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Home My WebLink About1265 FOREST AVE; ; CB930701; Permit.. .. f • + y I ' l • A .. ?. .... 'I r • 31 }' 1)7114 Q~ 0~>( L t• • ~~i,, r . t • ,:i. LAPPROVAL L ' ' ., INS . ~'----DATE,_.O_·~-'l CLEARANCE _____ , CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION PLAN CHECK NO. 93-701 . City of Carlsbad Building Departllent 2075 Las Pal.,. Or., C&rlsbad, CA 92009 (619) 438-1161 PUN CK DEPOSIT _______ _ I P.ST. VAL VAUD.BY __________ _ I. PmMII l'VPE A - U COmmerc1al Li New Bu1ld1ng U tenant Improvement B -CJ Industrial C New Building D Tenant Improvement C -CJ Residential D Apartment O Condo CJ Single Family Dwelling CJ Addition/ Alteration CJ Duplex [J Demolition [J Relocation CJ Mobile Home CJ Electrical D Plumbing [J Mechanical [] Pool O Spa D Retaining Wall D Solar CJ Other DATE 2 PRQJECT INFORMATION FOR OFFICE USE ONLY Fo. (' t!,..j f.. /9 V e_ Building or Suite No. Pio , ntt o. CHECK BEWW IF SOBMI 11 f'.0: Cl 2 Energy Gales [J 2 Structural Cales [] 2 Soils Report C 1 Addressed Envelope ASSESSOR'S PARCEi. fie root' # OF STORIES EXISTING USE DESCRIPTION OF WORK SQ. FT. I CJ OD NAME ADDRESS L,c..,11 f S o IV CITY S. PkOPEkli OWNEK NAME CITY NAME CITY CITY STATE STATE !JC.# STATE 7. WURkFJlSI WMPRNSAIION ADDRESS ;1. !:' s 9 e.v; Is en--- zIP CODE 9::i~P5{:DAY TELEPHONE ADDRESS ZIP CODE ADDRESS ZIP CODE LICENSE C!ASS ZIP CODE DAY TELEPHONE DAY TELEPHONE CITY BUSINESS !JC. # DAY TELEPHONE ase o. STATE !JC.# Workers' Compensation Deciarat1on: I hereby alhrm that I have a cert1hcate of consent to self-insure issued by the Director of Industrial 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 POLICY NO. EXPIRATION DATE I Ceruhcate of Exemption: I certify that 1n the performance of the work for which this pem11t 1s issued, I shall not employ any person 1n any manner so as to become subject to the Workers' Compensation Laws of California. GNATURE DATE ...._J~~~~~n~e~r-~~~ at am exempt rom t e w or t e o owing reason: D I, as ow er 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 Llcense 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). a 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 tile 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 any applicant for a permit ---subj,e<t&~he applican a civil pena of not red dollars [$500]). ired to submit a business plan, acutely hazardous mate · s registration form or risk management and prevention program under Sections 2550 , 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Cl YES ONO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? CJ YES CJ NO ls the facility to be constructed within 1,000 feet of the outer boundary of a school site? DYES ONO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF ocx:uPANCY MAY NOT BE !SSUEDAF!l!R JULY I, 1989 IJNIJ'.';S TIIEAPPUCANT HAS MET OR IS Ml!ETING TIIE REQUIREMENTS OF TIIE OFFICE OF I!MERGENCY SERVICES AND THE AIR POLLUTION WNTROL DISflUCT. 9. WNSIRUCIIUN LENDING AGENC¥ I hereby afhrm that there 1s a construction lending agency for the performance of the work for which this permit 1s issued (Sec 3097(1) Civil Code). LENDER'S NAME LENDER'S ADDRESS 10. APPUCANi e£k:IMCAIION I certify that I have read the application and state that the above 1nformauon 1s correct. 1 agree to comply with all City ordinances and Slate 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 CTIY OF CARISBAD AGAINST ALL UAIIIIJTIES, JUDGMEN"J'S, CXlSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CTIY IN WNSF.QUENCE OF TIIE GRANTING OF TIDS PERMIT. OSI-IA: An OSHA pennit 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 a thorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 303(d) Unifonn B ding e). APPLICANTS SIGNATURE DATE: -"_7,"-../--'--i'-~"' • Finance • • • > CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB930701 FOR 09/28/93 DESCRIPTION: 19 SQ COMP SHINGLES RE ROOF TYPE: MISC JOB ADDRESS: STE: INSPECTOR AREA PD PLANCK# CB930701 OCC GRP CONSTR. TYPE NEW LOT: APPLICANT: 1265 FOREST AV HARDESTY, KENNETH A. PHONE: 619 729-8684 CONTRACTOR: OWNER: REMARKS: MH/KEN SPECIAL INSTRUCT: TOTAL TIME: CD LVL DESCRIPTION PHONE, tl1: :UL PHONE: 1 INSPECTO. . ACT COMMENTS _is __ s_T _R_o_o_ff_R_e_r_o_o_f _________ ffj_ fr~ kt- DATE DESCRIPTION 071693 Roof/Reroof ***** INSPECTION HISTORY***** ACT INSP AP PD COMMENTS ROOF SHEATHING