HomeMy WebLinkAbout2627 REGENT RD; ; CB920013; Permitr
B U I L [> I N G P E R M I 'I Permit No: CB9200l
ProJect No: A92000ob
:.>eve.iopner t Nn:
01/07/92 14:52
Page 1 of 1
Job Address: 2627 REGENT
Permit Type: PLUMBING
Parcel No : 208-133-06-82
Valua~ion: O
Construction Type: NEW
Occupancy Group:
Rfl
Description: GAS LINE REPAIR
Appl/Ownr : DEPENDABLE PLUMBI~G
792Y SILVERTON AVE
SAN DIEGO , CA
*** Fees Required
Fees:
Adjustments:
Total Fees:
Fee descript1.on
Enter 'Y" for Plum
Gas Piping System
> PLUMBING TOTAL
Stt :
Closs Cod~:
619
CITY OF CARLSBAD
F 1 : 5837 01/07>792: 0001 01 02
C-PRMT 10-00
Status:
Applied:
Apr/Issue:
T ~ ur)
Ul/07/9<.'.
o:/07/'l
Validated By: DC
200-12121
,00
.DO
10.00
A* ~
Ext fee Dat :1
7.50 Y
2.50
10.00
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APJ>ICATION PLAN CHECK NO_
City of carlsbad Building Departllef"lt
2075 Las Palaas Dr., carlsbad, CA 92009 (619) 438-1161 EST.VAL,__ _____ ..,,....,;;;___ ___ _
Pu.II CK DEPOSIT.....,,L.. ____ _
VAUD. BY_.....,L... _____ _
I. PEkMII UPE DATE
A-UCOmmerc1al □New Bu1ldmg U tenant Improvement
B -0 Industrial □ New Building D Tenant Improvement
C -□ Residential □ Apartment □ Condo □ Single Family Dwelling □ Addition/ Alteration
□ Duplex □ Demolition □ Relocation □ Mobile Home □ Electrical DI Plumbing
□ Mechanical D Pool □ Spa O Retaining Wall D Solar □ Other
2. PRClJF.Cf OO'ORMATION FOR OFFICE USE ONLY
BuUdmg or Suite No.
Nearest Cross Street
LECAL DESCRIPI !UN No. Subd1vis1on Name/Number Omt No. Phase No.
CHECK BEWW IF S0BMII 1£0:
□ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope
ASSESSOR'S PARCEi,
DESCRIPTION OF WORK G-AS L( .,.__ it._(' 1 j>';..
SQ. IT. # OF STORIES
EXISTING USE PRQPPSEP USE
3. WN IACI PERSON (If dlHereni from apphcant)
NAME ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
•· APPIJCXNI
NAME
UCONIRACIOR □AGENI FORWNIRACIUR □OWNER UAGENI FOR OWNER
ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
S. :;!{~£k.;fi~WN~6\\tvSO"-' ADDRESS ;l-6 '.{'J R_r:c,-,r.,~ Rt:>
CITY CA"-\J bA.,,..__ STATE c~ ZIP CODE DAY TELEPHONE '7 2..'i--..2."3o'l
6. WNIRACIOR ,,_,1 •_)"'-a -,1,---,o,v ,.,_,_._ ,~ # _..OJ NAME ~'°" le.. r \l ,W, 1 .. (r ADDRESS , ,. , , v ~ · ,. .r .. o •
CITY S,.AJ ,1)1'°(;0 STATE CA ZIP CODE C,).11,6 DAY TELEPHONE .,26(:,-21 'l.. \
STATE !JC.# {J::, "1'70'-i.icENSE CLASS C-3 6 CITY BUSINESS !JC.# 11Cj80~8
CITY STATE ZIP CODE DAY TELEPHONE STATE !JC.#
7. WukkRRS' WWWWSA'IIUN
Workers' Compensation Declaration: I hereby afhrm that I have: a ce:rtUtcate of consent to self-msure issued by the: Director of lndustnal
Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified
by the Director of the: insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C).
INSURANCE COMPANY POIJCY NO. 8"f"?J"0 IUS° EXPIRATION DATE ~[6 _1 J"f /f 9 2..
□
□
□
certt t at m t e: pe: ormance o t e wor or w 1c t 1s pe:nmt ts 1ssu , s a not emp oy any person m any manner
the Workers' Compensation Laws of California.
/-7-9'L
u ere ya mn t at am exempt w or t e: o owmg reason:
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).
I am exempt under Section ________ Business and Professions Code for this reason:
(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 Llcense Law (Chapter 91 commencing 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 a · a civil penalty f not ore than five hundred dollars [S500]).
SIGNA11JRE DATE ~ 'J-1 "2,
Is the applicant or future bu1 . .,. pant 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?
□YES □NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
CYES CNO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
□ YES □ NO IF ANY OF 1llE ANSWERS ARE YES, A FINALCER11FICATI! OF CXOJPANCY MAY Nill BE ISSUED AFTER JULY I, 1989 UNIJ'.SS 1llE APPUCANT
HAS MET OR IS MEE11NG TIIE REQUIREMENTS 01' TIIE Ol'l'ICE 01' EMERGENCY SERVICES AND 1llE AIR POILUllON OON11l.OL DISl"RICT.
9. WNSIR0CIION D.NDING XCENCY
I hereby afhrm that there 1s a construction lending agency for the performance of the work for which thts permu 1s issued (Sec 3097(1) Civil Code).
LENDER'S NAME LENDER'S ADDRESS
10. APl'UCARI CER'IMCAIIUN
I cemfy that I have read the apphcatmn and state that the above mformauon as correct. I agree to comply with ail City ordinances and State laws
relating to building construction. I hereby 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 1llE QTY OF CARLSBAD AGAINST AIL IJAIIIUl1ES, JUDGMENTS, CDSTS
AND EXPENSES wmrn MAY IN ANY WAY A£DUIE AGAINST SAID QTY IN OONSllQUENCE 01' 11IE GRANTING 01' 11IlS 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 work is commenced for a period of 180 days (Section 303(d) Uniform Building Code).
APPIJCANT'S SIGNATURE DATE: /-?-J"l.
YELLOW: App 1cant PINK: Fmance
UNSCHEDULED INSPECTION
PLANCK f ------
JOB ADDRESS,_;;,..--...::;;..;.....,__ _ _.·~'--=--~:;;.....;;;..:;,___..;..~------------
PERMIT
TIME ARRIVE: _____ TIME LEAVE: _____ _
co LVL DESCRIPTION ACT COMMENTS ___ A~?-&=--~-~~Af ~-~· ~
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