HomeMy WebLinkAbout2706 MEDFORD CT; ; CB920764; PermitOH'l,~/92 lH: ,7
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APPROVA
~..._.-DATE.11 71 q 5
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION l!A. ~
PLAN GIECK NO.
City of carlsbad Building Departaent
Fsr. VAL /h z z 2075 Las Palaas Dr., carlsbad, CA 92009 (619) 438-1161
PLAN CK DEPOSIT VAIID. BV /Z----------
I. PFJlMII h'PE /_
A -□ Commercial U New Bulldmg 9(1Iinanc Improvement
DATE ~d;?.;2
B -□ Industrial □ New Building □ Tenant Improvement
C -□ Residential □ Apartment □ Condo □ Single Family Dwelling □ Addition/ Alteration
□ Duplex □ Demolition □ Relocation □ Mobile Home □ Electrical □ Plumbing
□ Mechanical □ Pool □ Spa □ Retaining Wall □ Solar □ Other
2. PROJF.C'f INFORMATION FOR OFFICE USE ONLY
Bu1@mg or Suite No.
OrJq-,
mt o. ase o.
CHECK BEWW IF SOBMI 11 ED:
□ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope
DESCRIPTION OF WORK
NAME ADDRESS
STATE ZIP OODE DAY TELEPHONE
ADDRESS
STATE ZIP OODE DAY TELEPHONE
ADDRESS /'jr:(),C-c:Jt?.C
STATE ZIPOODE ~OOr DAY TELEPHONE
NAME
CITY STATE
ADDRESS
ZIP CODE DAY TELEPHONE
STATE !JC.# LICENSE CLASS CITY BUSINESS !JC. #
CITY STATE ZIP CODE DAY TELEPHONE STATE !JC.#
7. WuitkHRS WMPENSAliON
Workers' Compensation Oeclarat1on: I hereby affirm 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).
INSURANCE COMPANY POLICY NO. EXPIRATION DATE
Certificate of Exempuon: I certify that m the performance of the work ior which this pemut 1s issued, I shall not employ any person many manner
so as to become subject to the Workers' Compensation Laws of California.
SIGNATURE DATE
8. OWNER-B0llhmt DmXRA:liON
OWner-Budder Declaration: I hereby afhrm that I am exempt from the Contracto?s Lcense Law for the foilowmg 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 Llcense 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 Llcense 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 Llcense 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 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
CoMPQ'.'IE I HIS sfCIION RJR NON-RESIUEN IIAL BUILDING PERMil'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 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?
CYES □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 YES, A FINAL CERTIFICATE OFoa:IJPANCYMAYNill Bl! JSSIIEDAFI1!RJULY I, 1989 UNLESS THE APPUCANT
HAS MET OR JS MEl!TING THE REQUIREMENTS OF nm OFFICE OF EMERGENCY SERVICES AND THE AIR FOillJTION CDNTROL DISilUCT.
9. WNSJRUCIION LP.Nome ACKNCY
I hereby afhrm that there 1s a construction lend mg agency for the performance of the work for which this penmt 1s issued (Sec 3097 (I} Civil Code).
LENDER'S NAME LENDER'S ADDRESS
10. APFiJCAN I cillilU'k!AIIUN
I certify that I have read the appUcatmn and state that the above mformat1on 1s correct. I agree to comply with ali Gfy 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 m SAVE INDEMNIFY AND KEEP IIARMIJlSS THE CflY OF CARISBAD AGAINST AIL LIABIUI1FS, JUIJGMENTS, <XlSTS
AND EXPENSES WIIlCH MAY IN ANY WAY Aa:RUE AGAINST SAID CflY IN CDNSEQUENCE OF THE GRANTING OF TIDS 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 commenuithin 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 t e WO is commenced for a period of 180 days (Section 303(d) Unifw;;e).
APPLICANTS SIGNATURE DATE:
PINK: Finance
CI':rY OF' CARLSBAD
INSPECTION REQUEST
PERMIT# CB920764 FOR 08/11/92
DESCRIPTION: 258 SF PER SPECS ALREADY BUILT
TYPE: PATIO
JOB ADDRESS: 2706 MEDFORD CT
APPLICANT: TRUXAW, PAUL
CONTRACTOR:
OWNER:
PHONE: 619
PHONE:
PHONE:
INSPECTOR AREA PY
PLANCK# CB920764
OCC GRP
CONSTR. TYPE NEW
STR: FL: STE:
729-2454
REMARKS: MH/JIM/739-1525
SPECIAL INSTRUCT:
f) 7i
INSPECTOR I -,-7---
TOTAL TIME:
--RELATED PERMITS--
LVL DESCRIPTION
PERMIT#
CB920619
RW920135
CD
11 ST Ftg/Foundation/Piers
TYPE
POOL
ROW
--------------------------------------
STATUS
ISSUED
ISSUED
ACT COMMENTS
££ _______ _
***** INSPECTION HISTORY*****
DATE DESCRIPTION ACT INSP COMMENTS