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Home My WebLink About1975 SWALLOW LN; ; CB984317; Permit,,, B U I L D I N G P E R M I T Permit No: C8984317 Project No: A9tir 5591 Development No: 12, 1 J/q8 15:lb Pa\re 1 of l Job Address: 1975 SWALLOW LN Permit Tvre: MECHANICAL Parcel No: 215-052-13-37 Valuation: O Occupancy Group: Descr11t1on: FURNACE CHANGE OUT Appl/Ownr TRI STATE REFRIG 609 S ESCONDIDO BLD ESCONDIDO CA 92025 *Ak. Fees Required Fees: AdJustn ent.:;: T t.a}. Fees: fee description Enter 'Y' for Mecha Install furn/Ducts/ *** Suite: Lot#: Construction Type: NEW Reference#: Status: ISSUED 735-9000 Applied: 12/10/98 Apr/Issue: 12/10/98 Entered By: BT .00 .00 24.00 Ext fee Data 15.00 Y 9.00 FINAL APPROVAL INSP. J2_ i3 DATE 5-7~ f CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 PERMIT APPLICATION FOR OFFICE USE ONLY PLAN CHECK NO. Cj y'. c../?J (7 r-) t(?--' EST. VAL. Plan Ck. Deposit CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 Validated BY----,,,--+-----t-;>"1""--:--- Date __ ~, ¢,,,,1---+-1-/ l....1.LO-f-( ~+-~-tt-- 1. PROjECT INFORMATION 117 5 6Ll} 14L \ Q L.,,) L N Address !include Bldg/Suite II Business Nama lat this addrassl Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total , of units Assessor's Parcel # Existing Use Proposed Use I of Bathrooms Name Address City State/Zip Telephone # Fax # ,3. . APPLICANT . ~cntractor O Agent for Contractor · 0 0wnir " 'D AgenfiotOwner -•.•.. n, S'tA-Tc. IR0£t?J7 I l>D'i~o. £s:-c.8(<.Jcl,1oy f..,cp,-.~L J:o -.••;""".""7 .. ;:-:., ..... • :,-~,--· -·. Name Address City State/Zip Telephone# 4. PROPERTY OWNER ; . G:-o;e,,bow Name Address City Telephone# s. CONTRACTOR • COMPANY NAME .. -- «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 • signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he Is exempt therefrom, and the basis for the alleged Any vi.e!_ation of Sectio~ 7~31 . 5 by any applicant for • rmit subjects the applicant to • civil penalty of not more than five hundred dollars I$ 5001!.:. . . ( e.. . . Q .-: -· .. C, 0 ~ State License # _,Z.,_· ,..(2"-'-a~e"--"s"---"'s;'--_ Address City State/Zip . Telepho~e ~., / License Class C-J,.l) c-~ City Business License, <;?<! tf, ~ Kq(o D!!signer Name Address City State/Zip Telephone State License # _________ _ 6. WORKERS' COMPENSATION -~ .... , ,.. ..... ·•··---~-. :;···· ~.'._-:;:-;:,~,.--~ :;: ~;""::·•: ', . Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 I have end will maintain a certificate of consent to self-Insure for workers' compens■tion es provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ~ve and will maintain workers' compensation, as required by Section 3700 cf the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy nu'}'ber ere: Insurance Companyf,tlt:[Gi"~m-pJ/VSue, "54,,,d.. Policy No'ZJ..'-J..Pcod4.'f-Cz82 I Expiration Date /-/-~rz (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS lt100J OR LESS) 0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is Issued, I shall not employ any person in any manner 10 as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workara' compenaetlon coverege Is unlawful, ■nd wn 1ubjact ■n employer to criminal pan■ltlaa and clvU fln■1 up to one hundred thousand doll t1 0001, IP--11ddhklin t coat of co atlon, dllmag■1 u PfOvlded for In Section 3706 of the Labor cod■• lnt■re■t and anomay's fNs. SIGNATURE -~-.a DATE 1 ~-(6--S<g, ·1. OWNER-BUILDER DECLARATION • ' ·· :·: : ,-i"','.'.'··-:·•·.:· ... ' .. :' :,P.;i',,0~~ · •·::' · "'"1'1r.· ,-:.• ;· ,·, I hereby effirm that I am exempt from the Contractor's License Law for the following reason: 0 I, as owner of the property or my employns with wages as their sole compensation, will do the work ■nd the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not ■ppty to ■n owner of property who builds or Improves thereon, ■ncl who does such work himself or through his own employees, provided that 1uch Improvements are not Intended or offered for ■ale. If, however, the building or Improvement ii sold within one year of completion, the owner-builder will h■va the burden of proving that h■ did not build or Improve for the purpose of 11le). 