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Home My WebLink About2580 LUCIERNAGA ST; ; CB910615; Permit• B U I L D I N G P E R M I T PF>rmi t ProJect Development No: CB910615 No: A9100737 No: 04/24/91 12 :28 Page 1 of 1 Job Address: 2580 LUCIERNAGA ST Str: Fl: Ste: Permit Type : RESIDENTAL ADD/ALT (UNDR $10K) Parcel No: 215-270-34-01 Valuation: 5,184 Construction Type : VN Occupancy Group: Class Code: Description : 288 SF PATIO ENCL ICBO#4383P Appl/Ownr : R .J . CONSTRUCTION 4901 COLUSA CARLSBAD, CA 92009 CONTRACTOR **'A Fees Fees: Adjustments: Total Fees : Fee description Building Permit Plan Check Strong Motion Fee -A BUILDING TOTAL Enter "Y" for Plumbing Enter "Y" for Electric Enter '' Y" for Remodel A ELECTRICAL TOTAL ($10 CITY OF CARLSBAD 4 0 2 • Status: Applied: Apr/Issue: ISSUED 04/15/91 04/24/91 KZH Validated By: 619-941-9188 .00 .OU 150.00 Ext fee 81.00 53.00 1. 00 135.00 5.00 10.00 15.00 * * * Data N y y 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 ________ _,_ __ "•·•--~ .. -.~~- PERMIT APPLICATION ~ V c;ty of Carlsbad su;1d;ng Department 2075 Las Pal mas Or., Carlsbad, CA 92009 (619) 436-1161 1. A • C 2. PERMIT TYP COMMERCIAL D INOUSTRIAL TENANT IMPROVEMENT □TENANT IMPROVEMENT IJ(RESIDENTJAL □APARTMENT OcoND0 ~SINGLE FAMILY DWELLING ~ADDITION/ALTERATION □DUPLEX ODEM0LITI0N OREL0CATJOH OM081LE HOME □ELECTRICAL □PLUMBING □MECHANICAL □POOL □SPA □RETAINING WALL □SOLAR Dor R PROJECT INFORMATION PLAN CHE K No. Nearest Cross Streets Add,e,o %.Rt> ,.,c,,t,fl/1/llt-,, $ / ,I,(; LEGAL DESCRIPTION Sutxli vis 1 on Name/Nunber Unit No. P ase No, PROPOSED USE BLDG. SQ. FTG. 2.N fl OF STORIES / 3. CONTACT PERSON "'"' K,,: "'141'20 .l ,/J.IJtlRO mYf1IC~4H$1p~ SIGNATURE ADDRESS 1f ,,,,,, Ct,,,I, V $ ,I/ STATE(!. 4,-ZIP CODE "~e,-~ DAY TELEPHONE ~4'/,. ,./rl¾J:, 4. APPLI ANT 1,jco,1,mo, NAME1?,J; c,,.,.1sr;a1,,,o,1;",,,,,:1 CITY t1' t:,JF ~ ,1$1,(}£ 0 AGENT FOR CONTRACTOR ADDRESS □OWNER lfAGENT FOR OWNER Z!P CODE j ..,_,.c~ DAY TELEPHONE 5. PROl'ERTY OWNER . NAME "17,4,M-,S' o.e 4'J.d- OWNER □LESSEE ADORESS zj';>p ~l.'Gl.k/Z Uf/t::A □TENANT CITY c".e"s ,,,a STAT~~ ZIP COOE 9J.I,,? DAY TELEPHONE 6. CONTRACTOR NAME /?,7:' 54/IS J C,A1'7:i?t1,eT7,,,11 7. CITY /::t:£'9,H,S,1),,£ STATt::,4, ZIP COOE ,~-~ DAY TELEPHONE P~/-,.,,,p<:P STATE LIC. # ~,t>#l.'J CITY BUSINESS LIC. • SIGNATUR TITLE DATE DESIGNER CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. # WORKERS' COMPENSATION \lorkers' Corrpensat1on Declaration: I hereby affirm that I have a certificate of consent to self-insure issued by the Director of Industrial Relations, or a certificate of \lorkers' Coq:,ensat ion Insurance by an actni tted insurer, or an exact copy or dupl i cate thereof certified by the o i rector of the insurer thereof f ii ed with the Bui ldi ng Inspection Department ( Sect i oo 3800, Lab. C). INSURANCE COMPANY POLICY NO. EXPIRATION DATE Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not eirptoy any person in any manner so as to become subject to the Workers' Coq:,ensation Laws of California. SIGNATURE~~ OATE 8. OWNER-BUIDECLARATION Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D I as owner of the property or my eirployees 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 i,rproves thereon,, and who does such work himself or through his own employees, provided that such i,rprovements are not intended or offered for sale. If, however, the building or i,rprovement is sold within one year of coo-pletion, the owner-builder will have the burden of proving that he did not build or i,rprove 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 License Law does not apply to an owner of property who builds or i,rproves thereon, and contracts for such projects with contractor(s) t i censed pursuant to the Contractor's License Law). D J am exerrpt 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, i,rprove, demolish, or repair any structure, prior to its issuance, al so requires the a pp\ i cant for such permit to f i le a signed statement that he is I i censed pursuant to the provisions of the Contractor's License Law (Chapter 9, coomencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exeirpt 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 doltars.[$5001 SIGNATURE COMPLETE THIS SEC 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-Tenner Hazardous Substance Account Act? □YES ONO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □YES ONO JS the facility to be constructed within 1,000 feet of the outer boundary of a school site? □YES 0,0 If ANY Of THE ANS\l:RS ARE YES, A FINAL CERTIFICATE Of OCOJ>ANCT NAY NOT BE ISSUED AFTER JULT 1, 1989 llllLESS THE APPLICANT HAS MET OR IS flEETING THE REQUIRBl:NTS Of THE OFFICE OF EMERGENCY SERVICES ANO THE AIR POLLUTION' CONTROL DISTRICT. 9. CONSTRUCTION LENDING AGENCY hereby aff i rm that there is a construction I ending agency for the performance of the work for which this permit is issued (Sec 3097( i) Ci vii code). LENDER'S NAME LENDER'S ADDRESS 10. APPLICANT'S SIGNATURE 1 certify that I have read the application and state that the above information is correct. I agree to corrply with all City ordinances and State laws relating to bui [ding 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 JNDENNJFT ANO KEEP HARflLESS THE CITY OF CARLSBAD AGAINST All LIABILITIES, Jll)GMENTS, COSTS AHO EXPENSES IJHICH HAY IN ANY WAT ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. Expiration. Every permit issued by the Building Official under the provisions of this Code shall e11pire by limitation and become null and void if the building or work authorized by such permit is not coomenced within 180 days from the date of such permit or if the building or wor~ authorized by such permit Is suspended or abandoned at any time after the work is coomenced for a period of 180 days (Section 30J(d) Uniform Building Code). □ O\.INER j0'coNTRACTOR □BY PHONE APPROVED SY: ______ _ DATE: _________ _ WHITE: File YELLOW: Applicant PINK: Finance , DATE d~h; UNSCHEDULED INSPECTION INSPECTOR. ___ /7~_·_,_Y_-____ _ PERMIT # 9/-,/5 _ if_ 11 JOB ADDRESS ,;l.5",j{J ~~ PLANCK# _____ _ TIME ARRIVE: _____ TIME LEAVE: _____ _ CD LVL DESCRIPTION ACT COMMENTS Li &#A '--~7 /"' ~