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HomeMy WebLinkAbout1229 PLUM TREE RD; MP; CB972970; PermitB U I L D I N G 10/09/97 14:02 Page 1 of 1 Job Address: 1229 PLUM TREE RD Permit Type: ELECTRICAL Parcel No: Valuation: 0 PERMIT Permit No: CB972970 Suite : MP Lot#: Project No: A9703789 Development No: Construction Type: VN Occupancy Group: Reference#: 0083 10/09~c000.1? 01 I SW ED App~f 10/0 9JSSOO Apr/Issue: 10/09/97 Entered By: MDP 259-6000 Description: IRR. PED. FOR : "COLLECTIONS" SAMBI Appl/Ownr : KITTINGER, 12626 HIGH SAN DIEGO, MICHELE BLUFF DRIVE#400 CA. 9 2130 619 *** Fees Required *** Fees Collected & Credits *** Fees: Adjustments: Total Fees: Fee description Enter "Y" for Electric Single Phase Per AMP * ELECTRICAL TOTAL Tota Credits: Total CITY OF CARLSBAD 2075 Las Palrnas Dr., Carlsbad, CA 92009 (619) 438-1161 .00 .00 35.00 Ext fee Data 10.00 Y 25.00 35 .00 FOR OFFICE USE ONLY PERMIT1 APPLICATION PLAN CHECK NO. q7 ~ z._cjl,.() 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 l't'(RMATtON 1229 umx..11. eeL Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Existing Use Proposed Use SO. FT. #of Stories # of Bedrooms # of Bathrooms 2. CONTACT PERSON (If different from applicant) Name City State/Zip Telephone# Fax# City 6. CONTRACTOR • COMPANY NAME (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, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged ption ny violation o action 7 31.5 by n a plican for a p it IT; tt:t;rit//J}l,° a~J:;ena Y of n n five hundred d liars [$500] Designer Name Address City State/Zip Telephone State License # _________ _ 6. WOIJ~ERS' 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 provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. □ Policy No.~QJ)2.52? JqL Expiration Date'5/qi (THIS SECTION NEED NOT BE COMPLETED IF THE MIT IS FOR ONE HUNDRED DOLLARS ($100] OR LESS) 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 as to become subject to the Workers' Compensation Laws of California. WARNING: Fallure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand do ars ( 100,00 add' Ion to e cost of compensation, damages as provided for In Section 3706 of thpH~Cl~terest and attorney's fees. s1GNATUR"'=aJ--'--4!!~~~:::....u"""~ia:~.;c..-----------------DATE 1u1-1, _'1_/___ 7. OWNER-BUILDER DE.(;~RATIQN . --+-"--t--'---';;---=-:::;.~--~---, I hereby affirm that I am exempt from the Contractor's License Law for the following 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 f?e· 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). 0 I am exempt under Section ______ Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials ~truction of the proposed property improvement. 0 YES ONO 2. permit for the proposed work. 3. firm) to provide the proposed construction (include name I address / phone number I contractors license number): 4. I plan to provide portions of work, but I have hired the following person to coordinate, supervise and provide the major work (include name I address I phone number/ contractors licens mber) .. ·_ ---------------------------------------------- 5. of the work, but I have contracted (hired) the following persons to provide the work Indicated (Include name / address / phone number / type PROPERTY OWNER SIGNATURE ______________________ _ DATE __________ _ COMPLra..r.tllS SECTION FOR NON:l!§_SIDENTIAL BUILDING PERMITS QNLY 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 O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 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 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 I hereby affirm that there Ii a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Code). LENDER'S NAME O _Q -c:: LENDER'S ADDRESS. ________________________ _ 9. APPLICANT CERTIFI A.TION I certify that I have read the application end state that the above information is correct and that the Information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Cit\' of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO 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 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 a tar the ork Is CQ_mmenced f r a eriod of 180 days (Section 106.4.4 Uniform Building Code). j )m APPLICANT'S s1GNATUR -...!:..2.,4,!l...,,Ga..!!,;~ .... c}';..."<:-}:i..'7f"'--:.i.-~-=-~ ..,,_-_==_:::,,.__________ DATE fO _ tf i.i --+,--,,f-...L-J'---------- WHITE: File YELLOW: Applicant PINK: Finance PERMIT# CB972970 DESCRIPTION: IRR. PED. FOR "COLLECTIONS" TYPE: ELEC CITY OF CARLSBAD INSPECTION REQUEST FOR 10/15/97 SAMBI RD INSPECTOR AREA PLANCK# CB972970 OCC GRP CONSTR. TYPE VN STE: LOT: JOB ADDRESS: 1229 PLUM TREE APPLICANT: KITTINGER, MICHELE CONTRACTOR: OWNER: REMARKS: C/HAROLD/929-1008 SPECIAL INSTRUCT: ::~::: 619 259-60002ff PHONE: z_ INSPECTO~ - TOTAL TIME: CD LVL DESCRIPTION ACT COMMENTS 32 EL Const. Service/Agricultural b ---'/i~D'----~/.~~f'----o/'--'-7 _______ _ 32 EL Const. Service/Agricultural ------------------~= ---------tr )tJ-/f;_, q7 ***** INSPECTION HISTORY***** DATE DESCRIPTION 101497 Const. Service/Agricultural ACT INSP CA PK COMMENTS RESET FOR 10-15-97