HomeMy WebLinkAbout1771 ANDREA AVE; ; CB950549; PermitI
Appl/'Ownr : CHRISTIAN BUILDERS
4656 RRIAH RIDGE ROAD
619 <J41
1667 04/27/95 0001 01 02 C-WT 45.00
c**
PERNa APWCAlYON
City of Carlsbad Building Departrnt 2075 La8 Palms Dr., Carlsbad, U PMOP (619) 438-1161
From List 1 (see back) give code of Permit-%:
For Residential Proiecu Only: From List 2 (see back) dve
....................................................
Code Of StruCNre-W:
Net WGain of Dwelling Units I
2 PRCIIESTINIQRMATION FOR OFFICE USE ONLY
Hulldlng or Sute NO.
N Lot No. Subd~vlszon NamUNumber Umt No. Phase No.
0 2 Energy Cab 0 2 Structural Cab 0 2 Soils Report 0 1 Addressed Envelope
DESCRIPTION OF WORK &$2Lf- E- TZU. Cbyrm~, m,7 IC. KL &A++<
SQ. FT. # OF # OF BEDROOMS # OF BATHROOMS
NAME (last name first) ADDRESS
SE PRO SE .
P (rr anterent trom appllcanlj
CITY STATE zw CODE DAY TELEPHONE
NAME (last name first) ADDRESS
CITY STATE zIr CODE DAY TELEPHONE STATE UC. #
Workers' mmpensatlon WElaratlon: I hereby attlrm that I have a certltlcate Ot consent to selt-msure lssued by the Ulrector ot lnduslnal 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).
offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License law dm 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 nor 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.).
0 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 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 strucNre, 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 [SOO]).
SIGNATURE MTB
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?
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
Is the facility to be-constructed within2,OOO feet of the outer boundary of a school site?
0 YES 0 NO
0 YES 0 NO
LENDER'S NAME LENDER'S ADDRESS
1 certlty that 1 have read the applumon and state that the above mtormatlon IS correct. 1 agree to comply with all Clty ardlnanees and state laws relating to building construction. I hereby authorize representatives of the City of Carlrbad to enter upon the above mentioned property far inspection purposes. IAISOACREETOSAVE~~ANDKEEPHARMIESSTHECITYOFcARlsBADAG~STAU.~JUDGMENT$DDSIS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANlWG OF THIS PERMIT.
OSHA: An OSHA permit ti^^ over 5'0" deep and demolition or construction of structures over 3 stories in height
Exviratian. Every llermit the vrovisions of this Code shall exoire bv limitation and become null and wid if the within 365 days from the date of such ork is commenced for a period of 180 DATE:
I c v YTE: File OW Applicant PINK: Finance
i3
CITY OF CARLSBAD INSPECTION REQUEST
PERMIT# CB950549 FOR 04/28/95 INSPECTOR AREA DESCRIPTION: R/R GFI, STUCCO, CLEANOUT PLANCKY CB950549 OCC GRP
TYPE: HISC CONSTQ. TYPE NEW
JOB ADDRESS: 1771 ANDREA AV STE :
APPLICANT: CHRISTIAN BUILDERS PHONE: 619
CONTRACTOR : PHONE :
OWNER: PHONE :
.:" ' UT:
REMARKS: MW/STEVE/941-9599 SPECIAL INSTRUCT: LATH PUB G GFI
INSPECTOR ,u
TOTAL TIME:
CD LVL DESCRIPTION ACT COMKENTS
17 ST Interior Lath/Drywall & 23 PL Gas/Test/Repairs 6
/8- z 3f" 8e A=-/ P~&W
" -
***** INSPECTION HISTORY *****
DATE DESCRIPTION ACT INSP COMMENTS
WORKERS' COMPENSATION DECLARATION
I hereby affirm under 'penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self-insure for
the performance of the work for which this permit is issued.
A. workers' compensation as provided by section 3700 of the Labor Code, for
I have and will maintain workers' compensation, as required by section 3700
issued. My workers' compensation insurance carrier and policy number are:
B. of the Labor Code, for the performance of the work for which this permit is
INSURANCE COMPANY POLICY NO. EXPIRATION DATE:
(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 which this permit is issued,
I shall not employ any person in any manner so as to become subject to the
I C. workers compen
Sig
Warning: Failure to secure workers' compensation coverage is unlawful, and shall be
subject an employer to criminal penalties and civil fines up to one hundred'thousand
dollars ($100.000). in addition to the cost of compensation, damages as provided for
in Section 3706 of the Labor Code, Interest and attorney's fees.
March 3, 1995
2075 Las Palmas Dr. - Carlsbad. CA 92009-1576. (619) 438-1161 FAX (619) 438-0894
~ ~~ " ~ ~~