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7618 05/21/96 0001 01 02
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L APPR-) -I J
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L -________ _J
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION ~ ~ City of Carlsbad Building Depar~t
2075 Laa PalES Dr., carlsbad, CA 92009 (619) 438-1161
I. P£kM.il IYPE
From List I (see back) give code of Permit-Type: ___________ _
---------------------------------------------------------
For Residential Profects Only: From Ust 2 (see back) give
Code of Structure-Type: ___________________ _ oi!-[)e;>t\~ f>
Net Loss/Gain or Dwelling Units
2. PRWECT INFORMATION FOR OFFICE USE ONLY
mt o. ase o.
CHECK BEWW IF S0BMI I IE :
□ 2 Energy Cales □ 2 Structural Cales C 2 Soils Report □ I Addressed Envelope
ASSESSOR'S PARCEi, Cove"--PAOP95EP USF. DESCRIPTION OF WORJ( Sol
# OF STORIES # OF BEDROOMS # OF BAIBROOMS
I
NAME (last name first) 'l('J{en rofD•PP•'l('~ / ADDRESS "9S-C/JJf J-7,.-v('O-v (TIANl"r; p,e/ S -, ,~,
CI1Y STATE (!4-ZIP CODE 6,/ ~/ DAY TELEPHONE (1t1'1)
NAME (last name first)
Cl1Y tl'l"" t
NAME (last name first)
Cl1Y& 'N/).. ZIP CODE 9J')
• NAME (last name first) ),,g,,;v
Cl1Y ()p/;:yuo{
ADDRESS
ZIP CODE q/ ~ !r,
UCENSE CLASS (!-./ STATE UC. CI1Y BUSINESS UC. # as name 1rs
CI1Y STATE ZIP CODE DAY TELEPHONE STATE UC.#
7. WukkF.ltS' WMPkNSA IION
Workers' Compensauon beclarat1on: I hereby afhrm that I have a cerui1cate of consent to self-insure issued by the 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).
SIGNATURE DATE
8. OWNEK-BUilDmt DFl!OOlXIIUN
□
□
□
uwner-uuuaer uec1arafion: I hereby afhnn ffiat I am exempt from ffie Contractors Llcense Law for the ioiiowmg reason:
I, as owner of the property or my employees with wages as their sole compensation, will do the w:ork 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 lhrough his own employees, provided chat such improvements are not intended
or offered for sale. If, however, lhe building or improvement is sold within one year of completion, the owner-builder will have lhe 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 Ucense Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects
with contractor(s) licensed pursuarn to the Contractor's Llcense 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 pennit 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.S by any applicant for a pennit
subjects the applicant to a civil penalty of not more than five hundred dollars [$500]).
SIGNATIJRE DATE
tOMPLE IE I AIS SEC I ION FOR NON-RESIOEN I IAt BOIWING PERMI IS ONLY:
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration fonn or risk management and
prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? □YES □NO
Is the applicant or future building occupant required to obtain a pennit from the air pollution control district or air quality management district?
□ YES □ NO
Is the facility lo be constructed within 1,000 feet of the outer boundary of a school site?
□ YES □ NO
IF AAY OP TIIEANSWERS ARE YES, A PINAL Cl!RTIPICATE OF OOCUPANCY MAY NOf BE ll!SIJED AF!llRJULY I, 1989 IINIJlSS 111E APPUCANT
HAS MET OR IS MEimNG nm REQUIREMENTS OP 11IE OFFICE OF EMERGENCY SERVICES AND 11IE AIR POLLUTION WN11IDL DISTRICT. 9. WNSI KOCI ION I.RNDlNG XGF.NCY
I hereby alhnn that there IS a construction lending agency lor the perionnance of the work lor which this penn1t 1s 1SSued (Sec 3097(1) Civil Code).
LENDER'S NAME LENDER'S ADDRESS IO. XPPllCANI CERIIFJCAIION
I ceruiy that I have read the apphcat10n and s1ale that the atxive miormauon 1s correct. I agree to comply with ail dty ordmances 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 ro SAVE INDEMNIFY AND KEEP IIARMLF.SS nm CTIY OP CARISBAD AGAIN!» AIL LlABIUllES, J\IDGMENTS, <DSTS
AND EXPENSES wmrn MAY IN AAY WAY ACJCRUE AGAINST SAID CTIY IN WNSEQUENCE OP 11IE GRANTING OF TIIIS PERMIT.
OSHA: An OSHA pennit is required for excavations over S'0" deep and demolition or construction of structures over 3 stories in height.
