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Home My WebLink About2617 LA GRAN VIA; ; CB980518; PermitV\11-14 B U I L D I N G U2/l9/'3t; 09:1'1 Pa<1e 1 of 1 Job Address: 2617 LA GRAN VIA Permit Type: PLUMBING ~arcel No: 216-250-37-0U P E R M I T Suite: Lot#: Permit No: CB98~~1~ ProJe.:t No: AY800b71 Development No: 4191 02/19/98 0001 01 C-PRMT Construction Type: 02 27-00 Valuation: o Occupancy Group: Reterence#: Description: EMERGENCY GAS LINE REPAIR Status: Applied: Apr/Issue: NI: W ISSUED 02/19/98 02/19/98 JM Appl/Ow~r : PHILLIPS LOUIS 2617 LA GRAN VIA CARLSBAD CA 92009 *** Fees Required *** -------------------------- Fees: Ad1ustments: Total Fees: Fee description -------------------Enter 'Y Gas P1p1ng System Entered By: 760 753-0382 & Credits -------------------------- I FINAL .00 .00 27.00 Ext fee Data 20.00 Y "/. 00 I INSP. ✓ ..,, ~LEARANCE~Y~.~,s~lgMi~-- CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION FOR OFFICE USE O~IJ . 0 O PLAN CHECK NO. 1_-p02J.. ~ CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL.------~--,-- Plan Ck. Depos1~it:,,.,_.,.....-_!~f-,.l.JJ..J-_ Validated BY'....l..L..!..:.....:.......,..-1-,-,,..+,..,,-- Date, ______ -','4-JL-!4-4<µ...._ ..J,.. 1. PROJECT INFORMATION 4< ~t/7 L4 6=twV Address Onclude Bldg/Suite II Businea Name , •• this lddrNII Legal Description Lot No. Subdtvisian Name/Number Unit No. Pha,e No. Total I ot units Existing UH PropoHd Uae SO.FT . lot Starin • of Bedrooms I of Bathrooms :2. . CONTACT PERSON Iii dfforwit fnlm .;.,ilanii Name Address ,3. APPLICANT D Contractor D Agent for Contrici:Of Name AddrHS ~ 4. PROPERTY OWNER CD ~/9UIV.#., Address ► Name !i. CONTRACTOR • COMPANY NAME Cltv , □ Owner-D Agent iai Owner CitY 4{.li ,~-~-'ir~-:C& Ctty State/Zip Telephone I Fax II State/Zip Telephone# State/Zip Telephone I (Sec. 7031.5 Business and Professions Code: Any City or County which require,■ permrt to construct, ■tter, improve, demolish or repair any structure, prior to Its issuance, also requires the applicant for such permit to file • signed statement that he is licensed purauant to the proviaions of the Contractor's Ucense Law fChapter 9, commending with Section 7000 of Division 3 of the 8usine11 and Profaaions Coda) or th■t he is exemPt therefrom, and the b11is for the alleged exemption. Anv violation of Section 7031.5 by any applicant for I permit subj■cts th■ app,llcant to a civil penalty of not men thin five hundred doHars (t 5001). Name Addreu City State/Zip Telaphone I State Ucense I _________ _ Ucensa Cl111 ________ _ City Buslneu Uc:enN I ______ _ Designer Name Addreu Cttv State/Zip Tetephone State License I _________ _ 8. WORKERS' COMPENSATION . -.-·1·~•~ ... --.--·-·-.-··· Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following dKl■retions: D I have and will maintain a certificate of consent to Hlf-fnsure fo, workara' companution •• provided by Sactlon 3700 of the Labor Code, for the performance of the work for which this permit is i11uad. D I have and will maintain workers' compensatkm, as required by Section 3700 of the Labor Code, for the pa,torm9nc1 of the work for which this permit is issued. My worker's compensation insurance carrter and policy number ere: Insurance Company____________________ Policy No. E,cpimlon Date. _______ _ !THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS lt1001 0R WSt 0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permh: ii inued, I ftH not employ any person In any m■mer ao 11 to become subject to the Workers' Compen11tion Laws of California. WARNING: F1Uure to NCUf9 worlclfl' compenntlon conrage It unlawful, and ataall aubj■ct an employer to c:rlffllnal peneltlu and dvll finis up to DIii hundred thousand dollar• Ct100,0001, In addition to the cott of comp■nudon, clamllga • provided tor In Section 3708 of Iha Labor ODH, lnteNat and ■ttom■y'■ fen. SIGNATURE____________________________ OATE.,----,,===--~ 7. OWNER--BUILDER DECLARATION , .. ~ · , . ·. '·'".:\;-t:,~Y.r/f"r"'~:•·::~ ... ,.,,•i•'fl'lT.!' ·~~. • I hereby Iffirm that I am exempt ffom the Contractor'• Uc.,.■ Law tor the foHowing ,...on: 0 I, •• owner of the property or my employeu with wages II their ■ole companntion, will do the work and the mucture 6s not Intended or offered for .... (Sec. 7044, Buslnua ■nd Prof■■■ionl Codi: The Contractor'■ Uc■ns■ L■w dON not 1ppty to ■n owner of prap■rty who build■ or lmprov■■ thereon, and who doll ■uch work hlm111f or through t\it own empfoy■n, prlMded thllt ■uch lmprovem■ntl ,,. not tntenct■d or offered for NII. It, however, the bulldlng· or 1n..