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HomeMy WebLinkAbout1530 JEANNE PL; ; CB971884; PermitPERMIT HAS fXPIREO IN ACCORDANCE WITH U.B.C SECTION 303 (d/ 01= . 1 DATE ____ SIGNATURE---~_..,....._ __ _ RNAL APPROVAL . ~SP. ___ DATE __ . _·LEARANCE _____ ,_, CITY OF CARLS~~~ (619) 438-1161 2075 ., Las Palrnas Dr Carlsbad, CA • FOR OFFICE USE ONLY -'ERMIT APPLICATION PLAN CHECK NO. CfJjtyL( CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Pal mas Dr., Carlsbad CA 92009 (760) 438-1161 1. PROJECT INFORMATION /530 ,7Z(/dNc A. Address (include Bldg/Suite II Buslneu N1m1 (1t this address} • Legal Description Lot No. Subdivision N1m11/Number Unit No. Ph1111 No. Total I of units Existing U11 ~ 31 ~~ (!,dZ<!µ.,1.r Proposed Use E dLLT -UXJ g>-U Wc!e- SO. FT. I of Be rooms I of Bathrooms Name Addr111 City St1t1/Zlp Telephone I Fu I ~:,-1 '·A~Pi.J;;Nf ·~~~]_8r:.?:IO~~i~liliiri~9lz•cr,,: · ~~;~1~F$/~~~~r;;11 ' ! ·' · ~ ~ .. ~ ;:;;6 z .s Name Addr111 City St1t41/Zlp Talephon1 I ·•Jl":;~RfYWt~t~1nw)_;~~'~n~5)i!~h-:rµ~&:; ~-~~e~~~-~~7;;:~~~;~ Name Address City ' State/Zip Telephone I '6. ···coNTRACTOli :. COMPANYiNAME~~~--~·o...7~~~~:~.!i£1-"'-••-.,. ::-~~; ·:"x... ...... ':~4 :fr•Y~~·--;~..'i~~-:-~~-~:-::-.:1~~~~~:~-·t "'!~<; ~~.,. :-:.~· · (Sec. 7031.5 Business ind Profe11ions Code: Any City or County which requires • permit to con■truct, alter, lmprov1, d1molish or repelr any structure, prior to Its Issuance, also requires the applicant for 1uch permit to fil■ • 1igned tt■t■ment that he Is licen■ed pursuant to the provl1ions of the Contractor's License Law !Chapter 9, commending with Section 7000 of Dlvllion 3 of the Buliness and Profe11ions Code! or that he ls exempt therefrom, ■nd the b11is for the alleged exemption. Any violation of Section 7031.5 by any 1ppllc1nt for• permit aubj■cts the ap icant to a civil penalty of not more than five hundred dollars 1$60011. eci ,.,.e_ )l/,E~/e,,/1., /,.2 U) 42 ~ds~ . I, 9 2 G /9-'t/-63L Name State License I -=(;~,t'.~/~O~g'~Lj __ Address Llcensa Cl11s __ C __ z._o ___ _ City State/Zip Telephone I City Business Ucansa I / pLC J/? ¥ ~ Designer Name Address City State/Zip Telephone State License I ________ _ 8. WORKERS' COMPENSATION •• I .... •1 :-----; :'.,,.."L·'1.r. ~ r-r:-~•· .•• ,.-',:r -.... ,1. Workers' Compenutlon Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain a certificate of consent to self-insure for workers' compensation II provided by S■ction 3700 of the Labor Code, for the performance of the work for which this permit Is issued. 0 I have and will maintain workers' compensation, 11 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 ■re: Insurance Company____________________ Policy No.____________ Expiration Date _______ _ (THl~CTJON NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS IUOOI OR LESS} [B"'" CERTIFICATE OF EXEMPTION: i" certify that In the perfo~mance of the work for which this permit is issued, I shall not employ any person In ■ny manner so as to become subject to the Workers' Compen11tion Laws of California. WARNING: Failure to 11c:ur1 worll■n' tlon covarega le unlawful, and ah■I IUbjaet ■n amployar to crlmklel pan■ltlaa ■nd clvll fin■• up to one hundncl thousand dollar• 1•100,00 , In _.lltlli...-i, ■t of compensation, d■magae u pn1vlded for In Section 3708 of the Labor code, lntarast ■nd attorney'■ fN■. SIGNATURE __ ~'-'---4---"-J..S,.~~4--------------DATE 7,.//-?'(Z 7. OWNER-BUILDER DECLARATIOt.f ·-,-:. : .. · •.·· • •• ._., ' ---· .. ·-. ·• · •. ·•• -.: :;:;,;. ;-,r~ · • · . -;;•·f "" ,. ·:·,~ I hereby.affirm that I am exempt from the Contractor's License L■w for the following reason: 0 I, as owner of the property or mv employees with w1g111 11 their sole compensation, will do the work and the structure Is not Intended or offered for sale (Sec. 7044, Business ind Prof■ssions Coda: 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 employNs, provided that auch lmprovem■nts are not Intended or offered for 11111. If, however, the building or Improvement Is sold within one year of completion, the owner-builder will have th■ burden of proving that he did not build or Improve for the purposa of 11le). 