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Home My WebLink About1022 PINE AVE; MULIT-PERMIT FILE; CB961994; Permit10/11/96 12:10 Page 1 of 1 Job Address: 1022 PINE AV Permit Type: PLUMBING Parcel No: 204-111-18-00 Valuation: 0 Occupancy Group: Description: REPAIR GAS LINE BUILDING P E RN IT Permit No: CB94 Project No: A9602795 Development No: Appl/Ownr DOKKEN, DIANA 1022 PINE AV CARLSBAD CA 92008 Suite: 0321 18/11/96 0001 01 02 Lot#: C-PR11T 2700 Construction Type: NEW Reference#: Status: ISSUED Applied: 10/11/96 Apr/Issue: 10/11/96 Entered By: RMA 619 729-6214 * Fees Required *** / Cb1 - / I -' 7T Fees: 27/00 Adjustments: / .o0,)) T. a1Ce Total Fees: /27,';S03 T' 1P 'y' / edescription/,' Enter Ufl for Plumb'/e Gas Piping System * PLUMBING TOTAL A \ 4 ected & Credits .00 S .00 27.00 Ext fee Data 20.00X 7.00 J 27.00 'I TEl) FINAL APPROVAL CLEARANCE CITY OF CARLSBAD 2075 Las Palnias Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION PLAN CHECK NO. q f 10 City of CarLsbad Buitding Department 2075 Las PaLmes Dr., CarLsbad, CA 92009 (619) 438-1161 EST. VAL PLAN CE DEPOSIT A A From List I (see back) give code of Permit-Type: --------------------------------------------------------- For Residential Projects Only: From List 2 (see back) give Code of Structure-Type: Net Loss/Gain of Dwelling Units 2. PROJECT INFORMATION FOR OFFICE USE ONLY Address Building or Suite No. NaPesdssti LEGAL DESCRIPTION Lot No. Subdivision Name/Number Unit No. Phase No. CHECK BELOW IF SUBMITFED: 02 Energy Calcs 02 Structural Calcs 02 Soils Report Dl Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DKSCPJPTION OF WORK -. rQ ve y LQ# OF ~JS't OWL O y C16 F BEDROOMS # OF BATHROOMS NAME (last name first) ADDRESS CITY STATE ZIP CODE DAY TELEPHONE AM (last name j ADDRESSf( f'vv€ 7/ve a STATE( ,q ZIP CODE DAY TELEPHONE PROPERTY OWNEK NAME (last name first) ADDRESS CIrla ( Cj€1E ZIP CODE DAY TELEPHONE CX)NTftA'fOR NAME (last name first) ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE UC. # LICENSE CLASS CITY BUSINESS UC. # DESiGNER NAME (last name first) ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE UC. # WORKERs' CDMPEI4SA11ON Workers' Compensation Declaration: I hereby affirm that I have a certificate of consent to self-insure issued by the Director of Industrial 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 Certificate ot,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 so as to bec me subject t Workers' Compensation Laws of California. SIGNATIRELJLDAYE Owner-Builder Declaration: -1 hereby affirm that I am exempt from the Contractor's License Law for the following reason: X 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 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.). 1, 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). 1 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^ Contractor's License Law C apter 9, commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he e e1jpt therefrom, api the si foy th alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects e a ánt to a civil nétialty f n n/or than five hundred dollars [$5001). SIGNATURE JV DATE 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? DYES ONO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? DYES ONO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? DYES 0 N IF ANY OF THE ANSWERS ARE YES A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. WNSI1{UC11ON LENDING AlENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(1) Civil Code). LENDER'S NAME LENDER'S ADDRESS APPLICANT CER111'ICA110N I certify that I have read the application and state that the above information is correct. I agree to comply with all City ordinances and State 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 TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARlSBAD AGAINST ALL UAB[LfliES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. 