HomeMy WebLinkAbout2061 LEE CT; ; CB920571; Permitt
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CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-l 161
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PERMIT APPLICATION PLAN CHECK NO. ~-57/
c;ty of cartsbad au; lding Depertaent
2075 Las Palaas De., caclsbad, CA 92009 (619) 438-1161
PIAN CIC DEPOSIT _______ _
I
EST. VAL
VAIJD. BY __________ _
I. PERMI I IYPH DATE
A -U COmmerc1al Li New Buddmg Li I enant Improvement
B • D Industrial D New Building D Tenant Improvement
C -□ Residential D Apartment D Condo D Single Family Dwelling □ Addition/ Alteration
LI Duplex LI Demolition □ Relocation □ Mobile Home □ Electrical D Plumbing
□ Mechanical □ Pool □ Spa D Retaining Wall D Solar □ Other
2. PRQIBCT INFORMATION FOR OFFICE USE ONLY
Ad~ress 20 ~ 7 lee (:..;,f
l-/4earest Cross Street
BuUdmg or Suite No.
UIDAL DESC:RIPI ION Lot No. SulXhVJs1on Name/Number 0mt No. Phase No.
CHECK BEWW IF S0BMII JED:
□ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Add~ Envelope
PROPOSED USE
/4IT. # OF STORIES
3. WN IACI PFJtSON (If amerent from applicant)
NAME ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
4. APPIJCXNI
NAME
□WNIRACIOR □AG£NI FORWNiRACIUR □OWNER □AGENI FOR OWNER
ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
NAME ADDRESS
ZIP CODE 4 DAY TELEPHONE
NAME
CITY
7olJ;r; ~ /Jj_()/1($11//1,rJDRESS /,..6 b-5' r,R/.BOPO i?D
,; 1 -s714-STATr()H-ZIP CODE 97-.tf}, DAYTELEPHONE 757-d~y
STATE UC.# t"/ i° LICENSE CLASS C'-/.(~ CITY BUSINESS UC. #
CITY STATE ZIP CODE DAY TELEPHONE STATE UC.#
7. WUkkERS' WMPENSXIIUN
Workers' Compensation beclarauon: I hereby afurm that I have a cert1hcate of consent to self-msure issued by the Ulrectorof lndustnal
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
Certihcate of Exemptmn: I certify that m the performance of the work for which this permit 1s issued, I shall not employ any person m any manner
so as to become subject to the Workers' Compensation Laws of California.
SIGNATURE DATE
8. OWN£K-BUllD£K DfillkXliuN
Owner-Builder beciaratmn: I hereby affirm that I am exempt from the Contractor's Llcense Law for the foilowmg 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.).
□ 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.S by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars [$500)).
SIGNATifRE DATI!
COMPLEIE IHIS S£CIIUN FUR NON-RESIDEN IIAt B0ILOING PERMil'S 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? □YES □NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
CYES □NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
□YES □NO
IF ANY OF THl!ANSWERS ARE YES, A FINALCERTIFICATI! OFCXDJPANCY MAYNITTBE ISWED AFll!RJW.Y I, 1989 UNLESS THl!APPIJCANT
HAS MIIT OR IS MJ!l!T1NG THI! REQUIREMENTS OF nm OFFICE OF EMERGENCY SERVICES AND THI! AIR FOIJ.llTION OONTII.OL DJSl'RICT.
9. WNSIRUCIION IENDING AGENCY
I hereby afhnn that there 1s a construction lend mg agency for the performance of the work for which this permit 1s issued (Sec 3097 (I) Cavll Code).
LENDER'S NAME LENDER'S ADDRESS
10. AWilt!ANI CEklfiiK!AliuN
I cemfy that I have read the apphcat1on and state thac the above mformatlon ts correct. I agree to comply wuh ail City ordmances 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
pu!JXlS"S. I A1SO AGREE ID SAVE INDEMNIFY AND KEEP HARMLESS THI! crJY OP CARISIIAD AGAINST ALL LIAIIIUl1ES, JllllGMENTS, CXlSTS
AND EXPENSES WIDCH MAY IN ANY WAY Aa:RUE AGAINST SAID crJY IN OONSEQUENCE OF THI! GRANTING OF TIIlS PERMIT.
OSHA: An OSHA pennit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height.
Expiration. Every pennit 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 pennit or if the building or work authorized by
such permit is suspended ~baJ!P~, at an~time after ~he 7rk is commenced for a period of 180 days (Section 303(d) Uniform uildin e). ·-
CANTS SIGNATU~ /1 Yli -/2) J DATE· ,.----
WI-IlTE: File YEIJ.OW: App 1cant PINK: Fmance
....
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB920571 FOR 06/17/92
DESCRIPTION: REPLACE DETERIORATED GAS LINE
TYPE: PLUM
JOB ADDRESS: 2061 LEE CT
APPLICANT: TOBIES PLUMBING
CONTRACTOR: '
PHONE: 619
PHONE:
INSPECTOR AREA PY
PLANCK# CB920571
OCC GRP
CONSTR. TYPE NEW
STR: FL: STE:
757-2583
OWNER:
REMARKS: MH/757-2583/AM IF POSS
SPECIAL INSTRUCT:
PHONE: ()
INSPECTOR ------'-"'-f-----""~'-'-J-----
TOTAL TIME:
ACT COMMENTS ~ ~
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CD LVL DESCRIPTION
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***** INSPECTION HISTORY*****
DATE DESCRIPTION ACT INSP COMMENTS