HomeMy WebLinkAbout1945 CAMINO VIDA ROBLE; J; CB910916; PermitBUILDING PERMIT
06/14/91 08*21
Page 1 of 1
Job ftddress: 1945 CflMINO UIDfl ROBLE Str« **
Permit Types PLUMBING
Parcel No«
Valuation" 0
C o n s t r u c t i o n Ty p e" NEW
Occupancy Group* Class Code*
Description' GfiS LINE TO SUITE J
a
Permit No" CB910916
Project No' 89101124
Development No"
10-00C-PRMT
ftppl/Ownr « GOOD flND ROBERTS
1090 JQSHUft UflY
UISTfl, Cfl 92083
*** Fees Requi red
Fees *
fidjustments*
Total Fees'
Fee descr i pti on
Enter "Y" for Plu
Gas Piping System
* PLUMBING TOTflL
Status" ISSUED
flppliedi 06/14/91
Apr/Issue^ 06/14/91
Ualidated By: DC
619 598-7614
d S, Credits
,00
,00
10,00
Ext fee Data
7.50 Y
2,50
10, 00
OTY OF CARLSBAD
2075 Las Palmas Dr., Carisbad CA 92009 (619) 438-1161
PERMIT APPLICATION
City of Carlsbad Building Department
2075 Las Palms Dr., Carlsbad, CA 92009 (619) 438-1161
I. PERMIT
A • Q Commercial U New Building U Tenant Improvement
B - D Industrial D New Building D Tenant Improvement
C - D Residential D Apartment DCondo D Single Family Dwelling D Addition/Alteration
D Duplex D Demolition D Relocation D Mobile Home D Electrical^HPIumbing.
D Mechanical D Pool D Spa D Retaining Wall D Solar D Other/ \
2. PROJECT INFORMATION
PLAN CHECK NO.
EST.VAL
PLAN CK DEPOSIT_
VALID. BY
DATE
FOR OFFICE USE ONLY
Address
Nearest Cross Street
BULUW II-1
D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D 1 Addressed Envelope
ASSESSOR'S PARCEL EXISTING USE PROPOSED USE
DESCRIPTION OF WORK tZ> <aUIT&
SQ.FT.-A # OF STORIES
3. uuMTAur PfcKSJw (.a oiiierenr trom applicant;
NAME
CITY STATE
ADDRESS
ZIP CODE DAY TELEPHONE
4. APPLICANT
NAME
U CONTRACTOR U AGENT I-OH
STATE
UUWNLR
ADDRESS
ZIP
J-CJK OWNER
DAY TELEPHONE
5, PROPERTY OWNER
NAME
STATE
ADDRESS
ZIP CODE DAY TELEPHONE
o. CONTRACIUR
NAME
CITY STATE
STATE L1C.
ZIP CODE
LICENSE CLASS
DAY TELEPHON"^
CITY BUSINESS LIC. #
DESIGNER NAME
CITY
V. WORKERK'UUMPENKA'I'IUN
Workers'Compensation Declaration: I hereby anirm that I have a certificate ot consent to self-insure issued by trie Director of 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).
INSURANCE COMPANY reJMfQ
thepenorm
POLICY NO. .EXPIRATION DATE
Certificate or Exemption: T certify that in the performance ot the work for which mis permit is issued, I shall not employ any person in any mariner
so as to become subject to the Workers' Compensation Laws of California.
SIGNATURE DATE
8. OWNER-BUILDhH DECLARATION
tJwner-Builder Declaration: I hereby ainrm that I am exempt from the Contractors License Law tor the following reason:
O
D
D
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 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).
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 DATE
COMPLETE THIS SECTION FOR 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 HS.NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?n YES XNO
Is the facility to be constructed withifiUOOO feet of the outer boundary of a school site?
D YES JBNO
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 MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SFJIV1CES AND THE AIR POLLUTION CONTROL DISTRICT.
. CONSTRUC'llUN LENDING AUEHCY _______
ITiereby attirm that there is a construction lending agency lor tne periormance ot the work for which this permit is issued tSec 3097(iJ Civil Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPLICANT
1 certity tnat l nave read tne application and state mat the above information is correct. I agree to comply with ail City ordinances ana 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 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 p?rmiU8 naf commenced within 365 days from the date of such permit or if the building or work authorized by
such permit is suspended or aband^ped a^an^time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code).
APPLICANTS SIGNATURE DATE:
File YELLOW: Applicant PINK: Finance
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT* CB910916 FOR 06/26/91 INSPECTOR AREA MC
DESCRIPTION: GAS LINE TO SUITE J PLANCK# CB910916
OCC GRP
TYPE: PLUM CONSTR. TYPE NEW
JOB ADDRESS: 1945 CAMINO VIDA ROBLE STR:** FL:**** STE: J
APPLICANT: GOOD AND ROBERTS PHONE: 619 598-7614
CONTRACTOR: PHONE:
OWNER: PHONE:
REMARKS: MH/TIM/598-7614 INSPECTOR
SPECIAL INSTRUCT:
/
TOTAL TIME:
—RELATED PERMITS— PERMITfl TYPE STATUS
CO910058 COFO ISSUED
CD LVL DESCRIPTION ACT COMMENTS
23 PL Gas/Test/Repairs
***** INSPECTION HISTORY *****
DATE DESCRIPTION ACT INSP COMMENTS