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Home My WebLink About2550 UNICORNIO ST; ; CB973362; PermitB U I L D I N G P E R M I T Permit N : 'B973362 Project Ne : A9704 3 .H Development l\J"): 11/04/97 09:13 Pctge 1 of 1 Job A~dress: 2550 UNICORNIO ST Permit Type: MISCELLANEOUS Parcel No : 215-280-24-00 Valuation: 2,880 Suite : Lot#: Occupancy Group : Reference#: DeGcription : REROOF 3000 SF , COMPOSITION Appl/Ownr : CAHEY CUSTOM ROOFING 3048 VIA MARIPOSA CARLSBAD, CA 92009 AAA Fees Requ i red **k Fee~: Adjustments : Total Fees : Fee description Miscellaneous Fee * MISCELLANEOUS T 760 L CITY OF CARLSBAD 1069 U/04/97 0001 01 C-PRHT 02 Construction rype· NE~ ~-00 Status: ISSUED Applied: 11/04/97 Apr/Issue: 11/04/97 Entered By : JM 591-3123 t .00 .00 89 .00 Ext fee Data 89.00 PERMIT FE 89.00 2075 Las Palrnas Dr., Carlsbad, CA 92009 (619) 438-1 161 FOR OFFICE USE ON PERMIT APPLICATION PLAN CHECK NO ·"""T1-.+---"-"'--=-"'-- " CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (160) 438-1161 Validated By_...(...+.L.!~-.,.....,~-:"7'=- Date, _______ __.~4----t'H--+~ 1. PROJECT INFORMATION Address (include Bldg/Suite I ) Business Nama Cat this addrusl 2.,£,S:0 \J N , C.. Q < ...:. , \,) Legal Descro,etion 0 y \?--- Lot No. Subdivision Name/Number Unit No. Ph■se No. Total I of units Assessor's Parcel I ~ ~\)~ ~ Existing UN E \'L ~()()0 Description of Work Proposed UH SO. FT. lof Stories I of Bedrooms I of Bathrooms 2. ·coNTACT PER.SON Cit different fioin ai,picinH Name Address City Stata/Zip Telephone I Fax • ,3 . APPLICANT \3 ,\µ_.,) Name .0" Contractor C ; e:::h r .., 4. P~ERTY OWNER .\'.S \' \ \.\ u..r n.$ Name D Agent for Contractor ~o~~ \) u-- Address Address s. CONTRACTOR· COMPANY NAME .. -. -□ owner-:o A;em ioi 0wne, ·•· -··. t\ 4o f>P .,( CV L IJ,. C Q .1 \-().., City State/Zip Telephone I \..,u,.. (l15.}-{A__ City State/Zip Telephone I (Sec. 7031.5 Business and Professions Code: Any City or County which requiras 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 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 (tSOO)). C.e,\r.li;'."i V.,:>o .h.Jrt ':3!2'1 '0 \J Jv-, til!:-Opc.ScJ,.J lu.. l o,p v-.-s:c,1.-112J Name Address City State/Zip Telephone I State License I S £) ':::\ !i\o 2,. License Cl■11 ( -3 (1 City Busines1 Lie-. I _______ _ Designer Name Address City State/Zip Telephone State License I _________ _ 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following d•cla11tions·, --·--~ ., ..... •!- O I have end will maintain a certificate of consent to Hlf•lnsure for workers' compenaation H provided by Section 3700 of the labor Code, for the performanc• of t~ork for which this permit is issued. • .EJ I have end 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 •nd policy number are: Insurance Company ~ jy---1' l ~ v ~ Q Policy No. ½ 'Y L,' t:I l Expi11tion Date _______ _ CTHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1•1001 OR LESS) D CERTIFICATE OF EXEMPTION: I certify th•t in·the performance of the work for which this permit ii iasued, I lh■II not employ eny person In any manner 10 es to become subject to the Workers' Compensation Laws of California. WARNING: Failure to aacur• workers' compenaetlon coverage la unlawful, and ahd aubjec:t an •mployer to crtmklal ,,....itlN end clvU fines up 10 one hundred thou1■nd dollars Ct100,000I, In addition to the coat of compenaatlon, darnegn N provided fOf In Section 3706 of the labor code, lnt-t and attorney·, fees. SIGNATURE 3 ,>d !°\ L~ DATE \ \,.. "1 • C,] 7. OWNER-BUILDER DECLARATION ••. ' • , .. : .. , ........ : ".:7'\'.;,';,,,,,...,, •••• :.· ,.,. •• , • .,,,,, ..... • ~ I hereby affirm that I am exempt from the Contractor's License Law for the following rH■on: 0 I, es owner of the property or my employees with wag•• H their sole compensation, will do the work end the structure la not intended or offered for Hie (Sec. 7044, Business and Professions Code: The Contractor's Licenae law does not apply to an o-of property who bullda or Improves thereon, and who don such work himself or through his own •mployee1, provld•d that such Improvements are not Intended or offered for Ille, ff, however, the building or Improvement la sold within one year of compl•tlon, the owner-builder will have the burden of proving that he did not build or Improve for the purpoae of 11le). D I, as owner of the property, am exclusiv•ly contracting with licensad contractora to construct the project tSec. 7044, Business and Profeaalone Code: The Contractor's License Law does not apply to an owner of property who build• or Improves thereon, and contract• for auch projects with contractorC1I llc-ed pursuant to the Cont11ctor'1 Licenaa law). 0 I am exempt under Section ______ Business and Professions Code for this raaaon: 1 . I personally plan to provide the major labor and materials for construction of the propoaad property Improvement. D YES ONO 2. I (have / have notl signed •n application for a building permit for th• prop01ed work. 3. I have contracted with the following person Cfirm) to provide the proposed construction Clnclude name / address / phone number / cont11ctors lie-• number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, aupe,viae end provide the major work Clnclude name/ eddre11 / ~ number/ contractors licen111 number): _______________________________________________ _ 6. i will provide some of the work, but I have contracted Chiredl the following persona to provide the work Indicated Clnclucle n1me / addreas / II"-number / type of work): _________________________________________________________ _ PROPERTY OWNER SIGNATURE---------------------'---- DATE ________ _ Is the applicant or future building occupant reQ1Mred to submit • business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25605. 25533 or 25534 of the Pr•sley-TaMer Hazardous Substance Account Act? D YES D NO Is the applicant or future building occupant required to obtain • permit from the air pollution control distri_ct or air quality management district? 0 YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school 1ite7 D 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. [a,• CONSTRUCTION LENDING AGENCY ·; , .. '"'' ~•---•-, •·--• .-,, •:•;~;•7?'~~,~~•,.,,...m ,r-"• ·-r-• .,.., ••--~---•--,., -·--·• • .,_ • I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is Issued !Sec. 3097Cil Civil Code). LENDER'S ADDRESS. ________________________ _ 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 ,apresentltivn of the Cltt of Carlsbad to •nter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO 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 s·o• 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 expir• 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 work is commenced for a period of 160 days CSection 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE ~-.,.J-' \-\ ( t.,...A,,.,__ DATE \ )' '1 q} WHITE: File YELLOW: Applicant P1NK: Finance