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Home My WebLink About2731 CHESTNUT AVE; ; CB950533; PermitBUILDING PERMIT 04/21/95 13:54 Page 1 of 1 Job Address: 2731 CHESTNUT AV Permit Type: PLUMBING Parcel No: 167-392-23-00 Valuation: 0 Construction Type: VN Occupancy Group: Description: GAS LINE REPAIR Suite Lot#: Reference*: Permit No: CB950533 Project No: A9500785 Development No: 1606 04/21/95 0001 01 02 C-PRHT 27.00 Status: ISSUED Applied: 04/21/95 Apr/Issue: 04/21/95 Entered By: MDP Appl/Ownr : BROWN PLUMBING 2697 STATE STREET CARLSBAD, CA. 92008 *** Fees Required ***-#** 619 729-4914 fees Collected & Credits * * * Fees: ,27,00 Adjustments: ,00 Total Fees: 27.00 Fee description. • Total- Credits;, Total Payment's! . Balance Due: Units Fee/Unit . 00 .00 27,00 Ext fee Data Enter "¥" for Plumbing 'Issue Fee > Gas Piping System „ • > * PLUMBING TOTAL ' .7,00 20.00 Y 7.00 27. 00 CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION * City of Carlsbad Building Department 2075 Las Palraas Dr., Carlsbad. CA 92009 (619) 438-1161 1. PKKM1T TXPE From List 1 (see back) give code of Permit-Type: For Residential Projects Only: From List 2 (see back) give Code of Structure-Type: _ Net Loss/Gain of Dwelling Units PLAN CHECK NO. EST.VAL PLAN CK DEPOSTT_ VAUD. BY DATE 2. PRQJECT INFORMATION FOR OFFICE USE ONLY AddressS «rt% ^^,f *o /e2L75V Nearest Cross Street Building or Suite No. LEGAL DESCRIPTION Lot No.Subdivision Name/Number Unit No.Phase No. CHECK BELOW IF SUBMITTED: O 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK SQ.FT. (_,lc^«— # OF STORIES # OF BEDROOMS # OF BATHROOMS 3. cuNiACT FEKHJN (it different from applicant) NAME (last name first)ADDRESS CITY ^^ STATE ZIP CODE DAY TELEPHONE 4. APPLICANT I^CONTRACTOR LJ AGENT FOR CONTRACTOR U OWNER U AGENT FOR OWNER NAME Jtjast name firs/} *i, * ai i ft ADDRESS CITY (-flfU.'$<&-4cl STATE /^ ZIP CODE DAY TELEPHONE 5. PROPERTY OWNER ' NAME (last name first) cm1 STATE ADDRESS ZIP CODE DAY TELEPHONE & 7- 7**?-*" 3 53 g* 6. CONTRACTOR NAME (last name first) STATE LIC. ADDRESS E DAY TELEPHONE LICENSE CLASS CITY BUSINESS LIC. # <£>/V DESIGNER NAME (.last name tirstj CITY STATE ADDRESS ZIP CODE DAY TELEPHONE STATE LIC. # 7. WORKERS'COMPENSATION Workers' Compensation Declaration: I hereby affirm that I have a certificate ot consent to self-insure issued by the Director of 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 for 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. OWNER-BUILDER DECLARATION Uwner-Builder Declaration: 1 nereDy affirm trial j am exempt rrom the contractors License Law tor the tollowing 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.). D 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). 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 O 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 MCT OR IS MF.E™G THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 9. CONSTRUCTION LENDING AGENCY Fliereby affirm that there is a construction lending agency tor the performance ot the work tor which this permit is issued (bee 3097(i) Civil Code). LENDER'S NAME LENDER'S ADDRESS 10. AFMJCAN1 1 certify that 1 nave 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 CITY OF CARLSBAD AGAINST ALL LIABILITIES, 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 at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code). APPLICANTS SIGNATURE DATE: WHITE: File YELLOW: Applicant PINK: Finance DATE UNSCHEDULED INSPECT. INSPECTO; PERMIT » QS>" J JOB ADDRESS t PLANCK # TIME ARRIVE:TIME LEAVE: CD LVL DESCRIPTION ACT COMMENTS (_