HomeMy WebLinkAbout1825 FOREST AVE; ; CB910848; Permit.4
BUILDING PERMIT Permit No: CB910848
07/15/91 10:13. Projct No A9100673
Page 1 of 1 ' Devlopthent No
Job Address 1825 FOREST AV Str Fl Ste
Permit Type RESIDENTAL ADD/ALT (UNDR $10K)
hT 4 '1 f . - 3465 07/15/91 0001 .01 02 Parcelflo.. - - C-PRHT 150.00
Valuation 9,504
Construction Type: VN
Occupancy Group: M ''. Class,Cbde:"
.. . -'•- Status:.. ISSUED
Description 528-SF-GARAGE - FORMERLY PC Applied 05/31/91
:CB91-571 RADMAJ-NOWGARAGE ONLY .. '.Apr/-Issue: 07/15/91
Validated By KZH
Appl/Ownr : TIPTON COLLEEN 619-434-3606.. - -
- 1845 FOREST AV
CARLSBAD, CA 92008
OWNER TIPTON, COLLEEN
Fees Required **C c OWNER Li
------
Fees: /209 .b
Adjustments:.. .\.00 oa1\Cr ,s:\ •
-Total Fees: i 20900 Total Paymen-ts 59.00.'
/ / V• BalarteDue.: \ ni
150.'00
tion
!Extri fee -Data !!!!i_s ---
Building Permit
7.6.00
Strong Motion Fee 1.90.
.
Plan Check
••
BUILDING TOTAL
7
dc
194. 00
Enter ",Y" for'Plumbing Issue e
"Y" for Elect ssuez? Y
Enter $II for Remode•1 . 10.00 '1
* ELECTIUCAL TOTAL (10 Minimum) 15.00
-- :• -. Y
1 -. • - . ..
•
1 - • - .-•-.-- . . '- -,
.';
FIIAL APPROVAL j
Dfft'~
I
-.: • -:
•
•-. -
CLEARA
i•.•_. '--•.•-• -' -- .- •-.. . - --
- - CITY OF. CARLSBAD I
*
.
2075 Las Palmas, Carlsbad CA 92009 (619) 438-1161
- -- . • '.,- •' -
PERMIT APPLICATION
City of Carlsbad Building Department
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
1. PERMIT TYPE I
A - 0 COMMERCIAL ONEW qTENANT IMPROVEMENT
B - 0 INDUSTRIAL DNEW 9TENANT IMPROVEMENT
C - [:]RESIDENTIAL OAPARTMENT OCONDO DSINGLE FAMILY DWELLING jDDITION/ALTERATION
ODUPLEX ODEMOLITION :IRE1OCATIoN DMOBILE HOME DELECTRICAL OPIUMBING
MECHANICAL DPOOL EJSPA DRETAINING WALL DSOLAR
PDAirT TI'JFnPMATTON PLAN CHECK No.
- - Address JJç Fire St ,,'
BJitding or Suite No.
Nearest Cross Streets i4 cj.A(c,.j'j_c./ xjf
Cit DEPOSIT
- 02 Energy Calcs 02 Structural Calcs D2 Soils Report 111 Addressed Envelope
ASSESSORS PARCEL / ,5• —
EXISTING USE PROPOSED USE
DESCRIPTION OF WORK d
~.
,Otn 41;? P) 7J
BLDG. SO. FIG. EU3 4C1 # OF STORIES /
CONTACT PERSON
NAME,// er C/(C41 Tplirn ADDRESS
CITY 0.4 iSt".4' STATE- ZIP CODE 012-6-f DAY TELEPHONE
SIGNATURE C. 4__(7
APPLICANT []CONTRACTOR 0 AGENT FOR CONTRACTOR MI<NER 0 AGENT FOR OWNER
NAME&,//ceJ. 77,pIi7t ADDRESS fS i"
CITY .a_t(Ske.c/ STATE ZIP CODE 9 Z DAY TELEPHONE 43 Lf 36 0 C.
PROPERTY OWNER OWNER
NAME o//'eP' 7 f'' ADDRESS ,(2r1r5/ OLESSEE OTENANT
CITY CC' -(S bc. d STATE ZIP CODE ' 2_4Z 6 DAY TELEPHONE
CONTRACTOR
NAME , £k'— bid ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
STATE LIC. N LICENSE CLASS CITY BUSINESS LIC. H
SIGNATURE TITLE DATE
DESIGNER NAME ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. N
WORKERS' COMPENSATION
Workers' Compensation Declaration: I hereby affirm that I have a certificate of consent to self-insure issued by the Director of 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. Q.
