HomeMy WebLinkAbout2711 HAYMAR DR; ; CB941460; PermitBUILDING PERMIT
11/14/94 09:47
Page 1 of 1
1 Job Address: 2711 HAYMAR DR Suite:
Permit Type: PLUMBING
Parcel No: Lot#:
Valuation: • D
Construction Type: NEW
Occupancy Group: Reference*:
Description: SEWER CONNECTION PER PETE
Permit No: CB941460
Project No: A9401725
Development No:
Status: APPROVED
Applied: 11/14/94
sue: 11/14/94
Appl/Ownr : HUFFMAN, MARTIN
1901 LINCOLN STREET
OCEANSIDE, CA 92054
*** Pees Required ***
Fees :
Adjustments :
Total Fees:
Fee description
Enter "Y" for Plumbi
Each Building Sewer ^f.
*- PLUMBING TOTAL
619 433-2607 C-PRMT 35-00
ted & Credits
. 00
. 0 0
3 5 . 0 0
Ext fee Data
20.00 Y
15. 00
35.00
RNAt APPROVAL
DATE
LEARANCE
CITY OF CARLSBAD
2075 Us Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION
City of Carlsbad Building Department
2075 Las PaIMS Dr., Carlsbad, CA 92009 (619) 438-1161
1. PEKM1T
From List 1 (see back) give code of Permit-Type:
For Residential Projects Only: From List 2 (see back) give
Code of Structure-Type:
Net Loss/Gain of Dwelling Units
2. PROJECT INFORMATION
PLAN CHECK NO.
EST.VAL
PLANCK DEPOSIT.
VALID. BY
DATE
FOR OFFICE USE ONLY
Nearest Cross Street L
Building or Suite No
Subdivision Name/NurflberLEGAL DESCRIPTION No.Unit No.Phase No.
CHECK BELOW IF SUBMITTED:
D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D1 Addressed Envelope
ASSESSOR'S PARCEL EXISTING USE PROPOSED USE
.DESCRIPTION OF WORK
SQ.FT.# OF STORIES # OF BEDROOMS # OF BATHROOMS
NAME (last name first)
CITY
ditierent trom applicant.}
STATE
ADDRESS
ZIP CODE DAY TELEPHONE
4. APPLICANT LTCONTKACTOR
NAME (last name first)
CITY
tJ AGENT FOR CONTRACTOR
ADDRESS
STATE ZIP CODE
LJ OWNER D AGENT FOR OWNER
DAY TELEPHONE
5. PROPERTY OWNER
NAME (last name first)
CITY
ADDRESS
STATE ZIP CODE DAY TELEPHONE
CITY <E^5S&Fi
DESIGNER NAME
CITY
-r^£_s^
£$<T •^xtc7'
STATE LIC
(.last name tirstj
T^ <f^t-
STATE <3^-
.#
STATE
.faL/ J$fa&?l&f
yl~yCsH/Qk~s V
ZIP CODE *?£>
LICENSE CLASS
ZIP CODE
ADDRESS /^^ $'SL/S^Ce>Lf^~
&¥~^ DAY TELEPHONE (6 / ^ 'V-
CITY BUSINESS LIC.
AUUKESS
DAY TELEPHONE
#
STATE LIC. #
7. WUKKEHS' UJMPENSAT1ON
Workers' Compensation Declaration: I hereby affirm that I nave a certificate of consent to self-insure issued by tneDirector ot Industrial
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 ot Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner
so as to become subject to the Workers' Compensation Laws of California.
SIGNATURE DATE
8. OWNER-BUILDER DECLARATION
owner-builder Declaration: I nereoy attirm tnat I am exempt trom tne contractors License Law tor the roTTowing 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^) 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 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 permit
subjects the applicant to a civil penalty of not more than five hundred dollars [$500]}.
SIGNATURE DATE
COMPLETE
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?
D YES D NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
D YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
D YES D NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AIT^ JULY 1, 1989 UNIESS THE APPLICANT
HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
9. UUNSmUUilOH LENDING AGENCY ~~~
I Hereby affirm that there is a construction lending agency tor the pertormance ot the work tor which this permit is issued [Sec 3097tiJ Civil Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPLKJVNl
I certity that I have read the application and state that the above information is 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 HARMLESS THE CITY OF CARLSBAD AGAMST All. UABOJIIES, JUDGMENTS, COSTS
AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SATO CITY IN CONSEQUENCE OF THE GRANTING OF THIS 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.-«ithorized 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:
WJffTE: File YELLOW: Applicant PINK: Finance
City of Carlsbad
Building Department
OWNER-BUILDER VERIFICATION
Attention Property Owner:
An 'owner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary delay in
processing and issuing your building permit. No building permit will be issued until this verification is
received.
, 1. I personally plants provide the major labor and materials for construction of the proposed property
improvement({yeVor no) ; .
^"" (—^
2. I (ftavgXhave not) signed an application for a building permit for the
proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction:
Name ;
Address City
Phone Contractors License No.
4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise,
and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following persons to provide the
work indicated:
Name Address Phone Type of Work
Signed:
Property
Date:
2O75 Las Palmas Drive • Carlsbad, California 92OO9-1576 • (619)438-1161