Loading...
HomeMy WebLinkAbout1701 CARISSA WAY; ; CB983546; Permiti^"-<tft( 10/15/98 15:06 BUILDING Page 1 of i Job Address: 1701 CARISSA WY Permit Type: PLUMBING Parcel No: 215-881-02-00 Valuation: 0 Occupancy Group: Reference*: Description: GAS LINE TO BBQ, ELEC TO BBQ : AND PORTABLE FOUNTAIN PERMIT Suite Lot#: Permit No: CB983546 Project No: A9804616 Development No: Appl/Ownr KIMO'S LANDSCAPE P O BOX 230860 ENCINITAS CA 92023 Construction Type: NEW Status: ISSUED Applied: 10/15/98 Apr/Issue: 10/15/98 Entered By: BT 801-7102 Fee Adjustment 54 Fee description Credits 2309 10/15/98 «X>1 01 02-™ »• V^XS'l- ;> • j^ %.•7 » v -v «4 t '• - ,' * Enter "Y" for PlunfB Gas Piping System Other f<f "3 p-Wir »*«,„_ tt^, I*ku* Fee > > > 2 20. 00 -— :T V.-^«'/ »-"v ^ ice LJctua 20.00 Y 14.00 7 n nn PT c-r- FINA INSP. CLEARANCE, ROVAL DATE CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION T CITYTOF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 1, PROJECT FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated Bv Date «\ Address (include BIdg/Suita »)Business Name lat this address) Legal Description Let No.Subdivision Name/Number Unit No.Phase No.Total * of units Description of Work 2. CONTACT PERSON Of drr * of Bstnrooms tVA, N«ma 3. APPLICANT Address ^1 City I Contractor O Agent tor Contractor ' O Owner Q Agent for Owner ~ -Z-?o£(af> State/Zip Telephone *Fax* Name 4. PROPERTY OWNERt>a Address City State/Zip Telephone /f Name Address Crty State/Zip Telephone » B. CONTRACTOR - COMPANY NAME "^^'._ .. (Sac. 7031.5 Business end Professions Code: Any Crty or County which requires • permit to construct, after; improve, demolish or repair any structure, prior to Its issuance, also requires the applicant for such permit to We a signed statement that ha 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, end the basis for the aUeged exemptio/v Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a etvH penalty of not more than five hundred dollars 1*5001). Name State License * Address License Class City CrryBu ,»» Stete/Zip .• Telephone * Designer Name Address City State/Zip State License t 6. WORKERS'COMPENSATION ................ .-._-_ ........ .... Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D 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. D I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, tor the performance of the work for wMch this permit is issued. My worker's compensation insuranca.camer and policy number are: ., Insurance Company ^^ ^~*> <V^V Policy No. C-Y^ 9 ~~ TV % ^7 "° ^Expiration Date H-?- (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS I* 1001 OR LESS) D CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shaN not employ any person hi any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Fallure>lo secure workers' compensation coverage is unlawful, and aha* subject an employer to criminal penalties and ervU fines up to on* hundred thousand doUarp^UW.OW). In addltth toitjjl cost of compensation. Damages aa provided for hi Section 3706 of the Labor e6do. Interest and attorney's fees. OWNER-BUILDER DECLARATION ' ' "-'"•'• / '\t^t^- •••' ..-••»••,'-• •- • - I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D I. ss owner of the property or my employees with wage* as their sole compensation, will do the work and the atructure la 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 sate. If, however, the building or improvement I* sold within one yeer of completion, the owner-builder will have the burden of proving that he did not buHd or Improve for the purpoee of eate). Q I, as owner of the property, em exclusively contracting with licensed contractors to construct the project (Sac. 7044, Business and Professions Code: The Contractor's License Law does not apply to en owner of property who buUds or improves thereon, and contracts for euch project* with contractorls) licensed pursuant to the Contractor's License Law). D I am exempt under Section Business and Professions Code for this reason: 1. I personally plan to provide'the major labor and materials for construction of the proposed property improvement. Q YES QNO 2. I (have / have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors Kcanae number): 4. I plan to provide portions of the work, but I have hired the following pi number / contractors license number): ^^^^ 5. I will provide some of the work, but I have contracted (hired) the following parson* to provide the of work!: >» .. /I to coordinate, auperviee and provide the major work (include name / address / phone irk Indicated (Include i / •ooftMS / phone number / type PROPERTY OWNER SIGNATURE COMPLETE THIS SECTION FOR DATE BUtLDMQ PERMITS OMIY"""'""" * -*— Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials regjstrati program under Sections 25S05. 