HomeMy WebLinkAbout1818 ASTON AVE; ; CB004535; PermitPLAN CHECK NO.
EST. VAL.
Plan Ck. Deposit
Validated By
Date
>* MITAPPLICATION .
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave , Carlsbad, CA 92008
. . . . . . . .. ... .. .
ISec. 1031.5 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 pu15umt to the provisions of the Contractor's License Law
lchsptsr 9, commending with Section 7000 of Division 3 of the Business and Professions Code1 or that he is exempt therefrom. and the baris for fhs alleged
exemption. Any violation of Section 7031.5 by any applicant for B permit subjects the applicant to a civil penalty of not more than five hundred doliars l150011.
Name Address City StatelZip Telephone X
State License X License Class City Business License #
Designer Name Addrssr City StatelZip Telephone
State License X
, ,,,
0 of the work for which this permit is issued.
0
iswed. My worker's compensation insurance Carrier and poiicy number are:
insurance Company Policy No.
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS Id1001 OR LESS)
0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this pwmit is issued. I shall not employ any person in any manner so as
to become subject to the Workers' Compensation Laws of California.
WARNING: Failure to secure workers' compensation coverage is unlawfuI, and shall subject an mployer to Criminal psnakiss and civil finer up to one hundred
thousand dollars ~$100.000). in addition to the cost of compensation. damages as provided far in Section 3706 of the Labor code, interest and attorney's tees.
SiGNATURE DATE
I have and will maintain a Certificate of Consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code. for the performance
I haw and will maintain workers' compemation. as required by Section 3700 of the Labor Code. for the performance of the work for which this permit is
Expiration Osle
., ..
I, as owner of the property or my employees with wages as their sole compensation, will do the
ISec. 7044. Business and ProfesSions Code: The Contractor's License Law does not apply to an owner
such work himself or through his own employees. provided that such improvements are not intended or 0
0 I, as owner Of the property, am exclusiveiy contracting with licensed contractors to cons
Contractor's License Law does not apply to an owner of property who builds or improves th
pursuant to the Contractor's License Law).
0
1.
2.
structure is not intended or offered for sale
0 builds 01 improves thereon, and who does
If. however, the building or improvement is the purpose of salel. . 7044, BUsine5S and Professions Code: The
for such projects with contractoils) licensed
I am exempt under Section
I pe~sonally plan to provide the major labor and materials for Construction of the p
I (have I have not1 signed an application for a building pBrmit for the propored wo
Business and Professions Code for this rea
rty improvemmt. 0 YES ON0
phone number I contractors license number):
4.
number I contractors license number):
I plan to provide portions Of the work, but i have hired the following per
program under Sections 25505. 25533 or 25534 of the Presley-Tanner Hazardous Substance AcCOUnt Act? 0 YES 0 NO
1s the applicant or future building Occupant required to obtain a permit from the air pollution Contmi district or air quality management district?
1s the facility to be constructed within 1,000 feet Of the outer boundary of a school site?
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE
0 YES NO
YES 0 NO
N CONTROL DISTRICT.
,, ,,
F EMERGENCY
DNCV
I hereby affirm that there is B ConstrUCtion lending agency for the performance of the work for which this permit is issued 1Sec. 3097111 Civil Codel.
LENDER'S NAME LENDER'S ADDRESS , . .., ,,, , 9 ,, ,
I Certify that i have read the application and state that the above information is Correct and that the information on the plans is accurate. i agree to comply with all
City ordinances and State laws relating to building Construction. I hereby authorize representatiws of the City Of Carlsbad to enter upon the above mentioned
property for inspection purpose5. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAO AGAINST ALL LIABILITIES,
JUDGMENTS. COSTS AN0 EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEOUENCE OF THE GRANTING OF THIS PERMIT.
OSHA An OSHA permit is required for excavations over 5'0" deep and demolition or ConStrwtiOn of Structures over 3 stories in height.
Onicial under the provisions of this Code shall expire by limitation and became null and void if the building or work
date of such permit or if the building 01 work authorized by such permit is suspended or abandoned
ction 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE DATE
YELLOW Applicant PINK: Finance
OCT-11-01 02:19PM FROM-LOKER 2ND FLOOR SiM4RiiETING +?§OD304474 T-ZOO P 02/02 F-862
Gitv of Carlsblad -1-
FAST tlir\CK PERMI? 2151 MICHELSON DM IFNINE CAW12
-Abbey Building Dqmrtmmt