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Du,cription· i.AR'IHQ~.JAKE BRACINt, F ~ i"'-i
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PROVAL
INSP . .w------DATE .----a
CLEAR NCE ____ _,
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION PLAN CHECK NO. qz,,-<j ~
City of Carlsbad Building Departaent
2075 Las Palms Dr., C&rlsbad, CA 92009 (619) 438-1161 EST. VAL
DATI!
B -□ Industrial D Tenant Improvement
C -□ Residential □ Apartment □ Condo □ Single _Jamily Dwelling □ Addition/ Alteration
□ Duplex □ Demolition □ Relocation l!'Mobile Home □ Electrical D Plumbing
□ Mechanical □ Pool □ Spa □ Retaining Wall □ Solar □ Other
2. PROJECr INFORMATION FOR OFFICE USE ONLY
Address .,1 ,ii 1' I i1"t, I 1' e., j),
Nearest Cross "treet
Bu1ldmg or Suite No. ,, .,
mt o. ase o.
CHECK BEWW If SOBMI 11 Eb:
□ 2 Energy Gales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope
ASSESSOR'S PARCEL EXISTING USE PROPOSED USE
DESCRIPTION OF WORI(
SQ. FT. # OF STORIES
3. WN IACI PERSON (ll dlllerent from appJJcant)
NAME£e/ .S~t2c/
CTIY~(~~ STATE~. ZIPCODE~~ DAYTELEPHONE ~~7fs:3/.2
ADDRESS~ :Ii/ Jvlie Pt..
•-APPll~idk □AG ORWNIRACIU WNER UAGENI FOK N
NAME ON 7HJ:r t.l:(/f:Z.. ADDRESS.,,?~,.?. C9/'t:,f ,tvo re~.
CllY ~ STATEQ,,. ZIP CODE 9).tJrt',/ DAY TELEPHONE z;2 Z-7~Y.l.,
S. ~~&'°",:;/ S:::ee.,.( ADDREss,),).~/ UU//,e i::>t. •
CI1YW11rrt-1'2t:K/ STATfY, ZIP CODE 9.Mc:1'.iC DAY TELEPHONE 7;.2-2 ',(1-1 b 6. WR
NAME .5<,,,,,, e Ct,!,-#-t/ ADDRESS
ZIP CODE CllY STATE DAY TELEPHONE
STATE I.IC.# LICENSE CLASS CllY BUSINESS I.IC. #
DESIGNER NAME #Et:)/</J-)(
Cl1Yrr4~ STATE a. ADDREss &3-56 sultr:IVJCI 3-5,:~
ZIP CODE9J:?3£ DAY TELEPHONQ~ STATE I.IC. #
7.~UJ
Workers' t.Zmpensatton Oeclarauon: I hereby afhnn that I have a ceruhcate of consent to self.insure issued. by the Director of 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
Ceruhcate of Exemption: I certtfY that m the performance of the work for which this permit 1s issued, I shall not employ any person m any manner
so as to become subject to the Workers' Compensation Laws of California.
SIGNATURE DATE
8. UWNEk-BUIID£k DFliARAIION
bwner-Bmlder Declaration: I hereby afhrm that I am exempt from the COntractor's License Law for the foilowmg 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 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.).
D 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 Llcense Law).
□ 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 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 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).
SIGNATIJRI! DATil
CDMPLEIE IHIS SECIION FOR NON-RESIOE:N IIAt B0ILOING PERMII's 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?
□YES □NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
□YES □NO
Is the facility to be constructed within 11000 feet of the outer boundary of a school site?
□ YES □ NO
IF ANY OF THE ANSWERS ARE YES, A FINALCERTIFICATil OFoa;upANCY MAY NOT BI! IS.5UED AFTER JULY I, 1989 UNLESS THEAPPIJCANT
HAS MET OR JS MEETING THE REQUIREMENTS OF nm OFFICE OF EMERGENCY SERVICES AND THE AIR POLLITllON <DN"IROL DISTRICf.
9. WNSIROCIIUN LF.NDING XGENCY
I hereby afhrm that there 1s a constructton lending agency for the performance of the work for which tbls pernut as issued (Sec ;3097(1) Cival Cooe).
LENDER'S NAME LENDER'S ADDRESS
IO. APPI.JCXNI Ci!kllPICAIION
I cenUY that I have read the application and state that the above mformauon 1s correct. I agree to comply with ail 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 HARMlllSS THE CfIY OF CARISBAD AGAINST AIL LIABIUI1FS, JUDGMENTS, CDSfS
AND EXPENSES WIIlCH MAY IN ANY WAY A£DUJE AGAINST SAID CfIY IN <DNSEQUENCE OF THE GRANTING OF 11IJS PERMIT.
OSHA: 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 abandoned at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code).
DATE: '&-/3-~
PINK: Fmance
.. ,
PERMIT# CB920802
CITY OF CARLSBAD
INSPECTION REQUEST
FOR 08/19/92
FOR MH DESCRIPTION: EARTHQUAKE BRACING
HEDRA X
TYPE: MOHO
JOB ADDRESS:
APPLICANT: ON
CONTRACTOR:
2281 JULIE PL
THE LEVEL
STR:
PHONE: 7277842
PHONE:
INSPECTOR AREA MP
PLANCK# CB920802
OCC GRP
CONSTR. TYPE NEW
FL: STE:
OWNER:
REMARKS: MH/JOHN/727-7842
SPECIAL INSTRUCT:
PHONE: P~---
INSPECTOR ~~-~---------
TOTAL TIME:
CD
77
77
LVL DESCRIPTION
MH Under Floor Bracing
MH Under Floor Bracing
ACT COMMENTS w ,~\,/\A,\
***** INSPECTION HISTORY*****
DATE DESCRIPTION
081792 Under Floor Bracing
ACT INSP
CA MP
COMMENTS