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Home My WebLink About2817 LA NEVASCA LN; ; CB983184; Permit09/22 /98 08:16 Paqe 1 of 1 B U I L D I N G Job Address: 2817 LA NEVASCA LN Permit Type: PLUMBING P E R M I T Suite: Lot#: Permit No: CB983184 Project No: A9804146 Development No: 1327 <'H /22/98 0001 01 C-PRHT Construction Type: 02 27-00 Parcel No: 255-103-05-00 Valuation: O Occupancy Group: Reference#: Status: VN ISSUED 09/22/98 09/22/98 MDP Description: INSTALL GAS LINE Appl/Ownr : ARMSTRONG ERIC 2814 LA NEVASCA LANE CARLSBAD CA 92009 Fees Required Fees: Adjustments: Total Fees: Fee description Enter "Y" for Plurnbi Gas Piping System *** 760 Applied: Apr/Issue: Entered By: 436-2990 Fees G llected & Credits .00 .00 27.00 Ext fee Data 20.00 Y 7.00 FINAi: PPROVAL INSP.....,fu ..... l ;>~_DATE I I / I 6 · 7L CLEARANCE ________ _ CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 FOR OFFICE USE ONLY PERMll' APPLICATION PLAN CHECK Nofe ·5/J''-'( CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. _________ _ Plan Ck. Deposit ________ _ Validated By _________ _ Date; _____________ _ ..,,1. PROJECT INFORMATION ·" Z'll 7 4 Al~v«zc« Address (include Bldg/Suite #I Business Name ,,t this 1ddreul Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use Proposed Use # of Bathrooms Name Address ::i. APPLICANT D Contractor 0 Agent ior Contrido; Address Citv , ~wnlr ... □ Agent ·;or ·0wne; State/Zip Telephone# Fax# Name -L _4. PROPERTY 0,JIINER _ / r vie ,Avr11flr City State/Zip Telephone # AJevtu-c,.., 11.-·l&vI1brnf ,.A-qz~ 1c.o 4,6-zcr:to Name Address Cltv StatelZip Telephone# &. CONTRACTOR • COMPANY NAME (Sec. 7031.5 Business and Professions Code: Any City or County which require, a permit to construct, alter, improve, demolish or repair any structure, prior to Its issuance, also requires the applicant for such permit to file • signed statement that he is licented purtuant to the provisions of the Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3 of the Business and Profeulons Code) or that he iii exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031 .5 by any applicant for a permtt subjects the applicant to a cMI penalty of not more than five hundred dollars lt5001J. Name Address City State/Zip Telephone I State License I _________ _ Ucense Class ________ _ City Business License I _______ _ Designer Name Address City State/Zip Telephone State License I _________ _ 8. WORKERS" COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D I have and will maintain a certificate of consent to self-Insure for workers' compensation as provtded by Section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued. D I have and will maintain workers' compensation, as required by Section 3700 of the Labor Coda, for the performance of the work for which this permit Is issued. My worker's compensation insurance carrier and policy number are: Insurance Company ___________________ _ Poticy No. ___________ _ E,cpi,atlon Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*1001 OR LESSI D CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so H to become subject to the Workers' Compensation Laws of Califomia. WARNING: Failure to secure workan' compenutlon co.,.,.. 11 unllwful, and ahal subject an employer to crlmlnal .penaltlea and civil finn up to one h&Mdred thousand dollars 1t100.000J, In llddldon to the coat of compenaedon, damages u provkled for In Section 3708 of the Labor code, Interest: end attorney'• feea. SIGNATURE,____________________________ DATE ________ _ 7. OWNER-BUILDER DECLARATION •.•. ~~:'!'