HomeMy WebLinkAbout1254 HOOVER ST; ; CB920704; Permit. " u -J :-V, PF.R-1 Pe1m1t No: lt~~ 7 4
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CLEARANCE-----a
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION a •
PI.AN CHECK NO . .
City of Carlsbad Building Depart111ent
2075 Las PalRias Dr., carlsbad, CA 92009 (619) 438·1161
I. P£1tMJ I IYPE
A -□ Commercial LI New Building □ Tenant Improvement
B -D Industrial □ New Building D Tenant Improvement
C -□ Residential D Apartment D Condo □ Single Family Dwelling 1'Acldition/ Alteration
□ Duplex □ Demolition □ Relocation □ Mobile Home D Electrical □ Plumbing
□ Mechanical D Pool □ Spa D Retaining Wall □ Solar D Other ____ _
2. PROJECT INFORMATION FOR OFFICE USE ONLY
Address 12.SD H~ Building or Suite No.
mt o.
□ 2 Soils Report □ 1 Addre»ed Envelope
PROPOSED USE
NAME ADDRESS
CITY ~E. STATE ZIP CODE DAY TELEPHONE
S. PIIDPERIY OWNER ~f-l.L NAME -g>~ ADDRESS
CITY ~ME STATE ZIP CODE DAY TELEPHONE
6. aJN"i'RAc'I
NAME S',ME ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
STATE UC.#
DESIGNER NAME 494M g_ LICENSE ClASS
ADDRESS
CITY BUSINESS UC. #
CITY STATE ZIP CODE DAY TELEPHONE STATE UC.#
7. WOllxE.ltS' wMPENSAl1ON
Workers' Compensation beclarauon: I hereby affirm that I have a ceruhcate of consent to sell-insure issued by the Director ol 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 Department (Section 3800, Lab. C).
INSURANCE COMPANY ONAt..E_ POLICY NO. EXPIRATION DATE
□
D
D
arauo : re ya 1rm t at am exempt ntracto s cense w or t e o owing reason:
or m employees with wages as their sole compensation, will do the work and the structure is not intended or
o for sale (Sec. 7044, · 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.).
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).
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 ($5001).
SIGNATIJRE DATE
COMPLETE TIiis 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?
□ 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?
□ YES □ NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
□ YES D NO
IF ANY OF Tiffi ANSWERS ARE YE.5, A FINAL CERTIFICATE OF ocx:tJPANCY MAY Nor BE IS.5UED AFfER JULY 1, 1989 UNLF_<iS nm APPUCANT
HAS MET OR JS MEETING nm RF.QUIREMEN1'S OF 11m OFFICE OF EMERGENCY SERVICES AND nm AIR POll.U1lON OONTROL DISfRICT.
9. OJNS'IR0CIION :cmmmc AGENCY
I hereby all 1rm that there 1s a construction lending agency tor the performance of the work for which this permit 1s issued (Sec 3097(1) CIVIi Code).
LENDER'S NAME LENDER'S ADDRESS
to. APPUcAN'I' cERifi.lCATION
I certify that I have read ihe apphcauon and state that ihe above mlormauon 1s correct. I agree to comply w ith 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 Al.SO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS nrn Cl1Y OF CARI.SBAD AGAINSf AIL IJABIIITIES, JUDGMENTS, CX>STS
AND EXPENSES WI-DOI MAY IN ANY WAY ACXJHJE AGAINSf SAID Cl1Y IN CDNSF.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 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 b 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 andoned at any time er the work is co enced for a period of 180 days (Section 303(d) Uniform Building Code).
APPLICANTS SIGNATURE DATE: z • ~ 0 ,22-
plicant PINK: Fmance
)
UNSCHEDULED INSPECTION ~.h r,6..1 INSPECTOR--,1~~------DATE
PERMIT# ~-~r p~a# ____ _
JOB AOORESS._,._/4-=d~s==---r:J~~~-----.....;;____,;:::;;_ __________ _
TIME ARRIVE: _____ TIME LEAVE: _____ _
CO LVL
L1
PERMITS
6/15/89
DES~
ACT COMMENTS
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