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Home My WebLink About1085 GOLDENEYE VW; ; CB971251; Permitp 'J I T r T t #: C" ,n Ar .. /Ownr : TIT"\(" pr " A ~ !Y'L ... C' ·p, ii. le F FINAL APPROVAL INSP .. IZD DATEl(~lb CLEA RANCE ____ _ CITY OF CARLSBAD 2075 Las Palrnas Dr., Carlsbad, CA 92009 (619) 438-1161 ~· : r A 7 • +- F PERMIT APPLICATION FOR OFFICE USE ONLY -1 2_ PLAN CHECK NO. 9 , 1 ..s 1 CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST.VAL.~~~~~~~~~~ Plan Ck. Deposit ---"4------~ 1. PROjECTINFORMATION { Cc, {/, r.H';_,,... Business Name .)~l""'iJrt'71...-,- at this address) Address (includ ldg./Suite #) !Oes-~t/&AlF ~.::: Vr" w Legal Description r / Lot No. Subdivision NamemLimber Unit No. Phase No. Total I of units fe ,,-, ar1' 4 .,- Assessor's Parcel I Afg:;e Cc-// J~e,,e,'?C/1 P~sed U~e ,.. 'Ef,t:I,,,.. .,-,,~ (. J;,~c:., c:;'nc- Description of Work SQ. FT. lot Stories I of Bedrooms , of Bathrooms ~s-o I (2. /li, 7q 2 'll]J1 ~ Name Address City Fax I 3. APPJ.!CANT _II Contractor U f)C. /tM ~..r It Ag_ent fo, Contractor O Owner !3-"gent fo, Own~ r C/'M,~ (. /(to -,v t}lt1-t:t Name (/ C-/>? E ,..r Address City State/Zip Telephone I 4. PROPERTY OWNER ~ ;;---'V,'-'f)."-<:::. _ _,,t,f._.c-..,,,..,:.....;..:;~c..__...1.f....::;.ry~r--:-;c-;-;f..C..,;,r.....:C,...:...;~;_..,......,,_j).;_'JC'----/?.'-r-'_-=f /f1'.l:...;.__:;,-=-j)_1 ' ...... i<-o __ _:C'::-/l--c::::-7.:......:..{_l __ e;/~--Z:...'-=r-:.._-.!:_F<.:;_e;.:..:7o:...__~Z...:.'-~'J" J .r1 '/ Name Address City Stete/Zip Telephone I 6. CONTRACTOR • COMPANY NAME (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 stetement 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 exemptl n. Any violation of Section 7031.5 by any applicant for a permit su~cts the applicant to a ci ii penalty of not more than fiva hundred dollars ($5001). MF ~ ¢,)J" Wf/'ftM Vil f?r'c o u 1t rc/ ,r-gc 70 Name . Address City State/Zip Telephone I State License I 6 12 l tf .J License Class Zf' City Business License I CeJc C-rc;~e ~J 2 s. H1.J-Y tcr ...ft'i..-t '[f.,.,.~'9 ~---7-,-2--f'r? 1 r City State/Zip Telephone Designer Name State License I -=c~~?,_'0_7'--''(._ __ Address 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declerations: ~ 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 . .12) I have and will maintain workers' compensation, as required by Section 3 700 of the Labor Code, for the performance of the work for which this permit is ~ued. My worker's compensatiop..insurance carrier end policy number ere: _ / Insurance Company C/f??~ pe-Policy No. 8:r).. t' :J / -8-7 /? 7 Expiration Date I 'Z _) / I (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 secure wOfkera' compensation covenge 11 unlawful, end lhd 1ubject an employer to criminal penaltle1 and civil flnu up to one hundred thousand doffar1 ($100,000), In addition to the coat of compensation, damagu u provided for In Section 3706 of the Labor code, lntere,t and attorney·, fee,. SIGNATURE DATE 7. OWNER-BUILDER DECLARATION --:::==:::-----;:::::.__~--,-~~-. 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 es their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business end Professions Code: The Contractor's License Law does not apply to en 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). (] 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, end contracts for such projects with contractor(sl licensed pursuant to the Contrector' s License Law). 