HomeMy WebLinkAbout2837 CACATUA ST; ; CB982054; PermitHrJILDTNG PERMIT Permit No: C8952054
Ob/23/98 13 : 54 Project No: A9802720
Page 1 of 1 Development No :
Job Address: 2837 CACATIJA ST Suite:
Permit Type : PLlJMBING
Parcel No: 215-370-24-O(J Lot#:
Valuation: 0 Construction Type : NEW
Occupancy Group: Reference#: Status: ISSUED
Description: EMERGENCY WATER LIME REPAIR Applied: 06/29/98
Apr/lssuc: 06/29/98
Entered By: JM
Appl/Ownr : SANDERS LOREN 760 438-4159
2837 CACATUA STREET
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CITY OF CARLSBAD
2075 Las Palmas Dr., Carisbad, CA 92009 (619) 438-1161
._. .
1 r* - PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(760) 438-1 161
- (at
FOR OFFICE USE ON
PLAN CHECK NO.
Date
this address)
Legal Description Lot No. Subdivision Namo/Numbr Phase No. Total X of units Unit No.
Assessor's Parcel X Existing Usa Proposed Use
Name Address Citv Statenip Telephone X Fax X
Name Addrees City Statamp Telephone I
t
(Sec. 7031.5 Business and Professions Code: Any Cky or County which requires a permit to construct. aker, 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 pwsuant to the provisions of the Contractor's Lirmse Law [Chapter 9, commending with Section 7000 of Division 3 of the Busineas and Professions Code1 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 penah of not more than five hundred dollars 165001).
Name Address Ci Statenip Telephone X
Stata Licensa X License Class ci Business Limn80 X
Designer Name Address City Stateltip Telephone
State Licmsa I
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
0 of the work for which this permit is issued.
[3 issuad. My worker's compensation insurance carrier and policy number am:
1nw:arice Company Policy No. Expiration Date
[THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR OM€ HUNDRED DOLLARS I$1001 OR LESS)
0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this parmit is issued, I shall not employ any person in any manner so as
to become subject to the Workers' Compensation Laws of California.
WARNINQ: Fah to secure workm' compenmth covemgm b unkwful. md rh.l lubj.ct an mnployw to abnl\d padtlo8 md dvH fines up to one hundmd
thousand dollan ($100.000). In .dditkn to the coat of wmpenWh, dunages as pr0Vid.d for h Section 3706 oftha labor cod.. Intomst and atromey'a toes.
SIGNATURE DATE
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
0 I, as owner of the property or my employees with wages as thair sole compensation. will do the work and the structure is not intended or offered for sala (Sec. 7044, Business and Profassim Coda: The Contmctor's Licensa 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 intandad 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).
0 I, as owner of the property, am exclusively contracting with licensed contractors to cmct the prqact (Set. 7044, Business and Profdons Code: The
Co tractor's Licanse Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contrectorls) licensed
I have and will maintain a certificate of consent to self-insure for workan' compensation as provided by Section 3700 of the Labor Code, for the performance
I have and will maintain workers' compensation, as requirad by Section 3700 of the Labor Code, for the performance of the work for which this permit is
7u7
s nt to the Contractor's Licanae Law).
I am exempt under Saction
I personally plan to provide the major labor and materials for construction of the proposed property improvement.m YES ON0
I (have / have not) signed an application for a building permit for the proposed work.
I have contracted with the following person (firm) to provide the proposed construction (includ name / address / phone number / contractors licensa number):
Buainess and Professions Code for this reason: I@
1.
2.
3.
4. number I contractors license number): I plan to provide portions of the work, but I have hired the following person to coordinata, supewise and provide the major work (include name I address / phone
PROPERTY OWNER SIGNATURE
program under Sections 25505,. 25533 or 25534 of the Praslay-Tanner Hazardous Substance Account Act?
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
Is the facility to be constructed within 1.000 feet of the outer boundary of a school site? 0 YES 0 NO
IF ANY OF THE ANSWERS ARE YES. A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPUCANT HAS MET OR IS MEETING THE
REQUIREMENTS OF THE OFFICE OF EMERQMCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
0 YES 0 NO
0 YES 0 NO
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code).
LENDER'S NAME LENDER'S ADDRESS
I certify that I havr read the application and data that the above information is correct and that the information on the plans is accurate. I agree to comply with all
City ordinances and Stata laws relating to building construction. I heraby 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 AQAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AQAlNST SAID 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 parmit is not co from the date of such permk or if the building or work authorized by such permit is suspended or abandoned at any time a of 180 days (Section 106.4.4 Uniform Building Code).
9APPLICANT'S SIGNATU DATE &-2?98