HomeMy WebLinkAbout2585 PIO PICO DR; ; CB920983; Permit'
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CITY OF CARLSBAD
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9371 09.'21/92 0001 01
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2075 Las Palmas Dr., Carlsbad, CA 92()()<) (619) 438-1161
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PERMIT APP0CA110N PLAN CHECK NO.
City ot carlsbad Building Department
2075 Las Pal .. s Dr •• Carlsbad, CA 92009 (619) 438-1161 EST. VAL ~ :5' ~ PIAN CK DEPOSIT, _______ _
I. PEkMI I IYPR
A . LI Commercial
B - D Industrial
C -0 Residential
DDuplex
U New Building O 'lenant improvement
D New Building D Tenant Improvement
D Apartment D Condo O Single Family Dwelling a Addition/ Alteration
Li Demolition
D Mechanical D Pool
0 Relocation O Mobile Home O Electrical D Plumbing
D Spa D Retaining Wall [J Solar Li Other
2. PRQJF.Cr INFORMATION FOR OFFICE USE ONLY
Aiid"'Jlf n µ , ).SOS° r,o cu Dr Budding or Suite No.
Nearest Cross Street C
nil o.
CHECK BEWW IF SOBMI l I £0:
D 2 Energy Cales LI 2 Structural Cales LI 2 Soils Report D 1 Addressed Envelope
DE~RIPTION OF WORK
Ji~/...
SQ. fr. # OF SlURIES
3. WN JACI PERSON (It dllierenf from appUcant)
NAME
CITY STATE
ADDRESS
ZIP CODE
4. APPUCXN i
NAME
DWNIRACIOR DAGEN I FUR WNIRXCIOR
ADDRESS
CITY STATE
CITY
NAME
CITY
CITY
STATE
STATE
STATE LIC. #
STATE
7. WOkkRR:,-' WMPENSXJION
ZIP CODE
ADDRESS
ZIP CODE
ADDRESS
ZIP CODE
LICENSE CLASS
ZIP CODE
DAY TELEPHONE
U OWNER LI ACEN I FOR OWNER
DAY TELEPHONE
~me__
DAY TELEPHONE
DAY TELEPHONE
CITY BUSINESS LIC. #
DAY TELEPHONE
ase o.
STATE LIC. #
Workers' Compensation Oeclarauon: I hereby afhrm tfiat l fiave a certU1cate of consent to sell-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 certified
by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C).
INSURANCE COMPANY POLICY NO. EXPIRATION DATE
Ceruhcate of Exemption: I certllY that 1n the performance of the work for which this permit ts issued, I shall not employ any person 1n any manner
so as to become subject to the Workers' Compensation Laws of California.
SIGNATURE DATE
8. OWNEk-BUliDER DFilARA'JJON
dwner-8u1ider beclarat1on: I hereby afhrm that I am exempt trom the Contracto?s 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.).
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
with contractor(s) licensed pursuant to the Contractor's license Law).
D 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 Llcense 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 permit
subjects the applicant to a civil penalty of not more than five hundred dollars [$500]).
SIGNATURE DATE
COMPLEI£ IRIS SECIION FOR NON-RESIDENIIAC BOILbiNG PERMll'S ONLY:
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 Ha1.ardous Substance Account Act?
CJ 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?
0 YES CJ NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
CJ YES ONO
IF ANY OF TIIEANSWERS ARE YES, A FINALCERTIFICATEOFoa:uPANCY MAY NOT BEISSUl!D AFil!RJULY 1, 1989 UHU!SS TIIEAPPIJCANT
HAS MET OR IS MEETING nm REQUlllEMEN1"S OF nm OFFICE OF EMERGENCY SERVICES AND TIIE AIR POLLIJ110K OONIROL DISTIIICT.
9. WNSIROCIION U!NDING ACf!Nti'
I hereby affirm that there 1s a construction lending agency for the performance of the work for which this permit 1s issued (Sec 3097(1} Civil Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPllcAN I CRklMci:ilON
I certify that I have read the application and state that the above 1nformatton 1s correct. I agree to comply with all Ctty 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 ID SAVE INDEMNIFY AND KEEP IIARMLESS 1llE CTIY OF CARIS8AD AGAINSf AU. LIAilllJTIES, JUDGMENTS, CDsrS
AND EXPENSES WIIlCH MAY IN ANY WAY Nil!UE AGAINST SAID CTIY IN CONSEQUENCE OF 1llE 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 permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code).
DATE: SyJ. I [: 7L •
WHITE: File YEIJ.OW: Applicant PINK: Finance
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DATE O 2,) --9 3 INSPECTOR . .,_L ... ~ .... -"""""-'---l~'---"~""'.:::;__ ~----
PERMIT # /J ff
Jes ADDRESS 2 5' YS Uo [Le D
PLANC:K t _____ _
TIME ARRIVE: _____ TIME I.EAVE: ____ _
CO LVL DESCRIPTION
31 .>ih!V..-rJ o CL,-CC.
PERMITS
6/15/89
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ACT COMMENTS ¥--