HomeMy WebLinkAbout2404 SIERRA MORENA AVE; ; CB971384; Permit#·
1'[ P. E' A • A P.
Aµpll
A l · t
X
y
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
• \'~'"-•' .-\~ti-..~ • .J. I, ... \ ,,.., ~ •I \.,
FOR OFFICE USE On Y
PERMIT APPLICATION ~~'in,,,. PLAN CHECK NO. r_ ?L liL(
CIT'C OF CARLSBAD BUILDING DEPARTMENT
~ 2075 Las Palmas Dr., Carlsbad CA 92009
( 61 9) 438-11 61
EST. VAL.-----,------
Plan Ck. OepositZ.Z QZ,)
Validated Bv. ._f"~
Date ~<;/47
Address Cinclude Bldg/Suite II Business Name (et this address)
Legal Description Lot No. SFR Subdivision Namo/Number Unit No, Phase No. Total I of units
Assessor's Parcel I Existing Use Proposed Use
Name Address City State/Zlp Telephone # Fax # ;~~~~~;;;;s~;kfu~fr\~mktt.011'f'1~~.9fQj;f~~~:,.Qt~~~~w~£tr;taq]J_4·i1,1'.:r ._.
Name Address City State!Zip Telephone#
li"~f.80fl:RJ.Y'i QWNffl~~~M:l ~~~~-•-t'QIPM) ,(GW~P!q; ~ McJotyre . Robert 2404 Sierra .Morena ve.
Hf t ' ; H • •11, • , • , • •"f. •'I!) ~-JJlt!l ~#ffl?U>.IY~4~·-
Name Address City State{Zlp Telephone II
!JiiiI CJ>JflR4CXOIJ-:,COM~ ~aw ~1\i1,.-
(Sec. 7031.5 Business and Profe11ions Coda: Any City or County which requires n permit to construct, alter, Improve, demolish or repair any 1tructure, prior to Its
issuance, also requires the applicant for such permit to file • signed statement that he Is licensed pursuant to the provisions of the Contractor's License Lew
(Chapter 9, commending with Section 7000 of Division 3 of the Business end Professions Code) or that he 11 exempt therefrom, and the basis for the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the appll~t ~enalty ol,{t mor~'2~re hun~ll'll~l500(1. A & J FOSTER PLUMBING 13706 -B HWY 8 BUS. •
Name Address C-3 6 City StatefZIPJ..20035l)llephona #
State License I 6 3 012 0 License Class__________ City Business License I _______ _
Designer Name Address City State/Zlp Telephone
St■te License I __ N=/.;A;.;;... _____ _
i41J ;.11.~0RKERSi,COMPENSA'rlOt(.J~.'Jt'!.':.."f'1f ~J'~~1 f./_ 1' \.1fG.~~;t_ .i!.~'.'m ~ ........ ,. ..... ~,~ ',:.i1,'i"ui: ''i,,,.X:7 .~ -~ , •
Worker•' Compenutlon Declaration: I hereby efllrm under penalty of perjury one ol the following declnratlons:
0 I have end will maintain • certificate of consent to Hll•lnsure for workers' compensation II provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit la issued.
XO I have end will maintain worker■' compensation, 11 required by Section 3700 ol the Labor CocJe, for the performance of the ~ork for which this permit Is
issued. My worker's compensation insurance carrier and policy number are: N 2 0 0 ?-S6-5 1 CONI'I NUOUS
Insurance Company FARMER INSURANCE Policy No. • Expiration Date --------
ITH IS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDREU DOLLARS lt100J OR LESS)
0 CERTIFICATE OF U<EMPTION: I certify that In the performance of the work for which this permit Is Issued, I shall not employ eny person In eny manner so es·
to become Bubject to the Workers' Compensation Laws of California.
WARNING: Fallure to aecure•workera' compenaatlon coverage la unlawful, end shall subject en employer to crlmlnel peneltl1ta and clvll flnea up to one huodred
thouaand dollars ($100,0001, In addition to the cost of compensation, damag11111irovlded for In Section 3708 of the Labq, code, lnt81'Ht and attorney'■ feH.