INSURANCE COMPANY POLICY NO. EXPIRATION DATE
Certificate of 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
OWNER-BUILDER DECLARATION Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
0 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 Contractors 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.).
EJ 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 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 penalty of not
more than five hundred dollars [$5001).
SIGNATURE DATE
COMPLETE THIS SECTION FOR NON-RESIDENTIAL 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?
DYES DNO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
DYES ONo
is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
DYES ONO
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.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 30970) Civil Code).
LENDER'S NAME LENDER'S ADDRESS
APPLICANT'S SIGNATURE
I certify that I have read the 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, JIEONENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID
CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
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 180 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).
APPLICANT'S SIGNATURE 1:IOWNER I1CONTRACTOR BY PHONE AROVED:8Y:
DATE:
WHITE: File YELLOW: Applicant PINK: Finance
r -
- CITY OF CARLSBAD
1 INSPECTION REQUEST
PERMIT# CB910848 FOR 09/lO/91. -"-INSPECTOR AREA PY
DESCRIPTION:, 528SF GARAGE -. FORMERLY PC - PLANCK# CB910848
CB91-571 RADMAJ-NOW GARAGE ONLY . 0CC GRP
TYPE: RAD ,CONSTR. TYPEVN
JOB ADDRESS: 1825 FOREST AV STR: FL: STE:
APPLICANT: CASTENS, MARCIA PHONE: 619-729-9458
CONTRACTOR: PHONE:
OWNER: TIPTON, COLLEEN ; PHONE:
REMARKS: RS/BRUCE INSPECTOR
SPECIAL INSTRUCT:
TOTAL TIME
*-
- • : •.
CD LVL DESCRIPTION ACT COMMENTS
19 ST Final Stiuctural
29 -PL F ina1-P1uinbi-n
39 ..EL Final E1ec-tria-1 :-•
49 -ME--Final Mechanical - __
-
***** INSPECTION HISTORY *****
DATE DESCRIPTION ACT INSP COMMENTS
080691 Exterior Lath/Drywall AP PY
080691 Exterior Lath/Drywall AP PY
073091 Frame/Steel/Bolting/Welding AP PY - •
073091 Frame/Steel/Bolting/Welding AP PY
073091 Roof/Reroôf. AP PY -
073091 Shear Panels/HD's AP PY
071991-- Ftg/Foundation/Piers AP PK - --
- • 1
-
- I . .- -•
fl.. •
ESG',IL CORPORATION.•:
9320 CHESAPEAKE DR., SUITE 208
SAN DIEGO,CA92123
(619)560-1468
DATE: •
JURISDICTION:
PLAN CHECK NO: SET:77
PROJECT ADDRESS: (16 -2-,5 -r 3cv',
A ICANT
JUR SD'ICTIO
U PLAN.
[]FILE COPY
DUPS
DDESIGNER
I
PROJECT NAME
fl The plans transmitted herewith have been corrected where
necessary and substantially comply with the jurisdiction's
building 'codes.
The plans transmitted herewith will substantially comply
with the jurisdiction's bui'lding'codeswhen'minor deficien-
cies identified are resolved and : checked by building department staff.
D The plans transmitted herewith have sighificant deficiencies
identified on the enclosed check list and should be corrected'
and resubmitted for a complete, recheck.
D:The check list transmitted herewith is, for, your information.
The ians are being held at Esgil Corp. until corrected
plans are s,ubmitted for recheck. -
.n,-The applicant's copy of the check list 'is enclosed for the
jurisdiction .to.return to theapplicant'contact person.
The applicant's copy-of ' the check list has been sent to:, '
Esgil staff did not advise theapp1icant contact person that
plan check has been completed.'
Esgil staff did. advise applicant that 'the plan 'check has
been completed. Person con,tacted:________________________
Date c.onta'cted: Telephone #________________
REMARKS: SoL () Ot 'W ~
L 1 . ivc YZ-v\i E2S F vZ LL1r t -wr- j
Per
qLL5 ?P1 , c-cL." P,-LL DC, (2" '',
By:'TTJ - Enclosures:
'ESGIL CORPORATION ' •
UGA UAA URN 0 D /'' -
t
IF
Date Jurisdiction C-y-zp
Prepared by: Bld g. Dept.
