINK: Finance