0 I em exempt under Section ------Business end Professions Code for this reason: 1. I personelly plan to provide the major labor and materials for construction of the proposed property Improvement. ~ YES ONO 2. ~ I have not) signed en application for a building permit for the proposed work. 3. I have contracted with the followln per (firm) to provide the proposed construction (include name I eddress I phone number I contractors license number): 4. I plan to provide portions of the work, but I have hired the allowing person to coordinate, supervise and provide the major work (include name I address I phone number I contractors license number): ______ ..... ...._...,__,._..._ __________________________________ _ 5. I will provide some of the work, but I have c11n!,tected ired) the following persons to provide the work indicated (include name/ address I phone number I type of work): ___________ ~~~~/_-r _ __,.,.,....---------------------~-~----------- Is the applicent or future building occupant required to submit e business plan, acutely hazardous materiels registration form or risk menagement and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act7 0 YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quellty management district7 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a 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 ANO THE AIR POUUTION CONTROL DISTRICT. [ii. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a c nstruction lending agency for the performance of the work for which this per t is issued (Sec. 3097(i) Civil Codel. LENDER'S ADDRESS ____ ..cM_...,___~--------------- I certify thet I have read the application end state that the ebove information Is correct and that the lnformetion on the plans Is accurete. I agree to comply with ell City ordinances and St1te laws releting to building construction. I hereby euthorize representatives of the Cltt 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 SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over 5'0" deep end 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 t · d for a period of 180 deys (Section 106.4.4 Uniform BuildinDgACTodE e). J /(.,,./Jt!' 7 APPLICANT'S SIGNATURE --o1'-L.-...L...1111!::.:___________________ f / • _! ··-· · -·~, • --n---• Dl .. llt'• S:in•nr.1111 ~· ~- -~--- I. Goldeneye lltew - .. -..,,. •, .... .. • ·-. -! ,o:. . '. '-')f"e . 0-.... . . ;'-~ .... ':-. ' ·• ol.. ,<' ... ; . ' ( --· . ; . · .. . . . .. .. ,. -. .. . . . . i;. ~· . . .... . ,' . . . . ·.·; MODEf COMPLEX .. . . . . ~· . . . . . . •' I ; ,.• .. I :.,. .. ' . . , ,. • • • .. .• t .... . . . ~ •· .· .· ... ;~ :',~. ·:·: . ·. ·.... ':.'· ,~,... .. · .. , . . ... .• "".I Ii . . . ·. ' . ' ) . . . •,. ' .. I / t!;t.t:J·.,, .~~ ,· ·.· ... •.,,· _.: ·: .. ~ 0 · . 2~ 40 ·J~ ' . ·~ ., . . .. . . ' ,· » . ~-~ I L__ o;, .. "'., -.. , . . . . , -w--·~S · ... : : '-~ (j (l:j , • ~ , . , .,: .• ,. ' '. .~·, ,,' . ·. . \..!J"'£1'tt· I . . · ~ Al t: -. . , .. ·•. .. p . . """''" ~i; ... ·.\ .,;_;.-·:· · :· ::·· ·. CJj'f?l~I ~ ... LoT ..,,,, St.. SEABRIGHT SALES OFFICE 1)1.At--l j_ LIGHT~NG PlAN IOSS" &olde"~'IE- V•~l.J !l::::=:==================~======::;::::=:==============:::;::====;-i "PEC",-. iT -.: F[> F _ {Q} RECESSED LIGHTING (]j RECESSED SPOT TA5LE CARPET 0 0 0 ~------, WOOD FLOORING 0 D D l'lDT 0 0 WII.£ D D 0 FLOOR PLAN DISPLAY TO MODELS C.4a 170~1, SYMBOLS <J PH PHONE JACK <J F FAX I PHONEC <J C COMPUTER LINE ~ SURGE PROTECTED OUTLET