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Home My WebLink About1145 CARLSBAD VILLAGE DR; ; CB930707; Permit07/16/93 14 46 B ^ I L D I N Page 1 of 1 Job Address: 114-5 CARLSBAD VILLAGE DR Permit Type PLUMBING Parcel No: 156-130-26-00 Valuation. 0 Construction "Type NEW Occupancy Group: Reference* • Description: INSTALL BACKFLOW DEVICE Appl/Ownr : WESTERN BACKFLOW P.O. 84? POWAY, CA, 92014: *** Fees Required P E R M I T Suite Lot#: Permit No. CB930707 Project No, A9301030 Development No: 3183 07/16/93 0001 01 02 C-PKHT 27,00 619 486-3555 Status: ISSUED lied. 07/16/93 Apr/Issue: 07/J 6/9 j Entered Bv . MDP Fees . Adjustments Total Fees • Fee description Enter "Y" for Plum Each Itistctll/Rep * PLUMBING TOTAL Credits *** 00 t oo 27 00 Ext fee Data 2P.OO Y 7 00 27,00 w^NAI/APPROVAL DATF!SP. CLEAR/^CEL CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA. 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Palraas Dr., Carlsbad, CA 92009 (619) 438-1161 1 PIIHMIT'IVPF, A - U Commercial U New Building U Tenani Improvement B - D Industnal D New Building D Tenant Improvement C - D Residential P Apartment DCondo D Single ^mily Dwelling D Addition/Alteration D Duplex D Demolition DRclocdtion D Mobile Home D Electrical D Plumbing QMechanical UPool D Sp<i D Retaining Wall DSolar dOther 2. PROJECT INFORMATION PLAN CHECK NO. EST VAL PIAN CK DEPOSIT r 7 "} <-> ^i- VAUD BY ^D^ DATE 1 / f Ct ( <?~l(A L- FOR OFFICE USE ONLY Nearest Cross Street LEGAL DESCRIPTION BuiTdmg or Sulle No Subdivision Name/Number TTnit No Phase No CHUCk BL'LOW II1 sUBMI'nrU D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED \Jgfi_ DESCRIPTION OT WORK 3 (juw rALT PEHMJN (ft dillerent Irom applicant.) NAME CITY SIA1E ADDRESS ZIP CODE DAY TE^LEPHONE 3T APPUCAN IJ BfCUN'l itA'CroP. UACKNT ['ORCONTRACIUR UOWNER |fcf AGENT FOR UWNLk NAME /£/£2>/f%4j j£&t/,6&JK/ ADDRESS J?0, ^^g.^ F*/J- C1TY •ffii£Jta** STAIE/<# ZIP CODt,^3^// DAY TELEPHONE ^^ ^^ 5 pK(JrtJfnr uwNiiK NAME -^S^^V6 &JL (?& CITY STATE t> (JUNTKACTUK , yX CITY •fS£&'*J SI ATE c^A- STATE LIC #£&&£ DLbltiNEK NAMt ADDRESS £/&*}£ ZIP CODE DAY TELEPHONE // sFsf cffX-5 ^ ADDRESS -^.&<C>G){ Sr<?-~ ZIP CODE %2&7y DAY TELEPHONE LICENSE CLASS (?-•&. CITY BUSINESS LIC # \ I P GS^~2_*~7 AIJUKlib CITY '; WOHKim" CuMI'liNSA'l'ION SI ATE ZIP CODE DAY TELEPHONE STATE LIC # Workers'Compensation DecidrdtfonI hereby affirm that r have a certificate of consent to self-insure issued by the Director oflndustriar 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 POUCY NO EXPIRATION DATE CcrtiUcate ot Exemption I certjiy tridt in the pcrtormancc ol the work lor which this permit is issued, l shall not employ any person In dny manner so as to become subject to the Workers' Compensation Laws of California owm^^mi^ni^m^"— Owner-Builder Declaration""I hereby affirm that I am exempt Irom the Contractor's License Law tor7he~ibTrowing?eason D 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 ) 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 10 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) D 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 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 tasis for the alleged exemption Any violation of Section 7031 5 by any applicant for a permit subjects tho^ppljpant to.a civil penalty of not more than five hundred dollars [$500]) SIGNATURE x^ J^$&£*^ DATE COMPLETE THIS SECTION RJR NON-RESIDFNT1AL BUILDING PFfiOTlTS 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? D YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district7 D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D NO ff ANY OF TI IE ANSWLRS ARE YES, A FINAL CLKTZF1CA TE OF OCCUPANCY MAY NOT BE ISSUED ATTEH JULY 1, 1989 UNLESS THE APPLICANT HAS MET OR LS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POIJAJTION CONTROL DISTRICT 9 CONSTRUCTION l£NDING Ali'tNCY 1 hereby alhrm tn<il there is a construction lending agency lor the pcrtormance ot the work tor which this permit is issued [Sec JOy/UJ v-ivil Code) LENDER'S NAML lENDER'S ADDRESS 10 APPLICANT CERTIFICATION 1 certify that I have read the application and si.ne that the above inlormation is correct I agree to comply with all Uty ordinances and btate laws relaiing to building construction 1 hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection purposes I AISO ACRKh TO SAVT INDEMNIFY AND KTJ.P 1 [ARMLESS HIE CTTY OF CARISBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND hXPENShS WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUF-NCF OF THF GRANTING OF THIS PFJIMTT OSIIA An OS1IA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stones in height Expiration Every permit issued by the 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 noi 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 work is commenced for a period of 180 days (Section 303(d) Uniform Building Code) APP NTS SIGNATURE DATE WHITE File YELLOW: Applicant PINK: Finance "- x< CITY OF CARLSBAD INSPECTION REQUEST PERMITS CB930707 FOR 07/21/93 INSPECTOR AREA PY DESCRIPTION: INSTALL BACKFLOW DEVICE PLANCKtf CB930707 OCC GRP TYPE: PLUM CONSTR. TYPE NEW JOB ADDRESS: 1145 CARLSBAD VILLAGE DR STE: LOT: APPLICANT: WESTERN BACKFLOW PHONE: 619 486-3555 CONTRACTOR: PHONE: OWNER: PHONE: REMARKS: MH/BILL/486-3555 SPECIAL INSTRUCT: TOTAL TIME: CD LVL DESCRIPTION 29 PL Final Plumbing INSPECTOR ACT COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS .Cqnsumer Food Protection Plai^p:heck and Construction Unit . ** OFFICE USE ONLY Intake Date /^ / ' H Act. Code ' City/County Code Route CodePLAN CORRECTION SHEET Field PC Staff Plan Check #E EST. NAME SITE ADDRESS OWNER/BUILDER MAILING ADDRESS START DATEGENERAL CONTRACTOR P/U CONTACT ^-—PLANS: (APPROVED,/DISAPPROVED- PLAN CHECKER -(•Circle One) Est. RECHECK FEE REQUIRED: $ Time (Signature) RECHECK APPOINTMENT DATE ENV. HEALTH OFFICE (S.D.) 1255 Imperial Ave.-3rd Fir, San Diego, CA 92186 (619) 338-2222 DHS:EHS-886 (8/91) EAST CO. ENV. HEALTH OFFICE 151 Van Houten Ave. Ste. B El Cajon, CA 92020-4429 (619) 441-6666 SAN MARCOS OFFICE 338 Via Vera Cruz San Marcos, CA 92069 (619) 471-0730