HomeMy WebLinkAbout2260 AVENIDA MAGNIFICA; BLDG 3; CB931283; Permiti
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2075 Lps Palms Dr., CarW, CA 9#w)9 (619) 438-1161
PERMIT APPLICATION
City of brlsbad Building Department 2b75 Las Palmas Dr., Carlsbed, CA 92009 (619) 438-1161
A - U Commercial U New Building U Tenant Improvement
B - 0 Industrial 0 New Building 0 Tenant Improvement
C - 0 Residential 0 Apartment 0 Condo Cl Single Family Dwelling 0 Addition/Alteratior
0 Duplex 0 Demolition 0 Relocation 0 Mobile Home 0 Electrical 0 Plumbing
0 Mechanical 0 Pool 0 Spa 0 Retaining Wall 0 Solar 0 Other
2. PRQlEfXINFORMATION
qr3-qzId PLAN CHECK NO.
I m. VAL
PIAN CK DEKXlT
VALID. BY 71 -a
DATE 111 Zzl 'b
FOR OFFICE USE ONLY
LEGAL mN Lot No. Subdiwsion NamdNumber Unit No. Phase No.
0 2 Energy Calcs 0 2 Structural Calcs 0 2 Soils ReDort 0 1 Addressed Envelo~e _.
ASSESSOR'S PARCEL P- USE DESCRIPTION OF WORK
CITY STATE ZIP CODE DAY TELEPHONE
NAME ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
STATE LIC. # LICENSE CLASS CITY BUSINESS LIC. # E
ZIP CODE DAY TELEPHONE STATE LIC. # STATE
Workers' Compensation Declaration: I hereby attirm that 1 have a certiticate of consent to selt-insure issued by the Director ot lndustnal 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. C).
INSURANCE COMPANY POLICY NO. EXPIRATION DATE Certlticate ot Exemption: 1 certity that in the pertormance ot the work tor 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: 1 hereby aftirm that I am exempt trom the Contractor's hcense Law tor the tollowing 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 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.).
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).
1 am exempt under Section
(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 [SSOO]).
0
0
0 Business and Professions Code for this reason:
SIGNATURE DATE
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?
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
IF ANYOF THE ANSWERS ARE YES, A FINALCERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED NTERJULY 1,1989 UNLESS THEAPPUCANT HAS MIX OR Is MElTING THE REQuIREMENls OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR PoLLUnoN OONTROL DISIRICI:
(ij Ciwl Code). I hereby attirm that there is a construction lending agency tor the pertormance ot the work for which this permit is issued [Sec 3097
0 YES 0 NO
0 YES 0 NO
0 YES 0 NO
LENDER'S NAME LENDER'S ADDRESS
I certity that 1 have read the application and state that the above intormation 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 SAVEJNDEMNIFYAND KEEP IlAlMLES THEQTYOFCARISBADAGAIN~ AUWtUlTES, JLIDGMENlX, aosIs AND EXPENSES WIUQI MAY IN ANY WAY ACXRUE AGAIN= SAID CITY IN ODNSEQUENCF, OF THE GRANTING OF TIUS PERMIT.
OSIIA: An OSHA permit is required for excavations over 5'0" 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 not commenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or abandaned at any time after the work is Commenced for a period of 180 days (Section 303(d) Uniform Building Code).
DATE: /I- -2243
WHITE: File YELLOW Applicant PINK: Finance
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DESCRIPTI ACT COtlTLEIITS
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