HomeMy WebLinkAbout1301 FOREST AVE; ; CB960632; PermitB ll I L D I N G
, • ., ., : 19
>dge 1 of 1
rob Address: 1301 FOREST AV
•ermi t Type: PLUMBING
•arcel No: 156-110-09-00
7aluation: O
P E R .M I T
Suite:
Lot#:
Permit No: CB'l6uf>32
Project No: A960L8~3
Development No:
6895 {)4/05!.'.96 00()! .OL O) Construction Typ-e. Nt:;W ~
lccupancy Group: Reference#: Stat~: ISSUED
Appl i e'tl~'RM:T4 IO c; / i&J. • (){'
Apr/Issue: 04/05/9b
Entered By: RMA
619-757-3729
>escription: KITCH-ELEC&PLUM,BATH-ADD SHOWR
: NEW FAU
Appl/Ownr : DRAY, MICHAEL
1212 CALIFORNIA ST
OCEANSIDE CA 92054
* ~ * Fees Required
Fees:
Adjustments:
Total Fees:
Fee description
Enter ''Y" for Plumbi
Each Plumbing F1xtur
Each Install/Repair
Each Water Heater
Other
* PLUMBING TOTAL
***
.00
.00
101.00
***
Ext fee Data
20.00 Y
14.00
7.00
7.00
53.00 ELEC'&MECH
101.00
'I~
f~~R~-'------------
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION PLAN CHECK NO.
. City of Carlsbad Building Depart.nt
2075 Las Pal .. s Dr., carlsbed, CA 92009 (619) 438-1161
I. PERMI I IYPR
From List 1 (see back) give code of Permit-Type:-------------
For Residential Projects Only: From List 2 (see back) give
Code of Structure-Type:---------------------
Net Loss/Gain of Dwelling Units
2. PROJECT INFORMATION FOR OFFICE USE ONLY
Address (.:55\ ~--(Ave.-Bu1id1ng or Suite No. --.-:,,
nit o.
CHECK BEWW IF SUBMI 11 £0:
LI 2 Energy Cales D 2 Structural Cales [J 2 Soils Report D 1 Addressed Envelope
4. APPllCANI ?[fCONIRACIOR UAGENI FO,tt.CONIRACIOR OOWNERr' OAG£N;4•utt.OWNER
NAME (last name first)~ k.,._i_~\ ADDRESS \ °L \L.---'-.__C..\ ~ ~I"-\ C-~
CilY ~ STATE Cl,<\_ ZIP CCDE9-1.G6:'\ DAY TELEPHONE t20 'e,Q<!.-S ~,
5. PkuPEklY oWNER
NAME (lastnamefirst)°+'"-'-t*~"'--I l:::>,c~ ADDRESS \~o\ ~ A.-0 '
CilY~C:U-~ STATE CA._ ZIP CCDE 92...cO-'t:, DAY TELEPHONE -r~-9_ ~'4 't::,L)
. NAME (last name first) 1:)c--~ ~"-'-..,c_l lC<oEc-\,_ ADDRESS \"2.-\ t-0_.c..__\,~f"'.(C..... ~
CilY ~"""'-~~ STA~ ZIP CCDE9.."2.C>S,'+-DAY TELEPHONE LS') ('.:)IL~ (cl.--LLD~ ",
STATE UC. #(,,SC\ \6t-tJCENSE CIASS -P::, CilY BUSINESS UC.#
DESIGNER NAME (last name fu'St) ADDRESS
CilY STATE ZIP CODE DAY TELEPHONE STATE UC.#
1. WORKElts' CDMP£NSAIION
Workers' Compensation Deciarat1on: I hereby affirm that I have a ceruhcate of consent to self-insure 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 De$ment (Section 3800, Lab. C).
<..r .L_ 22...Ci-Sb,--10,~.:::::.._
INSURANCE COMPANY ~ POLICY ~O. EXl'!RAT!oN DATE
1c t 1s permit 1s issue , s a not emp oy any person 10 any manner
SIGNATURE DATE
8. oWNER-BOnnmt bffiARAIIUN
Owner-Builder Declaration: I hereby affirm that I am exempt from the Confracfofs Llcense Law for the ioliow1ng 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 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 Llcense 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 Llcense Law).
Cl I am exempt under Section --------Business and Professions Ccxl.e 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 co the
provisions of the Contractor's Llcense Law (Chapter 9, commencing with Section 7000 of Division 3 of the Business and Professions Ccxl.e)
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]).
SIGNATURE DATE
COMPlllE IHIS SECl10N FOR NON-RES1DEN'l1AL BOlilllNG PERMll'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?
Cl YES Cl NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
Cl YES Cl NO
Is the facility co be constructed within 1,000 feet of the outer boundary of a school site?
Cl YES Cl NO
IF ANY OF TIIEANSWERSARE YES, A FINAL CERTIFICATE OF OOCUPANCY MAY NOT BE l!iSlJEll AITERJULY I, 1989 UNLESSTIIE APPLICANT
HAS MET OR IS MEETING 1llE REQUlllEMENTS OF 1llE OFFICE OF EMERGENCY SERVICES AND 1llE AIR POILUTION OONTROL DISl1UCT.
9. WNSIROCIIUN lliND1NG AGRNCY
I hereby aftlrm that there ts a construction lending agency for the performance of the work for which this permit 1s issued (Sec 3097(1) C1vH Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPUCAN I cmttFICAliUN
I certHY that I have read the application and state that the above 1nformat1on 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 Carlsbad to enter upon the above mentioned property for inspection
purposes. I AI.<;O AGREE TO SAVE INDEMNIFY AND KEEP HARMIBSS 1llE CTlY OF CARISBAD AGAINST AIL UABILITlES, JUDGMENTS, <DSTS
AND EXPENSES WIIlCH MAY IN ANY WAY ACDlUE AGAINST SAID CTlY IN OONSEQUENCE OF 1llE GRANTING OF 11lIS 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 Ccxle 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 authorized by
such permit is suspended or aba don~t a ea te work is commenced for a pericxl of 180 days (Section 303(d) Uniform Bui!~
APPLICANTS SIGNATURE DATE~~
PINK: Finance
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB960632 FOR 05/16/96
DESCRIPTION: KITCH-ELEC&PLUM,BATH-ADD SHOWR
NEW FAU
TYPE: PLUM STE:
INSPECTOR AREA PY
PLANCK# CB960632
OCC GRP
CONSTR, TYPE NEW
LOT: JOB ADDRESS: 1301 FOREST AV
APPLICANT: DRAY, MICHAEL
CONTRACTOR:
PHONE: 619-757-3729
OWNER:
REMARKS: MW/MIKE/PG 720-8045
SPECIAL INSTRUCT:
TOTAL TIME:
--RELATED PERMITS--
CD LVL DESCRIPTION
PERMIT# TYPE
CB960405 RAD
PHONE: PHONE, :idL_
INSPECT~~
STATUS
ISSUED
ACT COMMENTS
_1_1~ _s_T ~I_n_t_e_r_i_o_r~La~t-h_;_o_ryw~_a_1_1~~~~~~~~~~~~~~~~~~~~
DATE
042296
042296
041796
041596
041596
041596
***** INSPECTION HISTORY*****
DESCRIPTION
Const. Service/Agricultural
Shear Panels/HD's
Insulation
Underground/Under Floor
Rough Electric
Rough/Topout
ACT INSP
AP PY
PA PY
PA PY
AP TP
PA TP
AP TP
COMMENTS
DOWNSTAIRS ONLY LOWER LEVEL
EXISTING WALLS
WALLS
KIT fc REST RELOC