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Home My WebLink About2625 KREMEYER CIR; ; CB941234; PermitB U I L D I N G P E R M I T 09/30/94 13:36 Permit No: CB9412 34 Project No: A9401757 Development No: 1 Page 1 of 1 Job Address: 2625 KREMEYER CR Suite: 8893 09/30/94 0001 01 02 Permit Type: PLUMBING Parcel No: 155-170-09-00 Lot#: Valuation: O Construction Type: NEW Occupancy Group: Reference#: Description: REPLACE 5 GAS LINES : REPLACE EXISTING GAS LINES Appl/Ownr : PENA, DONNA CONTRACTOR 2625 KREMEYER CIR CARLSBAD, CA 92008 DONALDSON, WILLIE PO BOX 1621 OCEANSIDE, CA 92054 729-4344 Lie. C 547407 C-PRHT 55-00 Status: ISSUED Applied: 09/30/94 Apr/Issue: 09/30/94 Entered By: JPY *** Fees Required 'A** Fees Collected & Credits *** Fees: Adjustments: Total Fees: 55.00 Fee description Enter "Y" for Plumbinq IssLte Fee > Gas Piping System > * PLUMBING TOTAL Tor.al Cred1 1 s : Total Paymen .. s : Balance Due : Units Fee/Unit 7.00 CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 .00 .00 55.00 Ext fee Data 20.00 Y 35 .00 55.00 c-PERMIT APPLICATION City of Carlsbad Building Departllent 2075 Las Palms Dr., Carlsbad, CA 92009 (619) 438·1161 EST.VAL. __________ _ I. WJtMt I l"YP£ PLAN CK Dl!POSIT. ________ _ VAUD.BY, __________ _ DATE From Llst 1 (see back) give code of Permit-Type: ___________ _ For Residential Projects Only: From Llst 2 (see back) give Code of Structure-Type: ____________________ _ Net Loss/Gain of Dwelling Units 2. PROJF.Cf INFORMATION FOR OFFICE USE ONLY CHRCR BEWW IF SOBMII IED: □ 2 Energy Gales □ 2 Structural calcs □ 2 Soils Report □ 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPQSED t ISE DESCRIPTION OF WORK SQ. IT. # OF STORIES # OF BEDROOMS # OF BATIIRDDMS 3. WN IACI PERSON (II duferent from appltcanO NAME (last.name first) ADDRESS CITY C,'r y DAY TELEPHONE STATE IJC. # DESIGNER NAME (last name hrst) ADDRESS ZIP CODE tz/{)..T'f IJCENSE CLASS ADDRESS CITY BUSINESS IJC. # ....S-1/ / ,yt? 7 CITY STATE ZIP CODE DAY TELEPHONE STATE IJC. # 7. WOkkEkS' CDMPENSAlioN Workers' Compensauon Declarat1on: I hereby afftrm that I have a cert1hcate of consent to self-msure issued by the D1rector of lndustnal 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 POIJCY NO. EXPIRATION DATE Ceruhcate of Exemption: I certify that m the performance of the work for which this permit 1s issued, I shall not employ any person m any manner so as to become subject to the Workers' Compensation Laws of California. SIGNATURE DATE 8. OWNmt-B0llD£k DECIAkA'liuN Uwner-BuUder Declaration: I hereby afhrm that I am exempt from the Confradofs License Law for the foiiowmg 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, 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 contractor(s) 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 Ccxle: 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 permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commencing with Section 7000 of Division 3 of the Business and Professions Ccxle) 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]). SIGNATURE DATE COMPLEIE IHIS SEGIION FOR NON-RESIDEN IIAL BOILbJNG PERMITS ONLY: Js 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 □ND Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □YES □ND Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ YES □ NO IF ANY OF TIIE ANSWERS ARE YES, A FINAL CERTIFICATE OF oa:IJPANCY MAY NOT Bl! Jl?SllED AFl1lR JULY I, 1989 UNLESS TIIE APPIJCANT HAS MET OR IS Ml!IITING TIIE REQUIREMl!NTS OF TIIE OFFICI! OF EMERGENCY SERVICES AND TIIE AIR POIL\JTION aJNTilOL DISl1UCT. 9. WNSIROCIION LENDING AGENCY I hereby afhnn that there 1s a construcaon iendmg agency for the performance of the work for which this permit 1s issued (Sec 3097(1} ClVli Code]. LENDER'S NAME LENDER'S ADDRESS 10. APPIJCANI CFJlliFICAliON I certUY that I have read the application and state that the above miormat10n 1s correct. I agree to comply with all City ordmances 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 MSO AGRE!! 1U SAVE INDEMNIFY AND Kl!EP IIARMLllSS TIIE CITY OF CARISBAD AGAINSf ALL IJABJUl1l!S, JUDGMENTS, <DSfS AND EXPENSES W!IlCH MAY IN ANY WAY ACXJUJI! AGAINSf SAID CITY IN WNSEQIJl!NCI! OF TIIE GRANTING OF 11DS PERMIT. 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 issued by the Building Official under the provisions of this Code shall expire by limitation and become nun and void if the building or work authorized by such permit is not commenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned any time after thew is commenced for a period of 180 days (Section 303{d) Uniform Build~g Code).0 APPIJCANT'S SIGNATURE -DATE: '(._-5 Q ··? 7' PINK: Fmance TIMI ARJlIVl: ____ TIMI t.EAVI: ____ _ CD t.vt. D!SCJtIP'l'ION ACT COMMENTS u f'_L-~a-", '/}=u ____ ,4P_'--" . - -· ,DNiff •11s;1, - - -