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PERMIT APPLICATION
City of Carlsbad Building Department
PLAN CHECK NO. Cf t:_:, ( 3 ~ L.j
2075 Las Pal•• Dr., carlsbed, CA 92009 (619) 438-1161
I. PEkM1 I hPR
From list 1 (see back) give code of Permit-Type: _,Mc,ci=ScaC:.... _______ _
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For Residential Projects Only: From list 2 (see back) give
Code of Structure-Type: ____________________ _
Net Loss/Gain of Dwelling Units
2. PRQJECI" INFORMATION
Address I l,,R) Hunnningbird Rd. ~ ~~cTf"est Cross Street
Buildwg or Suite No. & Batiquitos ur.
FOR OFFICE USE ONLY
LEGAL DESCRIP I ION Lot No. SubdtvlSlon Name/Number Omt No. Phase No.
CHECK Bf:WW IF S0HMII lf:O:
D 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report D 1 Addressed Envelope
ASSESSOR'S PABGEI, EXISTING USE PROPOSER USE DESCRIPTION OF WORK Meter Pedestal --/~A l(!:,,t-r,~
SQ. IT. # OF STORIES # OF BEDROOMS 3. WN IACI PFJ&JN (I[ dtftereni from applicant)
NAME (last.name first) Waite, Lance ADDRESS
# OF BAlHROOMS
CI1Y STATE ZIP CODE DAY TELEPHONE
4. APPIJCANJ □WNIRACIUR JLAGENI FORCONIRACIOR uuwNtH. ~AGENI FOR OWNER
NAME (last name first) Waite, Lance ADDRESS 2385 Camino Vida Roble, /1107
CI1Y Carlsbad STATE CA ZIPCODE92009 DAY TELEPHONE (619) 929-1600 5. PRbPEk IY OWNER.
NAME (last name first) Western Pacific Housing -ADDRESS
C 1 b d CAAviara, -L. P.
92009
2385 Camino Vida Roble, #107
CI1Y ar s a STATE ZIP CODE DAY TELEPHONE (619) 929-1600
NAME (last name first) LAMCO Housing, Inc. ADDRESS 300 N. Continental Blvd., //390
C!lY El Segundo STATE CA ZIP CODE 90245 DAYTELEPHONE (310) 648-7200
STATEIJC. # 67570 9 LlCENSECLASS B CllY BUSINESS LlC. # 12 0 3 5 0 1
DESIGNER NAME (last name first) ADDRESS
CllY STATE ZIP CODE DAY TELEPHONE STATE LlC. # 7. WORREkS' WMFENSAIIDN
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Workers1 Compensation Deciarauon: I hereby afhrm that I have a certificate of consent to sell-msure issued by the Director of lndusrnal
Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified
by the Director of insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C). te Compensation
surance Fund POLlCY NO. 46-5588 EXPIRATION DATE 1-1-97
, 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.).
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 iness and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish, or repair
any structu , rior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the
provision f e Contractor's License Law ( apter 9, commencing with Section 7000 of Division 3 of the Business and Professions Code)
or that · exempt therefrom, and e bas for the alleged exemption. Any violation of Section 7031.S by any applicant for a permit
' applicant to a civil ty f n zre.._ than five hundred dollars [$500]).
DATE '-
pplicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and
re ntion program under Sections 25505, 25533 or 25534 or 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 ANY OF TIIEANSWERS ARE YES, AFINAL CERTIFICATE OF OCDIPANCY MAY NOT BE lliSlJEll AFIERJULY 1, 1989 llNLESSTIIEAPPUCANT
HAS MET OR JS MEIITING TIIE REQUIREMENTS OF TIIE OFFICE OF EMERGENCY SERVICES AND TIIE AIR POLLUTION OONTI!.OL DISTIUCT.
9. WNSIR0CIION LENDING AGENCY
I hereby afhrm that there ts a construction lend mg agency for the performance of the work for which this permit 1s tssued (Sec 3097(1} CivH Code).
LENDER'S NAME Sanwa Bank
JO. APPUCAN I CEkliFICAIJUN LENDER'S ADDRESS 4400 MacArthur Blvd., Newport Beach, CA 92660
I certify that I have read the apphcal:ion and state that the above miormatmn 1s correct. I agree to comply with all 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 AISO AGREE TO SAVE INDEMNIFY AND KEEP HARMLFSS TIIE CI1Y OF CAR!SBAD AGAINST AIL LlABIUTIES, JUDGMENTS, CDSTS
AND EXPENSES WIDCH MAY IN ANY WAY ACDlUE AGAINST SAID CI1Y IN OONSEQUENCE OF TIIE GRANTING OF TIDS PERMIT.
OSHA: An OSHA permit is required for
Expiration. Every permit issued by th
building or work authorized by sue
such pennit is suspended or
APPIJCANrs SIGNATU
cavations over S'O" deep and demolition or construction of structures over 3 stories in height.
0
WESTON GRP-WESTON MRSN Fax:310-820-5405 Jul 12 '96 12:37 P.02
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