HomeMy WebLinkAbout165 CHINQUAPIN AVE; ; 80-544; Permitwhich this permit is issued (Sec 3097 Civil Code) » r 1CONSTRUCTION LENDING AGENCY1 hereby affirm that there is a construction lenCERTIFICATE OF EXEMPTION FROMWORKERS COMPENSATION INSURANCE(This section need not be completed if the permit is for one hundred dollars ($100) or less)I certify that in the performance of the work for_yyhich this permit is issued I shall not employ anyperson in any manner so as to become subject tothe Workers Compensation Laws of CaliforniaNOTICE TO APPLICANT If after making this Certi*icate of Exemption you should become subjectto the Workers Compensation provisions of theLabor Code you must forthwith comply with suchprovisions or this permit shall be deemed revoked1 HAVE CAREFULLY EXAMINED THE COMPLETED AFHEREBY CERTIFY THAT ALL INFORMATION HEREONFURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUECOUNTY AND STATE LAWS GOVERNING BUILDING CCSPECIFIED HEREIN OR NOT 1 ALSO AGREE TO SAVELESS THE CITY OF CARLSBAD AGAINST ALL LIABILEXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINSOF THE GRANTING OF THIS PERMITQ H O S S O ^
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APPLICftyfe1? SIGNATURE _ - OWNER[] CONTR ACTORfJf^u/ "iA/A.ji^/17 /ft Sfl>0&r3l^ " AGENT Q BY PHONE UAAPPROVED BY1/"")/") DATE'jutt* AlJ^^vhAN OSHA PERMIT IS REQUIRED FORS 0 DEEP AND DEMOLITION OR COSTRUCTURES OVER 3 STORIES IN HEEXCAVATIONS OVMSTRUCTION OF-IGHTm3)
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1 OWNER BUILDER DECLARATIONDl hereby affirm that 1 am exempt from the Contractor s License Law for the following reason(Sec 7031 5 Business and Professions Code) Anycity or county which requires a permit to construct alter improve demolish or repair anystructure prior to its issuance also requires thef-o
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STATE LICENSEe 3£os99^1LICENSED CONTRACTOR S DECLARATION1 hereby affirm that 1 am licensed under provisions of Chapter 9" (commencing with Section7000) of Division 3 of the Business and Professions Code and my license is in full force and effeet«•»
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•DATE OF APPLICATION&//6/X&So ^PERMIT NUMBER1- /H ^H CITY OF CARLSBAD-BUILDING DEPARTMENT ^H ^B^ APPLICATION & PERMIT ^^ APPLICANT TO FILL IN INFOR - ^FUSE BALL POINT PEN ONLY 120Q ELM AVENUE (/14) 433.5525 MATION WITHIN RED LINESINSPECTION VALIDATES
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[OTHER DEPT s REQ COMPLETED1
ELEC METER-PERM-TEMP| OAS METER-PERM-TEMPj CFRT OF OCCUPANCY ISSUED
INTERDEPARTMENTAL INFORMATION SHEET
BUILDING DEPARTMENT
BUILDING ADDRESS
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CITY OF CARISBAO-
Bulldlug Department
PLANNING DEPARTMENT
70NE LOT SIZE LOT WIDTH
UNITS ALLOWED UNITS PROVIDED
PARKING SPACES REQUIRED
% COVERAGE ALLOWED
BUILDING HEIGHT ALLOWED
FRONT SETBACK
ALLOWED /- /X
PROVIDED
_PROVIDED_
_PROVIDED
PROVIDED
SIDE SETBACK
INTRUSIONS
LANDSCAPE & IRRIGATION PLAN COMMENTS
REAR SETBACK
ENVIRONMENTAL PROTECTION REQ
SCHOOL FEES: $
ADDITIONAL COMMENTS
S. P. F. FEES: $
OK TO ISSUE DATE TO FINAL DATE
INDUSTRIAL WASTEROW
SEWER CONNECTION
GRADING PERMIT
DRIVEWAY LOCATIONS
EASEMENTS DRAINAGE
LEGAL DESCRIPTION
ADDITIONAL COMMENTS_
P. F.PEES; $
OK TO ISSUE DATE PWI OK TO FINAL DATE
FIRE DEPARTMENT
3P*IT<KLING SYSTEMI
FIRE ALARMS
FIRE HYDRANTS
ADDITIONAL COMMENTS
FIRE PROTECTION EQJIP
EXITS
LOCATION
OK TO ISSUE DATE OK TO FINAL DATE
WATER DEPARTMENT
REQUIREMENTS OF APPROPRIATE DISTRICTS MET_DATE