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Home My WebLink About2843 UNICORNIO ST; ; CB971305; PermitJ i. .1 ., f \N ALAP F ~e,> .,., ..... ..., __.._ < , \ l l • \ CLEARANC' '--~ r - CITY OF CARLSBAD - 2075 Las Palrnas Dr., Carlsbad, CA 92009 (619) 438-1161 t T"' FOR OFFICE USE ONLY / PLAN CHECK NO. q [ { 30 $ PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 EST. VAL. _________ _ Validated By ________ ..._._ __ _ Plan Ck. Deposit _____ 1 ___ _ Oate ___ -"""'~ ....... f ....... n--""-+l...._7..___ tt :,J;\PROJEC'C INS:OAMATION~. ,.,.,. "'l _28 43-B Unicorno St. ________________________________ _ Address (include Bldg/Suite II Business Name (1t thi1 address) Legal 0eacription Lot No. Subdivision Name/Number ~ Unit No. Phase No. Total I of units Assessor's Parcel I Existing Use Proposed UH Description of Work SQ. FT. lof Stories I ol Bedrooms I of Bathrooms :2:~~i~sp~~~ 1~~~!7~=1i~niil ·;¼~~"t.!'~,,.,...,,: • •t:t• ··.~ .. ,, .l:)i,1,,t•'-"'i~"~-~~~-~~.w?t,4 ~f,:. 94 7 4 Sancarranco, J avi er 28 43-B Unicorno St CARLSBAO' 'C:'A'.. Name Address City State/Zlp Telephone # Fax I/ ~;;if AP....P.~CANT J □ ,!=on'1•~tQr.:' :.O !Agl!ffi 0,GiS:011iii91P~! o .. oit.,;i.tl:&t□.~o~(~g°if!!lr~;\~~;:,;9ij_4 !'17:., SHELLY JOHNSON/KRISTY FOSTER 13706-B HWY ·g BU.:,. r:..L CAJON"; • Name Address City State/Zip Telephone I/ ~;.:...GJ.P.80,~J.Y•O~Hl'IJ.;,.~1,l\"'1'.\!ti~~™:~g;,~m-1w1g(rc--m~~~4~:iii",i,i~,,. S~1Pcarraoco, ,Javier 2843-B Unicorno St. CARLSBAD CA. 9 0 - N■me Addreu City St1te/Zlp Telephone # iSti~C.ONlMC.TOR':.COW,IP.M'dtW,\ '1~11/i1V (Sec. 7031.5 Business and Professions Code: Any City or County which requires I permit to construct, alter, Improve, demolish or repair any atructure, prior to Its issuance, also requires the applicant for such permit to file • 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• permit subjects the applicant to• civil penalty of not more than five hundred dollart.U500II. A~ J FOSTER PIJJMBJNG ]3706-B HWY 8 BUS. EL CAJON CA. 92021 39 0-44 // Name Address City State/Zl~20035!elephone # State License# 630120 Ucen11 Class C-36 City Business License I _______ _ Designer Name Address City State/Zip Telephone State License # _....1N=/,;;A,_ _____ _ :e., ;1i,W.ORKERS! .coi..PENSATION,;i.!i:.i:rf.'.; .. ~:.;;r~~,:·i ~J~ lfr!~:t;.rt,~ .... ';;1~1.!2U~'r:_~11:.:iil:l'...~~~\'J~~~',!Jj1i{li -~~ ~ •.!:~. ~-~-... \. Workera' Compensation Declaration: I hereby affirm under penalty of perjury one of the following decl■r■tlons: 0 I have ■nd will maintain a certificate of consent to aelf•lnsure for workers' compensation H provided by Section 3700 of the Labor Code, lor the performance of the work for which this permit Is Issued. X O I have ind will maintain worker■' 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 FARMER INSURANCE Policy No. N2007-56-51 Expiration Date ______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1•1001 OR LESS) O CERTIFICATE OF EXEMPTION: I certify that In the performance of the work for which this permit Is Issued, I ■hall not employ any person In any manner so es to become subject to the Workers' Compensation Laws of California. WARNING: Failure to 11cut1• worker■' compensation covereg1 I■ unlawful, and shall ■ubject 1n employer to crlmlnel p1nelt1111 end clvll fines up to one hundred thousand dollar■ ($100,000), In addition to the cost of compensation, damages as provided for In Section 3708 of the Lebqr code, lntera■t end 1ttorney'1 f111. SIGNATURE _______________________ -'-------DATE _________ _ 1.' OWNER-BUILDER DECLARATION ·1,· • r ,;f.' :'l1f.'l.:, ,;J. t.' ~&. .. '.r_!,' ,. ;<. •" l~l'-&1.t..