0511k An OSHA permit is required for excavations over 5'O" deep and demolition or construction of structures over 3 stories in height. Expiration. /ver1 permit issued by the Building cial under the provisions of this Code shall expire by limitation and become null and void if the building orfroriauthorized by such,permit is t c mmen,&Y[thin 365 days from the date of such permit or if the building or work authorized by such pern1t is fispended or aband~d at ti after/hek is commenced for a period of/80 day' (Section 303(d) Uniform Building Code). APPLIANTIS SIGNATURE I /1 1 I / / 11/,, /7 DATE: UNSCHEDULED BUILDING INSPECTION DATE INSPECTOR PERMIT # > 7 Y 'P'> PLAN CHECK# JOB ADDRESS /'- DESCRIPTION 7à- L7 7 TIME ARRIVE: TIME CODE DESCRIPTION ACT COMMENTS F7 USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. I hereby affirm that I am licensed under Aflovislons of Oapter 9 (commencing with Sectlo 000) ot Division 3 of the Business and Pp ons Code, and my license is in I full force aojtafiecf. [, Lic No . 4... ifa.L Class 0 0 — I hereby affirm that I am exempt from the Contrac- tor's License Law for the following reason (Sec. 7031 Business and Professions Code: Any city or county which re- quires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the ap- plicant for such permit to tile a signed statement that he is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 commencing with Section 7000 01 Division 301 the Business and Professions Code) or that is ex- empt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by an applicant for a permit sub- jects the applicant to a civil penalty of not more than five hun- dred dollars ($500). 0 I, as owner of the property, or my employees with wages CC as their sole compensation, will do the work, and the struc- tare is not intended or offered for sale (Sec. 7044, Business .J and Professions Code: The Contractor's License Law does 5 not apply to an owner 01 property who builds or improves m thereon and who does such work himself or through his own cc employees, provided that such improvements are not intend- W ed or uttered for sale. It, however, the building or improve- Z ment is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or im- prove for the purpose of sale). O 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 im- proves thereon, and who contracts for each projects with a contractor(s) license pursuant to the Contractor's License Law). As a homeowner lam improving my home, and the follow- ing conditions exist: t. The work is being performed prior to sale. 2. I have lived in my home for twelve months prior to completion of this work. 3. !have not claimed this exemption during the last three years. tam exempt under Sec. ___________________ , B & P.C. for this reason thereby affirm that I have a certificate of consent to self insure, or a certificate of Workers Compensation Insurance, or a certified copy thereof (Sec. 3800, Labor Code). Z POLICY NO C19726587 COMPANY INA Copy is filed with the City Z LU 0 Certified copy is hereby furnished CERTIFICATE OF EXEMPTION FROM Vt WORKERS COMPENSATION INSURANCE - (This section need not be completed 1 the permit cc is for one hundred dollars 1511331 Or less) UJ Ix 0 I certify that in the performance of the worir for 1 0 which this permit is issued. I shall not employ any person in any manner so as to become subject to the Worlxets' Compensation Laws 01 California NOTICE TO APPLICANT If, alter making this Ceo - ficate of Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you mast forthwith comply with such provisions or this permit shall be deemed revoked D I hereby affirm that there is a construction cc lending agency for the performance 01 the work to, LU 01 which this permit is issued (Sec 3097, Civil Code) Lenders Name —II L Lender's Address CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 1200 Elm, Carlsbad, California 92008.1989 (619) 438-5525 JOB ADDRESS AV, ST.RD. NEARESTCROSSST, 3 DATE OF APPLICATIONI BUSINESS LICENSE VAL IO% PERMIT NUMBER 1022 Pine Ave. JQJ,4Qfl 1 2/6/86 1 50952 ZONE LOT BLOCK SUBDIVISION ASSESSOR PARCEL NO. CONTRACTOR CONTRACTORS PHONE# 204-111-18 So.eaiL Edwwtd.