HomeMy WebLinkAbout2745 VIA TULIPAN; ; CB970023; PermitPERMIT APPLICATION
City of C•rlsbed luilding Depertaent
PLAN Cl IECK NO. fl@ 2 _3
20~ L• Pal-Dr., Carlsbad, CA 92009 (619) 438-1161 PST. V/\1 .. ___________ _
I. PFitMrt I Yi'£ 1'I.AN CK UEl'a.rr ________ _
VA.lJU. DY ___________ _
l>All! rrum ljs1 I (,tt back) giv, coJ,.of Permit-Type: _______ .__ ___ _
·········--·------·---·-··-········--····················
fur llcsille111lal rruj~u Only: from List 2 (see back) glv,
C:o,le ur Structure-Type: _______ ..w.1.:.JJ.._ _________ _
Net l.oss/Gain of Dwelling Uniu _________________ _
2. PI\Wf.CT INmllMA'llON FOil OFFICE USE ONI.Y
AJJrcss 2745 Via Tulipan Du,IJmg or Suue Nu.
tlr;ircs1 Cro53 S1reeAvenida De Loui sa r .
LF.GAL otscllll>TION Lot Nu. suW1V1s1un Name/Numlicr 01111 No. l'hm;c No.
Cm.CK DF.IDW IF SODMI 11 £0: ,
0 2 Enrrgy Cales □ 2 Struqural Cales □ 2 Soil~ llrport D I Addrcs.~ed ~nvelope
ASSESSOR'S PAJ\CEL fis·~~G ~ DESClllmON OF WOllK wat e r Heat e r Replacemell011 PI\OPOSEU USE
SQ. FT # OF STOIIIES II OF BEDROOMS II OF IIATI 11\00 MS J. WN IXCI l'l!JtSON (1I il1llc1e11l irsnn apphcan(J NAME (last name lirstjliggs, Te rry AOOlU:SS 27 4 5 Vi a Tulipan
CITI carl sbad STATE CA ZIP CODE 92009 DAY TT.I.EPII0,4r,34-5544
-4. APl"IJCARI UWNillACIOll ;o.,..crn1 FOllwNmACIOli :UuWJtt'.l(h uAGii.NCTuifHWNtl{ S 't B NJ\ME (last name lirst) She lly J o hns on ADDRESS 3 /Ub tn.g way lj jjUSl. e ss, Ul. e
CITY El caj o n STATE CA 7.IP COOE9 2 0 2l DAY TEI.Ert10N.?90-4 4 77
s. i'llOP£)( IY OWHEll . • • NMIE (last name lirsjj.iggs, Terry ADDHE~745 Vi a Tul1.pan
c n~carlsbad STATF.CA 7.IP c01ft2 0 09. DAY TEI.F.PII0~.?4-5544
6. CDR"lltAC'IOlt
NMIE (last name lirstf. & J -Fo s t e r, I n c. 1 3706 Hig h way 8 Busi nes s , s u ite B ADDHESS
CITIEl Ca jon STATE CA
STATE I.IC. # 630120
ZIPCODE 9 1 977 DAYTELEPIIONE 39o-4477
LICENSE CIA'iS C-36 Cl1Y BUSINESS UC. #l 2 oo354
0£SIGN£il NAME (last name hrsi) ADD ....
r.nY STATE 7.lr CODE DAY TEl.EPIIONE STATF. I.IC. II
1. WOIIRfJts CDMl'F.NSAl1oR .
Workers' Compensation Oeclarauon: I hereby alhrm that I have a ceruhcatc ol consent 10 sell-insure 153uc<l by the Director ol lmlus1rml
!\elations, or a certilicatc or Workers' Compensation Insurance by an admllled Insurer, or an exact copy or duplicate tJ1ercof certified
by the Di,~tor of the insurer thcrcor filed whit the Duildlng Inspection Ocpartf!tent (Scctlon 3800, Lab. C).
INSUllAN.CECOMrANYFarmer s l'OlJCY NO.N2007-56-51EXJ>IIV\TION DA11~ 5-1 -97
Ccruhcale ol Exempuon: I ccruly that m the pctlormancc ul the work lor wluch tins pcnmt 1s 153ucJ, I shall not employ any pc1son III a11y ma1111
so as 10 become subject to the Workers' Compensation Laws of California.
SIGNATIJI\E DATE
A. oWREJt-bOl[l)Ell DEl.DJtAflON '
Owne.r-Du,liler Declaration: I hereby alhm1 Cha[ I am cxempl lrom U1c Cohliacloi's Uccnse Law lor U1c lollowmg reason:
D I, as owner of the propcny or my ,mployces with wages as their sole compensation, wlll do the work and the· slhlcture I~ not l111e111.led or
offered for sale (Sec, 7044, Business and Prorcsslon1 Code: The Contractor's Uccnse 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 lmprovemenL, arc nol Intended
or orrercd for sale. tr, however, tJic building or lmprovt!ment Is sold within one yar or compl,tlon, tJ1e owner-builder will have the l,urden
or proving tJ1at he did not build or Improve for tJic purpose or sale.).
