HomeMy WebLinkAbout1101 KNOWLES AVE; ; CB901972; PermitB IJ I L D I N G P E R M I T Permit
ProJect
Development
No: l · 1:: 1, 1 i ,
A '-I '(, .. -' 12127/90 Otl:39
P'lgP 1 of 1
,.T<>b Addi ess: 11 J 1 ~ !•,K;wLL, t'J.V
Perm1 t Type: ~1FMOLITION PERMIT
Parcel No: l~r .. l~-14-UU
valuation: o
Construction Type: NEW
occupancy Group: Clas~ Code:
Description: 2 SFD'S 1200 SF & 800 SF
: 1101 AND 1111 KNOWLES AVENUE
Appl/Ownr : LEWIS, ROBERT
1827 DORA DRIVE
CARDIFF, CA 92007
*** Fees Required
Fees:
AdJustments:
Total Fees:
Fee description
Enter "Y for r
Enter "Y" for PlUIJlbl. r
Total
$tr:
b19
No:
No:
Fl: Ste:
Status:
Applied·
Apr/Issue:
Validated By:
944-7424
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PERMIT APPLICATION
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City of Carlsbad Building Department EST. VAL. _______________ _ 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 .
1.
A
8
2.
PERMIT TYPE
COMMERCIAL
0 INDUSTRIAL 0NEW
0 RESIDENTIAL O APARTMENT
0 DUPLEX Js_oeMOLI TION
iCAL □POOL
TENANT IMPROVEMENT
0 TENANT IMPROVEMENT
.
.
.
□CONDO □SINGLE FAMILY DWELLING OADDJTI0N/ALTERATI0N
□RELOCATION □MOBILE HOME □ELECTRICAL □PLUMBING
QSPA □RETAINING WALL □SOLAR □OTHER
JECT INFORMATION PLAN CHECK NO.
11 0 I 4-1:ll'f J< IJDwU: .S ;h.J ~
Nearest Cross Streets
PLAN CIC DEPOSIT. ___________ _
VALID. BY. ______________ _
DA.TE _______________ _
LE~L DESCRIPTION
D_ttv is Cll-itL.S~l\<'.J ?fl
Lot No. Subdivision Name/Nunber f Unit No. Phase No.
CHECK BELOW If Sl.llMITTEO:
2 Energ Cales 02 Structural Cales
-~ '~f£:'.!:o 'lf
2
BLDG. SQ. FTG. ,. I
3. CONTACT PERSON
NAME i2o6Ea..r-U,.v", \
CITY ~,l.P11"°? f--1'1
4. 0 CONHACTOR
CI TY
PE.RTY OWNER ' rLOBetl-=f \....E.w •5
cA..:4?,ef:
1 Addressed Enve\o
PROPOSEO USE
# OF
0 L-0 £ ~ K-o I"' CS
f 2.-00 If ~
STORIES 'l 0-0
ADDRESS f't.21 110i2-A-LJ/L
STATE ZIP CODE 'i 2-oo 7 DAY TELEPHONE (j 4-'+ -7 " 7.... '-I
0 AGENT FOR CONTRACTOR
ADDRESS
Om.JNER 0 AGENT FOR OWNER
STATE ZIP CODE DAY TELEPHONE
OWNER
ADDRESS
'1" ,1. □LESSEE I 02-7 po,'-? Dt □TENANT
STATE~ ZIP CODE 1 "},,,C() / DAY TELEPHONE
6. CONTRACTOR
7.
8.
NAME ADDRESS
Cl TY STATE ZIP COOE DAY TELEPHONE
STATE LIC. # ____ _ LICENSE CLASS _____ _ CITY BUSINESS LIC. #
SIGNATURE Tl HE DATE
DESIGNER NAME
CITY
WORKERS' COMPENSATION
STATE
ADDRESS
ZIP CODE DAY TELEPHONE STATE LIC. #
Workers' CO!ll)l!nsat1on Declaration: hereby affirm that have a certificate of consent to self·insure issued by the Director of Industrial Relations,
or a certificate of Workers• corr-.:iensation Insurance by an actnitted insurer, or an e11act copy or duplicate thereof certified by the Director of the
insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C).
