HomeMy WebLinkAbout13 GREENVIEW DR; ; CB930704; Permit, I
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CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION .
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PLAN CHECK NO.
City of Carlsbad Building DepartlllE!t'lt
2075 Las Pal-s Dr., Carlsbad, CA 92009 (619) 438-1161 -
. . EST.VAL ___________ _
PLAN CK DEPOSIT _______ _
VAIID.BY __________ _
I. P£RM1 I l'YPE DATE
A -Li Commercial LI New Bu1Idmg O Tenant Improvement
B -• Industrial • New Building • Tenant Improvement
C -• Residential • Apartment • Condo • Single Family Dwelling •Addition/Alteration
• Duplex • Demolition • Relocation • Mobile Home • Electrical • Plumbing • Mechanical • Pool • Spa • Retaining Wall D Solar • Other ____ _
2. PRClJF.CfOOURMATION FOR OFFICE USE ONLY
Address / 3 6/!~I(' ;;.v Ir "V Dn 8u1ldmg or Suite No.
Nearest Cross Street
LEGAL DESCRIPTION Lot No. Sutxhv1S1on Name/Number Unit No. Phase No.
CHECK BEWW IF S0BMI 11 ED:
D 2 Energy catcs • 2 Structural catcs • 2 Soils Report • l Addressed Envelope
ASSESSOR'S PARCEL EXISZ:NG USE P,, )'ROPOSED USE DESCRIPTION OF WORK
SQ. FT. # OF STORIES
3. WN IACI PERSON (tr dulerenf tram applicant)
NAME ADDRESS
CITY
4. APPUCAN 1 UCON I RAC I OR
STATE ZIP CODE DAY TELEPHONE
J¥t!}g~~~~IOR_.;ljfg-1W ~:?Jt9¥~~ ~ NAME /?J~1f"/~c, C.
CITY ~ }?::>
S. PROP£1tlY OWN£1t
NAME ,4--rc.o
STATE C.l'r ZIP CODE q 2/ Z" DAY TELEPHONE £.3 c) -0 3 C, 5
lo/8~#°DRESS q(J</ //?:!i /1//£ S: (,,c/,
STATE ZIP CODE~n-l),4DAYTELEPHONE Cd'
CITY _s; 9n )o-tf' STATE ZIP CODE DAY TELEPHONE
STATE UC. # ""3'jf (sZJ LICENSE CLASS C!'' DESIGNER NAME ADDRESS
CITY BUSINESS UC. #
CITY STATE ZIP CODE DAY TELEPHONE STATE UC.# 1. wrnumru,.v OOMPENSAliON
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•
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Workers' Compensation beclarauon: I hereby athrm that I have a ceruf 1cate of consent to sell-msure issued by the Director of 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).
EXPIRATION DATE
er ere ya 1rm t at am exempt rom t e w or t e o owmg reason:
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.).
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 [$500]).
SIGNA111RE DATE
COMPLETE tAls SECMoN FOR NON-RESIDEN !'!AL BUILDING PERMI l's 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 ONO
IF ANY OF nm ANSWERS ARE YFS, A FINAL CERTIFICATE OF CXIlJPANCY MAY Nor BE ISSUED AFIER. JULY 1, 1989 UNIJ.'.SS nm APPUCANT
HAS MET OR IS MEETING n-m REQUIREMENTS OF n-m OFFICE OF EMERGENCY SERVICFS AND nm AIR POI.UJTlON CDN1ROL DISfRICT.
9. WNS'IROCnoN LENDING AGENt-V
I hereby athrm that there 1s a construcuon lending agency for the performance of the work for which this permit 1s issued (Sec 3097(1) C1V1i Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPllcAN t cEt'i1FICA11oN
I cerufy that I have read the apphcauon and state that the above mformauon 1s correct. I agree to comply with all City ordinances and State laws
relating to building construction. I hereby authorize representatives of the City of cartsbad to enter upon the above mentioned property for inspection
purposes. I AISO AGREE 10 SAVE INDEMNIFY AND KEEP HARMLF.SS nm Cl1Y OF CARLSBAD AGAINST ALL IJABILITIES, JUDGMENTS, CDSTS
AND EXPENSES WI-DOI MAY IN ANY WAY Aa:RUE AGAINST SAID Cl1Y IN CDNSEQUENCE OF nm GRANTING OF n-ns PER.MIT.
TE: File YEU.OW: Applicant PINK: Finance
06/21/94 INSPECTION HISTORY LISTING
FOR PERMIT# CB930704
DATE INSPECTION TYPE INSP ACT COMMENTS
07/15/93 Gas/Test/Repairs PD CO U
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