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Home My WebLink About2775 ROOSEVELT ST; 2; CB891481; PermitB U I L D I N G P E R M I T Permit No= CB891481 Project No= A8902587 Deueloprnent No = 10/02/89 13=25 Page 1 of 1 Job Address= 2775 ROOSEVELT ST Permit Type: PLUMBING Parcel No= 203-181-10-00 Valuation= 0 Construct ion Type: NEW Occupancy Group: Description= GAS REPAIR CONTRACTOR CHUCK'S PLUMBING 3800 WESTHAVEN CARLSBAD CA 92008 *** Fees Required Fee'!,: Adj 1Jstrnent'!,: Total Fees= Fee description *** 10.00 .00 10.00 Str: Fl= Ste= 0277 10/02/89 0001 01 02 C-PRMT 10-00 Cla'!,S Code= Status: ISSUED 10/02/89 10/02/89 DC *** Applied Apr/Issue Va 'Ii dated By= Lie. C 287306 Fees Collected & Credits Total Credit'!,• Total Payment:,= Balance Due• .00 .00 10.00 *** Units Fee/Unit Ext fee Data Enter "Y" for Plumbing !~sue Fee > 7.50 Y 2.50 10.00 Gas Piping System * PLUMBING TOTAL 2.50 CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carls bad Bui lding Department EST. VAL. ______________ _ 2075 Las Palmas Dr., Carls bad, CA 92009 (619) m -1161 1. A B C 2. PERMIT TYPE COMMERCI Al D INDUSTRIAL O NEIi D RESIDENTIAL □APARTMENT QOUPLEX 0 0EHOLI TI ON Q HECHANICAL QPOOL TENANT IMPROVEMENT 0 TENANT IMPROVEMENT QCON0O QSINGLE FAMILY 0IIELLING Q ADOITION/ALTERATION QRELOCATION Q MOBI LE HOME □ELECTRICAL ~UHBING OsPA □RETAINING IIALL OsoLAR OoTHER. _____ _ PROJECT INFORMATION PLAN CHECK Address 77 /c~OSl' ✓~l"t l:J:. PLAN CK DEPOSIT, _____ ...,... _____ _ VALID. BT ,/R/v,q DATE O C- Nearest Cross Streets G /l...fir,.; t:J LEGAL DESCRIPTION Lot No. Subdivision Name/Ncmber Unit No. Phase No. CHECK BELOW IF SU811ITTED: 02 Energy Cales 02 Structural Cales D 2 Soils Report D 1 Addressed Envelope EXISTING USE 3. 4 . 5. 7. ASSESSOR 'S PARCEL bESCRJPtiOR OF UoRk/Zt'-f'l,~Ce,_ BLOG. SO. FTG. CONTACT PERSON NAME CITY SIGNATURE APPLICANT NAME Cl TY PROPERTY OWNER NAME Cl TY DESIGNER NAME CI TY D CONTRACTOR WORKERS' COMPENSATION PROPOSED USE {,,-.....e. # OF STORIES ADDRESS STATE ZIP COOE DAY TELEPHONE D AGENT FOR CONTRACTOR QOIINER D AGENT FOR OIINER ADDRESS STATE ZIP COOE DAY TELEPHONE OIINER QLESSEE QTENANT ADDRESS STATE ZIP COOE DAY TELEPHONE ADDRESS ZIP COOE 3 l!'o o w~ .srr h ,,.,,,,, v STATE C 4-Cl';i_ooJ oAY TELEPHONE 7 ,,2 ?-ot::i t: I LICENSE CLASS {!,-5 £ CITY BUSINESS LIC. # <?_j 3 fl 2... TITLE i?w--1:?f!-ct-DATE /d/-,;2 -?c? ADDRESS STATE ZIP COOE DAY TELEPHONE STATE LIC. # Workers • C()f'l'4)ensat 1on 0eclarat1on: hereby affirm that I have a ccrtlftcate of consent to self·insure 1ssued by the Director of Industrial Relations, or a certificate of Workers• CC>ff1)ensation rnsurance by an achitted insurer, or an exact copy or dupl 1cate thereof certified by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C). INSURANCE COMPANY POLICY NO. EXPIRATIOH DATE Certificate of Ex~tion: I certify that in the performance of the work for which this permit is issued, I shall not eq:>loy any person in any manner so as to become slbject to the \lorkers' Coq,ensation Laws of California. SIGNATURE&~ ~ fu. ~E 8. OWNER-BUILDER DECLARATI owner-Bu1ldcr Declarat1on: I hereby aff1rm that I am exempt from the Contractor's License Law for the following reason: D I as owner of the property or my e~loyees with wages as their sole compensation, wit l do the work and the structure is not 1ntended or offered for sale (Sec. 7041., Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or i1Tproves thereon,, and who does such work h1t1tSelf or through his own ~loyees, provided that such tfll)rovements are not intended or offered