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Home My WebLink About2255 HIGHLAND DR; ; CB973769; PermitV/3L(o B U I L D I N G 12/09/97 11:22 P E R M I T Permit No: CB97376Y ProJect No: A9704857 Development No: Page 1 of 1 Job Address: 2255 HIGHLAND DR Permit Type: MISCELLANEOUS Parcel No: 156-051-16-00 Valuation: O Suite: Lot#: Occupancy Group: Reference#: Description: INSTALL VINYL SIDING OVER EXIS : STUCCO ON GABLE & GARAGE Appl/Ownr : AMERICAN HOME IMPROVEMENT 8920 KENAMAR DR #206 SAN DIEGO CA 92121 619 2110 12/09 /97 m O,l. Construction "" !r: St "'· Applied: Apr/Issue: Entered By: 586-1113 N€w ISSUEB-00 12/09/97 12/09/97 RMA /(, "'* Fees Required "** Fees Collected & Credits A*k. Fees: Adjustments: Total Fees: Fee description Miscellaneous Fee #1 A MISCELLANEOUS TOTAL 30. 0 .uo 30 .00 > .00 .00 30.00 Ext fee Data PERMIT I INSP .. , ___ DATE ___ _ CLEARANCE _____ _ IN: > • I CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION FOR OFFICE USE ONLY PLAN CHECK NO,q] 37 h1 CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. _________ _ Plan Ck. Deposit ________ _ Validate1 'T'<·.---~~=-------- Date, _ __..,-,,._.1,...14--1-.,,.-=---J.----- Phase No. Total # of units Assessor's Parcel # Proposed Use /."f~-051-I" S F,f Description of Work SO. FT. #of Stories # of Bedrooms # of Bathrooms lib~i~!li'-~~flli • .ftfi,;ci,~~~,i:ri;!i~~;~',,~ii~~~i~t~,~,l~!li~i~~Mtfi,,,i,t;;,; s Name Address City State/Zip Telephone# Fax# Name Telephone# ~~,~~ ,,_~~~::;:~thz~~;~~'"Af,{@fiil!J~,R~~~~~~~~'~i;~~~~.;.~~~~~!~l;1,~!~~~~~;r'i (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, commending 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). ,1 ,o -1,c11:,n1=(i)T 'i?"l~o rn t2 #; 0 SA ()tt'<do 9;;i,;} I Address City State/Zip Telephone # S -J / / State license# 79'/ 371 License Class (!, Ctf:I, e,t/l>o.3 City Business License# lo/0(9~ 3 Designer Name .::i:: Q~ CJ 3 (-.. it, 3 Address City State/Zip Telephone State License # _________ _ ■P.li*..._. .... _.~~;~~~;J~:!:itr~~r~:::rifi;:i,~f;;~ti:\~5,tt'.! -'' .. ' -'-' -·· ;~ -:~idi; :'.~j~~~(E~1ga~;~~jjf!;t{i~f.i-~fjii§J;:~;;;;t,1i~~l~I: )i0li~~~(1i;i~1J:;:::ti;:;:t'.,:·:: .·; :,~;:::~;.:;.3,,r1;~·;;:~ •. ;, Worker1' CompenHtion Oecl■r1tion: I hereby affirm under penalty of perjury one of the following declarations: 0 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 of the work for which this permit is issued. 0 I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company L11JEBTY mu r«A L PolicyNo.ruCG=tg/•c,S"':17Tf ... a?7ExpirationDate &/, /151 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) D 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: Failure ecure workers' comp satlon coverage Is unlawful, and shall subject an employer to criminal thousand dollars 00 001, In addition tot cost of mpensatlon, damages as provided for In Section 3706 SIGNATURE DATE ~ilils!mllffflllia'lll License for the following reason: D 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 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. lf, 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 ufJ)(ise of sale). D I, as owner of the property, am exclusively contracting with licensed contractors to construct t Ject (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improv~~n, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). _,,,..,,. .. - D I am exempt under Section ______ Business and Professions C_.9de·f01'\his reason: ,- 1. I personally plan to provide the major labor and materials for ~l)AStrUction of the proposed property improvement. D YES ONO 2. 1 (have/ have not) signed an application for a building_ peffnit for the proposed work. 3. I have contracted with the following person .1!.ir:mf'i~ provide the proposed construction (include name / address / phone number / contractors license number): 4. I plan to provide portions of the w1;1r,1c;'"b~t I have hired the following person to coordinate, supervise and provide the major work (include name I address / phone number/ contractors license numb:,,,,_/ ________________________________________________ _ ork, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type ts 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, 26533 or 25534 of the Presley-Tanner Hazardous Substanc!_~~unt.AoH-~·"Et--vEs· -□ NO Is the applicant or future building occupant required to obtain a permitjr.om-ttt~niTtl)oli~ti;~-~ontrol district or air quality management district? D YES O NO Is the facility to be constructed within 1,000 feet oJ..:ttte~uf8/b~·~~~~ry of a school site? D YES D NO IF ANY OF THE ANSWERS ARE YES~Flffi((CE;TIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF TH~_Q.Esce-of:EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 1iw11mu11~11>mlfllUBm1m1mH1;rr:tk±~:s:::~2221it:::\&~;::2~;tt:1:1rrss,r1iii:~;:j,1111t:11ng;;;;;;v:::.\:;;:i~:~;,2; :,u~1;;!fJi1:1m:;;:l;i~,1;;:;;::1+120t5:A,w:r:-: ~i;;;;;:!i::,'·;:~:· thereby 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 ,4/ () /1[1{ LENDER'S ADDRESS, ______________________ _ ............... F~§!~~:1~~;~1:t1~;~~,,wm:;(tr~ii:~i1;c;;~~➔if.ilfrJ~i;;~~2;1;;r::,i:r:;:t;i;riF.~!iit.~1:,::1k~iif11~~.;-~0~,r,:-r~~~;,r~~~¥:~t;>:1:e;11~urt:t~tf~::;t:ti:,,: r:~~f:'.~1i~~iJ~!!t~'.. 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 Citt 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. OSHA: An OSHA permit is required for excavations over 5'0n deep and demolition or construction of structures 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 if the building or work authorized by such permit is t 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 any time after e rk is commenced for a eriod of 180 days (Section 106.4.4 Uniform Building Code). DATE -~i~-1~/~t~;;~t~Z __ _ PINK: Finance