HomeMy WebLinkAbout2695 KREMEYER CIR; ; CB930030; PermitPERMIT APPLICATION
City of Carlsbad Building Departaent
2075 Las PalllllS De., Caelsbed, CA 92009 (619) 438-1161
PUN CK DEPOSIT _______ _
VAIID. BY __________ _
I. PERMII hPE DATI!
A -Li Commercial LI New Buddmg U l'enant improvement
B -□ Industrial □ New Building D Tenant Improvement
C -□ Residential □ Apartment D Condo D Single Family Dwelling □ Addition/ A1teration 5 ~ □Duplex □Demolition □Relocation □Mobile Home a,lilectrical □Plumbing \!::.I IC,O
□ Mechanical □ Pool □ Spa □ Retaining Wall □ Solar □ Other _5'C)() ~ p ¼\rtA-L
2. PROJECT INFORMATION FOR OFFICE USE ONLY
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ress
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□ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope
ASSESSOR'S PARCEi, EXISTING USE PROPOSED USE DESCRIPTION OF WORK
& ,-e
NAME
CI1Y STATE
ADDRESS
ZIP CODE DAY TELEPHONE
4. ~.J'.i~?~N IRXC IOR
CITY )
UAGENI FORCONIRACIUR
ADDRESS
STATE ZIP CODE
□ OWNER □ AGEN I FOR OWNER
DAY TELEPHONE
NAME
CITY STATE
ADDRESS
ZIP CODE DAY TELEPHONE •-;~ff-+':or-.&-t,\Ec\..nc..., ADDRESS ~0'3 \ 'St-'St 4po2l./)
d?,;' STATEcA--ZIPCODrfl/.O!°"l/ DAYTELEPHONE ~7yca 0
c:,;, 'fll STATE LIC. # ~--lCENSE CLASS e:. Jo CITY BUSINESS LIC. # I ms1-
CITY !/\_ 'A-STATE ZIP CODE DAY TELEPHONE STATE LIC. #
Workers' Compensation Declaration: I hereby afhrm that I have a cerultcate of consent 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 certified
by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C).
INSURANCE COMPANY POLICY NO. EXPIRATION DATE
0
0
0
Certificate of Exemptmn: I certUY that m the performance of the work ior which this penmt ts issued, I shall not employ any person m any manner
so as to ome subj to the Workers' Compensation La of California.
ya rm t at am exempt rom t e w or t e o owmg reason:
I, as owner of the pro 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
CcxJe: 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 CcxJe 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 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 ISS00]).
S!GNATIJRE DATI!
COMPLEIE IRIS SECIION FOR NUN-RESIDENIIAL BUILDING 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 2550S, 25533 or 25534 of the Presley-Tanner 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 CNO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
□YES ONO
IF ANY OF THE ANSWERS ARI! YES, A FINALCERTIFICATI! OF oa:IJPANCY MAY NOT BE ISSUl!D AFl'Ell JULY 1, 1989 UNIJ'.SS THE APPIJCANT
HAS MET OR lS Ml!l!TING THE RF.QUJREMENTS OF TIIE OFFICE OF EMERGENCY SERVICFS AND THE AIR POLLIITION WNTROL DlSTRICf.
ere ya 1rm l at
LENDER'S NAME V\
ere 1s a construction en mg agency or t
LENDER'S ADDRESS
or w IC { IS permit IS ISSU
I certify that I have read the apphcallon and state that the above mformat1on 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 1U SAVE INDEMNIFY AND KEEP HARMLESS THE CI1Y OF CARISBAD AGAINST AIL IJABIUTIF.S, JIJIJGMENTS, <DSTS
AND EXPENSES WIIlCH MAY IN ANY WAY ACCRUE AGAINST SAID CI1Y IN WNSEQUENCE OF THE GRANTING OF TIIlS 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 pennit issued by the Building Official under the provisions of this Code shall expire by limitation and become null a d void if the
building or work authorized by such permit is not commenced within 36S days from the date of such permit or if the building or wor uthorized 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 ilding e).
LI T'SSJGNl,'\jC11Ri~l-7""----DATE: ~a=-,,,____.<::..J.'+.Lc:,4-__
WHITE: File YELLOW: Applicant PINK: Fmance
05/19/93 INSPECTION HISTORY LISTING
FOR PERMIT# CB930030
DATE INSPECTION TYPE
01/26/93 Final Electrical
01/26/93 Final Electrical
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INSP ACT COMMENTS
RI RI MH/BRIAN/967-9067/967-5030
PD AP
05/19/93 INSPECTION HISTORY LISTING
FOR PERMIT# CB930031
DATE INSPECTION TYPE INSP ACT COMMENTS
01/26/93 Final Electrical RI RI MH/BRIAN/967-9067/967-5030
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