HomeMy WebLinkAbout148 SYCAMORE AVE; ; CB981134; PermitB U I L D I N G P E R M I T Permit No: CB981134
Project No: A9B01505
Development No:
04/21/98 13:01
Page 1 of 1
1 Job Address: 148 SYCAMORE AV Suite:
Permit Type: PLUMBING 6313 04/22/98 0001 01 02
Parcel No: 204-121-05-00 Lot#: C-PRMT 27-00
Valuation: 0
Occupancy Group: Reference#:
Construction Type: NEW
Status : ISSUED
Applied: 04/21/98
Apr/Issue: 04/21/98
Entered By: BT
Description: WATER HEATER REPLACEMENT
Appl/Ownr : MILLIGAN IAN
148 SYCAMORE AVE
Fees Required
Fees:
Adjustments:
Total Fees:
Fee description
Enter "Y" for Plumb·ng
Each Water Heater a d
*** ollected & Credits
.00
.00
27 .00
Ext fee Data
20.00 Y
7.00
EXPIRED ERMll
PER!,IIT HAS EX!IIREO IN ACCORDANCE w'.™ u.a.c.
SECT\ON 06.4.4 ( ~ =
SIGNATURE --;_p--i-----
DATE ~-----
I Fl ~ -~AL APPROVAL
1
,~1"~P. "-DAIT
I -----
1 CLL.:AHA~ JC_E..:::-=------
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
FOR OFFICE USE ONLY
PLAN CHECK NO. ff'!/$ PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(619) 438-1161
EST, VAL. ________ _
Plan Ck. Deposit ---,--,,ff,,-,.=--
Valldated By __ -t±,f-:,,"C?"<'::h-.r-J-,-
Date ______ --1-.,_t.e.....,_'-+_.'-',..._
[t:.;J.il'JWJECt lNF.PIIIMtiOil .
f!Wi ~~!'.'~ J1n.i AddrHu{H•J
l•g•I OascriptJon
A.s.ussor'1 Parcel I
Desctlpllon of Work
au,ln•N N•m• t•t lN• •ddt•11J
Lot No, Subdlvlalon N1mlt/Number Unit No. Phase No. Total I of units
SFR
Existing UH PropoHd Uu
SQ. FT, lof StorlH I of Bedrooms I of Bathrooms
l~.8!>m10'iQ\'(~~~lli..iiill~•'llliJWliJl'ill1JilttDW'ffl',!! ~~i\d:i'I;;. •
f Ja4 6 s,,caruare Ave• CARL 8 V\ • N.wi.ll1gan,au A ,... City . Stata/Zlp Telephone I
ll;ifi!lCDNtAAc:fllllii;CQMWl :ll•.
!Sec. 7031.5 Bu1ines1 and Prof .. alona Coda: Any City or County which requires • permit to con,truct, alter, lmp,ov1, damollsh or rep1lr any atructu,a, prior to Its
Issuance, also requites the applicant for such permit to fll• 1 algned 1t11ement that he la licen11d pur■utnt to the provleions of the Contractor'■ License Law
IChapu, 9, commending with Section 7000 of Division 3 of the Buslne11 and Prof111lon1 Cod•I or that ht 11 1x1mpt therefrom, end the basis for the alleged
u.empllon. Any violation of Section 7031.5 by any eppllc,nt for• permit aubjecta th• •PP'lc1nt to 1 ~•nelty of notc'Jere th~jt'rll'ndredj91~ca4~gi1.
eR :E'ffil !DDIG ~ J7 0 6 B HWY 8 BUS • . EL ON • .A; & J E C,g'f Ad fess City State/Zip 12 0 (nl!Pfione I
Uc1n11 Class ___ C_-_3_6 ____ _ St■II Ucanse I --<6,,_~,.._Q.,l~,i.,(),-__ _ City Bualn111 UcenH I _______ _
Designer Name Address City State/Zip Telephone
s1111 Uc1n11 I N,lA-..
re;; ;,~WORKEASl,COMPiiiilt1<ii(ffllil.li').l'!'IVJ.~l'J-!Mllll')iitiw.uJl:lll~Mall!Wl!Umlllllli1llwil@i11Mi!l'li~)\~iii'!lffl ,1::!.miili!';',,.:. •.· :.
Workars' Compena■tlon D1cl1retlon: I hereby affirm under penalty of parjury one of the followlng,d1d■r1tlona:
0 I h1v1 and will maintain • cartUlcat• of consent to 111f-ln1ure for worker,• comP9M1tlon II provldad by Section 3700 of th1 Labor Code, for the performance
of th, work for which this pe,mlt 11 l11u1d.
