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Home My WebLink About2576 LUCIERNAGA ST; ; CB951380; Permit, 10/02/95 10 :32 Page 1 of 1 B U I L D I N G Job Address: 2576 LUCIERNAGA ST Permit Type: MECHANICAL Parcel No: 215-270-35-01 Valuation: 0 P E R M I T Suite: Lot#: Permit No: CB951380 Project No: A9502018 Development No: 3929 l010J JC., 00C1 01 C....: ,. ' I • , Construction Type: Occupancy Group: Reference#: Status: Applied: NEW ISSUED 10/02/95 10/02/95 RMA Description: REPLACE FURNACE,ADD A/C W/ELEC Appl/Ownr : AIR SUPPLY 2075 CORTE DEL NOGAL #T CARLSBAD, CA 92009 *** Fees Required Fees : Adjustments: Total Fees : Fee description *** .53.00 .00 58 ,UO Apr/Issue: Entered By: 619-431-1740 Fees Collected & Credits •rotal C:r;:edi ts: Total Payments: Balance Due: .00 .00 53.00 *** Units Fee/Unit Ext fee Data ----------------------~-------------------------------~~------------------- Enter 'Y' for Mechanical Issue Fee> Install Furn/Ducts/Heat Pumps > Other > * MECHANICAL TOTAL 2 20.00 I 9.0u 15,00 Y 18.0U 20, 00 ELECT PEE 53.00 F~Ak APPROVAL 1t\J SP _k__ DATE /o/());!J > J ~, " ~~CE ______ _ CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT A"'PUCATION C'ity of ~rlsbad Building DepartRnt 2075 Las PalES Dr., C&rlsbad, CA 92009 (619) 438·1161 I. 14:kMII I iPE From List 1 (see back) give code of Permit-Type: ___________ _ PLANCHECKN0.1s f Jro l~:t""j!'lf---I .~·~ ,eya; tq:s: < . --------------------------------------------------------- For Residential Projects Only: From list 2 (see back) give Code of Structure-Type: ___________________ _ Net Loss/Gain of Dwelling Units 2. PROJF.C'f INFORMATION FOR OFFICE USE ONLY mt o. CHECK BEWW IF S0BMII IED: □ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope ASSESSOR'S PARCEL ENSTING USE DESCRIPTIONOFWORK f,/ecv FUl<.flflt-(<Z. Lv</\ frOD Cii-1 /j/r, I PROPOSED USE Ctr11J,7,,,.,;:, ~ 1 c,,,,,,-r--... et.,,..;r c,',,,_c,,,? SQ. IT. # OF sroruES / # OF BEDROOMS .:1. # OF BATiiROOMS 1 1 eren rom app ,can / 1__ . NAME (last name first) 5 (' ,t 1,J t ,J ADDRESS nnr,1 _;)... CITY -;,(n,-")<2. STATE ZIP CODE DAY TELEPHONE 4. APPLICANi QWNIRACIOR OAGE.rJI FURWNIRACiOR □ OWNER □ AGEN I FOR OWNER NAME (last name first) {rf1e C:-W ( U ADDRESS CITY STATE ZIP CODE DAY TELEPHONE '--f-3 I -(1 lfO S. PROPFRiY OWNER NAME (last name first) ADDRESS .? ~7C. l-vc I et,(/'J-"TW 5 T CITY ZIP CODE DAY TELEPHONE (.,/ 3 g' -5) If,- 6. WNHtACIOR ADDREss ?o 7 f"" con. re.. Oe l ,Vo &}. c.. NAME (last name first) ftl>t S v p ~ CITY CA?z.{51!,,?t) STATE C°,"t ZIP CODE '7 7c-o ? DAY TELEPHONE Lf 3 f-f 7'f V STATE UC.# )7.?cuo DESIGNER NAME (last name Ilrst) UCENSE CLASS C -;IO CITY BUSINESS UC. # / / ' .,,) 5 Q () ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE UC.# 7. WrntkP.kS' WMPENSA:IluN Workers' Compensation Oedarat1on: I hereby afhrm that I have a cert1hcate of consent to selt-msure issued by the Director of Industnal 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, I.ab. C). INSURANCE COMPANY {-v 1-{)e"-~ POUCY NO .. tJC.,?7f'lb iJi~TION DATE ,;J; 0( y SIGNATURE DATE 8. OWNER-B0llDiM bPilXRA:11oN Owner-Builder Declaration: I hereby afnnn that I am exempt from the Contractors Llcense law for the followmg reason: a a □ 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 Llcense 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 Llcense 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 Llcense 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 pennit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such pennit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's Llcense 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 7031.5 by any applicant for a pennit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]). SIGNATURE DATE COMPLEIE IHIS SECiioN FOR NON-RESIDEN liAt B0ILbiNG PERMI IS ONLY: Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration fonn 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 pennit from the air pollution control district or air quality management district? □YES □NO Is the facility co be constructed within 1,000 feet of the outer boundary of a school site? a YES a NO IF ANY OF TIIEANSWERS ARE YES, A FINAL CERTIFICATE OF OOCUPANCY MAY NOT BE~ AFll!R.JIJLY 1, 1989 UNLF.SS TIIE APPIJCANT HAS MET OR IS Ml!I!TING TIIE REQUIREMENTS OF TIIE OFF1CE OF EMERGENCY SERVICES AND TIIE AIR POIJ.U11ON CONTROL msnuc:r. 9. WNSIROCIIUN 1.RNDING .AGENCY I hereby afhnn that there 1s a consfrucuon iendmg agency for the perfonnance of the work for which thlS penn1t IS ISSued (Sec 3097(1) CivU Code). LENDER'S NAME iJu~ LENDER'S ADDRESS JO. XPPDCANI l!fllliFICAliON I cert.UY that I have read the apphcauon and state that the above miormauon IS correct. I agree CO comply with ail City ordinances 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 purposes. I AI.'iO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS TIIE Cl'lY OF CARI.5BAD AGAINST AIL IJABIU11ES, JUDGMENTS, CXJSTS AND EXPENSES wtnCH MAY IN ANY WAY ACCR\Jl! AGAINST SAID Cl'lY IN CONSEQUENCE OF TIIE GRANTING OF 11DS PERMIT. OSHA: An OSHA pennit is required for excavations over S'O" 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 pennit is not commenced within 365 days from the date of such pennit or if the building or work authorized by such pennic is suspended or aban at any time after,d:h~ ~rk is commenced for a period of 180 days (Section 303(d) Unifonn Buildin~e). APPLICANTS SIGNATURE AJ /(/12' DATE: IO 6> ,- WHITE: File YEU.OW: App 1cant PINK: Finance 0 r WISKIPYYR XH3PSQ'J;91 1 OATW __ /~b~/-7~ 1 /_i_r ___ _ Pt.Mies•------ JOI AOouss ___ z __ s-""'7,..~:....?""k'."'lc._1..f.;a;1,M~:.c:.i.t.'°~.-a::~------------ TIMZ AltltIVI: Ctl t.VL ..:il.. -Jl:J... ----------- ·,w:.111 •11111, OUOIPl'IOII - TIMZ t.UVI: AC'l' COIQCl!ITS ~ -----