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Home My WebLink About2738 LA COSTA AVE; ; CB930449; PermitPERMIT APPIJCATION PLAN CHECK NO. f?~✓~ City of carlsbad Building Depart111ent 2075 Las Pal..,. o,., caetsbad, CA 92009 (619) 438-1161 I. PEkMI I liPE lg1~---I A -U Commercial U New Building U l'enant Improvement B -D Industrial □ New Building D Tenant Improvement C -□ Residential D Apartment D Condo D Single Family Dwelling O Addition/ Alteration □ Duplex U Demolition □ Relocation □ Mobile Home U Electrical □ Plumbing □ Mechanical □ Pool □ Spa D Retaining Wall □ Solar □ Other 2. PRCllECT INFORMATION FOR OFFICE USE ONLY Address )?3,Z Nearest Cross Street {o}-f;;s or Su~ LEGAL DESCRIM-ION fut No. SufXhv1S1on Name/Number 0mt No. Phase No. CHECK BEWW iF SOBMl 11 ED: □ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPQSEP USE DESCRIPTION OF WORK t:{ .5 I'~ ( er'\ Ir SQ. FT. tJ # OF STORIES 3. WN IACI PERSON (II d1rferent from applicant) NAME ( ""-t-fqc-111 1 ADDREss CllY STATE ZIP OODE DAY TELEPHONE 4. Al'PUU\Nt UC0NIRACIOk OAGENI FOR WNIRACIUR ADDRESS DOWNER □AGENI FOR OWNER NAME C "ttfr,.i c+ o( CllY STATE ZIP OODE DAY TELEPHONE s. r7~mn oi;;iAt,11 JJ-er/.e_ STATE (. ADDRESS ZIP OODE z_; (" O 5 f-c71 /H ..e__ ~36-?t? CllY I DAY TELEPHONE NAME CllY -H,'-/-1'\t,f /)f'fJ1,,,.)'J,, ADDRESS ,;)..6 97 1tlls}lf.4 {l:-!rr;J-') z1PmDE qJ1>0Y DAYTELEPHONE CllY BUSINESS !JC. # DESIGNER NAME STATE uc. # 4 '{f.,)f/fucENSE CLASS C 3 G ADDRESS CllY STATE ZIP OODE DAY TELEPHONE STATE !JC.# 7. WORRERS WMPRNSXIION Workers' Compensation Declaration: I hereby afiirm that I have a certthcate of consent to self-msure issued by the Director of Industnai 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 DA TE Certll1cate of Exempuon: I certUY that m the performance of the work for which this pernut IS ISSued, I shah not employ any person m any manner so as to become subject to the Workers' Compensation Laws of California. SIGNATURE DATE 8. OWN£1t-B0liDM DFl!LARAlluN bwner-Huilder Declarat1on: I hereby affmn that I am exempt from the COntracto?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 Ccxle: 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 Llcense Law). D I am exempt under Section ________ Business and Professions Ccxle 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 WMP0'.1£ IHIS S£CIION FOR NON-RESIDEN IIAL B0IIDJNG PERMll'S 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? □YES ONO Is the applicant or future building occupant required to obtain a permit 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 ONO IF ANY OF 1111! ANSWERS ARI! YES, A FINAL CERTIFICATE OF ocx:LIPANCY IIIAY Naf BE ISSUED AFmR JULY I, 1989 UNLESS 1111! APPIJCANT HAS MET OR IS MEETING 1111! REQUIREMENTS OF T1IE OFFICE OF EMERGENCY SERYICES AND 1111! AIR POIJ.IJTION CDNTROL DISl'RICT. 9. WNSJRUCIIDN IP.NDlNG AGENCY I hereby afhrm that there 1s a construction lendmg agency for the performance of the work for which this pernut 1s issued (Sec 3097(1) Civd Code). LENDER'S NAME LENDER'S ADDRESS 10. APPLICANI cmtl'WICA:IION I certify that I have read the apphcauon and state diat the atx>ve mformauon 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 AI.50 AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS 1111! CfIY OF CARISBAD AGACNST AIL IJAIIIUTlES, JIJIJGMENTS, <DSTS AND EXPENSES WIIlCII IIIAY IN ANY WAY NDUJE AGACNST SAID CfIY IN CDNSF.QUENCE OF TIIE GRANTING OF 11I1S 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 pennit issued by the Building Official under the provisions of this Ccxle 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 ab doned at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Ccxle). APPLICANT'S SIGNATURE DATE: 5""-/ l -o/ 3 PINK: Fmance PERMIT# CB930449 DESCRIPTION: GAS LINE REPAIR TYPE: PLUM CITY OF CARLSBAD INSPECTION REQUEST FOR 05/17/93 STE: INSPECTOR AREA PD PLANCK# CB930449 OCC GRP CONSTR. TYPE NEW LOT: JOB ADDRESS: 2738 APPLICANT: ART BROWN CONTRACTOR: LA COSTA AV PLUMBING PHONE: 619-729-4914 OWNER: REMARKS: MH/JUNE/729-4914 SPECIAL INSTRUCT: TOTAL TIME: CD LVL DESCRIPTION PHONE: , PHONE: ~ ~ INSPECTO;j?; ' ACT COMMENTS _23 __ PL _G_a_s_J_T_e_st_J_R_e_p_a_i_· r_s ______ ~ 6rJ ~ ------------------------------------ ***** INSPECTION HISTORY***** DATE DESCRIPTION ACT INSP COMMENTS