HomeMy WebLinkAbout1635 CHESTNUT AVE; ; CB950848; PermitBUILDING PERMIT
06/27/95 07:40
Page 1 of 1
Job Address: 1635 CHESTNUT AV Suite:
Permit Type: ELECTRICAL
Parcel No: 205-220-09-00 Lot#:
Valuation: 0
Construction Type: NEW
Occupancy Group: Reference*:
Description: UPGRADE ELEC SERVICE FROM 100
: AMP TO 200 AMP
Permit No:
Project No:
Development No:
CB950848
A9501220
Appl/Ownr : ZACHRY, JEFF
1635 CHESTNUT AV
CARLSBAD, CA 92008
*** Fees Required ***
Status:
Applied:
Apr/Issue:
Entered By:
***
619-434-4632
Fees Collected & Credits
ISSUED
06/27/95
06/27/95
RMA
***
Fees: 31.00
(Adjustments: ,00
Total Fees: 35.00
Fee description
Total .Credits!
Total Payments-.
Balance Duei
Units Fee/Unit
.00
.00
35.00
Ext fee Data
Enter "Y" for Electric Issue Fee >
Remodel/Alter Per
* ELECTRICAL TOTAL
100 .25
10.00 Y
25.00
35. 00
2490 06/27/95 0001 0.1 02
C-PRHT
CLEARANCE
PROVAL
DATEl±i
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION H^t^H
City of Carlsbad Building Department ^kL fjfm
2075 Las Palaas Dr., Carlsbad, CA 92009 (619) 438-1161 Xflgt^^
1. PERMIT TYPE
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 Dwellinx Units
2. PROJECT INFORMATION
PLAN CHECK NO. ^\^f)l^\6
EST.VAL
PLAN CK DEPOSIT ,
VALID. BY RA^ .
DATE ' L \ <\-I \ rtC-^V \ * ' V\ >
FOR OFFICE USE ONLY
Nearest Cross Street
LEGAL DESCRIPTION Subdivision Name/Number Unit No.Phase No.
CHECK BELOW IF SUBMITTED:
D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D1 Addressed Envelope
ASSESSOR'S PARCEL EXISTING US PROPOSED USE
DESCRIPTION OF WORK
SQ.FT.
G»-<VO-e_ t£Cjt<Jr«r.
# OF STORIES (
ay FV-YJYV\ IOO
# OF BEDROOMS 3
To 2jD£>
# OF BATHROOMS
rrerent_trom appucantj .» -^
j£.A C-f\ *~ ^ JlSr^
CITY
ADDRESS
ZIP CODE DAY TELEPHONE
APPLICANT TJCONTRACIUR D AGENT FOR CONTRACTOR LTOWNtR uAotNi FOR OWN
NAME (last name first) ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
5. PROPERTY OWNER
NAME (last name first)
CITY
ADDRESS
STATE ZIP CODE DAY TELEPHONE
6. CONTRACTOR
NAME (last name first)
CITY
ADDRESS
STATE ZIP CODE DAY TELEPHONE
STATE LIC. #LICENSE CLASS CITY BUSINESS LIC. #
NAME (last name tirstj TUJDRtSS
CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. #
7. WORKERS COMPENSATION
Workers' Compensation Declaration: I hereby affirm that I have a certificate of consent to selt-insure issued by the Director ot Industrial
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 POLICY NO.EXPIRATION DATE
Certificate ot 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 DATE
8. OWNER-BUILDER DECLARATION
X uwner-uuilder Declaration: 1 hereby artirm that 1 am exempt rrom tne contractors License Law tor tne following reason:
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).
D I am exempt 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, 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 penaltv*f not more than five hundred dollars [$500]).
SIGNATURE Q>^^ ^/H^t^V DATE (f - 3(~l - 1S~~
(JUMfLETE TH(ti/ SEPIX^I FOR jfclN-RESIDEN'/lAL 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 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?
D YES D NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
D YES D NO
IF ANY OF THE ANSWERS ARE YES. A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1,1989 UNLESS THE APPLICANT
HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
9. UJNSTKUUIIUN LEND1NU AGENCY
I hereby attirm that there is a construction lending agency tor the performance ot tne work tor which this permit is issued (Sec 3097(i) Civil Codej.
LENDER'S NAME LENDER'S ADDRESS
LJlKllMLjUHJN
1 certify that I nave read tne 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 SATO CTTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA permit is required for excavations over S'O" 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 abandoned at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code).
APPLICANTS SIGNATURE ^ _ /7 DATE: fa-'Z.7-
FE:0File YELLOYft Applicant PINK: Finance
City of Carlsbad
Building Department
OWNER-BUILDER VERIFICATION
Attention Property Owner:
An 'owner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary delay in
processing and issuing your building permit. No building permit will be issued until this verification is
received.
1 . I personally plan to provide the major labor and materials for construction of the proposed property
improvement (yes or no)
2. I (have/have not) HArO€: _ 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:
" | A- _Name
Address . City
Phone Contractors License No.
4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise,
and provide the major work:
Name ^ • A-
Address _ City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following persons to provide the
work indicated:
Name Address Phone Type of Work
Signed:
Property Owner
Date:
2O75 Las Palmas Drive • Carlsbad, California 92OO9-1576 • (619) 438-1161