HomeMy WebLinkAbout1270 HOOVER ST; ; CB901760; Permit..
8 U I L D I N G P E R M I T
11/01/90 14:33
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Job Address: 1270 HOOVER ST Str:
Permit Type: ELECTRICAL
Parcel No: 206-150-05-00
Valuation: 0
Construction Type: NEW
Occupancy Group: Class Code:
Description: TEMPORARY POWER POLE NEW SFD
Permit No: CB901760
Project No: A9000646
Development No:
Fl: Ste:
Status: ISSUED
Applied: 11/01/90
Apr/Issue: 11/01/90
Validated By: KZH
Appl/Ownr : VANBUREN, BRADLEY 729-0635
OWNER
***
Fees:
Adjustments:
Total Fees:
1880 MARRON RD STE. 102
CARLSBAD, CA 92008 -----
Fee description
CITY OF CARLSBAD
9183 11/01/90 0001 01 02 • o,)
OWNER CR_ ~O {)j
le.cted & Credits ***
.oo
.oo
15.00
Ext fee Data
5.00 Y
10.00 Y
15.00
2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161
PERMIT APPLICATION
Cjty of Carl sbad Building Department
2075 Lat Pal mas Dr., Carl sbad, CA 92009 (619) 438-1161 EST. VAL ______________ _
PLAN CK DEPOSIT ___________ _
VALID. BY ______________ _
1. PERMIT TYPE DATE _______________ _
A .
B
COMMERCIAL
D INDUSTRIAL
TENANT IMPROVEMENT
0 TENANT IMPROVEMENT
C ~RES I DENT I AL O APARTMENT
D DUPLEX D DE MOL IT I ON
0 MECHANICAL □POOL
□CONDO □SINGLE FAMILY DWELLING □ADDITION/ALTERAT ION
□RELOCATION □MOBILE HOME □ELECTRICAL ,.)2PLUMBING
OSPA □RETAINING WALL □SOLAR □OTHER /£MP. Jt>i.-E
2. PROJECT INFORMATION PLAN CHECK No.
Address 1:l ?o Hoo\J/CR Bull
Nearest Cross Streets H I 4 >f'-,'rfi O LEGAL DESCRIPTION Lot No. Subdivision Name/Nt.nt>er Unit No. Phase No.
CHECK BELOII IF SUBIIITTED:
2 Energ Cales 2 Structural Cales 1 Addressed Envelo
ASSESSOR'S PARCEL EXISTING USE PROPOSED USE
VoW£R..
BLDG. SO. FTG. # OF STORIES
3. CONTACT PERSON
NAME ADDRESS
ZI P COOE CI TY STATE DAY TELEPHONE
SIGNATURE
4. APf.bICANT
NAME DM-OU:~ \)
0 CONTRACTOR
A+\ \S ~t:.-t-l
0 AGENT FOR CONTRACTOR
ADDRESS
□OWNER J("1 AGENT FOR OWNER
CITY STATE ZIP COOE DAY TELEPHONE
5. PROPERTY OWNER OWNER □LESSEE □TENANT
6.
7.
NAME R ,c:...,~ 'O ~(i2..£0'!L)>.
CITY STATE
CONTRACTOR
NAME c9 w N lc-R_ -
CITY STATE
STATE LIC. # ____ _
SIGNATURE
DES I GNER NAME
CITY
WORKERS' COMPENSATION
STATE
ADDRESS
ZIP COOE
ADDRESS
ZIP COOE
LICENSE CLASS _____ _
TI TLE
ADDRESS
ZI P COOE
DAY TELEPHONE ?4)-6180
DAY TELEPHONE
CITY BUSI NESS LIC. #
DATE
0AY TELEPHONE STATE LIC. #
\Jorkers• Corr.,ensation Declarat;on: hereby affirm that have a certificate of consent to self·insure issued by the Director of Industrial Relations,
or a certificate of \iorkers• C001)ensation Insurance by an actnitted insurer, or an exact copy or duplicate thereof certified by the Director of the
insurer thereof filed with the Bui lding Inspection Department (Section 3800, Lab. CJ.
INSURANCE COMPANY POLI CY NO. EXPIRATION 0ATE
Certificate of Exen-.,tion: I certify that in the performance of the work for which this permit is issued, I shall not efll>loy any person in any manner
so as to become subject to the \Jorkers• COOl)ensation laws of California.
SIGNATURE DATE
8. OWNER-BUILDER DECLARATION
Owner-Builder Oeclarat1on: 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 efll)loyees with wages as their sole compensat ion, 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 irrproves thereon" and who
does such work himself or through his own efl'4'.)loyees, provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, t he owner-builder will have the burden of proving that he did not build or improve for the purpose
of sale.).
0 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 irrproves thereon, and cont racts for such projects with contractor(s)
licensed pursuant to the Contractor's License Law).
0 I am exeirpt under Section __________ _ Business and Professions Code for this reason:
(Sec. 7031.5 Bus iness and Professions Code: Any City or County wh ich 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 l icensed pursuant to the provisions of the
Contractor 1s llcense Law (Chapter 9, coornencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exefl'4)t therefrom,
and the basis for t he 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 f ive hundred dollars [S500)).
SIGNATURE DATE
COMPLETE THIS SECTION FOR NON·RESIDENTI AL BUILDING PERMITS ONLY:
Is the applicant or future building occupant required to submit a business plan, acute ly hazardous materials registration form or r isk management and prevention
program under Sections 25505, 25533 or 25534 of the Presley· Tanner Hazardous Substance Account Act?
□YES O 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 O MO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
Ores
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE I SSUED AFTER JULY 1, 1989 UIILESS THE APPLICANT HAS NET OR IS MEETING THE REQUIREMENTS
OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
9. CONSTRUCTION LENuING AGENCY
hereby affirm that there i's a construction lending agency for the performance of the work for which this permi t is issued (Sec 3D97(i) Civil Code).
LENDER 'S NAME LENDER 'S ADDRESS
10. APPLICANT'S SIGNATURE
I certify that I have read the application and state that the above informat ion is correct. I agree to COffl>lY with all Clty ordinances and State laws relating
to building construction. I hereby authorize representat ives of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. J ALSO
AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JLOGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID
CITY IN CONSE0UENCE OF THE GRANTING OF THIS PERMIT.
Expiration. Every permit issued by the Building Official under the provisions of this Code shall e1.pire by l imitat ion and become null and void i f the building
or work. authorized by such rmit 1s not comnenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended
or abandoned at er the work. is conmcnccd for a per iod of 180 days (Section 303(d) Uniform Building Code).
D OWNER D CONTRACTOR OBY PHONE APPROVED BY: _______ _
DATE: __________ _
WHITE: File YELLOW: Applicant PINK: Finance