HomeMy WebLinkAbout2028 CARACOL CT; ; CB921255; PermitBUILDING PERMIT
12/07/92 09:13
Page 1 of 1
Job Address: 2028 CARACOL CT Suite:
Permit Type: PLUMBING
Parcel No: 215-120-19-00 Lot#:
Valuation: 0
Construction Type: NEW
Occupancy Group: Reference*:
Description: GAS REPAIR
Permit No: CB921255
Project No: A9202550
Development No:
Appl/Ownr : BROWN, ARTHUR PLUMBING
2697 STATE STREET
CARLSBAD, CA 9
*** Fees Required
Fees :
Adjustments:
Total Fees:
Fee description
Enter "Y" for PI
Gas Piping System
* PLUMBING TOTAL
Status: ISSUED
Applied:
Apr/Issue: 12/07/92
Entered By: DC
619 729-4914
0347 12/07/92 0001 01 02C-PRMT 27-00
ected & Credits ***
.00
.00
27.00
Ext fee Data
20.00 Y
7.00
27.00
CITY
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION
City of Carlsbad Building Department
2075 Las Palmas Dr., Carlsbad, CA 92009 (eis) «8-ii6i
1. PERMIT TYPE
A - [^COMMERCIAL QNEU QTENANT IMPROVEMENT
B - D INDUSTRIAL QNEW QTENANT IMPROVEMENT
C - C] RESIDENTIAL QAPARTMENT QCONDO QSINGLE FAMILY DWELLING [^ADDITION/ALTERATION
DDUPLEX ODEMOLITION DISLOCATION DH°BHE HOME QELECTRICAL
DMECHANICAL QPCOL D«PA QKETAINIHG WALL DSOLAR POTHER.
2.PROJECTm INFORMATION PLAN CHECK No.FOR OFFICE USE ONL-Yiress
Nearest Cr
EST. VAl
PLAN CK DEPOSIT_
VALID. BT
DATE
.
C+
Unit NoLEGAL DESCRIPTION Subdivision Name/Number Phase No.
CHECK BELOW IF SUBMITTED:
D2 Energy Calcs D2 Structural Calcs Q2 Soils Report D1 Addressed Envelope
ASSESSOR'S PARCEL
DESCRIPTION" OF WORK
EXISTING USE PROPOSED USE
8LDG. SO. FTG.# OF STolES
3. CONTACTPERSON
NAME ADDRESS
CITY
SIGNATURE
4. APPLICANT x* DETRACTOR
NAME Ay-f'fi^' ^701/^M TPI^/^t
CITY
5. PROPERTY. OWNER _ yi. ,
STATE
1, D AGENT
STATE
OWNER
ZIP CODE
FOR CONTRACTOR D OWNER
ADDRESS
ZIP CODE
^~" ~. -&
DAY TELEPHONE >O» V^"~ *T7 J 7
D AGENT FOR OWNER
DAY TELEPHONE
D LESSEE DTEN*NT
NAME
CITY
ADDRESS
ZIP CODE
6. CONTRACTl
NAME
STATE LIC. #
ZIP CODE
LICENSE CLASS
S^
/ ? £
DAY TELEPHONE
CITY BUSINESS LIC. #
SIGNATURE
DESIGNER NAME
CITY
7. WORKERS'COMPENSATION
TITLE
ADDRESS
STATE ZIP CODE
DATE
DAY TELEPHONE STATE LIC. #
Workers' Compensation Declaration: 1 hereby affirm that I have a certificate of consent to self-insure issued by the 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 POLICY NO.EXPIRATION DATE
Certificate of Exemption: I certify that in the performance of the work for 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 DECLARATION
Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
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.).
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 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?
DYES DNO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
DYES DNO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
DYES QNO
IF ANT OF THE ANSWERS ARE YES. A FINAL CERTIFICATE OF OCCUPANCY HAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE RETIREMENTS
OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
9. CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(i) Civil Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPLICANT'S SIGNATURE
I certify that 1 have read the application and state that the above information is correct. I agree to comply with all City ordinances and State laws relating
to building construction. 1 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.
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 180 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).
APPLICANT'S S/GjlATURE _ 4 J /) y D °"NER [^CONTRACTOR QBY PHONE APPROVED BY:
DATE:
HITE: File YELLOW: Applicant PINK: Finance
DATg /£ ~ 7- / £*» INSPECTOR,
PERMIT » / c2 /cJ5Z> ^ PLANCK
JOB ADDRESS
TIMI ARRIVE: TIME LEAVE:
CO LVL DESCRIPTIOM ACT COMMENTS
PEHCXTS
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