0 I, 11 owner of the property, ■m excluslv■ly contracting with llcansad contractors to construct the proj■ct (Sec. 7044, Business ■nd Professions Coda: The Contractor'■ License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(sl licensed pursuant to the Contractor's Ucansa Law). 0 I am exempt under Section ______ Business and Professions Code for this rt1son: 1. I personally plan to provide th• major labor and m1teri1ls for construction of the propo■ed property improvement. 0 YES ONO 2, l (have / have notl signed an application for ■ building permit for the proposed work. 3. I have contracted with the following peraot'I (firm} to· provide the proposed construction (Include name / address / phone number / contractors licensa number): 4 . I plan to provide portions of the work, but I have hired the following person to coordinate, supervi■e and provide the major work (Include n■m■ / 1ddra11 / phone number/ contractors Ileen■■ number}: ____________________________________________ _ 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work Indicated (include name / address / phone number / type of work}: ______________________________________________________ _ PROPERTY OWNER SIGNATURE______________________ DATE _________ _ /COMPLETE THIS SECtiON FOR N<J/MtsliJENtW!iOILbiNO PEiiMlfJ'.ciNt.f.i.W,:T!Jt.~'!6 P1f:!!'L';:':; · :~:1~-~'!·'ffil'i~iffli1•1Wl"l:t1~i~:"".-:r:"':1r,:r~~•l'~'i'!~l:"!i:1:;, 11 the applicant or future building occupant r■quired to submit • business plan, ecut■ly huardous m■tariala registration form or rlak management and prevention program under Sections 26505, 25533 or 26634 of the Pr■sley-TaM■r Hazardous Substanc■ Account Act? 0 YES O NO Is the applicant or future buldlng occupant required to obtain e permit from the air pollution control district or air quality management district? 0 YES O NO ls the facility to be constructed within 1,000 feet of the outer boundary of e school lite 7 0 YES O NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIF1CATE OF OCCUPANCY MAY NOT IE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFF1CE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. la.. CONSTRUCTION UNti1NirAGENCY7''":::-,:,... .. :;''•Jj;_~~;:?'~~!'r":"!'::~ ~!!'17"~~•":""'. ·1~:'.':•-,,,..::;a1·;'·".:'"?;'..i, '•"t •.~---~'."'''.''~r:··, . ',, ':'.°!", ;;.~ ...... ~ 't ,;. l hereby affirm that there is I construction landing agency for the performance of the work for which this permit le Issued (Sec. 3097(11 Civil Code}. LENDER'S NAME _____________ _ LENDER'S ADDRESS ______________________ _ l certify thet l have read the application end 1tat■ thet the above Information ls correct ■nd thet the lnfonnatlon on the plan■ le ■ccurata. I agrH to comply with ■11 City ordinances end State law■ relating to building construction. I hereby authorize rap,nent1tiv11 of the Cltt 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 6'0" dNp and demolition or construction of structur11 over 3 stories In height. EXPIRATION: Every permit Issued by the Building Offlc ovislone of this Code shill axplre by limitation ■nd become null and void If the building or work authorized by such permit Is not commenced withl m the data of 1uch permit or If the building or work authorized by such permit is suspended or abandoned at any time after he Is commenced for Madallf-1§ d1ys (Section 108.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE 7 -//-97- CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB971884 FOR 07/16/97 DESCRIPTION: INSTALL 3 TON A/C, 30 AMP CIR CHANGEOUT 75000 BTU FURNANCE TYPE: MECH JOB ADDRESS: 1530 JEANNE PL STE: INSPECTOR AREA PLANCK# CB971884 OCC GRP CONSTR. TYPE NEW LOT: APPLICANT: COASTAL AIR MECHNICAL CONTRACTOR: OWNER: REMARKS: C/JULI0/729-6276 SPECIAL INSTRUCT: ~:~~c:::._4_8~~~--0_3_2_1 _______ _ TOTAL TIME: ~,~· CD LVL DESCRIPTION ,· ACT _;tOMMENTS _4_3_ M_E _A_i_r_c_o_n_d_f_FU_r_n_a_c_e_s_e_t _______ fi :#6¥T-~/l,J (A./ee/17t/JL, il5£!'J) ------------------ ------------------ ***** INSPECTION HISTORY***** DATE DESCRIPTION ACT INSP COMMENTS