HomeMy WebLinkAbout1946 KELLOGG AVE; ; CB971211; Permit. -..
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CLEARANCE Ytr 07-_ ==:::J
CITY OF C~R~!9;~ (6 19) 438-1161
2075 Las pa}mas Dr., Carlsba ,
FOR OFFICE USE ONLY
PERMIT APPLICATION . ... PLAN CHECK NO. q 1 / '.2, i/
CIT.Y OF t;ARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(760) 438-1161
EST.VAL. _________ ~
Plan Ck. Deposit---------
Validated By _______ ........,.__ __
Date. ___ _,_..L--+-+-.+~~~----
1. PROjECT INFOJl~ATION /9411, I< cUtJ GG
Address (include Bldg/Suite I) Business Name (at this address)
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total I of units
Proposed Use
#of Stories I of Bedrooms I of Bathrooms
[2. CONTACT PERSON (It dltflllWlt from 81)pllcantl
Name Address City State/Zip Telephone I Fax I
,..-----............ ,, . .-: --r:1-... ,. r:r.-·~·APPLICANf -~ontilotor ~....-0 -AgentTorl::ontractor Downtr D Agent1or 6wnir"~.--~ ..
Address City State/Zip Telephone I
~,.,;t't ,., ,:•
Name Address City State/Zip Telephone I
f&~CONTRACToR--:. COMPANY NAME~1""""""__...._......,.."...,.,:,,;z--..• ",~-.~ ·'11: ....
(Sec. 7031 .6 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, commending with Section 7000 of Division 3 of the Business and Professions Code! or that he is exempt therefrom, end the basis for the elleged
exempt~. Any violation of Section 7031.6 by any applicent for a permit subjects the applicant toe civil penelty of not more than five hundred dollars ($6001).
~d G ~A/S7-.:i-os7 C!l-£s7Vt<r C,17c.L5113/lt) 'J;.od<f' 7,;i. 'I 7~~ 7
Name -?/-f-L"£ 0 Address }2 City State/Zip Telephone I
State License I I f · z. ll License Class ,!;;2_ City Business License I --------
Designer Name Address City Stete/Zip Telephone
State License I----------
6. WORKERS' COMPENSATION
Workers' Compensation Declaration: I hereby effirm under penalty of perjury one of the following declarations:
0 I have and will maintain a certificate of consent to self-insure for workers' compensation IS provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
0 I have and will maintain workers' compensetion, IS required by Section 3700 of the Labor Code, for the performence of the work for which this permit is
issued. My worker's compensetion insurence cerrier end policy number ere:
Insurance Company Policy No. Expiration Date _______ _
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS)
0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ eny person in eny manner so es
to become subject to the Workers' Compensation Laws of California.
WARNING: Fellwe to Hcure worker•' compenHtlon coverage la unlawful. and ahell aubject en employer to criminal penettlaa and civil fine• up to one hundred
thousand dollar• ($100,000), In addition to tha coat of companutlon, damage• u provldad for In Section 3706 of tha Labor coda, lnteraat and attorney'• feaa.
SIGNATURE DATE __________ _
'7. OWNER-BUILDER DECLARATION · ·' _., ....
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
0 I, as owner of the property or my employees with wagas as their sole compensetion, 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, ind who does
such work himself or through his own employns, provided that such improvements are not intended or offered for Hie. 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:
1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO
2. I (have I have not) signed an application for a building permit for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction (include n1me I address I phone number I contractors license number):
4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name I address I phone
number I contractors license numberl=----------------------------------------------
5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name/ address I phone number I type of work): ________________________________________________________ _
PROPERTY OWNER SIGNATURE-----------------------DATE ______ ~--
¥ !"'.., .... . ' .
Is the applicant or future building occupant required to submit • business pl1n, acutely hazardous materials registration form or risk management and prevention
program under Sections 26506, 26633 or 26634 of the Presley-Tanner Hazardous Substance Account Act7 0 YES O NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district 7 0 YES O NO
Is the facility to be constructed within 1,000 Int of the outer boundary of a school site7 0 YES D 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 ANO THE AIR POLLUTION CONTROL DISTRICT. ia.-CONSTRUCTiotlltNDINGAGENCv.'~·~·':'J; .. ":;-!"'~"'"'~,'.';":"'""':""""-~:'1'""::_-::,,,....:'.':""'u~.,.... "-'.""T • ..,..,...":.'"' ... • -j· ,,. ~,,. ... ""' ·
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Code).
LENDER'S NAME _____________ _ LENDER'S ADDRESS. _______________________ _
I certify that I have read the application and state that the above information is correct and that the information on the plana la 1ccurate. I agrea to comply with all
City ordinances and State laws rel1ting to building construction. I hereby authorize rapresantativn of tha Cltt of C1rtsbad to enter upon the above mentioned
property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES,
JUDGMENTS, COSTS ANO 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" dnp and demolition or construction of structurn 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 pe1mit is not commenced within 366 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 s commence fo erlod 180 deJ' (Section 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE ct' DATE ~ If r-f 7
CITY OF CARLSBAD
INSPECTION REQUEST
PE:ru1IT# CB971211 FOR 05/14/97
DESCRIPTION: UNDERGROUND PLUMBING ONLY FOR
TI (CB970998)-SONALI
TYPE: PLUM
JOB ADDRESS: 1946 KELLOGG AV STE:
INSPECTOR AREA
PLANCK# CB971211
OCC GRP B
CONSTR. TYPE VN
LOT·
APPLICANT: P & G CONSTRUCTION
CONTRACTOR:
PHONE: 760 729-7447
PHONE:
OWNER: PHONE:
REMARKS: RS/GARTH/ INSPECTOR -:;:-;::;-:;:-;;~~-~~z:::ioc!ies--~~-
SPECIAL INSTRUCT: REQUESTING EARLY A.M. (8-8:30 PREFERABLY)
TOTAL TIME:
--RELATED PERMITS--
CD LVL DESCRIPTION
PERMIT# TYPE
FAD96027 FADD
STATUS
ISSUED
ACT COMMENTS
21 PL Underground/Under Floor pt ___ _
***** INSPECTION HISTORY*****
DATE DESCRIPTION ACT INSP COMMENTS
10/16/97
DATE
05/14/97
05/14/97
INSPECTION HISTORY LISTING
FOR PERMIT# CB971211
INSPECTION TYPE INSP ACT COMMENTS
Underground/Under Floor RI RI RS/GARTH/
Underground/Under Floor PK AP
HIT <RETURN> TO CONTINUE .•.
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