ó 438-2600 OWNER'S NAME OWNE R'S PHONE PLAN I.D. # BLDG USE CODE CONTRACTOR'S ADDRESS 729-6214 M/M Vo!then. , LICENSE NO. OWNERS MAILING ADDRESS Impata CaiLsbad 50952 STANDARD PLAN # BUILDING SO. FOOTAGE DESIGNER LICENSE # DESCRIPTION OF WORK Ho_IQat9J DESIGNER'S ADDRESS -&v DESIGNER'S PHONE ctIAPMQ 'S-2126 F/P FLR ELEV. I I NO OCCGP EDO 00I257 2IT4186 3OOO' I STORIES YO NO CENSUS TRACT GP LAND USE PARKING SPACE RES UNITS GRADING PERMIT ISSUED —F REDEVELOPMENT I I TYPE 0CC LOAD I FIRE SPR I j I AREA I I CONST 0 N 0 Y 0 ND vU ND Not Valid Unless Machine Certified QTY. PLUMBING PERMIT - ISSUE QTY. MECHANICAL PERMIT - ISSUE SUMMARY/ACCOUNT NUMBER EACH FIXTURE TRAP , INSTALL FURN DUCTS UP TO 100,000 BTU - BUILDING PERMIT 01-00-00-8220 EACH BUILDING SEWER - OVER 100,000 BTU SIGN PERMIT 01-00-00-8221 EACH WATER HEATER AND/OR VENT - BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01-00-00-8806 EACH GAS SYSTEM 1 TO 4 OUTLETS . BOILER/COMPRESSOR 3.15 HP TOTAL PLUMBING 01-00-00-8222 EACH GAS SYSTEM 5 OR MORE . METAL FIREPLACE - ELECTRICAL 01-00-00-8223 EACH INSTAL.. ALTER, REPAIR WATER PIPE . - VENT FAN SINGLE DUCT - MECHANICAL 01-00-00-8224 EACH VACUUM BREAKER - MECH EXHAUST - HOOD/DUCTS - MOBILEHOME 01-00-00-8225 WATER SOFTNER - RELOCATION OF EA FURNACE/HEATER - MOBILEHOME PARK INSP EACH ROOF DRAIN (INSIDE) . ' SOLAR 01-00-00-8226 TOTAL MECHANICAL I - STRONG MOTION 80-92-33-0519 TOTAL PLUMBING . FIRE SPRINKLERS 01-00-00-8227 PUBLIC_FACILITIES_FEE 32-00-00-8930 QTY. ELECTRICAL PERMIT - ISSUE QTY. SOLAR- ISSUE BRIDGE FEE NEW CONST EA AMP/SWTBKR COLLECTORS - SCHOOLFEE -DISTRICT I PH 3 PH . STORAGE TANKS . Carlsbad 80-92-21-0519 EXIST BLDG LA AMP/SWT/BKR ROCK STORAGE ' Encinitas 80-92-22-0519 1PH 3 P . PUMP San _Diegailo 80-92-23-0519 REMOOEL.'ALTER PER CIRCUIT . PLAN CHECK FEE San Marcos 80-92-24-0519 TEMP POLE 200 AMPS . OVER 200 AMPS LICENSE TAX 01-00-00-8162 TEMP OCCUPANCY (30 DAYS) M F F 80-92-57-0519 CREDIT DEPOSIT TOTAL ELECTRICAL I TOTAL SOLAR /5... TOTAL FEESPAYABLE -7 _ I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY Expiration. Every permit issued bythe Building Official under the provisions oflhia * AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code Shalt expire by limitation and become null and void If the building or work SO" DEEP AND DEMOLITION OR CONSTRUCTION OF authorized by such permit is not commenced within 180 days from the dale of such DECLARATIONS ARE TRUE AND CORRECT AND FURTHER CERTIFY AND AGREE IF A PERMIT IS permit, or if the building or work authorized by such permit is suspended on STRUCTURES OVER 3 STORIES IN HEIGHT ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON- abandonedat any time after the work is commenced for a period 01180days. -. STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND APPLICANT'S SIGNATURE OWNER 11 CONTRACTOR APPROVED BY DATE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE BYPHONE0 1Q.....___. _ GRANTING OF THIS PERMIT. no~_______ TYPE DATE INSPECTOR BUILDING FOUNDATION REINFORCED STEEL MASONRY GUNITE OR GROUT - FLOOR & CEILING SUB FRAME SHEATHING 0 ROOF 0 SHEAR FRAME EXTERIOR LATH INSULATION INTERIOR LATH & DRYWALL PLUMBING SEWER AND BL/CO EJIPLICO UNDERGROUND 0 WASTE 0 WATER TOP OUT 0 WASTE 0 WATER TUB AND SHOWER PAN GAS TEST o WATER HEATER 0 SOLAR WATER ELECTRICAL El ELECTRIC UNDERGROUND 0 UFFER ROUGH ELECTRIC 0 ELECTRIC SERVICE 0 TEMPORARY O BONDING 0 POOL - MECHANICAL 0 DUCT & PLEM., 0 REF. PIPING HEAT - AIR COND. SYSTEMS VENTILATING SYSTEMS CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ITEMS ABOVE HAVE BEEN APPROVED FINAL PLUMBING ELECTRICAL MECHANICAL GAS BUILDING SPECIAL CONDITIONS FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS 1 INSPECTORS NOTES INSPECTION REQ. IF CHECKED INSPECTORS APPROVAL DATE I SOILS COMPLIANCE PRIOR TO FOUNE5ATION INSP - I I I STRUCTURAL CONCRETE OVER 2000 PSI PRESTRESSED CONCRETE POST TENSIONED CONCRETE - FIELD WELDING HIGH STRENGTH BOLTS SPECIAL MASONRY I PILES CAISSONS - I i •DEVELOPMENTAL SERVICES BUILDING DEPARTMENT 1200 ELM AVENUE CARLSBAD, CALIFORNIA 92008-1989 (619) 438-5525 May 29, 1986 Mr. & Mrs. Dokken 1022 Pine Avenue Carlsbad, CA 92008 Dear Sir: Recently you have had a permit pulled in your name to change your water heater. It is important that you have the work done checked out by one of our inspectors for your protection. There is no charge for this service. Please contact the Building Department at 438-5525 to arrange a time when it would be convenient for you to have this inspection made. Thank you. BUILDING INSPECTION DEPARTMENT CITY OF CARLSBAD