HomeMy WebLinkAbout2326 LA COSTA AVE; A; CB950516; Permitt l r L [1 ~ N l• P E. • M : l • erin tt· N, : t , , l
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1561 04/19/95 0001 01 02
L, t#: C-PRMT 30-00
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LHAMBERLIN, DIA~E
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LAR~SBAD, CA 9211~
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CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
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PEMql' APPLICATION PLAN CHECK NO.CJ C/so-s,,
City of carlsbed Building DepartEnt
2075 Las PalES Dr., Carlsbad, CA 92009 (619) 438-1161
I. PmtMfl l"YPE
From Ust l (see back) give code of Permit-Type: ___________ _
fg~ii-c___ I
For Residential Projects Only: From List 2 (see back) give
Code of Structure-Type: ,-"/,f(, b'·l S
Net Los.VGain of Dwelling Units
FOR OFFICE USE ONLY
[!,14 C/ cJ-IJO 1.
mt o. ase o.
CHECR BEWW IP SUBMII JED:
□ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope
ASSFSSQR'S PABCFJ, ~USF
DESCrurnoN oF woRK C:11s g We.. 111£ • PROPPSEP USE
SQ. IT. # OF BEDROOMS~ # OF BATIIROOMS
ADDRESS
NAME (lastnamefirst)ChCtll'\ /1'1, PIO.l"U-ADDRESS b/~1, (I. U'\ C,cs.rl¼-AL,L.,L.'
CITY C»v ls{x, STATE ZIP CODE C: . 1f.' DAY TELEPHONE -I 7 'is~
. NAME (last name first) ~oem/ -:]Ud'f (']I 1ci'rd'1 ADDRESS
CITY~(/ JjtU{,Slt C ,Tq STATE ZIP FODE DAY TELEPHONE
6. ulN i'HACI ~(7 . -:-; \o NAME (last name first) "t ::;;,wli YIU m Iv'\ t'1 ADDRESS
CITY 0~ fl-f'\.S ICU STATE (j4 ZIP CODE 'Jd05'--/ DAY TELEPHONE
STATE UC.#
DESIGNER NAME (lase name hrst)
UCENSE CLASS CITY BUSINESS UC. #
ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE STATE UC.#
7. WOilkERY WMPENSAhUN
Workers' Compensation Declaration: I hereby afhrm that I have a cert1hcate of consent to self-msure issued by die 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 POUCY NO. EXPIRATION DATE
Ceruhcate of Exempuon: I certify that m the performance of the work for which this permit ts 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. UWNER-BOliDtk DEl!i.XkA.iiuN
Owner-Builder Declaration: I hereby afhrm that I am exempt from the ConfradoPs License Law 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. 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 (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 conrractor(s) licensed pursuant to the Contractor's License 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 License Law (Chapter 9, commencing with Section 7000 of Division 3 of the Business and Professions Code)
or that is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subj Y3lJPli nt to a civil nalty of ot ~ than five hundred dollars [$500]). _
SIGNA l\ DATE 1
ls 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 districc?
□YES □NO
ls the facility to be constructed within 1,000 feet of the outer lx>undary of a school site?
□ YES □ NO
IF ANY OF TIIE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCDJPANCY MAY Nar BE ~ AFTER JULY 1, 1989 UNI1!SS TIIE APPUCANT
HAS MET OR IS MElmNG TIIE REQUIRl!MENTI, OF TIIE OFFICE OF EMERGENCY SERVICES AND TIIE AIR POLLUTION OONTilOL DISTRICT.
9. WNSIROCIION LENDING ACF.Nti'
I hereby afhrm that there 1s a construction Iendmg agency for the performance of the work for which this permit 1s ISSued (Sec 3097(i} CiVli Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPllCAN i CERIIFICAIJUN
I cefbfy that I have read the application and state that the above mformat1on 1s correct. I agree to comply w1m au L;1ty ordmances ana :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 AISO AGREE ro SAVE INDEMNIFY AND KEEP HARMLESS TIIE CITY OF CARISBAD AGAINSf AIL LIAIIIUTIES, JUDGMENTS, CDSTS
AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN OONSF.QUENCE OF TIIE GRANTING OF TIIIS PERMIT.
OSHA: An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height.
Pl'ISBIRYYQ IIIPISAION
OATl __ v_4 ___ ?'J_< __ _ IMSPICTOl_J;/;.~=-----
P!JUUT t______ PLAHC:Jt t
JOI A00llSS ,23:;2{. /4 l..A. ~ -----
TIMZ AJUtIW: _____ TIMZ t.lAV'I: ____ _
CO Lvt. OISCJlIP'l'ION
~ ~Test
--
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PIMlff
f/11/19
--
ACT COMNIM't'S
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--
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CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB950516 FOR 05/03/95
DESCRIPTION: INSTALL GAS & ELECT METERS-SDG
TYPE: ELEC
JOB ADDRESS: 2326 LA COSTA AV
APPLICANT: CHAMBERLIN, DIANE
CONTRACTOR:
OWNER:
PHONE:
PHONE:
PHONE:
INSPECTOR AREA PY
PLANCK# CB950516
OCC GRP
CONSTR, TYPE NEW
STE: A LOT:
619-433-1785
REMARKS: MW/MICHELLE/566-1634
SPECIAL INSTRUCT:
INSPECTOR lfF
TOTAL TIME:
CD LVL DESCRIPTION
23 PL Gas/Test/Repairs
------------------t ------------------------------------
***** INSPECTION HISTORY*****
DATE
042195
042195
042095
DESCRIPTION
Gas/Test/Repairs
Final Electrical
Gas/Test/Repairs
ACT co
AP co
INSP
PD
PD
PY
COMMENTS
NO TEST
NO ENTRY