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HomeMy WebLinkAbout1689 ROBIN PL; ; CB982973; PermitB U I L D I N G P E R M I T 09/03/98 12:11 Permit No: CB982973 Project No: A9803877 Development No: Page 1 of 1 Job Address: 1689 ROBIN PL Suite: Permit Type: PLUMBING Parcel No: 215-740-08-08 Lot#: Valuation: 0 Occupancy Group: Reference#: Construction Type: NEW Status: ISSUED Applied: 09/03/98 Apr/Issue: 09/03/98 Entered By: BT Description: GAS LINE TO BBQ Appl/Ownr : JOHN & JEAN HUNGERFORD 1689 ROBIN PL CARLSBAD CA 92009 *** Fees Required *** Fees: Adjustments: Total Fees: Fee description Enter "Y" for Plu bing Issue Fee Gas Piping System 918-9595 0786 09/00/98 0001 01 C-PRHT Fees Collected & Credits 02 Total Credi ts: Total Payments: Balance ue: Units E'ee/Unit .00 .00 27 .00 :a .oo * * 7( Ext fee Data 20 .00 Y 7.00 CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PiRMIT APPLICATION FOR OFFICE USE ONLY PLAN CHECK NO. q Z211 ..3 CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL---------+~ Plan Ck. Deposit --..,.,---.~...-->-L-- Validated By ___ ...,..._....,._..a.,..--- Date _____ -=H__,,_~~"""""""',---- Address (include Bldg/Suite II) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total II of units Existing Use Proposed Use SO. FT. llof Stories II of Bedrooms II of Bathrooms 2. CONTACT PERSON llf different from •ppllc•nt) Name State/Zip Telephone II Fax II 4. PROPERTY OWNER :"2aAI < M Q kx;✓-e._ Name Address City State/Zip Telephone II 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 ha 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 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)). Name Address City State/Zip Telephone II State License II __________ _ License Class _________ _ City Business License II _______ _ Designer Name Address City State/Zip Telephone State License II __________ _ 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: O 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. O I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company ______________________ Policy No._____________ Expiration Date _______ _ (THIS SECTION NEEO NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESSI 0 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: Failure to aecure workera' compenHtlon coverage la unlawful, and ahall aubject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), In addition to the cost of compenHtlon, damages as provided for in Section 3706 of the Labor code, Interest and attorney's fees. SIGNATURE ______________________________ DATE _________ _ 7. OWNER-BUILDER OECl:ARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: O 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 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). O I am exempt under Section ______ Business and Professions Code for this reason: , . 2. 3. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES I (~ / have not) signed an application for a building permit for the proposed work. wit e fol wi7g person (firm) to provide the proposed construction (include name / address / phone number / contractors license numberl: 4. I plan to provide portions of the work rdinate, supervise and provide the major work (include name / address I phone number / contractors license number):. ___ +. .... "-":..::::>.....L:....:"'--+-'"""=:..:c-<-;..,:,,1-_____________________________ _ 5. i will provide some of the work, but i have contracted (hired) the following persons to provide the work indicated (include name I address / phone number / type of work): ___________ ,,,,_ _____ T"" ____ -:---------------------=--.,....--,----,----------- PROPERTY OWNER SIGNATURE ..:=,tf:,~k!'.!~..::::14~~~~r_---------- COMPLETE THIS SECTION FOR NO 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? 0 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 O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 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 ANO THE AIR POLLUTION CONTROL DISTRICT. 8.. CONSTRUCTION LENDING AGENCY 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 ------------------------------9. 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 accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Citt 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 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 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 after the ork is commenc d for a iod of 180 days (Section 106.4.4 Uniform Building Code). j / c/ APPLICANT'S SIGNATURE ~::~;;~h"l,+'-'"'il=--=+1..-c~'h'._________________ DATE _ _,q,~,....,~_..rc,9.....--'~"--------- YELLOW: Applicant PINK: Finance PERMIT# CB982973 DESCRIPTION: GAS LINE TO BBQ TYPE: PLUM CITY OF CARLSBAD INSPECTION REQUEST FOR 11/13/98 JOB ADDRESS: 1689 ROBIN PL APPLICANT: JOHN & JEAN HUNGERFORD CONTRACTOR: PHONE: PHONE: OWNER: PHONE: STE: 918-9595 , INSPECTOR AREA PY PLANCK# CB982973 OCC GRP CONSTR. TYPE NEW LOT: REMARKS: C/JOHN/619/794-6600 EX 3134 SPECIAL INSTRUCT: HOMEOWNER DOES NOT KNOW INSPECTOR r IF THIS INSr~EQUIRED. TOTAL TIME: LVL DESCRIPTION ACT COMMENTS CD 29 PL Final Plumbing /\,/J ____ n- ------------------ ***** INSPECTION HISTORY***** DATE DESCRIPTION 091198 Gas/Test/Repairs ACT INSP AP PY COMMENTS