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Home My WebLink About1259 VERONICA CT; TP; CB962132; PermitPERMIT APPLICATION PLAN GIECK NO. City of tarlsbad Buildit'1i Depart.!nt 2075 Las Pal-Dr., carlsbad, CA 92009 (619) 438·1161 1. PERMt"t fiPE From List 1 (see back) give code of Permit-Type: ____________ _ ............. -------·-.... --........................ ---------·-------·--·· .... .. For Residential Projects Only: From List 2 (see back) give Code of Structure-Type: _____________________ _ Net Loss/Gain of Dwelling Units 2. PRQJF.Cf INFORMATION FOR OFFICE USE ONLY Address /;? S 1 V tf fl,,~ r,) 1 ''--A C.-f-' Building or Suite No. Nearest Cross Street 11:CAL DESCRIPTION Lot No. Subd1vis1on Name/Number Omt No. Phase No. cAECK BEibW IF SUBMII IED: □ 2 Energy Gales □ 2 Structural Gales □ 2 Soils Report □ 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK SQ.IT. #OFSfORI~ 3. WN IACI PERSON (11 different from applicant) NAME (last name first) ADD~S # OF BEDROOMS # OF BATIIROOMS NAME(lastnamefirst) /-lt!?t1-Fo~ .J/4~1 ADDRESS 7.SOAJ, C'i+tz.AC cJ /kW'-'/ ti.A crrv C:.5,::..o(l.)J_;j_O STATE C.J/. ZIP CODE 9?o'2-$" DAY TELEPHONE (, [9, '7-/'J? NAME (last name first) ,/£~!(_ 1-/{},A,f; j ( 1'11/1-«.1 "1 ~ss CITY STATE ZIP CODE DAY TELEPHONE 6. rnN'i'RACJOk T"e~ Pov..>erz_ -1y3·fGyo..7 ADDREss 1111 P 7&.J h',v. Ave NAME (last name first) CI1Y / JU,4, f..A,~ STATE CA. ZIP CODE 'fe, ~ 7 DAY TELEPHON( (/-'f ) t,) :;J. -/ '77 J STATE UC. # l/j.3 J./3) LICENSE CI.ASS C-/ 0 D£SIGN£R NAME (last name hrst) ADDRESS CITY BUSINESS UC. # CITY STATE ZIP CODE DAY TELEPHONE STATE UC. # 1. WoR.XERS' rnMP£NsAl1ON □ □ □ Workers' Compensation Declara11on: I hereby affirm that I have a cemlica1e ol consent 10 sell-insure issued by lhe Director ol lndustnal Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C). I hereby allirm that I am exempt from the Contractor's License Law lor the following reason: 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 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 purpose of sale.). 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). I am exempt under Section _______ Business and Professions Code for this reason: (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 pennit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commencing 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 ($500]). SIGNATIJRE DATE COMPLETE I Als SECTION FOR NON-REsibEN liAL BUILDING PERM! ts 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 Act? 0 YES ONO ls the applicant or future building occupant required to obtain a permit from the air pollution cono-ol district or air quality management district? □ YES □ NO Is the facility co be constructed within 1,000 feet of the outer boundary of a school site? □ YES ONO IF ANY OF TI-IE ANSWERS ARE YFS, A FINAL CERTIFICATE OF ocx:tJPANC't' MAY Nar BE~ AFTER JULY 1, 1989 UNLESS TI-IE APPUCANT HAS MET OR IS MEE11NG TI-IE IIBQUIREMENTS OF TI-IE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLU11ON OONTROL DISl1UCT. 9. WNSI k0Cl1ON i.l:NuiNC AC£Nct I hereby allirm lhat lhere is a construcaon lending agency for lhe performance of ifie work for which lh1s penn1t 1s issued (Sec 3097(1) Civil code). LENDER'S NAME LENDER'S ADD~S Io. APPUCAN I C£1tlUICAl1ON I cemly that I have read lhe apphcaaon and state that the above inlorma11on is correct. I agree to comply w11h all C1ry ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Garlsbad to enter upon the above mentioned property for inspection purposes. I Al.'iO AGREE TO SAVE INDEMNIFY AND KEEP HARMLF.S.5 nm ClTY OF CARI.S8AD AGAINST AU. UABIIJ1lES, JUDGMENTS, CDSTS AND EXPENSES WlDOI MAY IN ANY WAY ACX:RUE AGAINST SAID ClTY IN CDNSEQUENCE OF nm GRANTING OF nns PERMIT. OSHA: An OSHA permit is required for excavations over 5'0" deep a.nd 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 expire by limitation and become null and void if the building or work authoriz such permit is not commenced within 65 ays from the date of such permit or if the building or work authorized by such permit is suspended ab oned at any t'm ~work · enced for a period of 180 days (Section 303(d) Uniform Building Code)<-7 APPLICANTS SIGNATUR DATE: 11-()S-_/(,, .