HomeMy WebLinkAbout1285 CARLSBAD VILLAGE DR; ; CB951584; Permit,A B U I L D I N G
-, *^" >10/SO/95 14=45
Address ^SS CARLSBAD VILLAGE DR
e, ELECTRICAL
Parcel No-
Valuation: °
Occupancy Group- Tr,
Description TPP FOR XMAS TREE LOT
=
Apol/Ownr : ART SMITH ELECTRIC
2354 OXFORD AV
CARDIFF BY THE SEA
PERMIT
Suite:
Permit No CBS51584
Project No- A9502312
Development No.
4400 10/W.5 00<U f 0, ^
construction VP^ NEW >5.0C
Status ISSUED
Applied: 10/30/95
Apr/Issue: 10/30/95
Entered By: TP
619-944-4484
Fees :
Adjustments:
Total Fees-
Fees Required ***
3 f^(.5»*
**.Collected & Credits * *
,00
00
Fee description
>;,, ^ p^KSf^%t _Ext_fee__Data
Enter "V" for Electric
Single Phase PerjAMr-/ / V
* ELECTRICAL TOTAfl ;(. ,
10.00 Y
25 00
35.00
FINAL APPROVAL
INSP. / DATE
CITY OF CARLSBAD
2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161
PERM" APPLICATION* X /
City of Carlsbad Building Department
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
1 PURM1TTVPE
from List 1 (see back) give code of Permit-Type
For Residential Proiects Only From List 2 (see back) give
Code of Structure-Type / Q O
Net Loss/Gain of Dwelling Units
PLAN CHECK NO.
EST.VAL
PLAN GK DEPOSIT
VALID BY ~
DATE
2 PROJECT INFORMATION
Address
FOR OFFICE USE ONLY
Nearest Cross Slreet
Building or Suite No
LEGAL DESCRIPTION"Lot No Subdivision Name/Number Unil No Phase No
CHUCK BELOW It SUBMl'lTLTJ
D 2 Energy Calcs Q 2 Structural Calcs D 2 Soils Report D 1 Addressed Envelope
ASSESSOR'S
DESCRIPTION OF WORK
SQ FT f # OF STORIES # OF BEDROOMS # OF BATHROOMS
3 (JUNTAL'l PEHSUN (il ditlerent (rom applicantj
NAME (last name first)
CITY / SI ATE
ADDRESS
ZIP CODE DAY TELEPHONE
CITY STATE ZIP CODE DAY TELEPHONE
5 MtoPCUTV OWN!
NAME (last name first)
CITY STATE
ADDRESS
ZIP CODE DAY TELEPHONE
NAME (last name first)
CITY STATE
STATE. LIC #
ZIP CODE
LICENSE CLASS
DAY TELEPHONE
CITY BUSINESS LIC #
NAMh (.last name first)ADDRESS
CITY STATE ZIP CODE DAYTFLEPHONE STATE LIC #
7 WORKIJth' COMPENSATION
Workers' Compensation Declaration 1 hereby dltlrm thaTIhave a certificate of consent to self-insure Issued by the Director ol 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 [hereof filed with the Building Inspection Department (Section 3800, Lab C)j >-i s* . Sit^r t*"t* _
rV iv k\ iA i u JINSURANCE COMPANY POLICY NO EXPIRATION DATE
Lertnicdte ol Exemption T certify that in the perform<ince of the work for which this permit is issued, I shall not employ any person in any manner
so as to become subjecfi to the Workers' Compensation Laws of California
SIGNATURE DATE /o - Jo-
8 UWNIJl-Bl
Uwner-liuilaer Declaration Thereby alhrm mat 1 am exempt from the Contraaors License Law tor Lhc lollowing 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 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 Ijcense 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, 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 LS500])
SIGNATURE DATE
COMPLETE TiTTg SFCTION FOR NON-RES1DENTIAI BUILDING-PERMITS ONLY
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or nsk management and
prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act?
D YES D NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
D YES D NO
Is the facjjjry io be constructed within ],000 feet of Ihe outer boundary of a school site?
D YES D NO
IF ANY OF TI IE ANSWERS ARE YES, A FINAL CERTUTCATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS Tl ffi APPIJCANT
HAS MET OR IS MIXTING HIE REQUIREMI'JfTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL D1CTRICT
' CUNSTKUCTION LKNIMNG
I hereby attirm that there is a construction lending agency lor the perlormance ot the work tor wnich this permit is issued (.Sec 3097U7 Civil
TO"
LENDER'S NAME
APPLICANT LENDER'S ADDRESS
lawsT certify that 1 have read the application and state thai " th~e "above intormation is correct I agree to comply with ^11 City ordinances and Stale
relating to building construction I hereby authonze representatives of the City of Carlsbad to enter upon the above mentioned property for inspection
purposes I AISO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARISBAD AGAINST A1JL LIABILITIES, JUDGMENTS, COSTS
AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF HIE GRANTING OF THIS PERMIT
OSIIA. An OSHA permit is required for excavations over 5'Q" 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 authonzed 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 the work is commenced for a penod of 180 days (Section 303(d) Uniform Building Code)
APPLICANTS SIGNATURE DATE _
WHITE: File YELLOW: Applicant PINK: Finance