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Home My WebLink About1339 KNOWLES AVE; ; CB950281; PermitPERMIT APPLICATION PLAN CHECK No. q s. ".rz 8--l City of Carlsbad Building Departlllent l ~V~DEPOSIT _______ _ 2075 Las PalllllS Dr., Carlsbad, CA 92009 (619) 438-1161 i. PRkMI 1 NPR VAIJD. BY __________ _ From List I (see back) give code of Permit-Type: __ _JRL.O>..J.A--1,.D>=:: ____ _ DATE For Residential Projects Only: From Use 2 (see back) give Code of Structure-Type: _______ S::::...f:..,:D=--------- Net Loss/Gain of Dwelling Units ¢ 2. PROJF.Cf INFORMATION FOR OFFICE USE ONLY Address \'?,~ Bmldmg or Sutte No. mt o. ase o. CHECK BEWW IF S0BMI 11 £0: D 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report D l Addressed Envelope ASSESSOR'S PARCEL DESCRIPTION OF WORK 'P~o (o.,er EXISTING USE PROPQSED USE # OF STORIES # OF BEDROOMS # OF BATI!ROOMS I NAME (last name first) 1 eren rom app 1can SAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE 4. APPUCANI ~UNlH.ACJUK UAli.tNl l'UtlCUNlH.AClUK DOWNER DAGEN I FOR OWNER NAME (last name fir..t) WORTH ING, INC B. ~DRESS P. 0. BOX 1 0 4 1 CITY CARLSBAD STATE CA ZIP CODE 9201 8 DAY TELEPHONE ( 6 1 9) 729-3965 5. PltOP£k['y oWREk ,,. __ l-,1,A LL-A · NAME (last name first) I fypte.,'--/ r-,re,1 ADDRESS CITY STATE ZIP CODE DAY TELEPHONE NAME(lastnamefir..t) WORTHING, INC, B.A. ADDRESS P.O. BOX 1041 CITY CARLSBAD STATE CA ZIP CODE 9 2 0 1 8 DAY TELEPHONE ( 6 1 9 ) 7 2 9 -3 9 6 5 STATE UC. # 3 9 8 7 6 4 UCENSE CLASS B 1 CITY BUSINESS UC. # 5 4 9 2 0 0 DESIGNER NAME (last name hr..t) WORTHING, B. A. ADDRESS p. O. BOX l O 4 1 CITY CARLSBAD STATE CA ZIP CODE 92018 DAYTELEPHONE729-3965 STATE UC.# BJ 392894 7. WukkERS' WMPENSAIION Workers' Compensation Oeclarat1on: I hereby afhrm that I have a cert1hcate of consent to seif-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). INSURANCE COMPANY STATE FUND POUCY NO. 2 2 9-6 5 3 7 EXPIRATION DATE O 1/95 Certthcate of Exemption: I certify that m the pertormance of the work for which this permit 1s issued, I shali not employ any person m any manner so as to become subject to the Workers' Compensation Laws of c.alifomia. SIGNATURE DATE 8-OWN£lt-B0UDER Dfi!IXRAJION Owner-Builder Declaration: I hereby afhnn that I am exempt from the Confractor's License Law for the foiiowmg 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 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.S 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 [$5001). SIGNATURE DATE WMPLEIE IHIS SECIION FOR NON-RESIDENIIAL BUIIDING PERMIIS 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 □ NO IF ANYOFTIIEANSWERS ARE YES, AFINAL CER11FICATE OF OCOJPANCYMAYNOf BE ISSlll!ll AFJERJULY l, 1989 UNIJ'.SS TIIE APPLICANT HAS MITT OR IS MEJITING TIIE REQUIREMENTS OF TIIE OFFICE OF EMERGENCY SERVICES AND TIIE AIR POLLIJ11ON a>N111.OL DISI1IICT. 9. WNSIRUCl10N LRNDING AGENCY I hereby afhrm that there 1s a construction lendmg agency for the performance of the work for which thts permit ts 1SSued (Sec 3097(i) dvU Code). LENDER'S NAME LENDER'S ADDRESS JO. APPIJCAN I CEkliFJCAUON I certify that I have read the apphcat10n and state that the above mformat10n 1s correct. I agree to comply with ali City ordmances 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.50 AGREE 1U SAVE INDEMNIFY AND KEEP HARMIBSS TIIE CI1Y OF CAllISIIAll AGAINSf AU. LlABIUl1ES, JUDGMENTS, CXlSTS AND EXPENSES WIIlCH MAY IN ANY WAY Aa:RUE AGAINSf SAID CI1Y IN CONSEQUENCE OF TIIE GRANTING OF TIDS 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 Code 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 a ed at y time after the work is commenced for a period of 180 days (Section 303(d) Uniform Builfl Cocle). APPUCANT'S SIGNATU ,_.-'""•A• .. DATE: ~7.fl_~ PERMIT# CB950281 DESCRIPTION: 176 SF PATIO CITY SPECS TYPE: PATIO CITY OF CARLSBAD INSPECTION REQUEST FOR 06/28/95 COVER STE: INSPECTOR AREA PD PLANCK# CB950281 OCC GRP CONSTR. TYPE VN LOT: JOB ADDRESS: 1339 KNOWLES AV APPLICANT: WORTHING, BROOKS CONTRACTOR: PHONE: 619 729-3965 OWNER: REMARKS: MW/DIANA/729-3965 SPECIAL INSTRUCT: TOTAL TIME: --RELATED PERMITS-- CD LVL DESCRIPTION PERMIT# CB941325 CB950041 RW950008 TYPE RAD POOL ROW PHONE: uL PHONE: /2,_L;\ INSPECTOR~--:c____.'-'<-....,_-<..::._...;;__-=--- STATUS ISSUED ISSUED ISSUED ACT COMMENTS =19===ST===F=i=na=l==S=t=~==c=t=u=r=a=l==========f'!.:= heir- ------------------- ***** INSPECTION HISTORY***** DATE DESCRIPTION 031095 Ftg/Foundation/Piers ACT INSP AP MP COMMENTS -r-. .... . , /1D.o 0l+eN7~ I I \lr, ,.._I II I = u.,,, o , 11,, .o City of CA. LSBAO BU U.O lf-.J G DE P7. 4o 1 (p 11 \ 11 ~ ,, ! / \ ; 110,C, i I I ' I I I/ I 04 ( ' .) u