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Home My WebLink About201 GRAND AVE; ; CB960050; PermitSuite BUILDING P E R M I 01/10/96 13:23 Page 1 of 1 Job Address: 201 GRAND AV Permit Type: PLUMBING Parcel No: 203-232-15-00 Lot*; Valuation: ° Occupancy Group: Reference*: Description: REPAIR SEWER LINE Permit No: CB960050 Project No: A9600094 Development No: 5^61 0:.,-iO/9t OOCi 01 C? Construction TJyjRpT NEW T.. ,;;,;< Status: ISSUED Applied: 01/10/96 01/10/96 DC Apr/Issue Entered By Appl/Ownr : GARNER MARQUE CONSTRUCTION 2973 CARLSBAD BLVD CARLSBAD, CA 92008 *** Fees Required *** 619 434-4350 Fees : Adjustments: Total Fees: Fee description Enter "Y" for Plu Each Building Sew * PLUMBING TOTAL llected & Credits *** .00 . 00 35.00 Ext fee Data 20.00 Y 15.00 35.00 PI £££>/'MPT"ULLHiihi Jl/L. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Palms Dr., Carlsbad, CA 92009 (619) 438-1161 From List 1 (see back) give code of Permit-Type: For Residential Projects Only: From List 2 (see back) give Code of Structure-Type: Net Loss/Gain of Dwelling Units PLAN CHECK NO. EST.VAL PLANCK DEPOSIT. VALID. BY ~_ DATE 2. PROJECT INFORMATION FOR OFFICE USE ONLY -Address Nearest Cross Street Building or Suite No. LEGAL DESCRIPTION Lot No.Subdivision Name/Number Unit No.Phase No. CHECK BELOW Ir SUBMITTED: D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USR PROPOSED USE DESCRIPTION OF WORK SQ.FT. -Sc» V/? ^ # OF STORIES # OF BEDROOMS # OF BATHROOMS 3TUUNIAL.J FLJtwJN (jr ditterent rrom applicant; NAME (last name first) CITY STATE ADDRESS ZIP CODE DAY TELEPHONE U CONTRAC. ITJR U AGhN I FOR CON 1RACTOR U OWNER U AGENT FOR OWNER NAME (last name first) ADDRESS CITY STATE ZIP CODE DAY TELEPHONE S. PROPERTY OWNER NAME (last name first) CITY t / /7 STATE ZIP CODE DRESS DAY TELEPHONE ercONTRACTOR NAME (last name first) CITY DESIGNER NAME [last name first) ADDRES /?&ZIP CODE ' DAY TELEPHONE STATE LIC. #LICENSE CLASS CITY BUSINESS LIC. # ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. # 7TWORKERS' COMPENSATION Workers Compensation Declaration: I hereby affirm that I nave 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). INSURANCE COMPANY POLICY NO.EXPIRATION DATE Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I snallriot employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. SIGNATURE DATE BrtJWNER-BUILDER DECLARATION Owner^DUilder Declaration: I hereby atnrm that t am exempt from tne Contractors License Law for tnelollowing 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 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 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 [$500]). SIGNATURE DATE COMPLETE THIS SECTION FOR 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 25534 of the Presley-Tanner Hazardous Substance Account Act? P 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 district? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES Q 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. CUNSTHUCJTTOH LENDING AUEHCY ~~~ 1 hereby attirm that thereTs a construction lending agency tor the performance or me work tor wnich this permit is issued (Sec 3097U) Civil Code). LENDER'S NAME LENDER'S ADDRESS CbKllf'lUATIUN 1 certity that 1 have read che application ana state that the above imormation 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 properly for inspection purposes. IALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAWST Ali IIABILITIES, 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 5'0" deep and demolition or construction of structures over 3 stories 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/j? 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^ny time aftejxhe wqriflg'commenced for a period of 180 days (Section 303(d) Uniform Building Code). APPLICANT'S SIGNATURED ^*, * _ S? J s&y^,^*. - J——— DATE: File PINK: Finance PERMIT! CB960050 DESCRIPTION: REPAIR SEWER LINE TYPE: PLUM JOB ADDRESS: 201 GRAND AV APPLICANT: GARNER MARQUE CONSTRUCTION CONTRACTOR: OWNER: REMARKS: MW SPECIAL INSTRUCT: CITY OF CARLSBAD INSPECTION REQUEST FOR 01/11/96 INSPECTOR AREA PLANCKf CB960050 OCC GRP CONSTR. TYPE NEW STE: LOT: PHONE: 619 434-4350 PHONE: PHONE: INSPECTO; TOTAL TIME: —RELATED PERMITS—PERMITI TYPE AS950034 ASTI CB950632 MISC CD LVL DESCRIPTION 22 PL Sewer/Water Service STATUS ISSUED ISSUED ACT COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS City of Carlsbad Building Department WORKERS' COMPENSATION DECLARATION hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self-insure for A. 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 ™ B. of 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: (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. Signaturc^^^^^y^^^^^^Pate 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-O894