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Home My WebLink About1075 LIGHTHOUSE RD; ; CB982083; PermitPERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 ,. FOR OFFICE USE O~L Y O-?-, PLAN CHECK N81•1-1{).~&!J"'--"....,..f)<.. . .L--/_ EST. VAL. _____ "tJ_g+~r'--- Plan Ck. Deposit--------- Validated By•-----.Z~~,--j;--\---- Date. ______ ... G_.o4\~ ...... -=..~-l)~-- Business Name (at this address) Legat DescriptiO Subdivision Name/Number Unit No. Phase No. Total # of units Existing Use Proposed Use SO. FT. #of Stories # of Bedrooms # of Bathrooms Address ''O AJenflor 'e«,ntraC!or Name Address 4. PROP.ERTY OW~ER Q ,CDS :i:, V1>M,ft Name &i ·.' 'CON'l'IIACTO~ •C011PANY'WAMIIT . ,.,,··ck··' . City 0 Owner · · 0 ;l\gent 10< Owner City O!rc.sw City State/Zip Telephone# Fax# State/Zip Telephone# C'.ll-9Joo~ State/Zip 7rto-7t£3 -ora :.:,tJJt Telephone# (Sec. 7031.6 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 # _________ _ e. woal(ERS' 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 tor which this permit is issued. 0 I have and will maintain workers' compensation, as required by Section 3700 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 ($100) 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: Fallure to ucure workers' compenaadon coverage la unlawful, end shall subject en employer to criminal penatttaa and clvll fines up to one htmdred thousand dollars ($100,000), In addlt~ to the coat of compen-■tlon, damages•• provided for In Section 3706 of the Labor code, Interest end attorney's fan. SIGNATURE______________________________ DATE ________ _ 7. OWN.Ell-8UltDElt11ECLAIIATION :, : · "'" I hereby affirm that I am exempt from the Contractor's License Law for the following reason: ! 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 . 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 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 tor such projects with contractor(s) 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. D YES ONO 2. 1 (have/ have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person {firm) to provide the proposed construction (include name / address / phone number / contractors license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name/ address / phone number/ contractors license number):; ________________________________________________ _ 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number I type of work)=------------..,-,-----,..,--=----~c:>,,-------------,-,,------------- DATE __;~'-4(-2.LJD'-4/c..:,"}(...J.if,____ PROPERTY OWNER SIGNATURE ----.l.a~..._I.i.;:_ .. .a..,-..£.:,!::!~~.ld,!,i,,(.j_~----- :coMPLETE THIS SECTION FORWON-IIESIOEN71Al. 8UILDINOPERM 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• Tenner Hazardous Substance Account Act? 0 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? 0 YES D 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 ANO THE AIR POLLUTION CONTROL DISTRICT. a.. .:CONSTRUCTIOPftENDINGA~CY, .. 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 '9. APPl;ICANT"C--ERTl=FICA-:c. =no7·· _..,-N7:';, .. 7.i,,-:-,-===-:-:,--LENDER'S ADDRESS ________________________ _ 1 certify that I have read the application and state that the above information is correct and that the information on the plans is 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 ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY 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 commenced for a period of 180 days {Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE _________________________ _ DATE ___________ _ WHITE: File YELLOW: Applicant PlNK: Finance ,., • ;11.J CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB982083 FOR 07/14/98 DESCRIPTION: 123 SF PATIO COVER TO CITY SPE TYPE: PATIO STE: JOB ADDRESS: 1075 LIGHTHOUSE RD APPLICANT: CURTIS DUPLAK CONTRACTOR: PHONE: 753-0123 PHONE: INSPECTOR AREA PLANCK# CB982083 OCC GRP CONSTR. TYPE NEW LOT: OWNER: REMARKS: C/CURTIS/619/277-670 SPECIAL INSTRUCT: HOME 431-05 PHONE: INSPECTOR ____ /} __ ~_-____ _ TOTAL TIME: CD 19 LVL DESCRIPTION ST Final Structural ------------------ ------------------ ------------------ ACT COMMENTS Af _______ _ ***** INSPECTION HISTORY***** DATE DESCRIPTION I /v J J;{ ---n--I .----1-~-( ::f>,17 _, ACT INSP //.f I I 32 J I 'V // COMMENTS ' • -~ - .~ ::·· . •,r ..-' Grass , •• , •• ~. ~ "I' , ~-\. t4j. .• -~ .H0l)SE . ~___,- N ""I •• •qu•ls ""I ""I ft □ 1075 Lighthouse Rd Carlsbad,, Ca 92009 . . . . . Lot 21 6/98 .C ., -< •• ~ ·I I(