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Home My WebLink About2323 CARINGA WAY; 14; CB971867; PermitML. BUILDING PERMIT 07/08/97 16:32 Page 1 of 1 Job Address: 2323 CARINGA WY Suite: 14 Permit Type: MECHANICAL Parcel No: 215-240-27-07 Lot*: Permit No: CB971867 Project No: A9702370 Development No: 6763 07/08/97 0001 01 02 C-PRMT 87-00 Valuation: 1,850 Occupancy Group: Reference*: Description: INSTALL FIREPLACE TO SPECS : ICBO 3507 Appl/Ownr : MICHAEL MALLOW 8855 POLLAND SAN DIEGO, CA 92123 *** Fees Required *** Construction Type: NEW Status: ISSUED Applied: 07/08/97 Apr/Issue: 07/08/97 Entered By: JM 619 268-8541 Collected & Credits Fees : Adjustments: Total Fees: Fee description Enter 'Y' for Mech, Other * MECHANICAL TOTA * * * . 00 . 00 87 . 00 Ext fee Data 15. 00 Y . 72.00 PERMIT FE! 87.00 2075 CITY OF CARLSBAD Palmas Dr., Carisbad, CA 92009 (619) 438-1161 JERMlf APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 INFORMATION FOR OFFICE USE O PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated Bv Date Address (include Bldg/Suite «Name (et this address) Legal Description Assessor's Parcel * Description of Work •i rnUTHOT BiebcriM ii Cot No. Subdivision Name/Number Existing Use ii- Sa. FT. *of Stories i "^:ia^:aaiia^r~^j"«»r«ji^^ Unit No. Phase No. Total * of units Proposed Use f of Bedrooms t of Bathrooms m^fatgaMfOfrai/y'-evft *7»"» <•.« - •*. * Name Address City State/Zip Name Address City State/Zip Telephone * " Name Address City State/Zip Telephone » lMrinW^-• " - (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 {(500)). Name State License * {oJd>3/'3 Address License Class City State/Zip City Business License f Address City State/Zip TelephoneDesigner Name State License * 6. WORKERS' COMPENSATION ". Workers' Compensation Declaration: I hereby affirm 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 as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. O I have and will maintain workers' compensation, as required by Section 3700 of the Labor Coda, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Ct>mpanv-1<5yyy-y*T £pf*se> £[,5 . f^^J^> Policy No. /2.'5?/£>'5 *?-*?"? Expiration Date *?-£>/ -tft (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*100) OR LESS) O 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 aa to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' cornMnsatkm coverage is unjaWfjaX and ahal subject an employer to criminal penalties and dvll fines up to one hundred thousand dollars U100.Qlrtiyn(«ddJtjo£to^na cost/a* cwrfgef»atfo£.4aniagM as provided for hi Section 3706 of the Labor code, Imareti artdattomey'i fees. SIGNATURE 3>C^L- /£%., r*ff^^~ ./^^£ _ DATE ,As£. £ /?Y~ " I hereby affirm that I am exempt from the Contractor's License Lew for the following reason: 0 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 aale. If, however, the building or improvement is sold within one veer of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of aale). Q 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) Hcensed pursuant to the Contractor's License Law). Q 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. Q YES QNO 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 construction (include name / address / phone number / contractors license number): 4. I plan to provide portions of the work, but I have Mred the following person to coordinate, supervise and provide the major work (include name / address / phone number / contractors license number): _ _ _ ; _ | _ . _ 5. I will provide some of the work, but I have contracted (Nred) the following persons to provide the work indicated (include name / address / phone number / type of work): PROPERTY OWNER SIGNATURE DATE w*g?lfi!j|p5*ifp«S^ 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 25SOS, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? O YES D NO Is the applicant or future bUlding occupant required to obtain a permit from the air pollution control district or air quality management district? O YES D NO Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? D 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 AND THE AIR POLLUTION CONTROL DISTRICT. - " ••*'•" 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 ADDRESSLENDER'S NAME 1; I certify that I have read the application and state that the above Information is correct and that the information on the plena la accurate. I agree to comply with eH City ordinances and State lews relating to building construction. I 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, OSHA: An OSHA permit is required for excavations over S'O* deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit Itsued by the Building Official under the provisions ofythts. Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced wj»rffrr?65 days from the dote ofadch permit or if the building or work authorized by such permit is suspended or abandoned at any time afterAfte^orfcyjax^mmejR^sd^Dr a period^erf'WQjaj^JSedtion 106.4.4 Uniform Building Coda). fcPPLICANTS SIGNATURE DATE CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB971867 FOR OB/22/97 DESCRIPTION: INSTALL FIREPLACE TO SPECS ICBO 3507 TYPE: MECH JOB ADDRESS: 2323 CARINGA WY APPLICANT: MICHAEL MALLOW PHONE: CONTRACTOR: PHONE: OWNER: PHONE: REMARKS: C/BARBARA/930-0695 PM PLEASE SPECIAL INSTRUCT: WORK #618-7126 INSPECTOR AREA NF PLANCK! CB971867 OCC GRP CONSTR. TYPE NEW STE: 14 LOT: 619 268-8541 INSPECTOR A/P TOTAL TIME: CD LVL DESCRIPTION 69 MA Final Masonry ACT COMMENTS ***** INSPECTION HISTORY ***** DATE DESCRIPTION 072897 Fireplace/Tie Straps ACT INSP CO NF COMMENTS SEE NOTICE NOTICECITY OF CARLSBAD " ^ ^^ ™ m ^^ ^^ 438-3550 BUILDING DEPARTMENT 2075 LAS PALMAS DRIVE LOJCATION. f PERMIT NO. 9 7- TIME I. \ FOR INSPECTION CALL 438-3101. RE-INSPECTION FEE DUE? I I YES > I FOR FURTHER INFORMATION, CONTACT _PHONE CODE ENFORCEMENT OFFICER SD COMPENSATION INSURANCE P.O. BOX 807, SAN FRANCISCO,CA 94101-0807 FLJISID CERTIFICATE OF WORKERS-COMPENSATION INSURANCE ISSUE DATE: 04-01-97 POLICY NUMBER: 1281889 - 97 CERTIFICATE eXPIRES: 04-01-98 STATE CONTRACTORS LICENSE BOARD-WORKER'S COMP. BOX 26000 SACRAMENTO CA 95826 JOB: LIC 1616313 INCEPTION DATE: 04-01-97 D.O. : SAN DIEGO This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days' advance written notice to the employer. We will also give you 30 days' advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other documentwith respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies. -PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.OO PER OCCURRENCE. STANDARD EXCLUSION: INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY. .ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 04/O1/97 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER LEGAL NAME A. MICHAEL MALLOW CONSTRUCTION 3678 PAUL JONES AVE SAN DIEGO CA 92117 MALLOW, ALAN MICHAEL PRINTED: 03-19-97 P0409 SCIF 10265 (REV. 2-95)