Expiration. Every pennit 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 pennit is not commenced within 365 days from the date of such pennit or if the building or work authorized by
such pennit is suspended or abandoned at a time after the wo • mmenced for a period of 180 days (Section 303(d) Unifonn Buildin e •
APPUCANTS SIGNATURE DATE: ....;;i.ol!l..<.1. ')' 6
WHITE: F PINK: Fmance
0
.,
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB960906 FOR 07/01/96
DESCRIPTION: 300 SF PATIO COVER-POOL & REC
AREA-COSTA DO SOL-GREYSTONE
TYPE: PATIO
INSPECTOR AREA
PLANCK# CB960906
OCC GRP
CONSTR. TYPE NEW
JOB ADDRESS: 1022 LIGHTHOUSE RD
APPLICANT: LAND CARE INC
CONTRACTOR:
STE: LOT:
OWNER:
REMARKS: MW/NIELS/431-8870
SPECIAL INSTRUCT:
TOTAL TIME:
--RELATED PERMITS--
LVL DESCRIPTION
PERMIT#
GR950016
SE950115
CB951618
CB951671
SE950133
SE960006
CB960147
SE960015
SE960025
SE960047
SE960067
CD
19 ST Final Structural
TYPE
GRADING
SWRSD
SFD
COM
SWRSD
SWRSD
MISC
SWRSD
SWRSD
SWRSD
SWRSD
PHONE: 6909-985-7155
PHONE:
PHONE:
INSPECTOR
STATUS
ISSUED
ISSUED
ISSUED
ISSUED
ISSUED
ISSUED
ISSUED
ISSUED
ISSUED
ISSUED
ISSUED
ACT COMMENTS
!¥-------------------
DATE DESCRIPTION
062596 Final Combo
***** INSPECTION HISTORY*****
ACT INSP
NR PY
COMMENTS
FINAL BUILDING INSPECTION
DEPT: BUILDING ENGINEERING
PLAN CHECK#: CB960906
PERMIT#: CB960906
FIRE PLANNING U/
PROJECT NAME: 300 SF PATIO COVER-POOL & REC
AREA-COSTA DO SOL-GREYSTONE
ADDRESS: 1022 LIGHTHOUSE RD
CONTACT PERSON/PHONE#: MW/NIELS/431-8870
SEWER DIST: CA WATER DIST: CA
DATE: 06/25/96
PERMIT TYPE: PATIO
L 5 1996
==============================================----=-=========================
INSPECT~#~ DATE ~-1-<tt t/ INSPECTED: APPROVED DISAPPROVED BY: ,:
INSPECTED DATE
. BY: INSPECTED: APPROVED DISAPPROVED
INSPECTED DATE
BY: INSPECTED: APPROVED DISAPPROVED
=================================-======---=-------------=======--------===-=
COMMENTS:
BUILDING INSPECTION
DEPT: BUILDING PLANNING U/M WATER
PLAN CHECK#: CB960906
PERMIT#: CB960906
PROJECT NAME: 300 SF PATIO COVER-POOL & REC
AREA-COSTA DO SOL-GREYSTONE
ADDRESS: 1022 LIGHTHOUSE RD
CONTACT PERSON/PHONE#: MW/NIELS/431-8870
SEWER DIST: CA WATER DIST: CA
DATE: 06/25/96
PERMIT TYPE: PATIO
L 5 1996
============================================================================= ~~~PECTE~~~ ~t~!ECTED: 7-(-?t APPROVED v DISAPPROVED
INSPECTED DATE
BY: INSPECTED: APPROVED DISAPPROVED
INSPECTED DATE
BY: INSPECTED: APPROVED DISAPPROVED
==============================================-==============================
COMMENTS:
DEPT: BUILDING ENGINEERING
PLAN CHECK#: CB960906
PERMIT#: CB960906
FIRE
PROJECT NAME: 300 SF PATIO COVER-POOL & REC
AREA-COSTA DO SOL-GREYSTONE
ADDRESS: 1022 LIGHTHOUSE RD
CONTACT PERSON/PHONE#: MW/NIELS/431-8870
SEWER DIST: CA WATER DIST: CA
U/M WATER
DATE: 06/25/96
PERMIT TYPE: PATIO
INSPECTE (I DATE /
====== (ji)=============================================================
BY: '"--' INSPECTED: ]-(-96 APPROVED _._/_ DISAPPROVED _
INSPECTED
BY:
INSPECTED
BY:
DATE
INSPECTED:
DATE
INSPECTED:
APPROVED DISAPPROVED
APPROVED DISAPPROVED
===========================--=======-=---------------------------------------
COMMENTS:
FINAL BUILDING INSPECTION
DEPT: BUILDING ENGINEERING FIRE PLANNING &ATER
PLAN CHECK#: CB960906 DATE: 06/25/96
TYPE: PATIO PERMIT#: CB960906 PERMIT
PROJECT NAME: 300 SF PATIO COVER-POOL & REC
AREA-COSTA DO SOL-GREYSTONE
ADDRESS: 1022 LIGHTHOUSE RD
CONTACT PERSON/PHONE#: MW/NIELS/431-8870
SEWER DIST: CA WATER DIST: CA
ffnITJ-· II ~ ~ I. m , ,ffi1 .UH 5-1996
~\ L CARLSBAD
L--._t-4.IJNICIP'.L WATER DISTRICT
==================================-=====-=====-===--=========================
~~;PEC~~~ECTED: 6-J'i-fbAPPROVED L
INSPEC ED DATE BY: __________ INSPECTED: ___ APPROVED
INSPECTED
BY:
DATE
INSPECTED: APPROVED
DISAPPROVED
DISAPPROVED
DISAPPROVED
============================-===========-===---===--=========================
COMMENTS:
.
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