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PPROVAL Y--
INSP.~--DATE 2-/1.-8/ ~1
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
Pl!RMIT APPLICATION
City of Carlslm Buildire D-rtant
2075 Laa Pal-Dr., Carlslm, CA 92009 (619) 4311-1161 0 . . .
I. PP.kMJI hPE
From List 1 (see back) give code of Permit-Type: ___________ _
For Residential Projects Only: From Li.st 2 (see back) give
Code of Structure-Type: ____________________ _
Net Loss/Gain of Dwelling Units
2. PRClJF.C'f INmRMATION
Addr~
FOR OFFICE USE ONLY
-,;; .3f!. 9 m,.J,00 Roi Nearest d-oss Street
U:GAL DEStRIPliON Lot No.
CHECK BEWW IF S0BMII JED:
/' ( 1 Bu1ldmg or Suue No. ~ ,. ,. sbtlO\ , C,, 9 z, c o f'
Subd1vmon Name/Number
□ 2 Energy Cales □ 2 Structural Cales C 2 Soils Report □ 1 Addressed Envelope
Omt No. Phase No.
6SSESSOB'S PAP.CTI. FXlSJJNG USE PBO?QSFP USE
DESCRIPTION OF WORK
-t, ,,t:,t' sp--H,r,r, c.,.,,,,..._
SQ. ti. # OF STORIES # OF BEDROOMS
3. WN IXCI PEltSON (II dlHerent from appUcanO
NAME (last name first) ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
4. XPPUCANI UCONIRACIDR
NAME (last name first)
□AGENI FURWNIAACIUR □OWNER
ADDRESS
0 AGEN I FOR OWNER
CITY STATE ZIP CODE DAY TELEPHONE
5. PkOMl IY OWNER
-NAME (last name first) hAJ<, /I. (J.Jh, ,-n, . .J ADDRESS .:13.2? JJJ,,,sriau Rd
# OF BA TilROOMS
STATE t'I,,, ZIPCODE 9,ucy' DAYTELEPHONE 'J.f'•9'foc,
NAME (last name first)
CITY STATE
STATE UC.#
ZIP CODE
LlCENSE CLASS
ADDRESS
DAY TELEPHONE
CITY BUSINESS !JC. #
DESIGNER NAME (last name hrst) ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE STATE !JC.#
7. WUkkkRS' CDMPENSA'liUN
Workers' Compensanon Declarauon: I hereby affirm that I have a ceruf1cace of consem 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 cenified
by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C).
INSURANCE COMPANY POIJCY NO. EXPIRATION DATE
Cerulicare of Exempuon: I cemfy that m the perlonnance of the work for which chis 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. OWNEk-HUllDEK Dfi!iJJtA.liuN
Owner-Builder Declaration: I hereby afhnn ffiai I am exempt from the Confracfofs License Law for the ioiiowmg reason: qr-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. Jf, 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, Busine.u 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).
□ 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 Busine.u and Profe.uions 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 [SS00J).
SI~~~~~tiiil;2"£s10EN I !AL SOIWINC p£kMI IS bNLY: DATE / l sfle:, 9-,.
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 ro ~ constructed within 1,000 feet of the outer boundary of a school site?
□ YES □ NO IF ANY OF TIIEANSWERS ARE YES, A FINAL CERTIFICATE OF OOCUPANCY MAY NOT BE~ AFIER.JULY 1, 1989 UNLllSS 11lE APPIJCANT
HAS Mirr OR IS MElmNG 11lE REQIJllll!MENTS OF 11lE OFFICE OF EMERGENCY SERVICES AND 11lE AIR POLLUTION OONTROL DISilUCT.
9. WNSl'kGCliUN LERDLNC ACE.ACi
I hereby affirm that there LS a construction lending agency for the perionnance of the work tor which this permit 1s issued (Sec 3097llJ CivU Code).