0 I h1v1 and will maintain worka,a' comp1n11tlon, H requlfld by Section 3700 of'the Labor Code, for the performance of the work for which thl• permit la
lsiued. My wot-ker'1 compensation ln1uranc1 carrlar •nd policy nUmb1r 111: N2007_56_51 CONTINUOUS
Insurance Company FABMER IWS[TRANCE, Policy No,.____________ Explretion Date _______ _
!THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR DNI HUNDRED DOUARS 111001 OR LE8S1
0 CERTIFICATE OF EXEMPTION: I certify that In the parformance of the wo,k for which thlt parmlt 11 l11ued, I 1h1II not employ 1ny person In any m1nner 10 u
to become 1ub)ect to the Workat1' Companutlon Laws of C11ifornl1.
WARNING: Feffura to 11cur1•workar1• comp1n11tlon coverage I• unlawful, and 1hell 1ubJ1ct 1n employer to crlndn1I p1naltl11 and clvll fines up to one hundred
thouHnd doPa,a (♦ 100,000J, In 1ddlUon to th, coat of comp1n11tlon. dam191111 provld1d for In Section 3708 of the L1bcv code, lnte,eat and altorn1y'11111.
SIGNATURE _____________________ ~------DATE ________ _
7. , .. ·. OWNER-BUILDER DECIARATIOI! ~''°"''m?i;,lli;/~ f!li!J/.tli\'lll!~\tJ~r.llli:~ljlf,!iijli\',!:llllRSIDillli!illll!iJllillll·:~111m,:111.!Jl.'~1;.:~,~ir,'!l:,~::.r~ ' ' ..
I hereby 1Hirm th1t I em uempt from the Contractor'• Uc1n11 Lew for the following re11on:
0 I, as owner of the property or my employees with w1g11 es thair 1011 comp1n11tlon, will do the work and the 1tructura la not intended or offered tor ule
!Sac, 7044, Business and Profe11lona Code: The Contrector'■ Uc1na1 Law do11 not apply to an owner of property who bulld1 or Improves thereon, ind who does
such work himself or through hll own 1mploy111, p,ovld■d that 1uch lmprovemtntl ,,. not Intended or offered for 1111. If, however, the building or lmprov1ment 11
sold within on, y .. r of complatlon, the own•r•bulldar will have th• bwd1n of proving that he did not bulld or Improve for th• pu,po11 of 1111).
O I, 11 owner of th, p,op,rty, •m 1xclu1lvely contracting wllh llcansed contr1ctor1 to con1truct" th• project CS1c. 7044. Bu1ln111 ■nd Prof111lon1 Code: The
Cont11ctor'1 Ucen11 Law do11 not 1pply to 1n owner or property who build• or Improve, th1r1on, Ind contr1ct1 for ,uch proJ1ct1 with contractorl•I Uc1n11d
PUl'IUant to th• Contflctor'I Uc,nH Lewi. .
0 I 1m axempt undar Section ______ Bu1ln111 ind Profe11lon1 Coda for this re11on:
1. I p1rson1tly pltn to provide th• m•Jor labor ind m1t1rl1l1 for construction of th• propo11d property lmprovemant. 0 YES ONO
2. I (have / have not) 1lgn1d en 1ppllc1tlon for• bulldlng permit for th• propo11d work;
J. I h1v1 contracted with th1 following person (flrml l? provld• the prop011d con1tructlon (Include name I 1ddr111 / phone number / contr1ctor1 licensa number):
4. I plen to provide portion, of the work, but I h1v1 hired the following person to coordinate, 1upervl11 ind provide the mljor work llnclude n,me / 1ddress / phone number I contr1c1ors license number):. ____________________________________________ _
5. I will provide some of the work, but I hive contracted !hired) the following p■r1on1 to provide the work lndlceted (Include neme / address / phone number I typa of workl: ______________________________________________________ _
PROPERTY OWNER SIGNATURE ________________________ _:::.:.:.:_:========--c-:::-_
•_;;o~:rn1s,secuofl,f,(IR.f/P!!.-N/$//l~IMJ:.l!.IIJl.l)_i.N~,ill<SMiD.ftiN•'"IWlffl!!liSl!H¥ll!"I\WU: NllY,1!'//t::C,';.1',i!'l;!l:;~1:~,,.Jl',.•,;,, ,
lt the 1ppflc1nt or futw• bulldlng occupant requlrad to 1ubmlt • bulin■H plen, 1c:ut1ly hl1erdou1 m1te,l1l1 reg/1tr1tlon form or risk menagement end prevention
progrlm undtr Sections 26505, 25533 or 25634 of the Praliey-TaMer Henrdou1 Substenc■ A""""n' A ... ,