D I, as owner of tli~ property, am cxclusively contracting with licensed contractors to construct the project (Sec, 7044, Duslncss ant.I l'rorcs.•ion~
Code: The Contractor's Ucensc Law does not apply to an owner or property who builds or Improves tJ1ercon, and contracu for such projccu
with contraclor(s) lic,nsed pursuant lo the Contractor's Ucense Law).
D I am exempt under Section _______ Business and Prorcssions Code for this reason:
(Sec. 7031.S Business and Prorcsslons Code: /lny City or County which requires a pennit to construe!, alter, Improve, demolish, or repair
any structutt, prior to iu Issuance, also requires the applicant for such permit to lilc a signed statcm,nl that he is licensed pursuant to the
provisions of th, Contractor's Ucensc Law (Chaptl!r 9, comm,ncing with Section 7000 of Division 3 or tlic Business and Prufcs.~ions Code)
or that he Is cxcmpl therefrom, and the basis for th, alleged exemption. Any violation or Section 7031,5 by any applicant for a permit
sul,jccll the applicant 10 a civil penalty or not more 1han five hundred dollars ($5001).
SIGNAlVJ\£ DATE
COMPLEIE IHI$ SECMON FOil NON-ltE5iOEN11AL oOILDING l'EHMll'S oNLY:
Is the applicant or Cuture building occupant required to submit a l,usiness plan, acurely hazardous materials registration fonn or risk managcmenl a
prevention program under Sections 25505, 25533 or 25534 or the Presley-Tanner Hazardous Substance Account Act7
□ YES □ NO
Is the applicant or Cuture building occupant «:{!Uired to ol,tain a pcnnlt from the air pollution control district or air quality management di~trict7
□ YES ONO
Is the facility to be constructed within 1,000 reet of tl1e outer boundary or a school sltc7
□ YES ONO
IF ANY OF 111£ ANSWEJlS ARE YES, A FINAL CERTIFICATE OF OCDJPANCY MAY NCYT BE IS..WEl> AFim JULY I, 1989 UNl.f"SS 11 Iii Al'l'IJCAI
llAS MET OR IS MEET1NG TIIE IU'.QULJU!M.ENTS OP nnt OFFICE OP £M£1\CF.NCY SERVICES AND TIIE Alli l'OIJ.lTllON a)N'lllOI. UIS'llllC'l
9. (X)NSI lt0Ci1ON IJ'.NDING XGF.NCV ~ 097{1) C1v1rcoo
LENDER'S NAME l.ENDEl\'S ADDRESS
10. APPUCAR l CECl1FlCA 110A
I cen,ly 01at I have read Oie application and state that the above mlorma11011 1s correct. I agree to comply wuh all C11y orilma11ccs a11il State la
relating to l,uilding construction. I hereby authorize representatives or the City of Carlsl,ad to enter upon the above mentioned proJK'ny for insp<-cl
purposes. I Al.SO AGI\T:.E 1U SAVE INDEMNIFY ANO KEEP IWtMLESS TIIE 01Y OP CAI\ISBAD AGl\1.NS'T AIJ, I.IAl)IIIlll'.S, JUIX:Ml:Nl"S, Cll
ANll EXPENSES WlU□I MAY lN ANY WAY N.Xl\UR M:::AlNST SAID 01Y IN CDNSEQUENc:£ OP 111£ Gl\NfllNG OJI 1111S l'IU\Mff.
OSIIA: /In OSIIA permit is required for ucavatlons over s•o• deep anJ demolition or construction or structures over 3 stories in height.
Expiration. Every pcnnh issued by the Building Official under the provisions or this Code shall expire 1,y limitation and become null and void ir
building or work authorlied by such permit Is not commenced within 365 days rrom the date or such permit or i~ the building ~r work a_u1~10ri1.et
such permit is suspended or a~~1~ncd at any time arter the work is commenced for a period or 180 days (Section 30J(d) Umfurm ~l~•ljli~•i-f:9
APPLICANTS SIGNATIJI\E nCZ:O\JY\..00l\_==:=====::;---:-~---::--:---UA It: ~
UNSCHEDULED BUILDING INSPECTION
DATE 0/4/97 ---,-----,-------INSPECTOR __.$b ______ f<_1_-..... S _____ _
PERMIT# q-,CX)"L3 PLAN CHECK# -----
DESCRIPTION ----------------------
TI:ME ARRIVE: -----TIME ____ _
CODE DESCRIPTION 1 COMMENTS
1i)m~ ;1
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