HomeMy WebLinkAbout1370 KNOWLES AVE; ; CB910759; PermitPERMIT APPLICATION IA V
City of Carlsbad Building Department EST. VAL. ______________ _ 2075 Las Palmas Dr., Car)sbad, CA 92009 (619) 43Hl61
1.
A
PERMIT
COMMERCIAL
PLAN CK DEPOSIT ___________ _
VALID. BY, ______________ _
DATE _______________ _
B tJ INDUSTRIAL
TENANT IMPROVEMENT
□TENANT IMPROVEMENT
C ....... ES !DENT I AL O APARTMENT
0 DUPLEX ODE MOL IT ION
□MECHANICAL □POOL
□CONDO □SINGLE FAMILY DWELLING □ADDI TJON/Al TE RATION
□RELOCATION OM061LE HOME □ELECTRICAL □PLUMBING
□SPA □RETAINING WALL QS0LAR
2. PROJECT INFORMATION PLAN CHECK No. F '""'''' /370
Nearest Cross Streets
LEGAL DESCRIPTION Unit No. Phase No.
CHECK BELOW IF SUINJTTED:
Q2 Energy Cales qz Structural Cales
3.
4. lrcONTRACTOR
CITY
D 2 Soi ls Repart
# OF STORIES /
0 1 Addressed Envelope
EXISTING USE PROPOSED USE
ADDRESS /617 &.!Jr,/IJ v/57/J w/rr
STATEGP ZIP COOE ~ DAY TELEPHONE 61"( 7 2..<f
0 AGENT FOR CONTRACTOR
ADDRESS
STATE ZIP CODE
0 AGENT FOR OWNER
DAY TELEPHONE
S'S/7
5. PROPERTY OWNER OWNER
ADDRESS AS~ &/6,,/,.,
ZIPCOOE 9~
□LESSEE ~._ .0TENANT
""' ColllSv1trrn..o ~rrtr
m,4'(£1~ STATQ)
vtSr-11 Ul1't'1 f'r(
DAY TELEPHONE ~ " ~
6. CONTRACTOR_ ,...._,__,,,,_ ""tM~ -c.,v .....-, ADDRESS /6 7? ~
Zl P COOE 9a:i0!
lllYrfl ~ #
7.
8.
C ITYC/'1(2£: STATE Q-DAY TELEPHONE 7Z:i. _ SS ,,
CITY
ATE LIC. ,'31S'.2-•78C.
STATE
LICENSE CLASS .B ... ___ _
TITLE
ADDRESS
ZIP CODE
CITY BUSINESS LIC. #
DATE
DAY TELEPHONE STATE LIC. #
Morkers' C~nsat,on Declaration: hereby affirm that have a certli,cate of consent to self-insure issued by the Director of Industrial Relations,
or a certificate of Workers' Con,::,ensat ion Insurance by an actni t ted insurer, or an exact copy or duplicate thereof cert if; ed by the Di rector of the
insurer thereof filed with the Building Inspection Department (Section 3800, Lab. Cl.
INSURANCE COMPANY POLJCY NO. EXPIRATION DATE
Certificate of Exefl'4)tion: I certify that in the performance of the work for which
so as to become subject to the lJorkers' Coopensation Laws of California.
SIGNATURE DATE
OWNER-BUILDER DECLARATION
is issued, I shall not
Owner-Builder Declaration: ! hereby affirm that I am ex~t from the Contractor's License Law for the following reason:
in any manner
DI as owner of the property or my errployees 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 errployees, provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of CDffl)letion, 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).
0 J am e:11errpt 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, coomenc i ng with Section 7000 of O i vision 3 of the Business and Professions Code) or that he is exerrpt therefrom,
and the basis for the alleged e:11errption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not
more than five hl.O:lred dollars [$500]).
SIGNATURE DATE
COMPLETE THIS SECTION FOIi NON-RESIDENTIAL BUILDING PERMITS cmLY:
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?
OYEs □No
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
Ores □No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
□YES QNO
IF ANY OF TNE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCaJPANCT NAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS
OF THE OFFICE OF BERGENCT SERVICES AND THE AIR POI.LUTION CONTROL DISTRICT.
9. CONSTRUCTION LENDING AGENCY
hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097Ci) Civil Code).
LENDER'S NAME #/4 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 cowply with al\ 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, Jll>GMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID
CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
Bui\di g Official under the provisions of this Code shall expire by limitation and become null and void if the building
need within 180 days from the date of such permit or if the building or lo'ork authorized by such permit is suspended
oomenced for a period of 180 days (Section 303(d) Uniform Building Code).
□ O'wNER ~CONTRACTOR OaY PHONE APPROVED ''BY: _______ _
DATE:
YELLOW: Applicant PINK: Finance
PERMIT# CB910759
DESCRIPTION: RELOCATE GARAGE
CITY OF CARLSBAD
INSPECTION REQUEST
FOR 06/27/91
ON SAME LOT
TYPE: MISC
JOB ADDRESS: 1370
APPLICANT: MEDINA,
CONTRACTOR: CONERY,
OWNER:
REMARKS: MH
SPECIAL INSTRUCT:
TOTAL TIME:
LVL DESCRIPTION
KNOWLES AV
CONSTANTINO
LAWRENCE
PHONE:
PHONE:
PHONE:
ACT COMMENTS
INSPECTOR AREA PK
PLANCK# CB910759
OCC GRP
CONSTR. TYPE VN
FL: STE:
CD
19 ST Final Structural ft!_ _____ _
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***** INSPECTION HISTORY*****
DATE DESCRIPTION
051491 Ftg/Foundation/Piers
ACT INSP
AP MP
COMMENTS