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES —"ISA. r. >'«»•>•'.-*•, .-.. n form or risk management and prevention D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? O YES D 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. i8. CONSTRUCTION LENDING AGENCY " "" -. ~ VT-V«T!», „,,..,..,.-.,,.. „_,..,.._._, 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 '9. APPLICANT CERTIFICATION -,---,-—...„ ,~,.^. ,.,-,...,._..—,,,-,-,,, ,.^T,^,. .,. ,^^,,_„,_,,, 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. I agree to comply with all Crty 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 5'0W deep end demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the BuHding Official tinder 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 at any time after r ' ' " — . — . » ' «*• APPLICANT'S SIGNATURE ~jt • — — — _—r_ ...... .,._ «.v Hi erwMK pvjisaeit wi M IIIV UUIIUIIIU Ul WUf r the^ork is^pmmime^t for^ period of 180 days (Section 106.4.4 Uniform Building Code)./<— r* rt—- / DATE WHITE. Fita YELLOW: Applicant PINK: Finance City of Carlsbad Inspection Request For: 1/13/99 Permit# CB983546 Description: AND PORTABLE FOUNTAIN 1701 CARISSAWY Lot Type: PLUM Sub Type: Job Address: Suite: Location: Tract: AND PORTABLE FOUNTAIN APPLICANT : KIMO'S LANDSCAPE Owner: Remarks: Inspector Assignment: Phone: Inspector: Total Time: CD Description 29 Final Plumbing 39 Final Electrical Requested By: JIM Entered By: CHRISTINE Act, Comments CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB983546 FOR 10/19/98 INSPECTOR AREA DESCRIPTION: GAS LINE TO BBQ, ELEC TO BBQ PLANCK* CB983546 AND PORTABLE FOUNTAIN OCC GRP TYPE: PLUM CONSTR. TYPE NEW JOB ADDRESS: 1701 CARISSA WY STE: LOT: APPLICANT: KIMO'S LANDSCAPE PHONE: 801-7102 CONTRACTOR: PHONE: OWNER: PHONE: REMARKS: R/KIM/801-7102 INSPECTOR SPECIAL INSTRUCT: TOTAL TIME: —RELATED PERMITS— PERMIT* TYPE STATUS CB973740 CONDO ISSUED CD LVL DESCRIPTION ACT COMMENTS 23 PL Gas/Test/Repairs 31 EL Underground/Conduit-Wiring ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP COMMENTS DO \d CERTIFICATE (DP LIABILITY fNSURANOE DATE (MM/DD/YY) 03/17/1998 PRODUCER C209) 297-9484 FAX (209)297-4558 I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION andean*. Tonrrarl-nrc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE.anascape contractors HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Insurance Services, Inc. [ ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 400 Bullard j CpMPANIES AFFORDING COVERAGE Clovis, CA 93612 f COMPANY ' ""Frefrfb'rit Compensation Insurance Attn: Ext: sb I A 'NSURED Kimo's Landscaping P.O. Box 230866 Encinitas, CA 92023 : v» : COMPANY D COVERAGES > '^ ' - — -— - ^ — — — , -7- — , 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. CO TYPE OF INSURANCE '• DnMr v u. luocB ; POLICY EFFECTIVE I POLICY EXPIRATION: _«LTR TYPE OF INSURANCE : _ POLICY NUMBER _ i DATE (MM/DO/YY) ; DATE (MM/DO/YY) : _ _ LIMITS GENERAL LIABILITY ! I i GENERAL AGGREGATE IS COMMERCIAL GENERAL LIABILITY ! I | PRODUCTS - COMP/OP AGO | I /; CLAIMS MADE i | OCCUR i ' j i ; PERSONAL & ADV INJURY [j OWNER'S & CONTRACTOR'S PROT I III' EACH OCCURRENCE I $ i ; ! FIRE DAMAGE (Any one fire) is . J _ j _ i _ MED EXP (Any one person) \ S AUTOMOBILE LIABILITY : I I .....;. • :' : • ' ; COMBINED SINGLE LIMIT :JANY AUTO ; : : | "ALL OWNED AUTOS | j j "eobiLY INJURY ..................... I, ; SCHEDULED AUTOS \ \ ; ; (Pw person) j ....... :H'*EDAUTOS | i - i i'toD^'tNJURY ..................... [" NON-OWNED AUTOS : j ; ; (Per accident) : ............................................ : j i ; PROPERTY DAMAGE JS GARAGE LIABILITY ! II AUTO ONLY - EA ACCIDENT : S ANY AUTO ; 11; OTHER THAN AUTO ONLY: '•• ; I ; I E ACH ACCIDENT 1$ _ ! _ I _ I _ AGGREGATE; S EXCESS LIABILITY I ' : j • EACH OCCURRENCE : $ I UMBRELLA FORM I j i AGGREGATE I S •' OTHER THAN UMBRELLA FORM j i ; ! $ WORKERS COMPENSATION AND i '' '• ! ! X : TORY^InTS 'W' ^ ^98-748497-01 i 04/01/1998 I 04/01/1999 ; -^HACODENT I , 1.000.000 :|NCLI i i i.EP!***:.^*?.!^...;' .......... ^000,000 OFFICERS ARE: _ X ; EXCL i _ ! _ ; _ EL DISEASE - EA EMPLOYEE j S 1 , OOP , OOP OTHER ! •.':'• ESCRIPTION OF OPERATIONSn.OCATIONS/VEHICLES/SPECIAL ITEMSLicense #418720 his Certificate Revises Certificate Dated 03/14/98 Contractors State License Board Workers Comp Unit P.O. Box 26000 Sacramento, CA 95826 CANCELLATION ; , SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHA/.L IMPOSE NCvBegGjVTION OR LIABILITY OF ANY KIND UPON THE COjRPANYm^AGENTS OR REft(ES34TAT|VES. AUTHORIZED REPRESENT*