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Home My WebLink About2812 ROOSEVELT ST; ; CB941639; PermitB U I L D I N G P E R M I T 12/12/94 13:49 Pac;e 1 of 1 Job Adrlress: 2812 ROOSEVELT ST Suite: Permit Type : PLUMBING Parcel No: 2u3-182-04-0 0 Lot#: Valuation : u Construction Type: VN Occupancy Group: Description: U/G PLUMBING : CONSTRUCTION Referen_e#: ONLY-NO NEW Permit No: CB94 1639 Projert No: A94 U~4 2U [1evelopment No : 9928 12/12/94 0001 01 02 C-PRMT 27-00 Status: ISSUED Ap1,,lied: 1:~/12/94 Apr/Issue: 12/12/94 Entered By: MDP Appl/Ownr : DONAHOE, KENNETH 4101 PARKSIDE PLAC 619 434-7678 CARLSBAD, CA. **le Fees Required Fees: Ad justments: Total Fees: cted & Cr•?di ts .00 .00 27.0U Fee description ~~~~~ t Ext fee Data -------------------------------------- Enter "Y" for Plumt.1' Each Plumbing Fixture * PLUMBING TOTAL 20,UO Y 7 .0U 27.LlO A APPROVAL i!NSP. ~:z.;.._-DATE 1/.;u.Jr- CLEARANCE 7 7 PERMIT t,PPUCATION PLAN CHECK NO. fl{~ l b :S7 City of Carlsbad Buildire Department 2075 Las PalES Dr., Carlsbad, CA 92009 (619) 438·1161 I ESf. VAL I. PkkMII NPR PIAN CK DEPOSIT _______ _ VAUD.BY _________ _ DATE From List 1 (see back) give ccxle of Permit-Type: ___________ _ --------------------------------------------------------- For Residential Projects Only: From Llst 2 (see back) give Code of Structure-Type: ____________________ _ Net Loss/Gain of Dwelling Units 2. PRUIF.Cl" INFORMATION FOR OFFICE USE ONLY A<ldressZf,12.. ~a.,- Nearest Cross Street G IZIUJJ:> Bmldmg or Suite No. Subd1v1S1on Name/Number Uni[ No. Phase No. t£GAt DESCRJifl ION Lot No. CHECK BEWW IF S0BMI 11 ED: D 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope ASSESSOR'S PARCEi. EXIUJNG USE DESCRIPTION OF WORK U {(,, f\.J...._!:,."'l O-N l{ . I.Jc /JU'-,..] SQ. FT. # OF STORIES # OF BEDROOMS # OF BATHROOMS 3. WN IACI PFltSON (if dlUerenf from apphcant) NAME (last.name first) ADDRESS CI1Y STATE ZIP CODE DAY TELEPHONE DOWNER OAGENI FOR OWNER 4. APPIJCANI OWNIRACIOR DAGEN I FOR CONIRACIOk ADDRESS NAME (last name first) CllY STATE ZIP CODE DAY TELEPHONE 5. PRuPEki'Y OWNkk NAME (last name first) ADDRESS CI1Y STATE ZIP CODE DAY TELEPHONE 6. WN iitAC'luk NAME (last name first) llOI-J~~ 1 l(ENl\le:Tl\ ADDRESS -4\0 I ~\)>E '.?\ • CI1Y~S'a.~ STATE CJ>. ZIP CODE .q'2..,l>D~ DAYTELEPH0NE 4:'!,A--1/..78 STATE UC.# £'1:ftf!l31 UCENSE CLASS 8, CI1Y BUSINESS UC.# DESIGNER NAME (last name hrst) ADDRESS CI1Y STATE ZIP CODE DAY TELEPHONE STATE UC.# 7. WOIUMtS' OOMPENSAJIUN Workers1 Compensation Declarat1on: I hereby afftrm that I have a certificate of consent to seif-msure 1SSued 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 POUCY NO. EXPIRATION DATE Certificate of Exemption: I certtfy that m the performance of the work for which this permit 1s issued, I shall not employ any person many manner so as to become subject to the Workers' Compensation Laws of California. SIGNATURE DATE 8. oWNRk-BOiIDkk Dl!CIARXliON Uwner-BuUder Declaration: I hereby afnrm that I am exempt from the Confradofs Llcense Law for the followmg reason: D 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 Llcense 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 Llcense Law does noc 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 co 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, 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 pennit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]). SIGNATIIRE DATE COMPU!'IE IHIS SECiioN FOR NON-RESIDENTlAt B0lilllNG PERMilS ONLY: Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration fonn 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? □YES □NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ YES □ NO IF ANY OF TIIEANSWERS ARE YES, AFINAL CERTIFICATE OF OCDJPANCYMAYNOT BE ISSUED AFI1!RJULY 1, 1989 UNLESSTIIE APPUCANT HAS MET OR JS MEJmNG TIIE REQUil!EMENTS OF TIIE OFFICE OF EMERGENCY SERVICES AND TIIE AIR POll.UTION CDNTilOL DISlllICT. 9. WNSI KOCI ION I.RNDING AGRNCY I hereby afhrm that there ts a constructton lendmg agency for the performance of the work ior which thtS permit 1s issued (Sec 3097(1) Ctvtl Code). LENDER'S NAME LENDER'S ADDRESS 10. certt at ave rea e app 1cat1on an state at t e a ve m ormat1on ts correc . agree to comp y WI a ty or mances an tare aws 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 HARMIBSS TIIE CfIY OF CARISBAD AGAINST AIL UABIUTIES, JUDGMENTS, CDSTS AND EXPENSES WHICH MAY IN ANY WAY A(x:tl.lJE AGAINST SAID CfIY IN CDNSEQ\IENCE OF TIIE GRANTING OF TIIlS 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 n menced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned ar an a r the wo is commenced for a period of 180 days (Section 303(d) Uniform Building Codw APPUCANT'S SIGNATURE DATE: IL-IZ,• "T ' . I UNSCHEDULED INS PECT!Otf INSPECTOR---,~::::::'.'.'::::::;;c_ ______ _ PERMIT# _______ _ JOB AODRESS ___ ~Z8=.wl'L=--1R=a2,;,J;.,,£t::.Jidf'.l<:l::.l(..i·Z:~.ff.~.--------------- TIKE ARRIVE: ______ TIKE L.EA VE: ______ _ CD LVL DESCRIPTION z:L P!lUUTS 6/15/89 ACT COMHEHTS