-onme11t ll sold within one year of compl.,lon, the owner--builder wm have the burden of proving thlt he.did not bulfd or Improve for the purpo■■ of ■ell). ~ I, as owner of the .property, em ■xcluslvetv conttacting with licel'IHd contractors to construct the pro;.c, CS.C. 7044, Buatneu end Proteuion■ Cada: The Contractor's License Law do■I not apply to en owner of property who builds or improves thereon, and contractl for IUCh pro;ecu .wtth conuactorCaJ lk:■nHcl pursuant to the Contractor'• Uc1n11 Law). 0 I am exempt lfflHr S9ctton ______ Buslneu and Prof■utons Code tor this r■■son: 1 . I personally plan to provide the major labor and m■t■rilfs for constructkm of the propoud property Improvement. □ YES ONO 2. I (have I have notl signad an 1pplic1tlon for a building parmlt tor the propoaed work. 3. whh th■ person J' t provkle the propoted COft■tfUctfon Clnduda n■m■ / lddrw■ / phone number / contractors license number): 4. I plan to provide portions of the work, I hive hired the following person to coordinate, lup■MINt and provide the m■)or work tlnclude name/ ■ddrlN / phon■ number/ contractora license number).:_--------------------------------------------- 5. I will provide 1om1 of th■ work, but I hive contracted lhlredJ the foHowtng pereons to provkle the work lndk:at■d Hnctud■ Mme/ eddreu / phone number I typa of work):. ________ ;~;;;~;;~~=~~!tfi!ffffij-{~-~-;;-;-f~-ij,-,r_'ii,_;;_;;_;:_;~-c;-;_;;_;;;_;;_:;_;;;_~----------;-,---,":=:--::::;------PROPERTY OWNER SIGNATURE 'COMPLETE THIS SECTioN FOR~ iUUJiNG Is the applicant or future building occupam requirad to submit • busin■u plan, acutely hlurdous mat.,._ 1■gil,ballu11 form or risk m■n11gement: and prevention program under Sections 25605, 25633 or 25534 of the Prnley•T■m■r Hazardous Subltanc■ Account Act? 0 YES D NO Is the applicant or future building occupant required to obtain• permft from the air poltutton control dlstrl_ct or air qu■Ntv management di11ne11 0 YES D NO Is the facility to be constructed wh:hin 1,000 feet of the outer boundary of I school 1h17 D YES D NO IF ANY OF THE ANSWERS ARE YES. A FINAL CERTIFtCATE OF OCCUPANCY MAY NOT IE ISSUED UNWS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES ANO THE AIR POLLUTION CONTROL DISTRICT. :a.·· coNsTiluCT10NUND1NGAGENCY ·,• -.,,,.. ............... , .. ,:•••.-• ·,~,,,··~·::7:r:·~•,.,.,...., ..... ,,. ...... ,.. : ............. ,., ..... ,.· ... , ..... , .. -·,.., ... , ,.,.--: -•.-i• · ,, __ I hereby affirm that there Is a construction lending agency for the partormance of the work for which this permit Is tuuad CSec. 3097(1) Civil Code). LENDER'S NAME_____________ LENDER"SAOORESS. _______________________ _ ;9_ APPLICANT CERTIFICATit>N ~ ' · ,. "~ ·•; r,TT .. ,_ .. n., ~ · ···,-~-.-,·:-:-·.·"•·..,-.rr,7':·''"·•::;:rp,;i,_!""'•,..,, .. :•~t<'•·"''""""'l"P"'·'-: I certify that I have r11d the application and It1te that the above information ls correct ■nd that: the Information on the plans 11 accurate. I agree to comply with 11! City ordinances and State laws r■tating to building construction. I hereby authortu ,eprn■ntlltivfl of the Cttt of Certllbed to tnter upon th■ above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP MAIIMLESS THE CJTY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO 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 excevatk»ns over s•o• deep end damolh:lon or construction of structures over 3 atortll in height. EXPIRATION: Every permit issued by the Building OfticlII under the provisions of this Code shall expire by limitation and become null and void if the building er work authorized by such permit is not commenced within 385 diva from the date of such permh or tf the building or work authorized by such permit is suspended °' abandanad at any time aft a, tha wa, · a ta, a padad .•I 180 days I Section 108.4.4 Unifa,m BuHding Cada). ,?._ / a !/7 ~ ~PPLICANT'S SIGNATURE --~'ie~~~~~~~;i,.-..:(s:.____________ DATE __ _.7~,;.1/.,__ /_,7',.£L_-"lj-:,'-" ,,£_'---- YELLOW: Applicant PINK: Finance / UNSCHEDULED BIID.OING INSPECTION DATE ~.Vil_<\.~ PERMIT# 'l<xoS:l)a INSPECTOR =B=o 1 , $) • -{ g ),, PLAN CHECK# _____ _ -JOB ADDRESS ____s;¢t::!<""o~l.._)1.,_.:.1\..;:,.,,_t=,.GL,!:=..½l..!.l.~AOUo:::l:d'-~\i....lt..◄'--Ae""'-,, <<----------- DESCRIPTION _____________________ _ TIME ARRIVE: ____ _ TIME ____ _ CODE DESCRIPTION ACT COMMENTS --f!-vXJIJ-"'-'-, . ;::____ ___ jf__ -------