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Home My WebLink About2241 MASTERS RD; ; CB971887; Permitl FOR OFFICE USE ONLY >ERMIT APPLICATION PLAN CHECK NO. Cj'7/?'21 CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL.-------=--- Plan Ck. Deposit -c:r-+""-'--'J.<U._ 1. PROjECTINFORMATION Address (include Bldg/Suite Legal Description Phase No. Total I of units Assessor's Parcel # Existing Use Proposed Use I of Bathrooms Name "!!llil!!!m~. City $~-.,,~;CONTRACTOR'~ COMPANY NAMl~¼_/;MJl,Q¾Jfllt~':;k,L !~~.~4~~'.:~~~' «-:•" , .. ,,. St•~~..f'-~::L.~.l,'!t~~n• , ~~~-::"!,1''f.''! State/Zip Telephone I Fax I {Sec. 7031.5 Business and Profusions Coda: Any City or County which requires a permit to construct, aher, improve, demolish or repair any structUra, prior to Its issuance, also requires the applicant for such permit to file a signed statement that he Is licensed pursuant to the provision, of the Contractor's License Law !Chapter 9, commending with Section 7000 of Division 3 of the Busineu and Professions Code) or that he is exempt therefrom, end the be1i1 for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjec:tl the applicant to a dvil penalty of not more than five hundred dollars (t500II. Name --,;-z.,qJ1 -,~ O "1 State License , ___ / ______ _ Address License Class _,(3--~-/~-----City :~:=~~~=:~.e~L€TI~~ .7:l~"·24(£ t? , ly ,kif~~~~,~?~ J«R£½n~ f53-:'lf:? 3 Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of "¥-iollowing declarations: 0 I have and will maintain • certificate of consent to self-insure for workers' compensation as Pfc,yjded by Section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued. 0 I have and Wm maintain workers' compensation, as required by Section 3700 of the labor Code, for the performance of the work for which this permit is issued. My workei's compensation insurance carrier and policy number are: Insurance Company____________________ Polley No.____________ Expiration Date _______ _ !THIS ~TION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS (t1001 OR LESS( ~CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permlt 1s issued, I shall not employ eny person in any manner ao as to become subject to the Workers' Compensation Law of C omia. WARNING: Falue to •~woriien' thousand doRan 1$100,000I, In of SIGNATURE , DATE 7. OWNER•BUIU>Ell DE , .... ,·• . '_ ... ,,./.~ . .;::;,·_ I hereby affirm that I am exempt from the Contractor's Ucense Law for the following reason: 0 I, as owner of the property or my amptoyns with wages as their sole compensation, will do the work and the structure Is not intended or offered for sale (Sec. 7044, Business and Profeulons Code: The Contractor's Ucense 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•bullder will have the burden of proving that he did not build or impJove for the purpo11e of sale). 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professtons Code: The Contractor's License Law does not apply to an owner of property who builds or lmprovu thereon, and contracts for such projects with contractorts) licensed pursuant to the Contractor's Ucmse Law). O I am exempt under Section ______ Buainass and Profusions Code for this reason: 1 . I personally plan to provide the major labor and materials for construction of the proposed property Improvement. D YES ONO 2. I !have / have not) signed an application for e butldlng permit for the proposed work. 3. I have contracted with tht foJlowing person (firm) to provide the proposed construction !include name / addru• / phone number / contractors license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, aupervise and provide the major work (inctuda name / address / phone number/ contractors license oomberl:. ____________________________________________ _ 5. I will provide some of tlM work, but I hive contracted (hired) the following parsons to provide the work Indicated «include name/ address/ phone number/ type of work): ______________________________________________________ _ ::::; ::~:::;=E ""'~ii· ;:-;;;-;; .. ;;. ii·iii· iffl···ii:·7i'liiiuiii1U11Hiiii1<Gii-HiiM;;;,ii;•·ili--r.:lfifi·. ii'dN,i,iiti:itifii!il!im.11ii .. !l'"'~;;;t,i>.~oi .. ii:,,iii.;~;;;;.,;; .. ,iii,i;i··· ii. .. ; .~;;;,;;;,~.;. • .. ;;•.·.:, ,;;;~;;;·Ri!!I;, .iii.;;;, ,;;J"",~i.. ;,,..,;;:, ,;;:,T"!'!;;,>c'!' r-~'!"'i"'<~iti} Is the applicant or future building occupant required to submit • bu.ineu ptan, acutely hu:erdous materials reglstradon form or risk management and prevention program under Sections 26505, 25533 or 25534 of the Pr"ley•Tanner Hazardous Substanoe Account Act? 0 YES D NO Is the applicant or future bl.iilding occupant raquired to obtain a permit from the air pollution control district or air quality menegement district? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 VES O NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIRCA TE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POUUTION CONTROL DISTRICT. I hereby affirm that there 11 a construction.lending egency for the performance of the work for which this permtt ls luued ISec. 3097(1) Civil Code). LENDER'S NAME ____________ _ LENDER'S ADDRESS. _______________________ _ 19·, ;· 'APPUcAift ·catt1F1CATION;~+~~::"~-l'fi'.''~'~•~f;4;!~~~,~7.Tf!',f~~f..il~~~t:.ll1Ul'~~r,r.;;~il,~~~~~--, .... F·•,•·.0';-;'::::-s:::~1;'?::r.~-:~.A~~;:,, r ,-~-:,•::··::: I certify that I have reed the 1ppJicatlon ind state that th• 1bov1 lnform•tlon Is correct •nd thlt the information on the P~M Is eccurata. I agrN to compJy with 111 Citv ordinances and Stete l•w• relating to bulking construction. I tweby euthoriH rtpJeHntativN of the Cttt of Cartsbld to enter upon the 1bove mentioned property for Inspection purpoaN. 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 SAIO CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT, OSHA: An OSHA permit Is required for excavations over 5'0" dnp end demolition or construction of structures over 3 •tories in height. EXPIRATION: Every permit Issued by the Building Official under the proviaions of ode lhlll expire by limitation and become null work authorized by such permit is not commenced wlthin 385 days from such permlt or If the building or work authorized or abandoned at any time after the work Is com p od o on 108.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE Plr,.,11/', ,:;,,,.,,,.,. .. CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB971887 FOR 07/14/97 DESCRIPTION: GAS LINE TO BBQ TYPE: PLUM JOB ADDRESS: 2241 MASTERS RD APPLICANT: LANGSTON CONSTRUCTION CONTRACTOR: OWNER: PHONE: PHONE: PHONE: INSPECTOR AREA PLANCK# CB971887 OCC GRP CONSTR. TYPE NEW STE: LOT: 760 855-9583 REMARKS: R/855-9583 SPECIAL INSTRUCT: INSPECTOR _ __,:e;z--+--------- TOTAL TIME: CD 23 LVL DESCRIPTION PL Gas/Test/Repairs -------------------------------------------------------- ACT COMMENTS t-+£----- ***** INSPECTION HISTORY***** DATE DESCRIPTION ACT INSP COMMENTS