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HomeMy WebLinkAbout1026 LANDS END CT; ; CB961297; Permit~B l,7/,.</!.)6 1>:24 Paqe 1 of 1 'J I :, J~)t:, Addrt•~~ : 1026 LANDS END C':' Porm ... t Type: :PL'JMBING 1 I N , , F-' E: R M I ',.' ~uite: Lot#: Perrr:.1 t Ne : .:h'-1tl~l 7 Project '\jc>: A'tt>U1b49 ~evE=>lopment Ne.,: 85J9 07/15/96 0001 01 0~ C---'RMT Construct1on ':'ype: N~W ~ '. 0 Parcel No: 214-~31-18-00 Valuat on: O u~cupdncy Gro4p: Refc.renc-€'#: Std tu.:;: L;~,l E.) Descr1pt:on: GAS LINE TO BBQ Appl/Ownr : ANZIL, CLAUDIO & AN 1026 LANDS END CT SARLSBAD CA 920(9 Fees r,equired Fee:.::: Aclju~tment::=--: Tot..il F'ec s: Fee aescr.1pt1on Enter "'f' fc,r Plu Gd~ Pi~ing System * PLUMBING ':'OTAL A1->pl.1ed: 07/::.t,/'lt Apr/.:::ssue: 01;::.r..;9t> Entered By: RMA b19-bJ3 8913 1:ected & C.red.1ts • C, u . ( (, 2.7.('l) Ext fee Dc:t -l 20. 0 > Y 7. 0 0 ) 7. ( ) C'ltdl\f ADPRQVI'· INSP. -V . ·1 7/11/16 !CLEARANCE 4}: __ _ CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION PLAN OIBCK NO. City of Cart.-lulldi111 Deport.flt 2075 Laa P■l-Dr., Cart.-, CA 92009 (619) 438-1161 I. PEkMJ I liPE From List 1 (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. PRCllF.CI' INFORMATION FOR OFFICE USE ONLY Address \ 0·2..1 ... Building or Suite No. \.-~~" l=N.~ c..-c. ' Nearest Cross Street LEGAL 0EstRIJfl ION lot No. Subd1vts1on Name/Number Omc No. Phase No . .. CHECK BEWW IF S0BMII 1£0: □ 2 Energy Cales □ 2 Scructural Cales □ 2 Soils Report □ I Addressed Envelope ASSESSOR'S PARCEi '.2,l':\-§p\ · \l!, -09 EXISTING USE PAOPQSED USE DESCRIPTION OF WORK OF SlURIES # OF BEDROOMS NAME (last name first) . ADDRESS CllY STATE ZIP CODE DAY TELEPHONE ~I; _(la~t name first) ~ ~ ._ ,. , ADDRESS ~~\.-c..~~,~ ,...,. ..... ""'" ' CllY ~'::,~ , STATE ~ ZIP CODE ~C\ DAY TELEPHONE 6. WN'hW!IOk NAME (last name first) ADDRESS CllY STATE STATE UC.# DESIGNER NAME (last name hrsf) CllY STATE 7. WOR1tt:RS' WMPENSAIION ZIP CODE LICENSE CLASS ZIP CODE DAY TELEPHONE CllY BUSINESS UC, # ADDRESS DAY TELEPHONE # OF BATIIROOMS STATE UC.# Workers' Compensanon Oeclarauon: I hereby arftrm that I have a cert1hcate of consent to selr-msure issued by the Director of lndusmai 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 tiled with the Building Inspection Department (Section 3800, Lab. C). INSURANCE COMPANY POLICY NO, EXPIRATION DATE Ceruhcate of Exempuon: I cerufy that ID the pedonnance of the work for which this permit IS tsSued, I shall not employ any person ID any manner so as to become subject to the Worken' Compensation Laws of California. SIGNATURE DATE A. UWNEk-BOlturut bifiARXIION Owner-Builder Declaration: I hereby athrm that I am exempt from the Confradofs Ucense law for the foiiow1Dg 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 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 chat he did not build or improve for the purpose of sale.). □ I, as owner of the property, am exclusively contracting with licensed. contractors to construct the project (Sec. 7044, Bu;;iness and Professions Code: The Contractor's l.Jcense Law does not apply to an owner of property who builds or improves thereon: and convacts for :.uch projects with contractor(s) licensed. pursuant to the Contractor's License Law). I 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 pennil to construct, alter, improve, demolish, or repair any structure, prior to ics issuance, also requires the applicant for such pennit to file a signed statement chat 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 pennit subjects the plicant 10 ivil penalty of not more than five hundred dollars [SS00J). SIGNATURE 'I< DATE 7-/5-9(p 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 reql!ired 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 feel of the outer boundary of a school site? □ YES □ NO . IF ANYOFUIEANSWERSAREYl!S, AFINALCERTIFICATI!i:>F OCCUPANCY MAYNOI" BE ($sumAFrERJULY 1, 1989 UNU;SS UIEAPPUCANT HAS Mirr OR IS MElmNG UIE REQUIREMl!NTS OF 1111! OFFICE OF EMERGENCY SERVICES AND 1111! AIR POLLIJ11ON CDNTROL DISl1UCT. Y. tDNS I KOCI ION t.£NDING AGENCY I hereby aiurm that there IS a conscrucuon iend1Dg agency for the J)erformance of the work for which th1S permit 1s tsSued (Sec 3097(1) Civil Code). LENDER'S NAME I.ENDER'S ADDRESS 10. XPPllCXNI CERIIFICAIION I cemfy that I have read the appbcauon and state iliac the above 1Dfonnauon IS correct. I agree to comply with ah C1ry ord1Dances and Seate 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 AUD AGREE 10 SAVE INDEMNIFY AND KEEP IIARMIJ!SS UIE Cl"IY OF CARlSBAD AGAINST AIL IJABILITIES, JUDGMENTS, en.rs AND EXPENSES WIUOf MAY IN ANY WAY ALDUJE AGAINST SAID OTY IN WNSEQUENCE OF UIE GRANTING OF nos PERMIT. OSHA: An OSHA permit is required for excavations over S'O" deep and 'demolition or construction of structures over 3 stories in height. Expiration. Every permit issued by the B1.1ilding Official under the provisions of this Code shall expire by limitation and become null and void if the building or woric authorized by such pennit is not commenced within 365 days from the date of such permit or if the building or work authorized by such pennit is suspended or abandon al any rime after the work is commenced for a period of 180 days (Section 303(d) Uniform Buildin!?°'1Ctt APPUCAN1"S SIGNATURE V: • DATE: ?-✓i:._~ YELLOW: App 1cant PINK: Fmance c,