HomeMy WebLinkAbout1050 CHINQUAPIN AVE; ; CB941651; PermitBUILDING PERMI1
12/15/94 08 55
Page 1 of 1
Job Address 1050 CHINQUAPIN AV Suite
Permit lype MISCELLANEOUS
Parcel No 20b-Q5Q-21-00 Lot#
Valuation. 14 000
Construction iype NEW
Occupancy Croup Reference*
Description REFURBISHING EXISTING STAIRS
Permit No rB941b51
Pioiect No
Development No
Appl/Ownr JOHNSON, JACK
1483 MAPATHON AVENUE*
SAN DIEGO, CA
9980
613 5t>5-05G6
Status ISSUED
Applied 12/14/94
su<* 12/15/94
270 00C-PRHT
*** Fees Required it *t""*** ' r, fee's Collected & Credit;i ^*i * S, /* j
Fees ^2?0 0*
Adiustments ftl ,0
Total Fees /^ 2770*- 0
Fee description *f »*
Miscellaneous Fee|#4 f
* MISCELLANEOUS TOffM ' i
"^ | "*" t ~*
®f > { j f lotal CnsdijtSj. /
(J/ J' •*, f i'Total PaynQ.en%S ^
^ ^ j, lJni'i>£) !i ^ee/lJp-^t
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> *? J 2FQ 00^ V? * ^ i *
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270 00
Ext fee
270 00
00
Data
CITY OF CARLSBAD
2075 Las Palmas Dr Carlsbad CA 92009 (619) 438 1161
PERMIT APPLICATION
City of Carlsbad Building Department
2075 Las Palmas Or Carlsbad CA 92009 (619) 438 1161
1 PERMIT TYPE
From List 1 (see back) give code of Permit Type
For Residential Proiects Only From List 2 (see back) give
Code of Structure Type
Net Loss/Gain of Dwelling Units
PLAN CHECK NO /& ^ '
EST VAL
PLAN CK DEPOSIT
VALID BY
DATE
2. PROJECT INFORMATION FOR OFFICE USE ONLY
Address
Nearest Cross Street
Building or Suite No
C///A/Q<JAPfAJ
LEGAL DESCRIPTION Lot No Subdivision Name/Number Unit No Phase No
CHECKBELOW IF SUBMITTED
D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D1 Addressed Envelope
ASSESSOR S PARCEL EXISTING USE PROPOSED USE
DESCRIPTION OF WORK
SQ FT # OF STORIES # OF BEDROOMS # OF BATHROOMS
3 uuNTAur FfcKbuiM (it aitierent trom applicant;
NAME (last name first)
CITY STATE
ADDRESS
ZIP CODE DAY TELEPHONE
4 APPLICANT LJ CON rRACTOR
NAME (last name first)
CITY
U AGENT FORTCONTRACTOR
ADDRESS
STATE ZIP CODE
U OWNER D AGENT FOR OWNER
DAY TELEPHONE
5 PROPERTY OWNER
NAME (last name first)
CITY
ADDRESS
STATE ZIP CODE DAY TELEPHONE
6 CONTRACTOR
ADDRESS 3C?/ &first)
CITY t>AN-CH6G<i STATE -" ZIP CODE j-> DAY TELEPHONE
STATE LIC #_SScr-"75~l LICENSE CLASS _ P CITY BUSINESS LIC #
DESIGNER NAME (last name first;
CITY STATE ZIP CODE
JDRESS
DAY TELEPHONE STATE LIC #
7 WORKERS'COMPENSATION
Workers Compensation Declaration I hereby affirm that I have a certificate ot consent to self insure issued by the Director ot Industrial
Relations or a certificate of Workers Compensation Insurance by an admitted insurer or an exact copy or duplicate thereof certified
_byjh£-Dir£Cter_of the insurer thereof filed with the Building Inspection Department (Section 3800 Lab C)
POLICY NO 72b 6AC£175|EXPIRATION DATE
in the performance of the work for which this permit is issued I shall not employ any person in any manner
:ers Compensation Laws of California
8 OWNER
/ UwnejXBjHTderTteclaration rnereby attirm that 1 am exempt trom trie contractors License Law tor the following reason
D tr I as^ewner 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 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)
D 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 DATE
UJMPLETE THIS SECTION FOR NON RESIDENTIAL BUILDING PERMITS 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?
D YES D NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
D YES D NO
Is the facility to be constructed within 1 000 feet of the outer boundary of a school site?
D YES D NO
IF ANY OF THE ANSWERS ARE YES A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1 1989 UNLESS THE APPLICANT
HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT
5 CONSTRUCTION LENDING AGENCY
I hereby attirm that there is a construction lending agency tor the performance ot the work tor which this permit is issued (Sec 3097U) Civil Code)
LENDER S NAME LENDER S ADDRESS
10 APrUCANl CJiKIirlCAllUN
1 certify that I nave read the application and state that the above information is correct I agree to comply with all City ordinances 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 TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES JUDGMENTS, COSTS
AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SATO 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 stones 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 anyitime after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code)
APPLICANTS SIGNATURE ^ "—" DATE
oWHITE File YELLOW Applicant PINK. Finance