INSURANCE COMPANY POLICY NO. EXPIRATION DATE
Certificate of EXetrfltion: 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 IJorkers' Compensation Laws of California.
SIGNATURE DATE
OWNER-BUILDER DECLARATION
Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractor's License Law for the following 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 ~loyees, provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of c~letion, the owner·builder will have the burden of proving that he did not build or improve for the purpose
of sale.).
D ], 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, irrprove, 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, cOl!lllE'ncing with Section 7000 of Division 3 of the Business and Professions Code) or that he is ex~t therefrom,
and the basis for the alleged ex~tion. 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 do l l ars {$500] ) .
SIGNATURE DATE
COMPLETE 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 Pres\ey·Tanner Hazardous Substance Account Act?
□YES ON0
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
0YES 0NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
□YES o,o
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCQPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS NET OR IS 11:EYING THE IUIUIRENENTS
OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POI.LUTION CONTROL DISTRICT.
9. CONSTRUCTION LENDING AGENCY
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 LENDER'S ADDRESS
APPLICANT'S SIGNATURE 10. I certify that! have 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 ot 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 CARLSBAO AGAINST ALL LIABILITIES, JLOQl!ENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID
CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
Expiration. Every permit issued by the Building Official under the provisions of this Code shall e~pire by limitation and become null and void if
or wo authorized by such permit is not COIIITlenced within 180 days from the date of such permit or if the building or work authorized by such permit
or andoned at any time after the work is C011111enced for a period of 180 days (Section 3D3(d) Uniform Building Code).
the bui !ding
is suspended
/ "!J....owNER □ CONTRACTOR □ BY PHONE APPROVED BY: _______ _
DATE:
WHITE: File YELLOW: Applicant PINK: Finance
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CITY OF CARLSBAD
1200 CARLSBAD VILLAGE DRIVE · CARLSBAD, CALIFORNIA 92008
438-5621
REC'D FROM .L.EvJ IS A ;tJo L=/..S.t5Rc€ 4880 12/26/9~ ll<WC ~ ~ 05(?5 'lJ. 79 DATE ..I..
ACCOUNT NO. DESCRIPTION AMOUNT
. . .•. • 7
3 .;;i u -o?/ o .P~l-JC. F~C.JL 1rY tFe:.t::-s / ft 51 ,;7
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RECEIPT NO. 1 6 9 9 ._. , _, < < '. .. · ·.-TOTAL .i---/ C 7 ~ / J
~--'"""'"'-'___.."-"--'-CC."""-'''~• ..).,· --.-.,
PACIFIC BELL
7337 TRADE STREET, ROOM 5460
SAN DIEGO, CALIFORNIA 92121
Notice of Service Discontinuance
PERMIT DEPARTMENT C
CITY OR COUNTY OF _)r=h,~ !] i(-·&·u
TELEPHONE SERVICE TO:
!IOI !I !Ill
ADDRESS
WILL BE DISCONTINUED, AND ALL SERVICE LINES WILL BE REMOVED
BY // -/ &.J -Cf J
DATE
THIS BUILDING CAN BE MOVED OR
TELCO 213
soG/11
WJJl//f San Diego Gas & Electric
P.O. BOX 1831, SAN DIEGO, CALIFORNIA 92112
Notice of Service Discontinuance
PERMIT DEPARTMENT
CITY OR COUNTY OF
~ND/OWERVICE TO
ltt'>I '" I/ I I AOORESS
WILL BE DISCONTINUED, AND ALL SERVICE LINES WILL OE REMOVED
oy___,/c..::' ·«""---'· r::__,7_· 9_,_Q"-'--------
OATE
THIS BUILDING CAN BE MOVED OR RAZED AFTER THE AOOVE DATE.
-------··-·-~-·-
SAN DIEGO GAS & ELECTRIC COMPANY
FORM 106-2152A TELEPHONE
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