·· ··:o7:,'•,;~-;·,;rv-, ,.,;: •. ,,•·f:'ft"o-:· , .. I hereby affirm that I am exempt from the Contractor's License Law for the following reason: jg[" I, as owner of the property or my employns with wages as their sole compensation, will do the work and the structure is not intended or offered for aale ~S8c. 7044, Busineu and Professions Coda: The Contractor's License Law does not apply to an owner of property who buitde or Improves thereon, and who don aueh work himself or through his own employees, provided that such Improvements are not Intended or offered for 11te. If, however, the building or Improvement iii sold within one year of completion, the owner-builder will have the burden of pro\nng that he did not build or Improve for the purpoee of 11le). D I, as owner of the property, em exclusively contracting with licensed contractors to construct the pro)ect (Sec. 7044, Bualnn1 and Profe11lons Code: The Contractor's Licenae Law do .. not apply to an owner of property who builds or improves thereon, and contracts for auch projects with contractorl1J licenaed pursuant to the Contractor's License Law). D I am exempt under Section ______ Business and Professions Code fo, thi1 reason: 1. I personally plan 10 provide the major labor and materials for construction of the proposed property Improvement. D YES ONO 2. I (have / have not) 1igned an application for • building permit for the proposed. work. 3. I have contracted with the following person lfirm) to provide the proposed construction (Include name/ address/ phone number/ contractors license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work !include name / address J phone number I contractors licenae number):. __ -c,<-------,'1------------------------------------ 5. I will provide Iome of the work, but I of work}: PROPERTY OWNEF.I SIGNATURE 'COMPLETE THIS SECTION FOR N the following persons to provide the work Indicated (lndude name / addreu / phone number / type -,•••·~ -~-~--·~-' Is the •pplicant or future building occupant required to 1ubmlt a business plan, acutely hazardoua material, registration form or riak management and prevention program under Sections 25505, 25533 °' 25534 of the Presley•Tanner Hazardous Substance Account Act1 D YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air qualltv management district? D YES O_ 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 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. '8.. CONSTRUCTION LENDING AGENCY -·-• " •···:·.•,~·,-.-.,.,,_ ... , .. -.. -.,-'"'" .... -,· • ' =· ., ' · ,y.-· I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued (Sec. 3097!0 Civil Code). LENDER"S NAME _____________ _ LENDER"S ADDRESS _______________________ _ is. APPLICANT CERTIFICATION -.--,.·,· --.~-· .• ,_., ....... ,' ,?"'¥'''" I certify that I have read the application and state that the above Information is. correct and that the Information on the plans is accureta. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Cltt 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 SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for EXPIRATION: Every permit issued b work authorized by such permit is n,.) .. ''Jffl or abandoned at any time after the ~ APPLICANT'S SIGNATURE ' " deep and demolition or construction of structures over 3 storiu In height. under the provlIions of this Code shall expire by limitation and become null and void If the building or 1 i 365 da from the date of such permit or If the building or work author· ed by such permit is suspended 180 days (Section 108.4.4 Uniform Building Code). _.tfJ DATE _ _,_' /-+-~-2+-q_,_1.._ __ _ YELLOW: Applicant PINK: Finance 1/t.; 7 -C-3 CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB983184 FOR 11/13/98 DESCRIPTION: INSTALL GAS LINE TYPE: PLUM JOB ADDRESS: 2817 LA NEVASCA LN APPLICANT: ARMSTRONG ERIC CONTRACTOR: PHONE: PHONE: PHONE: INSPECTOR AREA RB PLANCK# CB983184 OCC GRP CONSTR. TYPE VN STE: LOT: 760 436-2990 OWNER: REMARKS: C/ AM PLEASE SPECIAL INSTRUCT: INSPECTOR ___ __J.g__c.....:::a_l_~----- TOTAL TIME: CD LVL DESCRIPTION ACT COMMENTS 23 PL Gas/Test/Repairs flr ______________ _ U -----------+ C(na«j .J4-------------- -------------------- ***** INSPECTION DATE DESCRIPTION ACT 110498 Gas/Test/Repairs co 110498 Underground/Under Floor co 101398 Gas/Test/Repairs CA 101398 Underground/Under Floor CA HISTORY ***** INSP COMMENTS RB SEE NOTICE ATTACHED RB SEE NOTICE ATTACHED PD PD