VALUATION AND PLAN CHECK FEE El Esgil
PLAN CHECK NO 1:--S 6r C-- c
BUILDING ADDRESS I'
APPLICANT/CONTACT BILL1t1-o PHONE NO. _
BUILDING OCCUPANCY - - DESIGNERPHONE_____________
TYPE OF CONSTRUCTION V.- NJ CONTRACTOR PHONE___________
BUILDING PORTION BUILDING AREA, VALUATION VALUE -,
MULTIPLIER .:
.. 1'•
AjrCondjtjonjnE • ______________ • •• ••
Commercial -: • •@ : •
Residential • •
Res or Comm,.,.-
Fire Sprinklers •
Total Value
I ~
3LFROW
' BUILDING PLANCHECK
. ENGINEERING CHECKLIST
.DATE: 18'31ik\I ITEM COMPLETE
PLANCHECK NO.H(P4. ITEM INCOMPLETE Y
0. NEEDS YOUR ACTION
2 3 825 P0REST AVE ITEM SELECTED,
T D D _ 1520 .
-tC C C PROJECT ID:________________________ -,
H' H H 4.
.•
E E E LEGALREQUIREMENTS -
K K K Site _Plan
E 1 1. Provide a fully dimensioned site plan drawn to scale.
Show: north arrow, property lines, easements, existing and
proposed structures, streets, existing street improvements,
/ right-of-way width and dimension setbacks.
1\JE 2. Show on site plan: (Finish floo elevations pad
elevations ,-eayajiohs p acent to
4 building, existing, topographic a1 line i, existing and
percent .(%). grade and
drainage ptns.
JvEE].,-3. Provide legal description and Assessors Parcel Number.
/ Dicretionary_ Approval Compliance
I7I ri r--1 .. LU L_J L_J 4. No Discretionary approvals were required. .
.
E E 5. Project compiies - with all Engineering Conditions of
Approval for Project No.
E 6. Project does not comply with the following Engineering
Cànditions of Approval.fór Project No.________________
Conditions complied with by: --.. Date:________
FieldReview . .
E E 7. Field review completed. No issues raised.
7'El El 8. • Field- review completed. The following issues or
- .
.
discrepancies with the site plan were found: -
• A. Site lacks adequate public improvements
-
B. Existing drainage improvements not: shown Or; in
-. . conflict with site plan.
• •; .
C.' Site is served by overhead power lines 1
P:\D0CS\MISF0RMS\FRM0010.DH - . • . REV. 02/27/91 •
, ii . - - .- •
V - -
- • . . .4 . . -
- .- .
. . .
E Grading is required , to access site create pad or
provide for ultimate street improvement
Site- access visibility. problems 'exist. ,,Provideonsite
turnaround or engineered solution to problem
El El El
ir
F Other
if
Dedication Requirements
ELi fi 0 9 No dedication required
F-1 El El lO. Dedication required. Please have a registered .Ciil
Engineer. or Land Surveyor prepare the appropriate legal
description together with an 8½" x 11" plat map and submit
with a title report and the required processing fee. All
easement documents mut be approved and'sigñed by owner(s)
prior-to issuance of Building Permit. The description of
the dedication is as follows:_______________________
. • Dedication completed, Date By:.
Improvement Requirements
11. No public improvements required. SPECIAL-NOTE: -Damaged or
ective improvements found adiacént to building site must
be repaired to the satisfaction of the City inspector prior -
to occupancy. •
fi [112. Public improvements required. This project requires -
construction of public; improvements pursuant to -Section
18.40 of the City Code.. Please have a registered 'Civil
• Engineer' prepare appropriate improvement plans and submit
for separate plancheck process through ,the Engineering
. Department. Improvement plans, must be approved,
appropriate securities posted and fees paid prior' to
issuance of permit. The required improvements are:______
Improvement plans signed, Date:by
P:\D0CS\MISF0RMS\FRM0010.DH . - ,.. . • . REV. 02/27/91
13. Improvements are required. Construction of the public
improvements may be deferred in accordance with Section
18.40of the City Code. Please'submit a letter requesting
deferral of the required improvements together a with
recent title report on the property and the appropriate
processing fee so we may prepare the necessary Future
- Improvement Agreement. The Future Improvement Agreement
must be signed, notarized and dpproved.by the City prior to
issuance of a Building Permit. ' •"
Future Improvement Agreement completed, Date:____________
By:_____________,t -:
13a. Inadequate information available on site plan to bake a-
determination on grading requirements. Please provide more
- detailed proposed and, existing. elevations and contours.