0 I, as owner of the property, ■m exclusively contracting with licensed contractor■ to con1truct the project (Sec. 7044, Business ■nd Profession, Cod■: The Contractor's License L■w does not apply to ■n own■r of property who build• or improvas thereon, ■nd contracte for 1uch projects with contr■ctorlsl licensed pursuant to the Contractor's License L■wl. · 0 I am exempt under Section ______ Business ■nd Professions Code for this reason: 1. I personally plan to provide the major labor and m1teri1ls for conatruction of the proposed property Improvement. 0 YES ONO 2. I (have / have not) signed an 1pplic1tion for I building permit for the proposed work. 3. I have contracted with the following person Uirml to provide the proposed construction «Include name / address / phone number / contractors license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, superviae and provide the major work Onclude n■me / address / phone number/ contractors license number): ______________________________________________ _ 6. I will provida some of the work, but I have contracted (hired) the following persons to provide the work Indicated Onclude name / address / phone number / type of work): _________________________________________________________ _ PROPERTY OWNER SIGNATURE ______________________ _ DATE ____________ _ 'COMPLETE THIS SECTION FOR NON-Rn/DENTW. ilUli.i>iNo PERMits 0Ni.f,"'i:'~~~,r-"'r:·~...,T'i'i~T'',~,~.,1r~ 'lf't~•!-7'·~·;,·w •" • ·.'•!·--····· .•.. · .. Is the applicant or future building occupant required to ■ubmit ■ business plan, ■cutely hazardous materials r■giatr■tion form or risk management ■nd prevention program under Sections 25505, 25533 or 25534 of the Preslay-T1nner H■zardoill Substance Account Act? 0 YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? O YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of I school 1ite 7 0 YES O NO IF ANY OF THE 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 AND THE AIR POLLUTION CONTROL DISTRICT. fa. --CONSTilucTioilH.air::ilNG AGENCY ·,• .. ,,, -.. -~,,... q"~-,-y•·:0 +·1:c:·"'='-;:""t''''"'~-,e-•H."'""~''.'"" ,,~-n: :-:--··•,~· "·• .... r, --... ~-· I hereby affirm that there is • construction lending agency for the performance of the work for which this permit Is Issued (Sec. 3097(i) Civil Codel. LENDER'S NAME _______________ LENDER'S ADDRESS. _________________________ _ ;9·; APPLICANT CERTiFICA Ti0N .. , ••. , .. , .. , . ··= ·~··-:-, .. -· . ---·,---,.-~~,,..,..,....,.~-;n•c.~, .... -··~,-,r~or.c-:rr,s·1•=r,.,.,~"·•;n·'1'l"=:,,-·'·~"''.,..,,,., .. ,.,~.,T ·c:-, I certify that I have read the application and state that the above Information Is correct and that the Information on the plans Is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Citt of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND 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 stories In height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expira 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 a t e iscommen.ced f • pe d of 180 d S tion 106.4.4 Uniform Building Code). APPLICANT'S SIGNATUR DATE _ ...... 1:oL...=-.-..... c ...... o"'---S-+-'6 __ _ WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Inspection Request For: 5/12/99 Permit# CB984317 Title: FURNACE CHANGE OUT Description: Type:MECH Sub Type: Job Address: Suite: Location: 1975 SWALLOW LN Lot I\PPLICANT : TRI STATE REFRIG Owner: SCHMIDT GORDON J TR&SCHMIDT DENI Remarks: AM PLEASE Total Time: CD Description Act Comments Inspector Assignment: RB --- Phone: 7608049914 Inspector: /2-B --~- Requested By: GORDON Entered By: CHRISTINE 43 AirCond/Furnace Set &_ ________ _ Inspection History Date Description Act lnsp Comments