LENDER"S NAME LENDER'S ADDRESS
10. XPPUC!AN I CERIIFICXIION
I certUY that I have read the appUcauon and state that the a&ive miormauon is correct. I agree to comply with all City ordinances and Stace 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 Al.'iO AGREE m SAVE INDI!MNIFY AND [([!Ep HARM1J'.SS 11lE CTIY OF CARlSBAD AGAINST AIL LlABIIJTIES, JUDGMENTS, CDSTS
AND EXPENSES WHIOI MAY IN ANY WAY A(DUJE AGAINST SAID CTIY IN OONSEQUENCE OF 11lE GRANTING OF TIIlS 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 pennit is suspended or ab doned at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code).
APPIJCANTS SIGNA R ~,,;. DATE: (7{),,. ij d. p/'C-u
WHITE: F e YELLOW: Applicant PINK: Finance
PERMIT# CB962383
DESCRIPTION: 648 SF
SPECS
TYPE: PATIO
COVERED
CITY OF CARLSBAD
INSPECTION REQUEST
FOR 02/28/97
PATIO-PER CITY
STE:
INSPECTOR AREA PY
PLANCK# CB962383 ace GRP
CONSTR. TYPE NEW
LOT: JOB ADDRESS: 2329
APPLICANT: WHITTON,
CONTRACTOR:
MASTERS RD
FRANK PHONE: 619 438-9400
PHONE:
OWNER:
REMARKS: BJN/WHITTON/
SPECIAL INSTRUCT:
PHONE:
INSPECTOR-~½--~'--------
TOTAL TIME:
CD LVL DESCRIPTION ACT COMMENTS
_19 __ s_T _F_i_n_a_1_s_t_r_u_c_t_u_r_a_1 ____ ~,t11-~/(2___ ______________ _
--------------------------------------
***** INSPECTION HISTORY*****
DATE DESCRIPTION
012897 Ftg/Foundation/Piers
ACT INSP
AP PY
COMMENTS
COASTAL PERMIT DETERMINATION FORM
(To Be Completed By Planning Staff)
This form is used to identify and record those projects which either require a
Coastal Development Permit or which are exempt from the requirement for a
Coastal Development Permit.
Note: This is not a building permit or a determination under the California Environmental
Quality Act.
COASTAL PERMIT DETERMINATION NUMBER: __ ..:..9..:a&:.,....._--....:.Z"-'-'--------
ASSESSOR'S PARCEL NUMBER: __ 2c::..:...I J:..._-_1 '1:....:::...3_---=o=-1 __________ _
NAME: -----=• r..::'-::..:' 11--'-'-k.:...,___,_f-l-'---'s;..;.:...1.1.•...:.fc....:...f-"'o'-'1-"'v"----------------------
ADDRESS: _.::2--=3::...2=--.,.9 _ __:_m-'--'--'c::..."::..:+--=""-'''---"-1--'i?:..:...:::a~c,~•,_f'"-----------------
LOCATION OF PROJECT (IF DIFFERENT FROM ABOVE): ________ _
PROJECT DESCRIPTION: _..,.(:;'-'-'-f"'ci--'J=--'F'---'-'I' C..,..;_T'--'I O.:.,._...;(a..;\'-CJV'-'('-'-/-----------
COASTAL PERMIT DETERMINATION:
[3] 1 . This development is exempt from the requirement for a coastal permit.
D 2. This development requires a coastal development permit from the City of
Carlsbad.
D 3. This development is in the State of California Coastal Commission area of
jurisdiction.
J-1;(1(<4) (c'l) JC 0247 C l.2-17 -Cf(_,
Planner's Signature Date
This determination relates only to the project described above and shown on the attached plans.
Any change to the project may change the determination status. If the information contained in
this submittal /including plans) is changed, found to be incorrect, or incomplete this determination
shall be invalid.
c: Applicant, Project File, Building Permit File (when applicable)
H·\AOM1N\COUNTER\DETERMINATION FORM (COP)