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Home My WebLink About2808 SOMBROSA ST; ; CB910860; Permit. - B U I L D I N G P E R M I T Permit ProJect Development No: CB91ll860 No: A9101051 No: 06/05/91 09:14 Pa9e 1 of 1 Job Address: 2808 SOMBROSA ST Permit Type: PLUMBING Parcel No: 255-102-04-00 Valuation : o Construct1on Type: VN Occupancy Group: DeGcription: GAS LINE REPAIR Appl/Ownr : PLOTKE PLUMBING PO BOX 2166 DEL MAR, CA 92014 CONTRACTOR : PLOTKE PLUMBtNG OWNER SUMMERS, DAVID ~A* Fees Required Fees: Adjustments: Total Fees: fee description Enter "Y" for Plumbing Gas Piping System j PLUMBING TOTAL Str: Fl: Ste: Class Code: CITY OF CARLSBAD 6 05 91 0 -Mi (ft /()/ Cf tatus: Applied: Apr/IG~Ue: Validated By: 619 b32-0461 ISSUED 06/04/91 06/05/91 DC Credits .00 .00 10.00 Ext ft?•? 7.50 2 .50 2.50 10.00 ~PPROVAL ~---Dm v/6/q, *I<* Data y 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 2q75 Las Palnas Dr., Carlsbad, CA 92009 (619) 438-1161 I. PfiltMII hPE A -D COmmerc1al D New Bmldmg Li tenant Improvement B -□ Industrial □ New Building D Tenant Improvement C -~esidential D Apartment □ Condo □ Single Family Dwelling □Addition/Alteration □ Duplex □ Demolition O Relocation D Mobile Home D Electrical }tl.Eumbing 0 Mechanical D Pool D Spa D Retaining Wall D Solar D Other 2. PRClJECr INFORMATION □ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report ~JESSOB'S PARCFI, pcmPTION OF WORK SQ. FT. # OF STORIES 3. WNIAC.I PERSON (If dnlerenl tram applicant) NAME ADDRESS □ 1 Addressed Envelope FXISTING USE po. 0,o'J_ 2..(blo PLAN cHECK No. Cb ff-?~o ESf.VAL,..._ _________ _ PLAN CK DEPOSIT ________ _ VALID.BY __________ _ DATE FOR OPPICE USE ONLY mt o. ase o. PBOPQSED USE \Jlo~ l)rl\b;rJ~ s. <;:;gv~k b.4\¥= STATE CA: ZIP CODE 92014 DAY TELEPHONE u,32..-O'::f b I NAME /fl(, !)'lr5 .S.uiY'Me,5 ADDRESS z..f;Ota 5oM.l:lroJ /l a. CITY £.~Sl;'.J,10 6. WNI NAME STATE C/1::: ZIP CODE qz.ooj DAY TELEPHONE 7S!) ·-!>?S-2. ADDRESS CITY STATE STATE UC.# ZIP CODE LICENSE CLASS DAY TELEPHONE CITY BUSINESS UC. # CITY STATE ZIP CODE DAY TELEPHONE STATE UC.# 7. WOJtkERS WMPENSAI ION Workers' Compensation bcciarat1on: I hereby al!lrm that I have a cert1hcate of consent to self-insure issued by the Director ol 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). POLICY NO. EXPIRATION DATE INSURANCE COMPANY Cemhcate of ExemptlOn: I certify that m the performance of the work for which this permit 1s issued, I shall not employ any person m any manner so as to become subject to the Workers' Compensation Laws of California. SIGNATURE DATE 8. oWNF.R-BUliDER DHCDJtA.IIUN bwner-Bmlder Oeclarauon: I hereby afhrm that I am exempt from the Contracto?s Llcense Law for the foilowmg reason: □ 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.). D 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 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 Llcense Law). □ I am exempt under Section ________ Business and Professions Code for chis 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 [$5001). SIGNATURE DATE COMPLEIE IHIS SECIION FUR NON-RESIDEN !!AL BUILDING PERMIIS ONLY: Is 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 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 ls the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ YES □ NO IF ANY OF TIIE ANSWERS ARE YF.S, A FINAL CERTIFICATE OF CXIlJPANCY MAY NOT BE ISSUED AFIBRJULY I, 1989 llNIBSS TIIEAPPUCANT HAS MET OR IS MEETING TIIE REQUIREMENTii OF TIIE OFFICE OF EMERGENCY SERVICES AND TIIB AIR POll.UTION <DNTilOL DISl1UCT. 9. WNSIR0CIION iENOING AGENCY I hereby afhrm that there 1s a construction lending agency for the perlormance of the work for which this permit 1s issued (Sec 3097(1} CIVli Code). LENDER'S NAME LENDER'S ADDRESS 10. APPllt!AN I cmtliFICAiKJN I cerufy that I have read the appl1cat1on and state that the above mformat1on 1s correct. I agree to comply with all City ordmances and Stale laws 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 TIJ SAVE INDEMNU-Y AND KFJ'.P ILARMIY.SS TIIE CITY OF CARLSBAD AGAINST ALL IJABIIITIES, JUDGMENTS, CDSTS AND EXPENSES WIDCII MAY IN ANY WAY A(x::JIIJE AGAINST SAID CITY IN CDNSEQUENCE OP TIIE GRANTING OF TIDS 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 1he 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 wo s commenced for a period of 180 days (Section 303(d) Uniform Building Code). APPLICANTS SIGNATURE PINK: Finance UNSCHEDULED INSPECTION 1 ) (t Y/1/ INSPECTOR \A)\,{" ~/'\..,/ ,/bc:J PLANCK t ------ JOB ADDRESS cJf() C f' C)/1"'} & I? .J ~ x s 7 r? /l1 · =:z:c ,{) e 14 / t. ~,4 .r-E__ TIME ARRIVE: ____ TIME LEAVE: ____ _ CD LVL DESCRIPTION ACT COMMENTS _({ __ _ \ .... "\