HomeMy WebLinkAbout2419 LA PLANCHA LN; MP; CB931297; PermitI NS 1,,,.__.:.,.,,...~.--
CLEARANCE _____ .
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION PLAN CHECK NO.
City of Carlsbad Building Departaent
2075 las Palaas Dr •• tarlsbad, CA 92009 (619) 438-1161 EST.VAL ___________ _
PLAN CK DEPOSIT ________ _
VAIJD.BY ___________ _
1. PH.ltMIT IYPE DATE,__ ___________ _
A -Li Commercial □ New Bu1ldmg Li Tenant Improvement
B -D Industrial Li New Building D Tenant Improvement
C 4JResidential D Apartment D Condo □ Single Family Dwelling □Addition/Alteration
0 Duplex □ Demolition □ Relocation □ Mobile Home llElectrical □ Plumbing
□ Mechanical □ Pool D Spa D Retaining Wall □ Solar □ Other ____ _
2. PRWF.Cf INFORMATION FOR OFFICE USE ONLY
Address Bmldmg or Sune No.
2417sLA PLANCHA LANE Nearest "Cross treet
LEGAL DESCRIPTION Lot No. SutxI1V1s1on Name/Number OmtNo. Phase No.
RANCHO PONDEROSA
CHECK 8£wW IF SOBMII I f:D:
□ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ l Addressed Envelope
ASSESSOR'S PARCEL EXISTING USE PARK PROPOSED USE DESCRIPTION OF WORK INSTALL PEDESTAL METER
SQ. Ff. # OF SlDRIES -----
3. WN IACI PERSON (Jf different from apphcant)
NAME ADDRESS
CI1Y STATE ZIP CODE DAY TELEPHONE
4. APPuCAN1 Ktt:oNIRACioR
NAME FOSHAY ELECTRIC UAGENl fURCUNIHAC'lUR □OWNER DAGEN! FoRoWNER
ADDRESS 7676 ENGINEER ROAD
CITY SAN DIEGO STATE CA ZIP CODE 9 2111 DAY TELEPHONE 2 77-76 7 6
s. ~~H'NfJ~~filA HOA ADDRESS 10455 SORRENTO VALLEY ROAD #102
SAN DIEGO CA 92121 277-7676 CITY STATE ZIP CODE DAY TELEPHONE
6. tDN'('IW;(uk
NAME FOSHAY ELECTRIC ADDRESS
ZIP CODE
7676 ENGINEER ROAD
CITY SAN DIEGO STATE CA 92111 DAY TELEPHONE 277-7676
CITY BUSINESS LlC. # 74000114
DESIGNER NAME
STATE LlC. # 175565 LlCENSE CIASS C-10
ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE STATE UC.#
1. WUkk£RS' t'.DMPENSXlitJN
Workers' Compensation Dedarauon: I hereby allmn that I have a cert1hcate of consent to self-msure 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).
EXPIRATION DATE 10/1/94
I hereby affirm that I am exempt from the Contractor's License Law for the lollowmg 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).
□ 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 pennit 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 pennit
subjects the applicant to a civil penalty of not more than five hundred dollars [$5001).
SIGNATURE DATE
COMPLE't.E ffils sEciioR Fbk NON·REsibtNTIAt HOILbiNd PERMITS oRLV:
ls the applicant or future building occupant required to submit a business plan, acutely haurdous materials registration form or risk management and
prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Haurdous Substance Account ht?
□YES □NO
Is the applicant or future building occupant required to obtain a pennit from the air pollution control district or air quality management disoict?
CJ YES □ NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
□YES □NO IF ANY OF THE ANSWERS ARE YF.S, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED APTER JULY 1, 1989 UNIBSS THE APPUCANT
HAS MET OR JS MKKTING nm REQUIREMENTS OF nm OFFICE OF EMERGENCY' SERVI~ AND nm AIR POillmON CDNTROL DISTRICT.
9_ CDNSI kOCfiON LF.NDiNG ACP.NL-V
i hereby allirrn that there 1s a construction lendmg agency for the performance of the work for which this penmt 1s issued. (Sec :309)(1) Civil Code).
LENDER'S NAME LENDER'S ADDRESS to. APPlltAN'I CER fiFR!AfidN
I certify that I have read the apphcauon and state that the above mlormauon 1s 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 SAVE INDEMNIFY AND KEEP HARMIJISS nm CflY OF CARLSBAD AGAINST AU. IJABlllTIES, JUDGMENTS,. CXlSTS
AND EXPENSF.S WinOI MAY lN ANY WAY ACX:lUJE AGAINST SAID CflY IN CDNSF.{JUENCE OF nm GRANTING OF nus PERMIT.
OSHA: An OSHA pennit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height.
Expiration. Every permit · ued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the
building or work authori such permit is not co need within 365 days from the date of such pennit or if the building or work authorized by
such permit is suspend or a ndoned at any ti a is commenced for a period of 180 days (Section 303(d) Uniform Building Code).
DATE: 11/23/93
· Fmance
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