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Home My WebLink About2904 MANAGUA PL; ; CB970546; Permit_, INSP.. DATE __ _ CLEARANCE __________ _ CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION FOR OFFICE USE ONLY 1 PLAN CHECK No.°fl-~C( i_o CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 EST.VAL. _________ ~ Plan Ck. Deposit--------- Validated By _________ _ Date. _____________ _ A~_(incluqe Bldpf~uite II -ot'1o~, Ko;.ull.7va Leg.I Description Assessor's Parcel I Busineu Neme (at thia addr ... l Lot No. Subdivision Name/Number Unit No. Existing Use Phase No. Total I of units Name Address City State/Zip Telephone I Fax II ~~..:::GL~or=~~J.iJ:~9!PE::2:0 .,gm?h'G:.A'"i.:idif.g"i!.n,frRfWRt¥PW~:.~~ ·~:,-~c_:_ ... Name Address City State/Zip Telephone I (Sec. 7031.5 Business and Professions Code: Any City or County which requires• permit to construct, alter, improw, demoliah or repair any atruc:ture, prior to Its issuance, also requires the applicant for such permit to file • signed statement thlt he is licensed ~ to the proviliona of the Contrector's Ucenae Law [Chlpter 9, commending with Section 7000 of Division 3 of the Business and Prof ... ions Code) or that he II exempt therefrom, and the heals for the 1lleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicent to I civil penelty of not more thin five hundred dollers (t50011. Neme Address City State/Zip Telephone I State License I----------License Class----------City Busineu License I------- Designer Name Address City St1te/Zip Telephone State License I---------- ~~.oCOMPEN.MTIOfii;.:..~~ 1::-~~-~-.,i.·~.,.:;.:,.1:..:;;:.,,~s;."'.!;j:-1,m,1 W%'112:f'FVetm&r,~z~:.s~.r ...... L Workers' Compensation Deel.ration: I hereby affirm under penalty of perjury one of the following declerations: 0 I hive end will m1int1in • certificate of consent to allf-insure for workers' compensation es provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 0 I hive end will meintain workers' compensation, es required by Section 3700 of the Labor Code, for the performence of the work for .'which thia permit is iasued. My worker's compensetion insurance carrier and policy number are: Insurance Company Policy No. Expiration Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1noo1 OR LESS) 0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I lhlll not employ 1ny person in 1ny manner so 11 to become subject to the Workers' Compensation Laws of C1lifomia. WARNING: Failure to 11Cure•workers' compensetion coverage is unlawful, and shell subject Ml employer to crimnll peNlltlea end clvll fines up to -tuidred thouAnd dollers ($100.000), in eddltion to the cost of compenution, demagu u provided for in Section 3706 of the L.i,q, code, lnterwt end •ttomey'a fNs. SIGNATURE DATE--------- i7, '..;DVVNER-BUILD~ DECLARAJJON ,1:,;,· -:~,:.~ .•• ;·, t...;;, 11"::'.t ~' ..:::...::....; .. :2::.,_;_, .'.. .:f~~~t.:~~ ,. I hereby affirm that I am exempt from the Contractor's License Law for the following reeson: · 1!('"°1, as owner of the property or my employees with w1ges as their sole compensation, will do the work 1nd the structure ii not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contrector's License Law does not 1pply to en owner of property who builds or lmprova thereon, and who does such work himself or through his own employees, provided thlt such improvements 1ra not Intended or offered for 11le. If, however, the building or improvement ii sold within one ynr of completion, the owner-builder will hive the burden of proving thlt he did not build or Improve for the purpoee of aele). ~. as owner of the property, 1m exclusively contr1cting with licensed contractor• to construct the projmct (Sec. 7044, 8ulineea and Profeaeion1 Code: The Contr1ctor's Uc-• Law does not 1pply to an owner of property who builds or improves thereon, ind contrlCU for IUCh projec:U with contr1ctorla) licensed pursuent to the Contr1ctor's Ucenae Law). 0 I 1m exempt under Section ------Business and Professions Code for this reason: 1 . I person1lly pl1n to provide the m1jor l1bor ind materi1ls for construction of the propoHd property improvement. 0 YES ONO 2. I (hive I have not) signed an 1pplic1tion for a building permit for the proposed work. 3. I hive contracted with the following person (firm) to provide the proposed construction (include n1me I addr ... I ph-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 / addreu I phone number I contractors license number): _____________________________________________ _ 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name/ address I phone number/ type ofwork): -4.t.-~ PROPERTYOWNERSIGNATUAE,~ ~ :..;;_ . DATE lto~:RC1JOIO:Q1tK~.11,11tJ>WQ~~riLY#:.e";·iJ~'\Wi:WPfl I SP}ME&~:c."h !: th~ a;::;!lic::it er future buildlr,; occupant r-.iuir6d tu •..t.mit • bu.i-. l,lian. acutely hlurcious m1teri1la regiatration form or riak manegement 1nd prevention program under Sections 25505. 25533 or 25534 of the Presley-Tinner Hu1rdous Subst1nce Account Act7 0 YES O NO Is the 1pplicant or future building occupant required to obtain • permit from the 1ir pollution control district or lir quelity man1gement district? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundlry of I school site 7 0 YES O 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. ~CQ.Jt$JRUCT10N LENDING.~GENCYJ:;:,.,,r.,~~~l:_~~-.~«:.,,~ '.:":.0'."~ ~·ty·;''l.'~' I hereby affirm that there is a construction lending agency for the performance of the work for which thia permit is ilaued (Sec. 3097(1) Civil Code). LENDER'S NAME _____________ _ 19;. _ APPUCANT CERTIFICATION LENDER'S ADDRESS------------------------ '• . ; "· I certify that I have read the applicetion and state th1t the 1bove information is correct and thlt the inform1tion on the pl1ns is 1ccurate. I 1gree to comply with all City ordinenc11 1nd State laws rel1ting to building construction. I hereby 1uthorize represent1tives of the City of Carlsb1d to enter upon the 1bove mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST All LIABILITIES, JUDGMENTS, COSTS ANO 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 excavations over 6'0" deep and demolition or construction of structurea over 3 stories in height. EXPIRATION: Every permit issued by the Building Offici1I under the provisions of this Code lhlll expire by Hmitetion ind become null and void if the building or work luthorized by such permit is "J.ommenced within 365 deys from the dete of such permit or if the building or work authorized by such permit is suspended or abandoned at any ti after the ~k is co . for• 'od of O (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATUR , . DATE PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB970546 FOR 03/18/97 INSPECTOR AREA PY PLANCK# CB970546 ace GRP DESCRIPTION: UNDERGROUND PLUMBING TYPE: PLUM JOB ADDRESS: 2904 MANAGUA PL APPLICANT: FASACK, STAN CONTRACTOR: OWNER: TOTAL TIME: --RELATED PERMITS-- CD LVL DESCRIPTION PERMIT# CB880100 CB881627 11 ST Ftg/Foundation/Piers TYPE SFD RETAIN STE: CONSTR. TYPE VN LOT: PHONE: 619 759-3458 PHONE: PHONE: STATUS EXPIRED EXPIRED j?>f-Tc)/E:!:_S #TCO~~, ***** INSPECTION HISTORY***** DATE DESCRIPTION 031297 Underground/Under Floor ACT INSP AP PY COMMENTS