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HomeMy WebLinkAbout1226 PLUM TREE RD; ; CB982113; PermitB U I L D I N G 07/06/91:l 12:56 P E R M I T Permit No: CB982113 Pro1ect No: A9802794 Development No: Page 1 of 1 Job Address: 1226 PLUM TREE RD Permit Type : MECHANICAL Suite: Parcel No: 214-543-35-00 Valuation: o Lot#: Occupancy Group: Reference#: Descriptjon: INSTALL 2 NEW A/C UNITS-NO : NO ELECTRIC Appl/Ownr : LAKE ELSINORE VALLEY HEATING & 16502 NECTARINE WY LAKE ELSINORE CA Fees Requ1red k*~ Fees: Adjustments: Total Fees: Fee description Enter 'Y' for Mecha i Install Furn/Ducts/ 9 2 5:....:3;...;0......-~~ 909 Construction Type : NEW Status: ISSUED Applied: 07/06/98 Apr/Issue: 07/06/98 Ent E ri:->< By· RMA 6 7 4 -7 8715 07 /06/98 0001 01 02 C-PRMT IT Credits .00 .00 33.00 *** Ext fee Data 15.00 Y 18.00 PERMlT HAS EXPIRED IN ACCORDANCE WITH u.a.c. SECTION 106.4.4 / . DAlE rJ / u / qCf SIGNATURE J:-j& • J 1 FINAL AP F l 10VAL INSP. _____ DATE ____ _ CLEARANCE ________ _ CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92()()<) (619) 438-1161 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. 9fl :2__/ l:J CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. __________ _ Plan Ck. Deposit ___ ,.....,,. _____ _ 1. PRo.iECT INFORMATION Address (include Bldg/Suite #) h Id-,,).. v,, f?l 4= ~ Business Name (at this address) Ltga1 Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use Proposed Use Description f ork iJ_./ _ d,-~FT. CONTACT PE~ ~ J;;ient from applicant} ~ # of Bedrooms # of Bathrooms Name 3. Address ~ontractor O Agent for Contractor State/Zip Telephone # Fax # . 1/e---'J, 7b 9 ? ?q' ""? l-"2- Telephone# 4-~o/ERTYOWN~R ~~re f i Jf/i I ( ..},---J2.). (p Name Address 6. CONTRACTOR • COMPANY NAME (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, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged JXemption. ,ny violation of Sect(o/' 703 by any applicant for a permit subjects the ap~can! to a civil penalty 9f not mo!.O, than five hundred dollars [$5001). /\< k;. ,..15>~ .,, t:. //a./te..-. ,:. L /Veuii..,,.,1-..u,J,._ ,,I., e. ~ · .,.,,., ,,Q-_, a Name Add ess City State/Zip Telephone# '7c:>:;'6>r 7Z i-2- State License # b I/JI</ 2-. License Class L -2 c:> City Business License # _______ _ Designer Name Address City State/Zip Telephone State License # _________ _ 6. WORKERS' COMPENSATlON Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: O 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. 0 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 _______ _ TION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) CERTIFICATE OF EXEMPTION: 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 Workers' Compensation Laws of California. WARNING: Failure aecur w rkars' co ensatlon coverage la unlawful, and ahall subject an employer to crlmlnal penaltle■ and clvll fine■ up to one hundred 00,0 compensation, damages as provided for in Section 3706 of the~? :ode, ~•t and attorney's fees. DATE 0~? ~ 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 (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply t o 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). 0 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). 0 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. 0 YES ONO 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 license number): 4. 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): ______________________________________________ _ 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 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 Act7 0 YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site7 0 YES O 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. ,8. CONSTRUCTION LENDING AGENCY 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 . 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 City ordinances and State laws relating to building construction. I hereby authorize representatives of the Citt 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 5'0" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued b u ding Official under the provisio s of this Code shall expire by limitation and become null and void if the building or work authorized by such permit i ot com need within 365 days from d of such permit or if the buildrng or work authorized by s?ch p rmit is suspended or abandoned at any time afte"r e work is ommen~ for a · 18 d (Section 106.4.4 Uniform BuildinDgACToEde). ?k /~ APPLICANT'S SIGNATURE t-=~ez..,.-:i~~,,?-.~:.._-,iA~c....£.;;,_____________ _.._/.,._7 ___ C,,~,L.Z_'---',..__......,_ _____ _ W ITE: Frie PINK: Frnance