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Home My WebLink About2265 MASTERS RD; ; CB973576; Permit11/21/97 15 :08 Page 1 of 1 B U I L D I N G Job Address: 2265 MASTERS RD Permit Type: PLUMBING Parcel No: 212-140-09-00 Valuation: 0 P E R M I T Suite : Lot#: Permit No: CB973576 Project No: A9704647 Development No: 1710 ll/21/97 ~~~ 02 27-00 Occupancy Group: Reference#: Construction Type: NEW Status: ISSUED Applied: 11/21/97 1709 U'4.1Wt'1~e01 11o321;97 Entere~~: RMA1e1 wa 804-0888 Description : GAS LINE TO FUTURE BBQ Appl/Ownr : GIOVANI,BERTUSSI 2265 MASTERS RD CARLSBAD CA 92008 *** Fees Required *le* Fees: Adjustments: Total Fees: **le 760 Pees Collected & Credits .00 .00 27.00 *le* Fee description Ext fee Data Enter "Y" for Plum Gas Piping System * PLUMBING TOTAL OVA1:. '" n orcre ___ ___ ..,'-.,I I ____ _ v-_~. nAt'CE _____ _ CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 20.00 Y 7.00 27.00 FOR OFFICE USE ONL V PERMIT APPLICATION PLAN CHECK NO. Of 735 76 CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. _________ _ Plan Ck. Deposit ---'""t"l-71---:--- Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use Proposed Use Name Address City ~,:: iJ\P/!Pi;Wrr 'O'co~cil,~®liiJ:ii,,adlii!i . iiiilJiiliiil_.,,tr State/Zip !W014 'It H Telephone II Fax I Name Address City State/Zip Telephone# ~- ~1:p2i.s!,1c1hL-1<~~::2:!!~\(~,+-'~v~.-~~~~':2-1.~~:..'.:::~:::'.:.,~C4~LJ.-C~C~· -,--,-➔J.O.-..:t!,.!::!..:~~~ ;;;~OTOA-~:tO_MPAN¥~~;:;~;;;~t¥~~~!!,llll'llliilldili;i.ffi,11t111!!Jg!ii·~: LL LJa:t•te/Zipii Wii=~~ (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, commending 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 ($5001). Name Address City State/Zip Telephone# State License# _________ _ License Class _________ _ City Business License# _______ _ Designer Name Address City State/Zip Telephone State License # _________ _ /l;J\_.-','.\WOJIKERSf·.CD--•ttoNr~~-~~i~W!;?g~r;j~~~'±§0~fiis15$~".~~-w;:wwH ..fflill~~~~ Workers' "compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ' D I have and will 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 worker's compensation insurance carrier and policy number are: Insurance Company____________________ Policy No.____________ Expiration Date. _______ _ CTHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1noo1 OR LESS) D 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 ao as to become subject to the Workers' Compensation Laws of Califomia. WARNING: Failure to ncure worken' compensation coverage Is unlawful, and ahal subject an employer to crhnlnal penaltiu and dvll flnu up to one hundred thousand dollars ($100,000), In addition to the cost of compenNtion, damages u provided for in Section 3708 of the Labor code, Interest and attorney's'"'· SIGNATURE, ______________________________ ,...-DATE ,~c·'~OWNEl!-BUILDE"'(IECl:ARAflbi\i~~ii,ii,!il\il!li~l::i!iill:l!!illJ~l'~!ii!!i!i~J);:,(~~.._,.,i!llli!l!L]Ziiihile~~ 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason: ]!$.. 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, end 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 ls 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, Busln ... 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 contractorlsl 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. D YES ONO 2. I (have/ 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 coMtruction (include name / address / phone number / contractors license number): 4. I plan to provide portions oft work, but I have hired the following person to coordinate, supervise and provide the major work (include name/ address / phone er): . .\--------------------------------------------- 5. (hired) the following persona to provide the work indicated (inclu e na e / address / phone number / type PROPERTY OWNER SIG tc:oMl'i!miii'ltlS•Ec:rtp DATE II Is the applicant or future bu1 frig occ pant req · ad to au mit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 26605, 25533 or 25534 of the Presley-Tanner HazardoUs Substance Account Act? D 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? D YES O NO Is the facility to be constructed within 1,000 feat of the outer boundary of a school site? D YES D NO IF ANY OF THE ANSWERS ARE YES, A ANAL CERTIFICATE 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 POLLUTION CONTROL DISTRICT. !ih.G;.~g~~QliWl~ ... ~,Gliitt~!titllt!t"V'-¥""-4'•.'_1'.t?,R~JF,, :t;,. ' "f~;i~}J;;_?.;;4;~~;~ ~l~'f!~:~~t I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 30970) Civil Code). LENDER'S NAME______________ LENDER'S ADDRESS 9<$WAffli!~~Rl1FICAJio8"'~;,;•,~,~;',i1/,J;iiiiiiia,,ll .. _"1Pt! iJl!l1 I certify that I have read the application and state that the above information is correct and that the information on the plans is acc~rate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Citt of Cartsbad 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 LlABILITIES, JUDGMENTS, COSTS AND 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 6'0• deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit iii;wed by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the buildlng or work authorized by such mit' s not commenced n 365 days _from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any tim after t a w H:C,...:.:.;'<:or • period of 180 days IS action 106.4.4 Uniform Buildin~A ~:d•l. / / /i.r /4] "~'' ,..,,,, Pl"-" -/ l