HomeMy WebLinkAbout1368 CYNTHIA LN; ; CB900766; PermitBUILDING
05/10/90 08 19
Page 1 of 1
Job Address 1368 CYNTHIA LN
Permit Type ELECTRICAL
Parcel No
Valuation 0
Construction Type NEW
Occupancy Group
PERMIT
Str
Permit No CB900766
Project No A8903540
Development No
Fl Ste
53f5 05/10/90 OOQl OJ 02
C-FRHT 10.00
Class Code
Description TEMP POWER ON PERM BASE
Status ISSUED
Applied 05/10/90
Apr/Issue 05/10/90
Validated By JPY
*** Fees Required **** * *Fees Collected & Credits * * *
Fees
Adjustments
Total Fees
Fee description
Enter "Y" for Electric
* pr.RrTRTrAr. TOTAL rSi
10
10.
l£
n \
00
00
00
3sue Fee >
Minimum )
Total Credits
Total Payments
Balance Due
Units Fee/Unit
10
Ext fe
5
10
00
00
00
?e
00
00
Data
Y
FINAL APPROVAL
IMSP ^4n pATf
CLEARANCE
CITY OF CARLSBAD
2075 Las Palmas Dr, Carlsbad CA 92009 (619) 438-1161
PERMIT APPLICATION
City of Carlsbad Building Department
2075 Las Palmas Or , Carlsbad, CA 92009 (519) «a-ii6i
1 PERMIT TYPE
A Q COMMERCIAL
D INDUSTRIAL
Q~NEWQTENANT IMPROVEMENT
QNEW QTENANT IMPROVEMENT
DAPARTMENT QCONDO QSINGLE FAMILY DWELLING
QDUPLEX QDEMOLITION QRELOCATION QMOBILE HOME QELECTRICAL
QMECHANICAL QPOOL QSPA DETAINING WALL QSOLAR QOTHER.
PROJECT INFORMATION PLAN CHECK No
4-
Address 1368 Cynthia Ln.
Nearest Cross Streets
BuiTiding^ or'Suite wo
EST VAL
PLAN CK DEPOSIT,
VALID BY
DATE S^
^kR OFFICE USE ONLY
LEGAL DESCRIPTION i/Nutnber Unit No Phase No
CHECK BELOW IF SUBMITTED
D2 Energy CaLcs n? Structural Calcs Q2 Soils Report Q1 Addressed Envelope
150-230-60-3 EXISTING USEASSESSOR'S PARCEL
DESCRIPTION OF UOB
PROPOSED USE
Temporary power on a permanant base
BLDG SQ FTG # OF STORIES
3 CONTACT PERSON
NAME Patrick Kelley ADDRESS 1622 Tremont
CITY _ ._ STATE ZIP CODE DAY TELEPHONE
Oceanside Ca 92054 433-5139
SIGNATURE „ o o
4 APPLICANT DCONTRACTOR Q AGENT FOR CONTRACTOR QOUHER Q AGENT FOR OUNE! ~ """^ "
NAME Same as above
CITY DAY TELEPHONE
5 PROPERTY OWNER
NAME
Same as above
CITY
OWNER
STATE
ADDRESS
ZIP CODE
DLESSEE OTENANT
DAY TELEPHONE
6 CONTRACTOR
NAME
Edgar Mullen Const.
ADDRESS P.O. BOX 1480
CITY
Carlsbad STATE LIC #
STATE ZIP CODE
CA 92008
LICENSE CLASS
DAY TELEPHONE
434-2233
CITY BUSINESS LIC #
SIGNATURE
DESIGNER NAME
CITY
7 WORKERS'COMPENSATION
TITLE
ADDRESS
STATE ZIP CODE
DATE
DAY TELEPHONE STATE LIC #
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 POLICY NO EXPIRATION DATE
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 to become subject to the Workers' Compensation Laws of California
SIGNATURE
8 OWNER-BUILDER DECLARATION
Owner Builder Declaration I hereby affirm that I am exempt from the Contractor s License Law for the following reason
I [ 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 )u r baie t
II 1 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 DUlldS Or improves thor^nn anH rnnrrartc fnr cnrh nrnifrl-Q ulth rnntrartnr^
licensed pursuant to the Contractor s License Law)
I am exempt under Section
ruct the project (Sec 7044 Business and Professions Code
thereon and contracts for such projects with contractor(s)
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])
SIGNATURE DATE
COMPLETE THIS SECTION FOR NON RESIDENTIAL BUILDING PERMITS 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 Acf
DYES QNO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district7
DYES DNO
Is the facility to be constructed within 1 000 feet of the outer boundary of a school site'
DYES QNO
IF ANY OF THE ANSWERS ARE YES A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY \ 1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS
OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT
CONSTRUCTION LENDING AGENCY
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
10 APPLICANT'S SIGNATURE
I certify that I have read the application and state that the above information is 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 ALSO
AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES JUDGMENTS COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID
CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT
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 180 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 connienccd for a period of ISO days (Section 303(d) Uniform Buildinq Code)
APPLICANT'S^SIGNATURE , ,T^. 0?OWNER Fl CONTRACTOR H BY PHONE APPROVED BY
—^_^—«==^ L(QV r<i DATE
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