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Home My WebLink About1377 NIGHTSHADE RD; ; CB970867; PermitBUILDING PERMIT Permit No: CB970867 04/14/97 11:53 Project No: A9701132 Page 1 of I Development No: Job Address: 1377 NIGHTSHADE RD Suite: Permit Type: PLUMBING 4104 04/14/97 0001 01 02 Parcel No: 215-641-26-00 . Lot#: C-PRMT 27.00 Valuation: 0 Construction Type: NEW Occupancy Group: Ref erence#: Status: ISSUED Description: GAS LINE TO BBQ Appl/Ownr : REESE, DONN 2711 E MISSION FALLBROOK, CA 92028 kA* Fees Required *** ---------------------------- Fees: 27,0 Adjustments: Total Fees: 2 , 7.0 (c ) Fee description -------- / Enter "1" for Plumbi.g re/F >< Gas Piping System * PLUMBING TOTAL AA FINAL APPROVAL INSP..c$ DATE '?Z CLEARANCE CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 Applied: 04/14/97 Apr/Issue: 04/14/97 Entered By: JM 619 728-9235 * .00 .00 27.00 Ext fee Data 20.00 Y (. \ 7.00 - 27.00 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (619)438-1161 -, FOR OFFICE USE ONLY PLAN CHECK NO: f"?1RC7 EST. VAL. Plan Ck., Deposit Z Validated By, p7)44 I) - Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use Proposed Use Description of Work . SQ. FT. #of Stories # of Bedrooms . # of Bathrooms 2 2 WoN 0 - Name _.- - Address City State/Zip Telóphone # Fax # Telephone Name f - Address City State/Zip Telephone # (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, after, 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, commending with Section 7000 of Division 3 of the Business and Professions Codel 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 toe civil penaity of not more than five hundred dollars ($50011. 5.- Name Address City State/Zip Telephone # State License # '553 '/ License Class C 2. 7 City Business License # Designer Name Address . City State/Zip Telephone State License Amo 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 workirs' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. O I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for :which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company Policy No. Expiration Date__________________ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$1001 OR LESS) CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for whichthis permit is issued, I shall not employ any person in any manner so as beCome lubject to the Wofkers' ,.mensatio Laws of California. WARNING: Failure to secure.roHcP'compensation cov!54 Is unlawful, md shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars C$1o0,0OjWfii egdltion to the cost otg9ñpensation. damages as provided for In Section 3706 of the Labaj cede, Interest and attorney's feds. 1C1JJ;I DATE gol AwF"A= 11uui - ,.__, .. _,,uli IJfli•!!!I II I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 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 (Sac. 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. It, 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 to an owner of property who builds or improves' thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractors License Law). 0 I am exempt under Section Business and Professions Code for'this reason: I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO I (have I have not) signed an application fore building permit for the proposed work. . I have contracted with the following person (firm) to provide the proposed construction (include name / address I phone number / contractors license number): I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name I address I phone number / contractors license number): I will provide some of the work, but I have contracted (hired) the following persons to provide the-work indicated (include name / address tphone number / type of work): . . PROPERTY OWNER SIGNATURE . ' DATE . :cM SEcnoN.FoR-N-ON4110 -7D Is ths applicant or future building occupant requred 'to submit a business plan, acutely hazardous materials registration tomi or flak management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES 0 NO Is the applicant or future building occupant required to obtain a permit from the sir pollution control district or air quality management district? 0 YES 0 NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. . 14 - I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME LENDER'S ADDRESS________________________________________________________ Es APPUCANT10ERTIFlcATION .'.' ;gjgL I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. .1 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 5'O deep and demolition or construction of structures over 3 stories- in height, EXPIRATION: Every permit issued by the,Biiljdng 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 c9sfOpncod within 3#9 days from the data of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the wg,t ( ommenced fqØ period of 180 days (Section 106.4.4 Uniform Building Code). / APPLICANT'S SIGNATURE DATE ' WHITE: File YELLOW: Applicant PINK: Finance - CITY OF CARLSBAD INSPECTION REQUEST PERNIT# CB970867 FOR 04/15/97 INSPECTOR AREA DESCRIPTION: GAS LINE TO BBQ PLANCK# CB970867 OCCGRP TYPE: PLUM CONSTR. TYPE NEW JOB ADDRESS: 1377 NIGHTSHADE RD STE: LOT: APPLICANT: REESE, DONN PHONE: 619 728-9235 CONTRACTOR: PHONE: OWNER: - PHONE: REMARKS: RS/728-9235 INSPECTOR SPECIAL INSTRUCT: - - TOTAL TIME: CD LVL DESCRIPTION - ACT COMMENTS 23 PL Gas/Test/Repairs - INSPECTION HISTORY DATE DESCRIPTION ACT INSP COMMENTS