for sale. If, however, the building or improvement is sold w1th1n one year of c001>lct1on, the owner-builder will have the burden of proving that he did not build or in,:>rove for the purpose of sale.). D I, as owner of the property, am exclusively contracting w1th licensed contractors to construct the proJect (Sec. 7041., Business and Professions Code: The Contractor's license Law does not apply to an owner of property who b.J1lds or 1q:,roves thereon, and contracts for such projects with contractor(s) l icensed pursuant to the Contractor Is L f cense Law). 0 I am ex~t 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, iff1)rove, demolish, or repsir 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, conmencing with Sect1on 7000 of Division 3 of the Bustness and Professions Code) or that he is exeff'f)t therefrom, and the basis for the alleged e•~tion. Any violation of Section 7031.5 by any applicant for a permit s\bjects the applicant to a civil penalty of not more than f ive hundred dollars [S500J ). SIGNATURE DATE COMPLETE THIS SECTION FOR NON·RESI0ENTIAL BUILDING PERMITS ONLY: Is the applicant or future building occupant required to subnit a business plan, acutely hazardous materials registrat 1on form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tamer Hazardous Substance Account Act? □YES ONO Is the applicant or future building occupant requ1red to obtain a permit from the air pollution control d1strict or air qualhy management district? QYES Q NO Is the facility to be constructed within 1,000 feet of the outer bo<n:lary of a school site? □YES IF ANT Of THE ANSWERS AIIE YES, A FINAL CERTIFICATE OF OCQJPANCY HAY IIOT BE I SSUED AFTER JULY 1, 1989 UIILESS THE APPLICANT HAS NET OR I S MEETING THE REQUIREMENTS OF THE OFFIC£ OF ENERGENCT SERVICES AIID THE AIR POI.LUTION CONTROL DISTRICT. 9. CONSTRUCTION LENJING AGENCY 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 10. APPLICANT'S SIGNATURE I certify that I have read the application and state that the above 1nformation 1s correct. I agree to c~ty with all C1ty ord1nances and State laws relating to building const ruction. I hereby authorize representat1ves of the C1ty of Carlsbod to enter upon the above mentioned property for inspection purposes. 1 ALSO AGREE TO SAVE INDEMNI FY ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JWGflENTS, COSTS ANO EXPENSCS IIHICH HAY IN ANY IIAY ACCRUE AGAINST SAID CITY 1N CONSEQUENCE OF THE GRANTING OF THIS PERMIT. Expiration. Every permit issued by the Building Official under the provisions of this Code shall expire by l1mitat1on and become null and void if or work authorized by such perm;t 1s not conmenced within 180 doys from the date of such pcrm1t or 1f the building or work authorized by such perm1t or abandoned at any time after the worl, 1s coomenced for a period of 180 days (Section 303(d) Uniform Bu1ld1ng Code). the bu1 lding 1 s suspended D OIINER ~TRACTOR D BY PHONE APPROVED BY: _______ _ DATE: ITE: File YELLOW: Applicant PINK: Finance .. PERMIT# CB891481 DESCRIPTION: GAS REPAIR CITY OF CARLSBAD INSPECTION REQUEST FOR 10/03/89 INSPECTOR AREA PLANCK# CB891481 OCC GRP CONSTR. TYPE NEW JOB ADDRESS: 2775 APPLICANT: CHUCK'S CONTRACTOR: CHUCK'S OWNER: ROOSEVELT ST PLUMBING PLUMBING STR: FL: STE: PHONE: 619 729-0961 ::g:: @.'\~ REMARKS: T3/MH/729-0961 SPECIAL INSTRUCTIONS: TOTAL TIME: CD LVL DESCRIPTION 23 PL Gas/Test/Repairs DATE DESCRIPTION INSPECTOR/_.)_.- ACT COMMENTS .fJL ________ _ ***** INSPECTION HISTORY***** ACT INSP COMMENTS FINAL AfFI0\11. INSP. __ .. __ CLEARANCE-----1