~filI'~lJ.r~~~~llilf!',..i:.:.,w,·(~:;}J:~...,_:,~,.I°, I hereby affirm that I am exempt from the Contractor's Licenso Law for the following reason: O I, as owner of the property or my employees with wages as their sole compensation, will do the work end 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 build■ or Improves thereon, and who does such work himself or through his own employees, provided that ■uch Improvements are not Intended or offered for aal1. If, however, the bull ding or Improvement Is sold within one year of completion, th1 owner•bullder will h1v1 the burden of proving that he did not build or Improve for the purpo■e of Hlel. 0 I, ■s owner of the property, 1m exclusively contracting with licensed contractor■ to construct' the PfOJect ISec. 7044, Buslne11 and Professions Code: The Contr1ctor'1 License Law does not apply to ■n owner of property who bullda or Improves thereon, ind contracts for ■uch projects with contractor(al licensed pursuant to the Contractor's Llcen■e Law). • 0 I ■m exempt under Section ______ Business ind Professions Code for this rea■on: 1. I personally plan to provide the major labor end materials for construction of the proposed property Improvement. 0 YES ONO 2. I lh■ve / hive not) signed an application for a building permit for the proposed work: 3. I have contracted with the following person (lirml to provide the proposed construction (Include name / addre11 / phone number / contractors license numberl: 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 / phone number/ contractors license numberl: ______________________________________________ _ 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 workl: _________________________________________________________ _ PROPERTY OWNER SIGNATURE________________________ DATE _________ _ toM~JHIS.'SECUON,.FOR./(O/,(;IU;~~Etl1.W,;ayaLQlt,1'31f.!~lJ.S1P.Ni:rlli'thllM:lallaa~~~~ ~:J:li!' ;1:l;{::i!l.1'.'S1 ;; i\ .\ Is the eppllc■nt or future building occupant required to ■ubmlt • business plan, acutely h1111dou1 materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Pr11loy-T1nner Hazardous Substance Account Act7 0 YES O NO Is the 1pplic1nt or future building occupant required to obtain • permit from the air pollution control district or air quality m■n1gem1nt di1trlct1 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of• ■chool ■Ile? 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 ANO THE AIR POLLUTION CONTROL DISTRICT. 8,, ' CONSTRUCTION LEN0ING'AGENCY· " I hereby affirm that there is • construction lending agency for the performance of the work for which this permit Is l11ued (Sac. 3097111 Civil Codel. LENDER'S NAME ---------~------• 9: ' APPLICANT CERTIFICATION,. I certify that I have read the application and state that the above Information Is correct end 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, JUOGMENTS, 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 6'0" deep and demolition or construction of atructures over 3 stories In height. EXPIRATION: Every permit issued by the Building Official under the provisions ol 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 ol such permit or If the building or work authorized by such permit Is suspended or abandoned at any time alter e work is commence r • period of 180. vs (Section 106.4.4 Uniform Building Code)~ / APPLICANT'S SIGNATURE .l.....<W..J-J...i,-"!.d..::......::!!::::!::~~:e::::::..!..:~~~-------DATE ~_ ,gCFt: ) WHITE: File YELLOW: Applicant PINK: Finance UNSCHEDULED BUILDING INSPECTION INSPECT0~_1 ___ S _______ _ PER ·, PIAN CHECK# ----- JOB ADDRESS c5?f 3_ ~ ') lJ j.J ,1 C O ~ /U / D DESCRIPTION --------------------- TIME ARRIVE: -----TIME ____ _ CODE DESCRIPTION ACT COMMENTS A \J 2~~ t1:-f -.~----< _____ _