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HomeMy WebLinkAbout2728 CHESTNUT AVE; ; CB910984; PermitBUILD 07/01/91 14:15" Page 1' of 1 Job Address: 2728 CHESTNUT AV Permit Type:'MISCELLANEOUS Parcel No: 167-392-10-00 , Valuation: 1,100 - Construction Type: VN Occupancy Group: '. ' Description: OPEN KITCHEN/FAM RM : MODIFY KITCHEN ELEC . Appl/Ownr :.GONZALES, BELYNN 2728 CHESTNUT AV . CARLSBAD, CA 92008 CONTRACTOR : WORTHING, BROOKS ."•' PO BX 1041 CARLSBAD, CA 92008 **•* Fees Required #** ING P E- R M I T Str: Permit No:.CB910984 Project No: A910.1212' Development No: Fir'- Ste: : ; 3261 07/01/9.1 0001 01 02 C-PRHf 69-00 Class Code: WALL ADD 4 CIRCUITS. " Status: ISSUED Applied: 07/01/91 Apr/Issue: 07/01/91 Validated By: CD 729 3965 . Lie, C 3'987'64 729 3965 * **Fees Collected & Credits *.** Fees: Adjustments: Total Fees : Fee description Miscellaneous Miscellaneous Fee ;#1 ' Fee #2 69.00 ,, .00 69. 00 . Total Credits : . - Total Payments : Balance Due : - ... Units. .Fee/Unit' > . ; 44.00 >'. "'.'. 25.00. . 00 . 00 69.00 Ext fee 44 25 . 00 . 00 Data BP 1 0 OA Miscellaneous Fee #3 * MISCELLANEOUS TOTAL 3,20 1,40 69.00 " f INS CLEARANCE APPROVAL DATE CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las PaI mas Dr., Carlsbad, CA 92009 (619) 438-1161 1. PEIIMII A - LJ Commercial U New Building U Tenant Improvement B - D Industrial D New Building D Tenant Improvement C-^Residential D Apartment DCondo D Single Family Dwelling ^Addition/Alteration D Duplex D Demolition D Relocation D Mobile Home D Electrical D Plumbing D Mechanical D Pool D Spa D Retaining Wall D Solar D Other 2. PROJECT INFORMATION Building or suite No. PLAN CHECK NO. EST.VAL PLAN CK DEPOSIT, VALID. BY DATE FOR OFFICE USE ONLY Address Nearest Cross Street LEGAL DESCRIPTION Lot No. Subdivision Name/Number Unit No.Phase No. CHECK I^LOW IF SUBMlTl'mi: D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D 1 Addressed Envelope ASSF.SSOR'5 PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK SQ.FT.# OF STORIES J hote 3. CONTACT FliKbUN (.it different [ronKapplicantJ NAME -.*, 4, CITY ADDRESS 2T7ZS> £\r<i*ibu u i- 7^ e STATE-J C& ZIP CODE tflfiOQ DAY TELEPHONE 4. APPIJGANI JBCON I KAC 1 OR QAGhNl rOR CON 1KAC1OK LJOWNtn LJACjhNl rUK UWNhR NAME - T ADDRESS CITY STATE ZIP CODE DAY TELEPHONE 5. PROPERTY OWNER NAME CITY ADDRESS 27Z© ^e^MOV STATE ZIP CODE DAY TELEPHONE 6. UONTUALTOR NAME CITY ^h^A \STATE 6V STATE UC. # ADDRESS 2.7"ZB ZIP CODE LICENSE CLASS DAY TELEPHONE CITY BUSINESS IIC. # CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. #....7. YtUKKKHif UOMPENSAllUN Workers' Compensation Declaration: I hereby affirm that I have a certificate ot consent to selt-insure issued by the Director ot 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 POLICY NO.EXPIRATION DATE Certificate of Exemption: I certify that in the performance ot the work tor 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. SIGNATURE DATE 8. OWNEH-BUUDER DECLARATION Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractors License Law for the following reason: D 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.). Q 1, 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). D 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 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 permit subjects the applicant 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? D YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT 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. CUNbTKUUTlON UtJjDlNCj AGENCY I hereby affirm that there is a construction lending agency tor the perlormance ot the work tor which this permit is issued (Sec 3097(1) Civil Code). LENDER'S NAME LENDER'S ADDRESS 10. APPLICANI CtKIlFICAllON 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 representatives 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 CTTY OF CARLSBAD AGAINST ALL IIABIUTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SATO CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit 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 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 atjmy time aft^-the^wm-k is commenced for a period of 180 days (Section 303(d) Uniform Building Code). APPLICANTS SIGNATURE DATE: .OW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB910984 FOR 10/21/91 DESCRIPTION: OPEN KITCHEN/FAM RM WALL MODIFY KITCHEN ELEC ADD 4 CIRCUITS TYPE: MISC ; JOB ADDRESS: APPLICANT: CONTRACTOR: OWNER: 2728 GONZALES, WORTHING, CHESTNUT AV BELYNN BROOKS PHONE: PHONE: PHONE: STR: 729 3965 729 3965 INSPECTOR AREA PD PLANCK* CB910984 OCC GRP CONSTR. TYPE VN FL: STE: REMARKS: MH/BARBARA/729-3965 SPECIAL INSTRUCT: AM IF POSSIBLE INSPECTO TOTAL TIME: CD LVL DESCRIPTION ACT COMMENTS 19 29 39 49 ST PL EL ME Final Final Final Final Structural fw Plumbing f Electrical / Mechanical / ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP 071791 Frame/Steel/Bolting/Welding AP PK 071791 Rough Electric AP PK COMMENTS ^ -? — -ct •3 3 en O