HomeMy WebLinkAbout2661 VANCOUVER ST; ; CB891925; PermitPERMIT APPLICATION
City of Carl sbad Building Department
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 EST. VAL ...3¥6 C. "
PLAN a: DEPOSIT j;--5 /-.,11)Ii I ~e5°
1.
A
B
C
2.
PERMIT
COll/4ERCIAL
D INDUSTRIAL
□RESIDENTIAL
OouPLEX
TYPE
TENANT IMPROVEMENT
0 TENANT IMPROVEMENT
□APARTMENT QCONOO ~FAMILY OIIELLING QADDITIDN/ALTERATION
□DEMOLITION □RELOCATION Q M08ILE HOME □ELECTRICAL QPLUHBING
□MECHANICAL □POOL □SPA □RETAINING WALL OsoLAR □OTHER _____ _
PROJECT INFORMATION PLAN CHECK
Address ..2.-(;. b I V/1/Y<:!(:)(..( v'i
~,;t'~t:7£',P ~ £LA.< Hearest Cross Streets
No.
VALID. BY __ ..A,.w.-+-....-------
DATE ----...J.~'-+...!..J~"4--I------
.L "l"I 'f WOl 01 Misc
LEGAL DESCRIPTION un, t No. Phase No.
CHECK BELOW IF SUBIII TTEO:
2 Energ Cales
3.
4.
5.
6.
7.
8.
BLDG. SO. fTG.
CONTACT PERSON
NAME
CITY
SIGNATURE
APPLICANT D CONTRACTOR
NAME
CITY
CONTRACTOR NAME
CITY
# OF STORIES
STATE
ADDRESS
ZIP CODE
0 AGENT FOR CONTRACTOR
ADDRESS
STATE ZIP CODE
OWNER
STATECW ZIP CODE
STATE
ADDRESS
ZIP CODE
ODIINER
STATE LIC. # ____ _ LICENSE CLASS _____ _
SIGNATURE
DESIGNER NAME
CITY
WORKERS' COMPENSATION
STATE
Tl TLE
ADDRESS
ZIP CODE
PROPOSED USE
DAY TELEPHONE
D AGENT FOR OIINER
DAY TELEPHONE
-B'fENANT
DAY TELEPHONE
DAY TELEPHONE
CITY BUSINESS LIC. #
DATE
DAY TELEPHONE STATE LIC. #
Workers' C~at1on Declaration: hereby aff1rm that I have a cert1f1cate of consfflt to stlf·1nsure issued by the D1rector of lndustr1al Relations,
or a certificate of IJorkers• Coq,ensation lnsurance by an ad'nitted ;nsurer, or an e.-.act copy or duplicate thereof certified by the Director of the
insurer thereof filed with the Bui lding Inspect ion Department (Section 3800, Lab. C).
INSURANCE COMPANY POLICY NO. EXPIRATION DATE
Certificate of Exemption: I certify that 1n the performance of the work for which this permit is issued, I shall not employ any person in any mamer
so as to become subj~t to the ~orkers• C~nsat1on Laws of California.
SIGNATURE DATE
OWNER-BUILDER DECLARATION
Owner·Builder Oeclarat,on: I hereby aff;rm that I am exeff'4)t from the Contractor's License Law for the following reason:
0 J as owner of the property or my ~loyees with wages as their sole c~nsation, will do the work and the s tructure is not intended or offered for sale
(Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to en owner of property who builds or iq;>roves thereon,, and who
does such work himself or through his own employees , provided that such in.,rovements are not intended or offered for sale. If, however, the building
or in.,rovement is sold within one year of co.,.,letion, the owner•builder will have the burden of prov1ng that he did not bui ld or in.,rove 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 w1th contractor(s)
licensed pursuant to the Contractor• s License Law).
0 I am exef1')t under Sect1on ___________ Business and Professions Code for this reason:
(Sec. 7031.5 Bus iness and Professions Code: Any City or County which requires a permit to construct, alter, in.,rove, demolish, or repair any structure,
prior to its issuance, al so requ1 res the applicant for such perm1 t to file a signed statement that he is licensed pursuant to the prov is ions of the
Contractor's License Law (Chapter 9, corrmenclng with Section 7000 of Division 3 of the Business and Professions Code) or that he is ex~t 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 (S500)).
SIGNATURE DATE
COMPLETE THIS SECTION FOR NON·RESIOENTIAL 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-Tamer Hazardous Substance Account Act?
□YES QNO
Is the applicant or future bu1lding occ1.4M1nt required to obtain a pcrniit fr0111 the afr pollution contl"'ol district Or" ail"' quality management district?
□YES QNO
Is the facility to be constructed within 1.000 feet of the outer boundary of a school site?
Ores
If AMY Of THE AJI.SIIERS ARE YES, A FINAL CERTIFICATE OF OCaJPANCY MY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS 111:T OR IS 111:ETIIIG THE REQUIREIIENTS
Of THE OFFICE OF EIIERGENCY SERVICES AIIO THE AIR POLLUTION CONTROi. DISTRICT.
9. CONSTRUCTION LENDING AGENCY
hereby affirm that there is a construct ion lending agency for the performance of the work for which th is perm! t is issued (Sec 3097( i) Civi I Code).
LENDER'S NAME LENDER• S ADDRESS
10 . APPLICANT'S SIGNATURE
1 certify that J have read the application ar,cj state that the above information 1s correct. I agree to c~ly w1th all City ord1nances and State laws relating
to building construction. I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspect;on purposes. I ALSO
AGIIEE TO SAVE INOENNIFY ANO KEEP HARNLESS THE CITY Of CARLSBAD AGAINST ALL LIABILITIES, JUOC11ENTS, COSTS ANO EXPENSES 1/HICH MY IN ANT WAY ACCRUE AGAINST SAID
CITY IN CONSEQUENCE OF THE GRANTING Of THIS PERNIT.
Expiration. Every permi t 1ssued by the Bu1lding Official under the provisions of this Code shall expire by lim,tation and become null and void if
or work author ued by such permit is not c ed within 180 days from the dote of such perm It or if the building or work author i ted by such permit
or abandoned al,..aA ttme after the work • ~orrmenced for a period of 180 days Section 303(d) Uniform Building Code).
the but lding
1 s suspended
APPLr<-s"slGNAT ~TRACTOR QBY PHONE APPROVED BY: _______ _
DATE:
PINK: Finance
PERMIT# CB891925
DESCRIPTION: 576 SF LATTICE
PREVIOUS COVER
CITY OF CARLSBAD
INSPECTION REQUEST
FOR 12/18/89
REPLACING
INSPECTOR AREA MP
PLANCK# CB891925
OCC GRP
CONSTR. TYPE NEW TYPE: RAD
JOB ADDRESS:
APPLICANT:
2661 VANCOUVER ST
GOWARD, JAMES PHONE: 714
PHONE:
STR: FL:
771-5625
STE:
CONTRACTOR:
OWNER: GOWARD, JAMES
REMARKS: Tl/MH/TONY/PEG/434-6465TRELLIS
SPECIAL INSTRUCT: Ta'
PHONE: 714 771-56? \ .•. )
INSPECTOR -DHAY....:,1~~-tJt'U ___ Vo>_v--___ _
BA
TOTAL TIME:
CD LVL DESCRIPTION ACT COMMENTS
15 ST Roof/Reroof
=tt
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***** INSPECTION HISTORY*****
DATE DESCRIPTION ACT INSP COMMENTS