Include accurate estimates of the gradingquántities (cut,
fill, import, export).• -.
No grading required as determined by the information
provided on the site plan
'A Grading Permit required.- separate grading plan prepared
by a registered Civil Engineer must be, submitted for
separate plan check and approval through the Engineering
Department. NOTE: The Grading Permit must be issued and
grading substantially-ôoiñplete and found acceptable to the
City Inspector prior to issuance of Building Permits.
Grading Inspector sign off. Date: by:_________
Miscellaneous Permits
16 Right-of-Way Permit not required
17., Right-of-Way Permit required. A.' separate Right-of-Way
Permit issued by the Engineering Department is required for
the following:- -
-
- -
Sewer -Permit is not required.
- Sewer Permit is required. A sewer Permit is required
- concurrent with Building Permit issuance. The fee required
- is noted below in the fees section.
-Perm . 20.' Industrial Wasteit' i not required.
P:\D0CS\MISF0RMS\FR140010.DH - - - " ' - - - '
- - REV. 02/27/91
E fl 21. Ihdustria1 Waste Permit is required. Applidant must
complete Industrial Waste Permit Application Form and
submit for City approval prior to issuance of a Building
Permits. Permits must be issued prior to occupancy.
Industrial Waster Permit accepted -
- -
Date:By
Fees Required
DN/1 27. Park-in-Lieu Fee :
Quadrant: Fee per Unit:• -
Total Fees
O N/A 23 Traffic Impact Fee -
Fee Per Unit:.- Total ,'Fee: '- *
E] /) 24 Bridge and Thorough fare Fee
Fee Per Unit: -Total Fee:__________
M NJfr3 25 Public Facilities Fee required
O N//a Facilities Management Fee Zone: Fee:
E] tJJ, Sewer Fees Permit No. --_EDU's
Benefit Area: Fee:________________
O fVA Sewer Lateral Required:
-Fee:_______________
29 REMARKS ,FUfl1P.E U I,Lv NJG PEiMT A PPUCT?OI\J.
\b4LiiT1OAJ OP ri41. S PERMr
O2 i-M/Mt €FT F4ME"JT P,AIO S7 Efr
N4PQOJEMEAiT EcUJFMEAiTS
p - ENGINEERING AUTHORIZATION TO ISSUE PERMIT
DATE
P:\D0CS\MISF0RMS\FRI40010.DH REV. 02/27/91
PLANNING CHECKLIST
Plan Check No. Address I '2S X kO
Planner CtV - - - Phone 438-1161 ext. .-P a le
(Name)
APN: 15,-ja-
Te of Project and" Use
Zone 1- I Facilities Management Zone
HL :•
Legend
Af
Item Complete
Item Incomplete Needs your action
1, 2, 3 Number in circle indicates plancheck number where deficiency, was
identified
Review Required: YES - NO
*
V
DATE OF COMPLETION:.
-
,V 4,j• * * V -: -
Compliance with conditions of approval? - If not, state Conditions which require action.
Conditions of Approval
Discretionary Action Required YES - NO
APPROVALJRESO. NO. DATE:
PROJECT NO.
OTHER RELATED CASES
•- V V Compliance with conditions of approval? If not, state conditions which require action.
V Conditions 'of Approval V
• V • ••
6,6~~ Cahfomia oaal Coiso:Pet Requird YES _NO
DATE OF APPROVAL:
V
V V
V
San Diego Coast District,.3111 Camino Del Rio South, Suite 200, San-Diego, CA. 92108-1725
V (619) 521-8036 -
*\. V
V* • V
Compliance with conditions of approval? If not, state conditions which require action.
Conditions of Approval •
•
V
Landscape Plan Required: YES NO /
. ..: •J' L
See anahed submittal requirements fr landscape. plans
Site Plan..
1. Provide a fully dimensioned site plan drawn to scald. Show: Nc
arrow, property lines, -easements, existing and proposed structures
streets, existing street improvements, right ot way idth' a-..
I dimensioned setbacks.
fl 2. Show on Site Plan: Finish floor elevations, elevations of finish grade
adjacent to building, existing topographical lines, existing anaproDose
slopes and driveway.
3 Provide legal description of property.
E 4 Provide assessor's parcel number.
