HomeMy WebLinkAbout1323 CASSINS ST; ; CB971381; PermitBUILDING PERMIT
' 05/28/97 08:04
I Page 1 of 1
' Job Address: 1323 CASSINS ST Suite:
! Permit Type: PATIO/DECK
Parcel No: 215-690-20-00 Lot# :
Valuation: 743
Occupancy Group: Referenced;
Description: 110 SF PATIO COVER CITY SPECS
: 743 WITH GAS AND ELECTRIC
Permit No: CB971381
Project No: A9701778
Development No:
Appl/Ownr : TAMBORELLI CONSTRUCTION
28520 HUCKLEBERRY LN.
SAN MARCOS, CA.
*** Fees Required ***
Construction Type: VN
Status: ISSUED
Applied: 05/28/97
Apr/Issue: 05/28/97
Entered By: MDP
6119 975-2043
Collected & Credits
Fees :
Adjustments:
Total Fees:
Fee description
Building Permit
Plan Check
Strong Motion Fee
Other
* BUILDING TOTAL
83.
** *
. 00
.00
83. 00
Ext fee Data
$726797 02 47.0014. 00
1. 00
47.00 GAS & ELEC
83. 00
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
BUILDING
05/28/97 07:53
Page 1 of 1
1 Job Address: 1323 CASSINS ST
Permit Type: PATIO/DECK
Parcel No: 215-690-20-00
Valuation: 743
Occupancy Group: Reference*:
Description: 110 SF PATIO COVER CITY SPECS
: 743
Appl/Ownr : TAMBORELLI CONSTRUCTION
28520 HUCKLEBERRY LN.
SAN MARCOS, CA.
*** Fees Required ***
PERMIT
Suite:
Lottf :
Permit No: CB971381
Project No: A9701778
Development No;
5337 05/28/97 0001 01 02
C-PRMT 36.00Construction Type: VN
Status: ISSUED
Applied: 05/28/97
Apr/Issue: 05/28/97
Entered By: MDP
6119 975-2043
Collected & Credits
Fees:
Adjustments:
Total Fees:
Fee description
Building Permit
Plan Check
Strong Motion Fee
* BUILDING TOTAL
36.
* *
. 00
.00
36.00
Ext fee Data
21.00
14.00
1 .00
36. 00
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(760)438-1161
i.IN
FOR OFFICE USE ONLY
PLAN CHECK NO.
EST. VAL. '
Plan Ck. Deposit
Validated By
Date
Address (include Bldg/Suite »)Business Name (at this address)
Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total # of units
Assessor's Parcel *Existing Use Proposed Use
Description of WorkPATIO CJDV&L UK ID
S/ CONTACT PERSON (If dHfwwt from
SO. FT.(Tof Stories * of Bedrooms * of Bathrooms
Name
**:•«<•
Address City State/Zip Telephone #Fax*
Name Address
Name Address
State/Zip Telephone if
State/Zip Telephone #
(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, commending 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 f*500J).
Name
State License #
Address
License Class B ** L
/ City State/Zip
City Business License »
Telephone »
Designer Name Address City State/Zip Telephone
State License f
6. WORKERS'COMPENSATION " , _ . - - , - - „„_,_,, „ ,„„,.,„ .,,„_ ,.r.
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
Q I have end will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
O I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My worker's compensation insurance carrier and policy number are:
Insurance Company Policy No. Expiration Date
(THJS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*100) OR LESS)
""•&. CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as
•^o become subject to the Workers' Compensation Laws of California.
WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars (SKDO.OOO), in addition to the.coat of comp*n*«}ion, damages as provided for in Section 3706 of the Latjw code/Interest and attorney'* fee*.
(^^ DATE
>••f7. ••' OVRBUILDER DECLARATION • ' • • • "f
I hereby-affirm that I am exempt from the Contractor's License Law for the following reason:
Q 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 end 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, »s owner of the property, em 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 contractors) licensed
pursuant to the Contractor's License Law).
D I am exempt under Section _ Business and Professions Code for this reason:
1 . I personally plan to provide the major labor and materials for construction of the proposed property improvement. O YES QNO
2. f (hsve / have not) signed an application for a building permit for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number):
4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone
number / contractors license number):
5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type
of work):
PROPERTY OWNER SIGNATURE DATE
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 2550S, 25533 or 26534 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? O YES O NO
Is the facility to be constructed within 1 ,000 feet of the outer boundary of s school site? D YES D NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE
REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.'—"—-— «^— » i ->-*•
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Code).
LENDER'S NAME _ LENDER'S ADDRESS
I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all
City ordinances and State laws relating to building construction. I hereby authorize representatives of the Crr> of Carlsbad to enter upon the above mentioned
property for inspection purposes. I ALSO AGREE TO SAVE. INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES,
OSHA: An OSHA permit is required for excavations over S'O' deep end 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 end void if the building or
work authorized by such permit is not commenced within 365 days from the date of suclvaermK or if the building or work authorized by such permit is suspended
or abandoned at any time after the work is commenced ior a period of 1 80 daws' (S*cBjxOO6 V.4 Uniform Building Code).
APPLICANT'S
d by such permit is not commenced within 365 days fro
t any time after the work is commenced ior a period of
sf 4* jw
SIGNATURE^rTTtf-^-^^^y -C--^^ N DATE
PlWIf •
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT* CB971381 FOR 07/23/97
DESCRIPTION: 110 SF PATIO COVER CITY SPECS
743 WITH GAS AND ELECTRIC
TYPE: PATIO
JOB ADDRESS: 1323 CASSINS ST
APPLICANT: TAMBORELLI CONSTRUCTION PHONE:
CONTRACTOR: PHONE:
OWNER: PHONE:
INSPECTOR AREA PD
PLANCK* CB971381
OCC GRP
CONSTR. TYPE VN
STE: -v LOT:
6119 975-2043
REMARKS: C/DEBRA/485-1600
SPECIAL INSTRUCT:
INSPE
TOTAL TIME:
CD LVL DESCRIPTION
19
29
39
49
ACT COMMENTS
ST Final Structural
PL Final Plumbing
EL Final Electrical
ME Final Mechanical
***** INSPECTION HISTORY *****
DATE DESCRIPTION ACT INSP
053097 Ftg/Foundation/Piers AP PD
053097 Gas/Test/Repairs AP PD
053097 Underground/Conduit-Wiring AP PD
052997 Ftg/Foundation/Piers AP PD
052997 Gas/Test/Repairs AP PD
052997 Underground/Conduit-Wiring AP PD
COMMENTS
COMPENSATION
INSURANCE
P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807
P U N D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
DECEMBER 20.1996 POLICY NUMBER:
CERTIFICATE EXPIRES:
r
KNIGHT CONSTRUCTION CO
7310 MIRAMR ROAD STE 600
SAN DIEGO CA 92126
JOB: ALL OPERATIONS
L
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California
Insurance Cornmissioner to the employer named, below for the policy period indicated. i ;_*..,.
This policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer.
We will also give you TEN days' advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the
policies listed herein. Notwithstanding any requirement,; term, or condition of any contract or other document with
respect to which this certificate of insurance may be Issued or may pertain, the insurance afforded by the policies
described herein is subject to all the terms, exclusions and conditions of such policies.
,AUTHORIZED REPRESENTATIVE , •* > -v' , „ PRESIDENT
f EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COST: $1,000,000 PER OCCURRENCE.
EMPLOYER
r
TAMBORELLJ CONSTRUCTION
28520 HUCKELBERRY LANE
SAN MARCOS CA 92063 NR
THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND SCIF 10262 (REV. 3-95)