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Home My WebLink About1031 PALM AVE; ; CB931022; Permit0 • l ... I w E l t l. l X CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT Al>PUCATION PIAN CHECK NO. 93-1822- City of carlsbad Building Departllleflt 2075 Las Pal-Dr., Carlsbad, CA 92009 (619) 438-1161 ESr. VAI.'-;::;;;==-~_,__~¥0 __ _ PLAN CK Il"III' -...- VAIID. BY ~~1;'5~n:>,,-,------- I. PERMII IYPE DAIB c,./,-,,q T A -U Commercial U New Bu1ldmg D tenant Improvement B -□ Industrial □ New Building □ Tenant Improvement C -□ Residential □ Apartment □ Condo □ Single Family Dwelling □Addition/Alteration □ Duplex □ Demolition □ Relocation □ Mobile Home □ Electrical D Plumbing □ Mechanical D Pool □ Spa □ Retaining Wall D Solar □ Other 2. PRQJECT INFORMATION FOR OFFICE USE ONLY Address 1031 Palm Ave. BuUdmg or Smte No. West Buildings Nearest Cross Street LEGAL DESCRIPI ION Lot No. Subci1V1s1on Name/Number Unit No. Phase No. CHECK BEWW IF S0BMII IED: □ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ l Addressed Envelope ASSESSOR'S PARCEi. DESCRIPTION OF WORK EXISTING USE g.oeoSED#;E SQ. Ff. # OF STORIES 3. WN IACI PERSON (IT dlHerenl from apphcani) NAME ADDRESS CI1Y STATE ZIP CODE DAY TELEPHONE 1-. XPPllCAN I NAME □WNIRACIOR UAG£NI FORWNIRACIOR DOWNER DAGEN I FOR OWNER CI1Y 5. PROPFJtlY OWNER NAME C..lv--wl.-,.., STATE Co NAME URBACH ROOFING CI1Y Vista STATE CA STATE UC. #602378 □1Y STAIB 7. WORkRRS' WMPP.NSAIIUN ADDRESS ZIP CODE ADDRESS ZIP CODE 1 Z.C, OJI DAY IBLEPHONE DAY TELEPHONE s-k-7/ --13<-j 7?7 ADDRESS ZIP CODE 2438 92083 La Mirada Suite H DAY TELEPHONE 72 7 -12 77 UCENSE CLASS CllY BUSINESS UC.# 026902 ZIP CODE DAY TELEPHONE STAIB UC.# 3 Workers' Compensation Oeclarat1on: I hereby aff1rm that I have a certificate of consent to self-msure issued by the Director of 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 DepartmentJ(tion 3800, Lab. C). INSURANCE COMPANY C:, <.. POUCY NO. lo<.){. 1.,.1.:ai--~IRATION DAIB rt1 1cate o xempt1on: cert1 t at m t r ormance o t e wor or w 1c t 1s permit 1s 1ssu , s a not emp oy any person m any manner so as to become subject to the Workers' Compensation Laws of California. SIGNATURE DATE 8. OWNmt-H0IIDkk tmCOOtXfiON Owner-Builder Oeclaratlon: I hereby affmn that I am exempt from the Contracto?s Llcense Law for the followmg reason: D 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.). D 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 Llcense 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 permit 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]). SIGNATURE DAIB COMPLEIE IRIS SEGIION FOR NON-RESIDENIIAL BUILDING PERMll'S 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? □ YES □ NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? C YES □ NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ YES □ NO IF ANY OF THI! ANSWERS ARE YES, A FINAL CERTIFICAIB OF O<X:UPANCY MAY Nill BE ISSUED AFIBR JULY 1, 1989 UNIJlSS THI! APPUCANT HAS MET OR IS MI!ETING THI! RF.QUIREMENTS OF nm OFFICE OF EMERGENCY SERVICES AND THI! AIR POillTI10N CDNTROI. DISfRJCf. 9. WNSIRUCIIDN LENDING AGENCY I hereby ahtnn that there 1s a constructmn lendmg agency for the performance of the work for which this permit 1s issued (Sec 3097(1) C1vH Code). LENDER'S NAME LENDER'S ADDRESS 10. APPUCXN I CFltliFICAIION I cernfy that I have read the apphcat1on and state that the above mformatmn 1s correct. I agree to comply with all City ordmances and State laws relating to building construction. I hereby authorize representatives of the City of c.arlsbad to enter upon the above mentioned property for inspection purposes. I AI.SO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THI! CTIY OF CARI.5BAD AGAINST AIL LlAIIIUl1l!S, JUDGMENTS, CDSTS AND EXPENSES WIDCII MAY IN ANY WAY A£DUII! AGAINST SAID Cl1Y IN OONSF.QUENCE OF nm GRANTING OF nns 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 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 permit is not commenced within 365 days from the date of such permit or if the building or work auth rized by such pennit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 303(d) Unifo Buildi g Code). PINK: Fmance 0'8/15/94 INSPECTION HISTORY LISTING FOR PERMIT# CB931022 DATE INSPECTION TYPE INSP ACT COMMENTS 03/17/94 Roof/Reroof RI RI MH/KAREN/727-1277 03/17/94 Roof/Reroof PY AP FINAL 09/27/93 Roof/Reroof RI RI RS/KAREN/727-1277 09/27/93 Roof/Reroof PY NR NOT FINISHED 09/24/93 Roof/Reroof RI RI MH/ROGER/ 09/24/93 Roof/Reroof PY AP HIT <RETURN> TO CONTINUE ..•