HomeMy WebLinkAbout2687 ROOSEVELT ST; ; CB951906; Permit,
B U I L D I N G P E R M I T Permit No: CB9519Ub
ProJect No : A9502774
Development No:
12/29/95 16:01
Page 1 o f 1
J o b Address: 2687 ROOSEVELT ST Suite :
Permit Type: MECHANICAL
Parcel No: Lot#:
Valuati on : O Construction Type : NEW
ISSUED
12/29/95
12/29/95
DC
Occupancy Gro up: Reference#: ' Status:
Description: REPLACE 2 HEATERS Applied:
Apr/Issue:
Appl/Ownr : YANG, HYUNG 619
Entered By :
4 38-5297
2915 CACATUA STREET
CARLSBAD, CA 9 2 009
*kl< Fees Required ***
Fees:
Adjustments:
Tota l Fees:
Total Credits:
Total ?ayments:
Balance Due:
.00
.00
33 .00
*'I,*
Fee descr i p tion Units F ee/lJnit Ext fee Da ta
Enter 'Y' f o r Mechanical I ssue
Install Furn /Ducts/Heat Pumps * MECHANICAL TOTAt
CITY OF CARLSBAD
9.00
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
15 .00 Y
18 .00
33 .00
PERMIT# CB951899
DESCRIPTION: RE-PIPE
BLDG
TYPE: PLUM
JOB ADDRESS: 2687
APPLICANT: LLOYD'S
CONTRACTOR:
OWNER:
CITY OF CARLSBAD
INSPECTION REQUEST
FOR 12/29/95
ENTIRE GAS LINE FOR
ROOSEVELT ST
PLUMBING PHONE:
PHONE:
PHONE:
INSPECTOR AREA
PLANCK# CB951899
OCC GRP
CONSTR. TYPE NEW
STE: LOT:
619-735-9050
REMARKS: BJN/JOE/
SPECIAL INSTRUCT:
INSPECTOR T) C---:,1,~:::_ ________ _
TOTAL TIME:
CD
23
LVL DESCRIPTION
PL Gas/Test/Repairs
--------------------------------------------------------
ACT COMMENTS
***** INSPECTION HISTORY*****
DATE DESCRIPTION ACT INSP COMMENTS
.
PERMIT APPUeATION e PLAN CHECK NO. .
City o1 Carlst.t Buildir-.i Depert.nt
2075 las Pal-Dr., Carlst.t, CA 92009 (619) 438-1161 .
EST. VAL'--------------
I. PERMfi IYPE PLAN CIC DEPOSIT _______ _
VAIID. BY ___________ _
From List I (see back) give code of Permit-Type: ____________ _
DATE. ____________ _
For Residential Projects Only: From List 2 (see back) give
Code of Structure-Type: _____________________ _
Net Loss/Gain of Dwelling Units __________________ _
2. PROJECT INFORMA110N FOR OFFICE USE ONLY
Mdress ;2 0,JJ 1 0 ~ O "'~ _ _ _ /,?..b-Bu1ld1:!_ or ;;~te N~ 71.
Nearest Cross s?reet /'--V V ~ -r, c.J -tr ..V-.
CECAL b£ScRll5'1ioN Lot No. Su&l1V1s1on Name/Number Unit No. Phase No.
CHECK BEWW IF susMII IEb:
□ 2 Energy Cales □ 2 Structural Cales D 2 Soils Report □ 1 Addressed Envelope
ASSESSOR'S PARCEL EXISTING USE PROPOSED USE
# OF BATHROOMS
I
NAME (last name first) ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
S. PROPER IV o
NAME (last name first) ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
6. cbN"i'RACluk
NAME (last name first) ADDRESS
CITY STATE
STATE UC.#
ZIP CODE
LICENSE CLASS
DAY TELEPHONE
CITY BUSINESS UC. #
DESIGNER NAME (last name first) ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE STATE UC. #
1. WORXERs' cbMP£NsA'tioN
Workers' Compensauon beclarauon: I hereby allmn that I have a ceruhcate of consent to sell-insure issued by lhe Director ol lndusmal
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 POLICY NO. EXPIRATION DATE
Eemhcate of Exempuon: I cerofy that in the performance of the work for which this permit 1s issued, I shall not employ any person in any manner
so as to become subject to the Workers' Compensation Laws of California.
SIGNATURE DATE • 8. oWNER-BUllDER 0£d..ARA'tioN
□
□
□
Owner-Builder Declaration: I nereby afhnn tnat I am exempt rrom tne contractors ucense Law 10r tne 1011owing reason:
.1, 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 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 permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500)).
SIGNATURE DATE
cbMPi.rtE THIS SECliON FOR NON-RESIDENTIAL BUILDING PERMITS ONLY:
ls 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? □ YES □ NO ls the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
□ YES □ NO
ls the facility to be constructed within 1,000 feet of the oute.r boundary of a school site?
□ YES □ NO
[F ANYOFTI-IEANSWERSAREYES, AFINALCER11FICA.TEOFoa:ul'ANCYMAYNOf BE~AYl'ERJULY 1, 1989 UNLESSnmAPPUCANT
HAS MET OR IS MEETING nm REQUIREMENTS OF nm OFFICE OF EMERGENCY SERVICES AND nm AIR POLLlITlON OONlROL DISfRICT.
9. WNSI R0Cl1oN LENDING AGENCY
I hereby alhrm ihat ihere IS a construction lending agency for the performance of the work for which this permit 1s issued (Sec 3097(1) C1V1t Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPUCAN I CERl1FICAl1ON
I certify ihat I have read the application and state that the above iniormauon 1s correct. I agree to comply with all City ordinances anel !;tate laws
relating to building construction. I hereby authorize representatives of the Ciry of Carlsbad to enter upon the above mentioned property for inspection
purposes. I AlSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS nm Cl1Y OF CARl.5BAD AGAINST AU. UABIIIl1ES, JUDGMF.NTS, CDSTS
AND EXPENSES WJDO{ MAY IN ANY WAY ACDUJE AGAINST SAID Cl1Y IN OONSF.QUENCE OF nm GRANTING OF nns 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).
APP T'S SIGNATURE DATE:
: File YELl..OW: Applicant PINK: Finance
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