SIGNATURE _______________________ --'-------DATE _________ _
7. ;. · OWNER-BUILDER DECLARATION •~,r~-,;'-' ' 'i .~p;14, '·:'lJfl :\'i ..::~:~ ... ii,1.;:,',:}:. ,\~'~•' \ -;; itr • !fM&~ i:)Jl.'i~~~~~t Lt.".; '· ·i,, t,,~t:\f.,;,\:,'
I hereby affirm that I em exempt from the Contractor's License Lew for the following reason:
0 I, as owner of the property or my employees with wages as their sole compensation, will do the work end the structure Is not Intended or offered lor sale
(Sec. 7044, Business end Professions Code: The Contractor's License Law does not apply to an ownor of property who builds or Improves thereon, end who does
such work himself or through his own employeH, provided that such lmprovementa ere not Intended or offered for aale. II, however, the building or Improvement Is
sold within une year of completion, the owner-builder will have the burden of proving thet he did not build or Improve for the purpoH of H lel.
0 I, es owner of the property, em exclusively contracting with llcanaed contractors to construct· the project (Sec. 7044, BuslneH and Professions Code: The
Cont rector's License Law doH not apply to an owner of property who builds or lmprovH thereon, and contract• for auch projacta with contractor(al licensed
pursuant to the Contractor's License Law).
0 I am exempt under Section ______ Business ancJ Professions Code for this reaaon:
1. I personally plan to provide the major labor and materials for construction of the proposad property Improvement. 0 YES ONO
2. I (have / have noU signed en application for a building permit for the proposed work:
3. I have contracted with the following person (firm) to provide the proposed construction (Include name I address I phone number I contractors license numberl:
4. I plan to provide portions of the work, but I have hired the following person to coordinete, supervise and provide the major work (include name / address f phone number/ contractors license numberl: ______________________________________________ _
6. I will provide some of the work, but I have contracted (hiredl the following persons to provide the work indicated (include name f address f phone number f type
of workl=----------------------~-----------------------------------
PROPERTY OWNER SIGNATURE--------------,---------DATE _________ _
~coMP,lj;J,E:rH1s.-sEc1Jot(,f()R N.0~$1.."-EN™'l_q1iPJN11,~,1.$1P.'11~i 1m~i'lw~m~M.~~:z!,!-f:1W:;...:G::jt1P:)SWiif.l
11 the applicant or future building occupant required to submit a business plan, acutely hazardous mnterials registration form or risk management and prevention
progrem under Sections 25505, 25533 or 25534 of the Pr11ley-T1nner Hu1rdou1 Substance Account Act? 0 YES O NO
Is the appllcnnt or future building occupant required to obtain • permit from the ■Ir pollution control district or air quallty m1neg1mant district 1 O YES O NO
Is the facility to be constructed within 1,000 IHI of the outer boundary of • 1chool site? 0 YES O NO
IF ANY OF lHE 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,, .,.CONS1'RUCTION LENDING"AGENCY•t'i 1,'~7,i'r;":t1t •~ ,~-• ':}?~:ff,J? '.°\'i;;{;;::,,_. ;r,; i-~~~~;Jl~~IJ'.';\:{ '. . , ..
I hereby affirm that there is a construction lending 1gency for the performance of tho work for which this permit 11 l11ued (Sec. 3097111 Civil Codel.
I certify th•t I have read the application and state that the 1bova Information Is correct and that the Information on the plans Is accurate. I agree to comply with all
City ordinances and State laws rellling to building construction. I hereby authorize repreaentatlves of the City of Carlsbad to enter upon the above mentioned
property fer -inspection purposes. 'I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABIUllES,
JUDGMENTS, COSTS 0AND 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 ,torles In height.
EXPIRATION: Every permit Issued by the Building Official under the provisions of this Code shall expire by limitation and become null ind void if the building or
work authorized by such permit la not commenced within 365 days from the date of such permit or II the building or work 1uth rized b~ such permit Is suspended
or abandoned at 1ny time altar the w k is co menced for I rlod of 180 days I tlon 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE DATE
PINK: Finance
CITY OF CARLSBAD
-' INSPECTION REQUEST
PERMIT# CB971384 FOR 06/11/97
DESCRIPTION: REPALCE WATER HEATER
TYPE: PLUM
INSPECTOR AREA
PLANCK# CB971384
OCC GRP
CONSTR. TYPE NEW
STE: LOT: JOB ADDRESS: 2404 SIERRA MORENA AV
APPLICANT: MCINTYRE, ROBERT
CONTRACTOR:
PHONE: 760 729-6461
OWNER:
REMARKS: R/ROBERT/729-6461
SPECIAL INSTRUCT:
TOTAL TIME:
CD
25
LVL DESCRIPTION
PL Water Heater/Vents
------------------
------------------
------------------
PHONE:
PHONE:
INSPECT082.-<-------------
ACT COMMENTS
tJ2_ ch 4/4 i.,
***** INSPECTION HISTORY*****
DATE DESCRIPTION ACT INSP COMMENTS