HomeMy WebLinkAbout2298 BRYANT DR; ; CB100360; PermitA •'
CITY OF
CARLSBAD
Building Permit Application
1635 Faraday Ave., Carlsbad, CA 92008
760-602-2717 / 2718 / 2719
Fax: 760-602-8558
www.ca rlsbadca .eov
Plan Check No. v
Est. Value
Plan Ck. Deposit
Date
DESCRIPTION OF WORK: Include Square F*«t of Affected Afe«{»)
"To
EXISTING USE PROPOSED USE GARAGE (SF)PATIOS (SF)DECKS (SF)FIREPLACE
YESO #NOD
AIR CONDITIONING
YES D NOD
FIRE SPRINKLERS
YES D NOD
CONTACT NAME (U DHhnnt Font AppHcairt)APPLICANT NAME
ADDRESS ADDRESS
CITY STATE ZIP CITY STATE
PHONE FAX PHONE
EMAIL EMAIL \ ,\sW 3&£PROPERTY OWNER
ADDRESS ADDRESS
CITY STATE OK CITY STATE ZIP
""Co
PHONE FAX
EMAIL
QVWa^
EMAIL
> 6LW\
ARCH/DESIGNER NAME&STATE LIC. #CLASS CITY BUS. UC.#
(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 theapplicant 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 theBusiness 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 acivil penalty of not more than five hundred dollars ($500)).
WORKERS COMPENSATION
Workers' Compensation Dtctarition: / hareby affirm under pwiady ofptqury em ottotfolkmingdtclaralions:
n lhav*andwMmaintiinacirtifk*aofcoflMnttoi*IMmw 3700 of llw Labor Code, for the performance of the work (or which Ihis permit is issued.
O I hav« «nd wW mwntata workm1 Mmptiwtton, as r«quir«J ty SKtkw 37
number are: Insurance Co. _ Policy No. _ Expiration Date _
This section need not be completed if the permit is for one hundred dollars ($100) or less.
K <^rtif«ate of Exemption: I certify that in the perfomiance of the woA for wWch this pemiit is issued. I shall not employ any f^
California. WARNING: Failure to ncure workers' compensation coverage ii unlawful, and shall subject an employer to criminal penalties and civil fines up to on* hundred thousand dollars (4100,000), hi
addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees.
CONTRACTOR SIGNATURE
OWNER-BUILDER DECLARATION
OAGENT DATE
(hereby affirm that I am exempt from Contractor's License Law for the following reason:
O I, as owner of the properly 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 emptoyees, provioW that such improvemerts are not intended or offered for
sale, ff, however, the building or improvement is sold wtthin one year of cornpletio
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 License Law does not apply to an owner of
property who builds or improves thereon, and contracts for such projects wim contradon^s) tonsed puisuant to the (^tractor's License Law).
D I am exempt under Section Business and Professions Code tor this reason:
1.1 personally plan to provide the major labor and materials for coretructicn rf ^ proposed propen^ improvement. OYes DNo
2.1 (have / have not) signed an application for a buHding permit for the proposed work.
3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number):
5.1 will provide some of the work, but I have contracted (hired) the following persoro to provide the wok indkated (include name/address/phone/type of work):
>tSf PROPERTY OWNER SIGNATURE OAGENT DATE
THIS SECTION FOR NON BUILDING PERMITS ONLY
te the appfcantw Mure bulkkigoccupart required to submit a business
Presley-Tanner Hazardous Substance Account Act? DYej O No
Is the applicant or future building occupant required to obtain a permKlrom^ air pollution control district or air qualitymanagenwnt district? OYes n No
tetr«fac% to be o^wtructoj within 1,000 teet of the outer boundary of a school site? OYes DNo
IF ANY OF THE ANSWERS ARE YES, >
EMERGENCY SERVICES AND THE AM POLLUTION CONTROL DISTRICT.
I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code)
I hereby aultorizB represented <* tie Cfydtab^
OSHA: An OSHA permit is required fcr excavations ovw 5D' deep and o^molifonorconstiuctoofslnjcUBsov8r3stonKinr»igrt
EXPIRATION: Every perrr« issued by Irw Building CWcial urxler tf« prov^
1 80 days *om DM da* of such permit or if Iht buiding or work aulhoriztdtysurtperrr* is suspended or abarc^
^APPUCANTS SIGNATURE _ S Jf \\ 0 ^ LAJLflJkuJU_^__DATE v-
City of Carlsbad Bldg Inspection Request
For: 04/12/2010
Permit# CB100360
Title: ADELMAN RES-RE-LOCATE ELECTRIC
Inspector Assignment: MC
Description: 200 AMP METERED PEDISTAL FROM REAR OF
PROPERTY TO FRONT
Type:MOHO Sub Type: REPAIR
Job Address: 2298 BRYANT DR
Suite: Lot: 0
Location:
OWNER ADELMAN PHYLLIS J
Owner: ADELMAN PHYLLIS J
Remarks: AM PLEASE
Phone: 7605353550
Inspector:
Total Time:
CD Description
39 Final Electrical
Act Comments
Requested By: TIM
Entered By: JANEAN
Comments/Notices/Holds
Associated PCRs/CVs Original PC#
Inspection History
Date Description Act Insp Comments
03/04/2010 32 Const. Service/Agricultural AP MC PEDESTAL RELOCATE PER PLAN, DRIVEN GRND ROD OK OK TO
REL METER
03/03/2010 33 Service Change/Upgrade CO MC COMPLETE WORK, DRIVE GROUND ROD
CITY OF
CARLSBAD
Unscheduled
Building Inspection
Building Department
1635 Faraday Avenue
Carlsbad CA 92008
760-602-2700
DATE:INSPECTOR:
PERMIT #:CONTACT: '
PHONE #:
JOB ADDRESS:
DESCRIPTION:
CODE DESCRIPTION ACT COMMENTS
Bldg Inspection Form Page 1 of 1 Rev. 06/09
03/02/2010 09:52 76043192S4 BOB BAKER VW SUBARU PAGE 13/14
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