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HomeMy WebLinkAbout1307 CORVIDAE ST; ; CB961989; PermitPermit No- CB961989 Project No A9602842 Development No BUILDING P E R M I T 10/15/96 14-53 Page 1 of 1 Job Address 1307 CORVIDAE ST Suite Permit Type PLUMBING 035S 10/15/96 0003 C'J 02 Parcel No 215-690-02-00 Lot# C-PBMT 27.CO Valuation 0 Construction Type NEW Occupancy Group Reference* Status ISSUED Description GAS LINE TO BBQ-NOT UNDER Applied '0/15/96 • STRUCT SLAB/PATIO Apr/Issue j0/15/96 Entered By• RMA Appl'/Ownr LANDSCAPE ARTISTRY 619 792-5030 3790 VIA DE LA VALLE, STE 204 DEL MAR CA 92014 Fees Recaured * * *.Fa-.??. Collected & Credits * V A Fees Adjustments • Total Fees Fee description. 27. 7 Jtal. Creel i ':s';- Total i'civmari'tc •. iralanc ;?•• Duo ; ..-•'Units : Fee/U; 00 00 27 00 Ext fee Data Enter "Y" for Plumb;:.W3 Issue Fee ••>, Gas Piping System ; ; > A PLUMBING TOTAL , 20 00 700 27 00 ll-n-u CITY OF CARLSBAD 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161 jGOtii^&^ PERMIT APPLICATION fiT^^Ma r T>H City of Carlsbad Building Department ^^*^fw 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 Xjg^r 1 PERMIT TYFK For Residennal Proiects Only From List 2 (see back) give Code of Structure-Type Net Loss/Gam of Dwelling Units 2. PROJECT INFORMATION Address i^rv- 1 CorM^h^ ^^ Building or Suite No Nearest Cross Street LEGAL DESCRIPTION Lot No Subdivision Name/Number PLAN CHECK NO. ^f f / Q Grf / <J? I 'Of/ EST VAL PLAN CX DEPOSIT VALID BY fA DATE /fo|/C IT/ FOR OFFICE USE ONLY Unit No Phase No 0 CHECK BELOW IF SUBMITTED D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D 1 Addressed Envelope ASSESSOR'S PARCEL I S - (t>°tO -EXISTING USE PROPOSED USE DESCRIPTION OF WORK fta§ (j^j^j^ "ft? SQ FT # OF STORIES # OF BEDROOMS # OF BATHROOMS 3 (JUNIAL."i KEJUUN (il different trom < NAME (last name first)I Sol ZIP CODE DAY TELEPHONE 4 APPLICANT DCON TRACTOR NAME (last name first) ACJEN 1 FOR CONFRALIUR UOWNbH U AGENT rOR OWNtR .^ADDRESS §-790 Via dia. L<«~ VcLLUL, STATE d. A- ZIP CODE °13-O 1 4 DAY TELEPHONE 1 °) P ' "S. D "3 i 5 PROPERTY OWNER . NAME (last name first) \(jt".€ Slftf j <K. STATE CA 'lC . hCLT'ci ZIP CODE "<* ADDRESS I3o~7 <forvid<3t^ ^O^l DAY TELEPHONE • s± CONTRACTOR \ • NAME (last name first) Ljjl HO^C (^Xp^ CITY Of \ (KCHf" STATE STATE LIC # ADDRESS 0 \A a CU LA- V<5L.ULJL/ ZIP CODE °f^<2J I (4 DAY TELEPHONE ~~]C\ 3- ~'. CLASS (- " ^- / CITY BUSINESS LIC # UtSlCJNEK NAME (last name tirst) C ^ CITY STATE ZIP CODE ADDRESS DAY TELEPHONE STATE LIC # 7 WORKERS' COMPENSATION 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) /O I /• t (*")(*" y I lf\ 1 7 f) I / / / G1 —~7INSURANCE COMPANY ( ^ fl_ I ( (juLIP POLICY NO W yj 7~'U' I EXPIRATION DATE ' / ' ' .^ Cenificate of Exemption ^\ certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California S1GNA'DATE 8 OWNKR-Bi 'EH DFXXARATION uwner-uuiider Declaration I hereby arnrm that 1 am exempt irom tne contractors License Law lor the tollowing reason 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 ) 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 License Law does not apply to an owner of property who builds or improves thereon, and contracts for sue h 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 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 [S500]) SIGNATURE DATE COMPLETE THIS StCllON rUR NON-RESIDENTIAL bUiLDING PERMITS 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 2S534 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 distnct or air quality management district? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES D NO 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 9 CONSTRUCTION LENDING ACJENCJY I hereby alfirm that tnere is a construction lending agency tor Uie performance of the work tor which this permit is issued (bee 30y7UJ Civil Code) LENDER'S NAME LENDER'S ADDRESS 10 APPL1LAN1 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 LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA. An OSHA permit is required for excavations over S'O" 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 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/a\ any time after the work is commenced for a period of 180 days (Section 303 (d) Uniform Building Code' APPLICANTS SIGNATURE Vl/ M «, yj |Aq DATE \O, IS ' 'File YELLOW: Applicant PINK. Finance CITY OF CARLSBAD BUILDING DEPARTMENT NOTICE DATE /A LOCATION PERMIT NO_ 438-3550 2075 LAS PALMAS DRIVE T|ME CD / T2 / t V c«A L c- / FOR INSPECTION CALL 438-3101- RE-INSPECTION FEE DUE1? YES FOR FURTHER INFORMATION, CONTACT _ PHONE BUILDING INSPECTOR CODE ENFORCEMENT OFFICER City of Carlsbad ^* ••P^^^H'Vf^^HHV^WIB^^^HQHHHHHBWBuilding Department WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by section 3700 of the Labor Code, for the performance of the work for which this permit is issued I have and will maintain workers' compensation, as required by section 3700 f the Labor Code, for the performance of the work for which this permit is issued My workers' compensation insurance carrier and policy number are INSURANCE COMPANY POLICY NO EXPIRATION DATE 10 ) (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) 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 become subject to the ™ C workers compensation laws of California Signature Date j 0 Warning. Failure to secure workers' compensation coverage is unlawful, and shall be subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, Interest and attorney's fees March 3, 1995 2O75 Las Palmas Dr • Carlsbad, CA 92009-1576 • (619) 438-1161 • FAX (619) 438-0894 ACORDL CERTIFICATE OF LIABILITY INSURANCE oT/To/Te PRODUCER TANENBAUM-HARBER OF CA. INC. 11610 IBERIA PL., SUITE 200 SAN DIEGO, CALIFORNIA 92128 (619) 487-8839 INSURED LANDSCAPE ARTISTRY INC. 3790 VIA DE LA VALLE SUITE 204 DEL MAR, CA. 92014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW COMPANIES AFFORDING COVERAGE COMPANY A FIRST FINANCIAL/MONARCH COMPANY B CALIFORNIA COMPENSATION INS. CO. COMPANYc COMPANY D COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS ^ TYPE OF INSURANCE i GENERAL LIABILITY A j X1i COMMERCIAL GENERAL LIABILITY , i CLAIMS MADE LX OCCUR , OWNER S & CONTRACTOR S PROT ! < AUTOMOBILE LIABILITY ! ' ANY AUTO , ALL OWNED AUTOS ! SCHEDULED AUTOS • HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS LIABILITY D THE PROPRIETOR/ I i ...,,, I PARTNERS/EXECUTIVE '• OFFICERS ARE ' EXCL OTHER POLICY NUMBER I F0157G411083 i i i ii W954101701 1 >OUCY EFFECTIVE ' POLICY EXPIRATION DATE (MM/DD/YY) DATE (MM/DD/YY) 10/12/95; 10/12/96 i . i 4/01/96 4/01/97 • LIMITS GENERAL AGGREGATE $ 1,000,00( PRODUCTS COMP/OP AGG S 1,000,00 PERSONAL & ADV INJURY It 1,000,00 EACH OCCURRENCE $ 1,000,00 FIRE DAMAGE (Any one fire) $ 50,00 MED EXP (Any one person) > $ COMBINED SINGLE LIMIT $ BODILY INJURY . (Per person) * BODILY INJURY ' , (Per accident) , * PROPERTY DAMAGE : $ AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY ' EACH ACCIDENT $ AGGREGATE ' S EACH OCCURRENCE $ AGGREGATE $ $ X WC STATU OTHTORY LIMITS ER ' EL EACH ACCIDENT $ 1^000^000 EL DISEASE POLICY LIMIT , S 1, QQQj QQ( EL DISEASE - EA EMPLOYEE $ 1 QOO 00( DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECtAL ITEMS PROOF OF INSURANCE ONLY. CERTIFICATE HOLDER NAMED INSURED &r*nan <jc_c H/OK\ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 3Q DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OH LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OH REPRESENTATIVES AUTHORIZED REBRESpNTATWE _S /&2&~&1^ % ACORD CORPORATION 1988