HomeMy WebLinkAbout2345 CAMINO VIDA ROBLE; ; CB900081; Permit01/19/90 ll!45 BUI LDI NG
Page i of i
Job Address: 2345 CAMINO VIDA ROBLE
Permit Type: PLUMBING
Parcel No:
Valuation: 0
Construction Type: NEW
Occupancy Group: Class
Description: GAS LINE FOR HEATERS
CONTRACTOR
PERMIT
Str:
OWNER
* ft *
CLIMATE CONTROL
1161 OPAL STREET
SAN DIEGO CA 92109
: MONTANO, EDDIE
2345 CAMINO VIDA ROBLE
CARLSBAD, CA 92009
Fees Required ***
Fees :
Adjustments:
Total Fees:
Fee description
10.00
.00
10, 00
Permit No: CB900081
Project No: A9000103
Development No:
Fl: Ste:
Enter Y" for Plumbing Issue Fee >
Gas Piping System >
* PLUMBING TOTAL
Status: ISSUED
Applied : 01/19/90
Apr/Issue :
Validated By: DC
Lie. C 353227 619 276-5424
619 931-1177
,Fee% -Col^&cfted & Credits ***
Total Credits**'
Total Pay^nts!
Balance' D\ie:
Units Fee/Wit
1.
.00
.00
10. 00
Ext fee Data
7.50 Y
2.50
10. 00
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161
PERMIT APPLICATION
City of Carlsbad Building Department
2075 Las Palmas Dr., Carlsbad, CA 92009 [BIS) 438-nei
1. PERMIT TYPE I
A - [J COMMERCTALQNEW nTEN"NT IMPROVEMENT
B - L7I INDUSTRIAL QNEW QTENANT IMPROVEMENT
c - PRESIDENTIAL QAPARTMENT QCONDO QSINGLE FAMILY DWELLING
QDUPLEX DDEMOLITION QHELOCATION QMOBILE HOME QELECTRICAL
QPOOL QSPA QRETAINING WALL QSOLAR QOTHER
2. PROJECT INFORMATION PLAN CHECK No.
£ST. VAL
PLAN CK DEPOSIT
VALID. BY
DATE
FOR OFFICE USE ONLY
Address
Nearest Cross Streets
BuiIding or Suite No.
LEGAL DESCRIPTION Subdivision Name/Number Phase No.
CHECK BELOW IF SUBMITTED:
Q2 Energy CaUs Q; Structural Calcs Qg Soils Report Addressed Envelope
ASSESSOR'S PARCEL EXISTING USE PROPOSED USE
DESCRIPTION OF
BLOG. SO. FTG.« OF STORIES
3. CONTACT PERSON
NAME
C1TY
ADDRESS
ZIP CODE DAY TELEPHONE
SIGNATURE
4.
5.
APPLICANT , SJTONTRACTOR
fiCS . ..
^•{^ S&GfV^- jO--f-£«-^
PROPERTY OWT^ER
NAHE ^^rx-Z^j ^^^
CITY
Q AGENT
STATEC
OWNER
STATE
FOR CONTRACTOR D OWNER
ADDRESS / { fa / Q0p.£
&: - Z I P CODE ^ "&-/ 0 ^
ADDRESS t^?V'S" CT
ZIP CODE
[H AGENT FOR OWNER
DAY TELEPHONE
HLESSEE
DAY TELEPHONE
DTEWANT
&S-//77
6. CONTRACTOR
MAME
DESIGNER NAME
ADDRESS / It/ {
ZIP CODE
LICENSE CLASS
T1TLE &*
ADDRESS
DAY TELEPHONE
CITY BUSINESS LIC.
DATE / /I ^ / 7
DAY TELEPHONE STATE LIC. #
7. WORKERS' COMPENSATION
Workers' Compensation Declaration: I hereby affi rm 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 c<-Q-y-3^—'certi-fy tha
POLICY NO. _// Lj f 3 9 &EXPIRATION DATE
Certificate of Exemption: I certt-fy 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.
8. OWNER-BUILDER DECLARATION
Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
I as ouner of the property or my employees with wages as their sole compensation, will do the uork 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 contractors)
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 0, commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom,
and the basi s for the a Ileged exempt ion. Any violat i on of Sect ion 7031.5 by any applicant for a permi t subjects the appli cant 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 n^o
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'
DfES QNO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY HAT HOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS
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 I 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. I hereby authorize represents!ives 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 corrmenced 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).
APPL1C SIGNATURE OUNER CONTRACTOR PHONE APPROVED BY;
DATE:
-77 WHITE: File YELLOW: Applicant PINK: Finance
UNSCHEDULED INSPECTION
h.DATE / / / 7 / 7° INSPECTOR
PERMIT #_ PLANCK
JOB ADDRESS
TIME ARRIVE: TIME LEAVE:
CD LVL DESCRIPTION ACT COMMENTS
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