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APPROVAL
~--DAT~;t~¥7
CLEARANCE ____ _
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION PLAN CHECK NO. Cj , ·1 I ,·1 'i ,-1 ...
City of tarlsbad Building D-rtaent
2075 Las Palau Dr~, Carlsbad, CA 92009 (619) 438·1161
1. Pf1iM1 I IYPE
From Llst 1 (see back) give code of Permit-Type: ____________ _
For Residential Projects Only: From Llst 2 (see back) give
Code of Structure-Type: ____________________ _
Net l.Dss/Gain of Dwelling Units
2. PROJECT INFORMATION FOR OFFICE USE ONLY
Nearest Cross Street
Building or Suite No.
~s1on Name/Number LEGAL bf.'.SCRIP I ION Onie No. Phase No.
CtttC!S,J:Sf'.WW IF SOBMII lfb:
liit'1"Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope
ASSESSOR'S PABCEI l{o 1-2--'fO -J c!f PYT"TiuN'!lQ.U)L.IS<tB~-•,S,;::._.1:F":_ ____ .JP~R110.1JPOt:!,,!;S:.JE;JQ.1.J.l/i.::S11.E~_.>i--fh1:1::?:I!:!o"8~~-----
DESCRIPTION OF WORK fi·tJ_t'. ,4-M V ' LA-~ if
(( ,Av, # OF STORIES f # OVBEDROOMS # OF BATIIROOMS
Pc(.
CITY
NAME (last name first) ~ a-1oB t-A. u: ucew
c1TY U rsk STATE C-14-ZIP CODE 'il-08<-f DAY TELEPHONE la I 7 -72-7-~ 5. PROPfilth OWNRk g_
NAME (lase name first) ~U:S. A. .'.Tof-1-0 ADDRESS r;).../ (cO ~l°t "-l i-S
CITY STATE ~ ZIP CODE '72,0,8 DAY TELEPHONE 2,,,:;._
NAME (lase name first) ADDRESS d).,/ 0 8 J..A Ice Ut ~ Qc_f
CITY u<m STATE C«) ZIP CODE 9-z-ce./DAY TELEPHONE G:J ( 7-72. 7 -~/3<::,<)
STATE !JC. #s2.-7.Z.2-3, LICENSE CLASS Js CITY BUSINESS !JC.# _j J) ), /-;,1
ast name 1rst
CITY STATE ZIP CODE DAY TELEPHONE STATE !JC.# 7. WUJtkf:ltS' UJMPENsAIION
Workers1 Compensation beclarauon: I hereby alf1rm that I have a ceml1cate of consent to sel!-msure issued by the Director of lndustnai
Relations, or a certificate of Workers' Compensation Insurance by an admirced insurer, or an exact copy or duplicate thereof certified
by the Director of the insurer thereof filed with the Building Inspection Depanment (Section 3800, Lab. C).
INSURANCE COMPANY POLICY NO. EXPIRATION DATE
I cemfy that m the peiformance of the work for which this permit 1s issued, I shall not employ any person m any manner
t to the orkers' Compensation Laws of California.
SIGNATIJRE DATE (
□
□
Owner-Builder Declaration: I hereby afhrm that I am exempt from the Contrador5s Llcense Law for the foiiowmg reason:
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 Contractor's Llcense Law does not apply roan 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. Jf, 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 Llcense 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. 7031.5 Business and Professions Ccxle: 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 Llcense Law (Chapter 9, commencing with Section 7000 of Division 3 of the Business and Professions Code)
or that he is exempt therefrom, and the bas" for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the af1>1ic3.nr to a civil penalty of more th n five hundred dollars [$500]). ·
SIGNATI/RE .__jMu__ . A__,, DATE ~ 9 c;;
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration orm or risk management and
prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act?
DYES □NO
Is the applicant or future building occupant required to obtain a permit from the air pollution cono-ol district or air quality management district? □YES □NO
Is the facility co be constructed wichin 1,000 feet of the outer boundary of a iehool site?
□ YES □ NO
IF ANY OF TIIEANSWERS ARE YES, AFINALCER11FICATEOF CXIlJPANCY MAY NOf BE ISSUED AFrERJULY I, 1989 lJNLF.SS TIIE APPLICANT
HAS MET OR IS MEETING TIIE REQUIREMENTii OF TIIE OffiCE OF EMERGENCY SERVICES AND TIIE Am POLLUTION ffiNTilOL DISllUCT.
9. WNSIR0CIION 11.NDffiG AGENCY
I hereby aU!nn ihat ihere a construcuon lending agency for ihe perfonnance of ihe work for which this permit 1s tssued (Sec 3097(1} Civil Code).
LENDER'S NAME LENDER'S ADDRESS
I cerufy that I have read the apphcat10n and state that the above inlormauon 1s correct. I agree to comply with all Llry 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 AJS() AGREE ID SAVE INDEMNIFY AND KEEP HARMLESS TIIE CITY OF CARISBAD AGAINST AIL IJABIU11ES, JUDGMENTS, CXlSTS
AND EXPENSES WHIG! MAY IN ANY WAY ACXJU/E AGAINST SAID CITY IN mNSEQUENCE OF TIIE GRANTING OF nos PERMIT •
. OSHA: An OSHA permit is required for excavations over S'O" deep and demolition or construction of structures over 3 stories in height.
Expiration. Every permit issued by the
building or work authorized by such
such permit is suspended or abandon
APPLICANT'S SIGNATIJRE
Wl-ilTE: File YELl.OW: Applicant PINK: Finance
PERMIT# CB962142
DESCRIPTION: 155 SF
ENTRY
TYPE: RAD
AREA,2ND
CITY OF CARLSBAD
INSPECTION REQUEST
FOR 06/06/97
STORY-ABOVE
STE:
INSPECTOR AREA PD
PLANCK# CB962142
OCC GRP
CONSTR. TYPE VN
LOT: JOB ADDRESS: 2160
APPLICANT: WATSON,
CONTRACTOR:
JANIS WY
ROBERT PHONE: 619 727-9800
OWNER:
REMARKS: R/JOHN/729-8994
SPECIAL INSTRUCT:
TOTAL TIME:
--RELATED PERMITS--
CD LVL DESCRIPTION
19 ST Final structural
29 PL Final Plumbing
39 EL Final Electrical
49 ME Final Mechanical
PERMIT#
RW960071
CB962263
TYPE
ROW
MISC
------------------------------------
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INSPECTO~..!...:... I""-.=_=. _____ _
STATUS
ISSUED
ISSUED
ACT COMMENTS
------------------
DATE
060397
060297
122796
121996
121896
121796
120496
***** INSPECTION HISTORY*****
DESCRIPTION
Final Combo
Final Combo
Exterior Lath/Drywall
Interior Lath/Drywall
Insulation
Frame/Steel/Bolting/Welding
Frame/Steel/Bolting/Welding
ACT INSP
CO PD
CO PD
AP PD
AP PD
AP PD
PA PD
PA PD
COMMENTS
8:45 NO ONE HOME
REVISE FLR JOIST
OK TO WRAP