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Home My WebLink About2625 KREMEYER CIR; 18; CB950904; Permit-C rJ/0 fJ -' 07/06/95 10:21 Page 1 of 1 B U I L D I N G Job Address: 2625 KREMEYER CR Permit Type: PLUMBING Parcel No: 155-170-09-00 Valuation: o Construction Type: NEW P E R M I T Suite : Lot#: Permit Project Development ~18' No: CB950904 No: A9501287 No: 2wl0 07/06/95 0001 01 C-Pr-:Hf 02 Occupancy Group: Reference#: Status: ISSUED 07/06/95 07/06/95 RMA Description: REPAIR OF GAS LINE-APT# 18 Appl/Ownr : PENA, DONNA 2600 KREMEYER CR CARLSBAD, CA 92008 *** Fees Required *** Fees: Adjustments: Total Fees: Fee description 27,00 .00 27.00 *** Enter "Y" for Plumbing Issue Fee > Gas Piping System > * PLUMBING TOTAL Applied: Apr/Issue: Entered By : 619-722-8402 Fees Collected & Credits Total Credits: Total Payments: Balance Due: ,00 ,00 27,00 *** Units Fee/Unit Ext fee Data 1 7.00 r"ll'.11\f ,tNSP.. tc t_LEARJi,n, 20 .00 Y 7.00 27.00 APPRO''" I flAT~ 710 <ti CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 ' PERMIT APPLICATION PLAN CHECK NO. City of Carlsbad Buildi~ Department 2075 Las Palaas Dr., carlsbed, CA 92D09 (619) 438·1161 I. PF.kMI I hPE From Llst 1 (see back) give code of Pennit-Type: ___________ _ --------------------------------------------------------- For Residential Projects Only: From List 2 (see back) give Code of Structure-Type: ____________________ _ Net Loss/Gain of Dwelling Units 2. PROJECT INFORMATION FOR OFFICE USE ONLY Address Nearest Cross Street mt o. ase o. CHECK BEWW IF SO BMI 11 ED: D 2 Energy Cales □ 2 Structural Cales ASSESSOR'S PARCEi, PROPOSED USE DESCRIPTION OF WORK SQ. FT. I NAME (~t.name first) CITI C TELEPHONE p C ~ /C,:,~ / ZIP CODE ~Z( DAY TELEPHONE 7 .2 _z_ -r '/ ('--'-.. LlCENSE CLASS CITI BUSINESS LlC. # CITI STATE ZIP CODE DAY TELEPHONE STATE UC.# 7. WOklMtS' cDMPENSA:i ION Workers' Compensation Declarat1on: I hereby affmn that I have a cert1hcate of consent to selt-msure issued by the Director 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 POLlCY NO. EXPIRATION DATE Ceruhcate of Exemption: I certify that m the perfonnance of the work for which this penn1t 1s issued, I shall not employ any person m any manner so as to become subject co the Workers' Compensation Laws of California. SIGNATURE DATE 8. OWNllll-B0IIDRk b£CLARA:li'.ulQ Owner-Builder Declarauon: I hereby afhnn that I am exempt from the Contractor's Llcense Law for the followmg 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 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 license 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 DATI! WMPLEIE IHIS SECIION FOR NON-kESIDEN IIAL BOltbING PEkMil's 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 to be constructed within 1,000 feet of the outer boundary of a school site? □ YES □ NO IF ANY OF nm ANSWERS ARE YES, A FINAL CERTIFICATE OF oa:uPANCYMAYNOT BE J!iSU1!D AFIERJULY 1, 1989 UNIBSS nmAPPLlCANT HAS MET OR IS MElITING nm REQUIREMENTS OF nm OFFICE OF EMERGENCY SERVICES AND nm AIR POLLUTION OONTROL DISTIUCT. 9. WNSIROCliuN LENDING AGF.NCY I hereby afhnn that there ts a construcuon lendmg agency for the perlonnance of the work for which thts penmt ts ISSued (Sec 3097(1J CtVJI Code}. LENDER'S NAME LENDER'S ADDRESS 10. APPDCAN I CFltiiFICAIION I cerufy that I have read the apphcauon and state that the above mformatton 1s correct. I agree to comply with all Ctty 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 AISO AGREE ro SAVE INDEMNIFY AND KEEP HARMLESS nm Cl"IY OF CARISBAD AGAINSf All. LlABIUrlF.S, JUDGMENTS, CDSfS AND EXPENSES WHICH MAY IN ANY WAY A=tUE AGAINSf SAID Cl"IY IN OONSEQUENCE OF nm GRANTING OF TIIIS PERMIT. OSHA: An OSHA pennit is required for excavations over 5'0" 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 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 pennit is suspended or abandon t any time after t ark is commenced for a period of 180 days (Section 303(d) Unifonn Buil<fulg Cade). _ _ APPLlCANTS SIGNATURE · DATE: .L_-(,, -7 _5 PINK: Fmance \ mllSJIIPYYQ +11,1a+o1 _ CATI 4/2:c,/r:;; t!fSPIC"t'Oll &~ PEJtNIT t C 5-/ {) y' Pt.\ifC:J: t .J'01 AD0us1 d 6J---; ~~ c:.,__, ·ft:--/-;___,-. -- TIKI UltIV'I:: ;: fx 0 TIKI r.&AVI:: /.'~5 co t.Vl. 0UatIP'l'IOII ACT CONNl!l'TS ,;2.1._ -z~v:,~zi; ~ ------------ FIIMl'N •1111•• - ,Z ------