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Home My WebLink About1012 TULIP WAY; ; CB970706; Permit• V e n #: A t A E t Fl~ INSµ _,/4 DAT -----· -- CLEA~ lANCE __ ~~~~ CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (6 19) 438-1161 PERMIT APPLICATION FOR OFFICE USE ONLY PLAN CHECK NO . C/-Z./fa)6 CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 EST. VAL. __________ _ ~c:r.1Na>RM4TJPN_::,,.,;.J:"' .... :..:r:.":l.~:·:i.z.:·~~,::._,~.:.;-:~:;:ili,;;;ti-:•;1iai""""':;;-~MIW"; .... iil·lii-i:·~~ .. ~~il~i•~· /o/2--r..n., 1 P WA'1 Plan Ck. Deposit :3' '7. ()() Validated By £,?t..,._ Date ~/2--7;/i 7 Address (include Bldg/Suite II ftf,4 p. ~ '-Is, Business Name (at this address)(" c,4.~1.S"A-D ..,,."{4ct -JI. 7.J-3,, vPINAJeX~A. H1<,<: U!f1rJ Subdivision Name/Number 'unit No. Phase No. Total I of units Legal Description Lot No. Assessor's Parcel I Existing Use Proposed UH .211./-t/;o -1 I S'"FD, s ,!I& Z> . Description of Work SO. FT. lot Stories I of Bedrooms If of Bathrooms ~-CONTACT PERSON (If diffeAll'lt from appllc:ant11 •: ~:_;-: • State/Zip Telephone I Fax, 4 _.,.~ .... CAA4[~Al> (,,q 9ZP09 State/Zip Telephone I 'jfil:~:~~~ ..,,;._, Name Address City State/Zip Telephone I .. ~NTM0MlbCC>lftf (Sec. 7031.5 Business and Professions Coda: Any City or County which requires • 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 provisiona of the Contractor's License Law [Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he la 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• civil penalty of not more than five hundred dollars [$6001). Name Address City Stete/Zlp Telephone I State License I _________ _ License Class _________ _ City Business License I _______ _ Designer Name Address City State/Zip Telephone State License I _________ _ L ~b .. W.OJIKERS' 1:0MPENSATION,i,~~-·.,.• .. ::~t;iC.-~;jLq.. _ __.. ... ~ ~-'"-<.~,w..:~·f ~c\t;~ 1.:$Ffitt!.,V·?f#:iz;?~~~~~ ... t;·~t~ .... /! .· -" ~ ......... Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain a certificate of consent to aelf•insure for workers' compensation H 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 la 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 l$1001 OR LESS) O 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 eny manner so es to become subject to the Workers' Compensation Laws of California. WARNING: Failure to Hcure•worltera' compensation coverage ia unlawful, and shall subject an employer to criminal penalties and dvll fines up to one hundred thousand dollars ($100,000), in addition to the coat of compensation, damages as provided for In Section 3706 of the Labqr code, interut and attorney's fNs. SIGNATURE______________________________ DATE _________ _ 7 .. OWNEJAIULDER DECLARATION . .,,"._,.j.-7.. •• 'if,:'.;S.Y.:~-~;Ki_. ·;;.f/, '-~::i..',, 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 a■le (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 purpoae of Hie). 0 I, as owner of the property, am exclusivaiy contracting with licensed contractors to construct the project (Sac. 7044, Buaineu and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves theraon, and contracts for euch project• with contractor(s) licenHd pursuant to the Contractor's Ucanse 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 (firml 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 / address / phone number / contractors license number): ______________________________________________ _ 5. I will of workl: PROPER j;Q~JHIS'SECTION..FOR N,O .• ..... ' --------' ' •• -.l,g,'t..,;! 'I£. t,, tl,~ o;,plic:::it or future t:uildir,,; occupant requor,N ,.:> ;;ul;mit a bu~ineu µian, acutely haurdoua materials reg1strat1on torm or risk management and prevention program under Sections 26505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Acc.:>.mt Act7 0 YES O NO Is the applicant or future building occupant required to obtain • permit from the air pollution control district or air quality management district 7 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 ANAL CERTIACATE 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. J8t. ~-CONSTRUCTION LENDING AGENCY '~ ' ~~~~~•~.,.-~,..,' •• --f:T, ..•• ~:. "!::'i,~~~~~'™'~~j[)'~, , -;,; . I hereby affirm that there 1s a construction lending agency for the performance of the work for which this permit ia issued (Sec. 3097(i) Civil Code). LENDER'S NAME ----------------19. 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 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 6'0" deep end demolition or construction of structuraa 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 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 the k is commenced for• peri of 1 BO days (Section 106.4.4 Uniform Building Code). IJ • APPLICANT'S SIGNATURE DATE PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB970706 FOR 04/21/97 DESCRIPTION: MOVED INTERIOR WALL 18" TO ENLARGEN FAMILY ROOM TYPE: MISC JOB ADDRESS: 1012 TULIP WY STE: INSPECTOR AREA PLANCK# CB970706 OCC GRP CONSTR. TYPE NEW LOT: APPLICANT: MELLIESINOS, CAROLYN CONTRACTOR: PHONE: 619 931-1636 OWNER: REMARKS: RS/RAY NEAL/748-2917 SPECIAL INSTRUCT: TOTAL TIME: LVL DESCRIPTION PHONE: PHONE: /7 ;f _:=- INSPECTO~~Q.~r'l~:z_~~~:::=__:=::::::::--- ACT COMMENTS CD 19 ST Final Structural AiJ ___ 17---- ***** INSPECTION HISTORY***** DATE DESCRIPTION ACT INSP COMMENTS 04/23/97 INSPECTION HISTORY LISTING FOR PERMIT# CB970706 DATE INSPECTION TYPE 04/21/97 Final Structural 04/21/97 Final Structural HIT <RETURN> TO CONTINUE ... INSP ACT COMMENTS RI RI RS/RAY NEAL/748-2917 PD AP I l w r r /> "J ·i: - • , r · ·1 -1 : -· ~ 1. . , ' - 0 /t, -= ... /.~, ~- i f r• L t ,, rt - ' ) w. : . y d q