HomeMy WebLinkAbout2201 LEVANTE ST; ; CB970152; PermitE
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APP ROVAL
IN-...;,""'""'....,.__ DATE,;; ·2 f J
7 7
CLEARANCE ____ _
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMlT APPLICATION .... FOR OFFICE USE O~
PLAN CHECK NO. '+If)_ [5 <J-
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(619) 438-1161
EST. VAL. _________ _
Plan Ck. Deposit . ~
Validated By f . er,_
Date \ lJJl 9'7
Business Name (at this address)
Unit No. Phase No. Total I of units
..2.
Proposed Use
Co
I of Bedrooms
Name State/Zlp Telephone I Fax I
Name Address City Stata/Zlp Telephone I
g>JtJWm>lkCQMP,
(Sec. 7031.5 Business and Professions Code: Any City or County which requires • permit to construct, alter, improve, demolish or repair any structura, prior to Its
issuance, also requires the applicant tor such permit to tile a signed statement that he is licensed pursuant to the provialona of the Contractor's License Law
(Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he ls exempt therefrom, and the basis tor the alleged
exemption. Any violation of Section 7031.5 by any applicant tor a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$5001).
Name Address City State/Zip Telephone I
State License I '--_ _,_ ______ _ License Class _________ _ City Business License I _______ _
Designer Name Address City State/Zip Telephone
State License I _________ _
OMPEN__M_TIO -~, -------
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarstiona:
0 I have and will maintain a certificate of consent to self-insure tor workers' col)'lpensation as provided by $action 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
by Section 3700 of the Labor Code, tor the performance of the work tor which this permit is
ber are:
Policy No._____________ Expiration Date _______ _
(THIS SECTION NEED NOT BE COMPLETED IF THE RMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS)
0 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.
WARNING: Failura to aecura•worbrs' compenaation coverage Is unlawful, and shall subject an employer to criminal penaltiea and civil fines up to one hundred
thousand dollars ($100.000), in addition to the cost of compensation, damages II provided for In Section 3706 of the l..abc¥ coda, lnterNt and attorney's fNI.
SIGNATURE DATE
17. O.WNER,BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law tor 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 tor 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).
0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sac. 7044, BusinNS end Proteaaions Code: The
Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for auch projects with contractor(s) licanaed
pursuant to th• Contractor's Ucenae Law).
0 I am exempt under Section ______ Business and Professions Code tor this reason:
1. I personally plan to provide the major lebor and materials tor construction of the proposed property Improvement. 0 YES ONO
2. I (have / have not) signed an application tor a building permit tor the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number):
4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone
number / contractors license number): ______________________________________________ _
5. I will
of workl:~~~e_~~~C.~~4:.=i~s;:2~~~~~~;.L~~(.c;;:::....~_a.~::=.~O:::::U!:~L.::!:i~=......f;~z::1~~~~~~~~:;i~,Sit:~~...,,.
PROPERTY OWNER SIGNATURE
r@.~JHIS SECTION. FQ!Vm
Is the applicant or future building occupant required to submit a busine p an, acutely hazardous materials registration form or risk management and prevention
program under Sections 25505, 25533 or 25534 of the Prffley-Tamer Hazardous Substance Account Act? 0 YES O NO
Is the applicam or future building occupam required to obtain a permit from the air pollution control district or air quality management district? 0 YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O NO
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
REQUIREMENTS OF THE OFACE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
l8 CONSTRUCTION LENDING AGENCY --...-~;;.;;;:allWlili.l.lt..i.--i--.liil..._...._ ..... :,.. ~
I hereby affirm that there is a construction lending agency for the performance of the work tor which this permit 11 issued (Sec. 30970) Civil Code).
LENDER'S NAME ______________ _
9. APPLICANT CERTIFICATION
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 representatives of the City of Carlsbad t o enter upon the above mentioned
property tor 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.
OSHA: An OSHA permit is required tor excavations over 5'0" deep and demolition or construction of structurN over 3 stories in height.
EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void it the building or
work authorized by such permit Is not commenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended
or abandoned at eny time after t for a riod of 180 days ( action 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE ~~:2::~~+==-...i~::::~~~~~"=4~-----DATE /-ol3 7'Z
PINK: Finance
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB970152 FOR 01/28/97
DESCRIPTION: CONDO CONVERSION-22Ql & 2203
LEVANTE ST-DUPLEX ef'-.
TYPE: MISC
STE:
INSPECTOR AREA TP
PLANCK# CB970152
OCC GRP
CONSTR. TYPE NEW
LOT: JOB ADDRESS: 2201 LEVANTE ST
APPLICANT: MAXEY, TOM
CONTRACTOR:
PHONE: 619 944-7918
OWNER:
REMARKS: MW/TOM/944-7918
SPECIAL INSTRUCT: UTIL & COMMON WALL
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INSPECTOe~/4~-~•-G"-'-ccf;i::_~~~'-;::_;::_ __ -===--
TOTAL TIME:
CD LVL DESCRIPTION ACT COMMENTS
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***** INSPECTION HISTORY*****
DATE DESCRIPTION ACT INSP COMMENTS
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