• Zoning: -
Front Required,.'. 2o' Shown
Int. tide: Required O Shown fO'
Stre4et Side Required A*-..-Shon'\A
Rear Required 4r Shown /i'
2 Lot coverage Required Y409' Shown - tJk-
g '
3. Héiht: Required Shown
17 17
- •
4 Parking Spaces Required 2 cor Showm -.2— cc
- Guest SpaesRequire4 •" Shbwn_____
0
- .• • ,. '
Additional Comments
-
(
- -. - •1 -
- -
OK TO ISSUE AND ENTERED, APP INTO COMPUTE-' ATE (
- . PLNCK.FRM
-.-
PERMIT APPLICATION
City of Carlsbad Building Department
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
1. PERMIT TYPE I
A - U COMMERCIAL pNEW DTENANT IMPROVEMENT
8 - [:]INDUSTRIAL DREW []TENANT IMPROVEMENT
C - []RESIDENTIAL DAPARTMENT DCONDO USINGLE FAMILY DWELLINGADDITION/ALTERATION
C3 DUPLEX DDEMOLITION DRELOCATION DMOBILE HOME DELECTRICA D PLUMB ING
DMECHANICAL LJPODl. [:1 SPA DRETAINING WALL DSOLAR C]OTH
EST. VAL
PLAN CX DEPOSIT 7Z62
VALID. BY
DATE
RMT 25?.00
/-, ,1
LAN
Address
3J5
Eore,t Ave.1ôd ijuitaing or surte NO.
if Nearest Cross Streets HiIa
LEGALDESCRIPTION _Lot _Nb. Subdivision ameuiv Unit 2' Phase No.
wI T - 2-1&q t-+
CHECX kL(74 IF SUBMITTED:
D2 Energy Calcs £12 Structural Cates 02 Soils Report ph Addressed Envelope
ASSESSOR'S PARCEL EXISTING USE SF 9_ PROPOSED USE
DESCRIPTION OF WORK ol
km FdHior 8drvi Fdd,t1bCt
BLDG. 50. FIG. t1.Q5'O # OF STO)4 /
CONTACT PERSON
NAME flQY'C.40L Ctr
CITY £arkbito( ,
(
ADDRESS 013 re,1e)(' 5t 51
STATE DAY TELEPHONE
NT FOR OWNER
ADD SS -38 t R
R
N (0,
CON DO6INER
NAME
SIGNATURE '7,1c1417J1..d L4A.Y
NT F
/
P CODE Zoo DAY TELEPHONE 79 ...gc-_57 CITY Car ho4
APPLICAN DCONTRACTOR
js OWNER OLESSEE [-]TENANT5. PROPERTY OWNER __
NAME cCoI(e-efl lip ADDRESS OW_ Av,4e, ,,N
CITY Cksbod STATE ZIP CODE DAY TELEPHONE
6. CONTRACTOR
NAME
~W/~w
ADDRESS / LICENSE CLASS
ZIP CODE DAY TELEPHONE CITY
STATE LIC CITY BUSINESS LIC. H H
SIGNATURE TITLE DATE
CITY - STATE ZIP CODE DAY TELEPHONE STATE LIC. H
Workers' Compensation Declap'ation: I hereby affirm that I have a certificate of consent to self-insure issued by the Director OY Industrial Relations,
or a certificate of Worke7' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the
insurer thereof filed wifl, the Building Inspection Department (Section 3800, Lab. C).
INSURANCE COMPANY / POLICY NO. EXPIRATION DATE
Certificate of Exeiryfion: I certify that in the performance of the work for which this permit is issued, I shalt not
so as to become siject to the Workers' Compensation Laws of California.
SIGNATURE / DATE
any person in any manner
Owner-Buildr Declaration: I hereby affirm that I am exempt from the Contractor's License Law for tire following reason:
O I as owne/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. 79(4, 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 s)d'ch work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building
or i,
roveeient 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.).
U I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7064, 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 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 penalty of not
more than five hundred dollars (55001).
SIGNATURE DATE
COMPLETE THIS SECTION FOR NON-RESIDENTIAL 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?
DYES ONO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district'
DYES ONO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
[]YES ONo
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAT 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.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(i) Civil Code).
LENDER'S NAME LENDER'S ADDRESS
APPLICANT'S SIGNATURE
I certify that I have read the 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 SAID
CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
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 180 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).
PL -S SIGNATURE DOWNER []CONTRACTOR 081 PHONE APPOVED NY: -
fJI/,PyJjpjj i') (A DATE:
WHITE: File YELLOW: Applicant PINK: Finance