HomeMy WebLinkAbout1005 WHIMBREL CT; ; CB971855; PermitCITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
FOR OFFICE USE ONLY
'ERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
PLAN CHEC!Si NO. q1to-Ss
EST. VAL. 'j.,,\ ff&?
Plan Ck. Deposit----.....+-----
(760) 438-1161
1. PROjECT INFORMATION ta:>S w HIMB,@t;L-vT,
Address (include Bldg/Suite #) Business Name lat this address)
Legal Description Loi No. Subdivision Name/Number Unit No. Phase No. Total # of units
Assessor's Parcel # Proposed Use
GoL/J
Description of Work # of Bedrooms # of Bathrooms
Name Address City State/Zip Telephone#
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Name Address City Telephone#
·s. · coNtRAc:ToR. coMPANV'NAME"""'"""""-~·-""' ""'"'···;i:=w••"'7 ' •
(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 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 ($5001).
Name Address City State/Zip Telephone#
State License # __________ _ License Class _________ _ City Business License # _______ _
Designer Name Address City State/Zip Telephone
State License # __________ _
6. WORKERS' COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
0 I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
O I have and will maintain workers' compensation, as required by Section ~700 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 _____________________ _ Policy No. ____________ _ Expiration Date. _______ _
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS)
0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as
to become subject to the Workers' Compensation Laws of California.
WARNING: Failure to aecure workers' compena■tlon coverage la unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars 1$100,000), In addition to the coat of compenaation, damages aa provided for In Sectlon-3706 of the Labor code, Interest and attorney·• fees.
SIGNATURE ________________________________ DATE _________ _
7. OWNERcBUILDER DECLARATION -·"
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
0 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 riot 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 lSec. 7044, Business and Professions Code: The
~~ctor' s License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractorls) licensed
pursuant to the Contractor's License Law}.
0 I am exempt under Section ______ Business and Professions Code for this reason:
1. I personally plan to provide the major labor and materials for construction of the proposed property Improvement. 0 YES ONO
2. I lhave / have notl signed an application for a building permit for the proposed work.
3. ntractors licen_u number.I..;_.&. I 2, 'l Lie-:ff'" 1 i;-,-
4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work linclude name / address / phone
number / contractors license number}:, _________________________________________________ _
5. I will provide some of the work, but I have contracted lhiredl the following persons to provide the work indicated (include name / address / phone number / type
of work}:, __________ ...., ___ .,.....--------------------------,--+----+-.=--,......---------
>(pROPERTY OWNER SIGNATURE,.J,..f.:::::!~..:......::~~~:..d~~.<!:..~-L-=l!::::..=::'.l..~----
'COMPLETE THIS SECTION FOR NON-RESIDEN71AL' IIUiLblNO PERMITifONL y;,l]•'!""i"';,•-•.-·F ,., ....... -:,~r.:.;r ,..~,...,. -•-»-,, ••
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 O NO
Is the applicant or future bt.ilding occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of• school site? 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 AND THE AIR POLLUTION CONTROL DISTRICT. r
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued (Sec. 3097(i} Civil Code}.
LENDER'S NAME ______________ _ 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 11 accurate. I agree to comply with all
City ordinances and State laws relating to building construction. I hereby authorize representatives of the Citt 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,
JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANV WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA permit is required for excavations over 5'0" 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 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 .of such permit or If the building or work authorized by such permit is suspended
or abandoned at any time after the work is com for a period of 180 days !Section 108.4.4 Uniform Building Codel. , j !
APPLICANT'S SIGNATURE --,~~~ .. if~~~~'-,l-.,,4nr.,t.'")!""r---_-_-_-_:-____________ DATE 1 ~'bf 4 7-
Vl:1, '"''~'-/\..,..,1;,.~,..• CIMV· c;.,'.:t..,,..,..
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB971855 FOR 08/19/97
DESCRIPTION: 144 SF BALCONY&l68 SF PATIO-
PER CITY SPECS
TYPE: PATIO
STE:
INSPECTOR AREA PD
PLANCK# CB971855
OCC GRP
CONSTR. TYPE NEW
LOT: JOB ADDRESS: 1005 WHIMBREL CT
APPLICANT: ANKENBRANDT, GERALD
CONTRACTOR:
PHONE: 7 60 43 8-7909
OWNER:
REMARKS: C/MATT
SPECIAL INSTRUCT:
TOTAL TIME:
LVL DESCRIPTION
PHONE: /] f PHONE: ~
INSPECTO~-----;t:;;;--~'-=--"""'-------
ACT COMMENTS CD
1 9 ST Final structural Ai2. ---!J----
***** INSPECTION HISTORY*****
DATE DESCRIPTION
07109 7 Ftg/Foundation/Pi ers
ACT INSP
AP PD
COMMENTS