HomeMy WebLinkAbout2796 CARLSBAD BLVD; ; CB891809; PermitBUILDING PERMIT
11/21/89 09:06
Page 1 of 1
Job Address: .2796 CARLSBAD BL Str:
Permit Type: ELECTRldAL
Parcel No: 203-172-15-00
Valuation: 0
Construction Type: NEW
Occupancy Group: Class Code:
Description: 100 AMP 1PHASE SERVICE
Permit No: CB.89180,9^
Project No: A8903216
Development No:
Fl: Ste:
Status: ISSUED
Applied : 11/21/89
Apr/Issue : 11/21/89
Validated By:
CONTRACTOR
***
BRINT, ALAN ELECTRICAL
P O BOX 6062
OCEANSIDE CA 9^56
Fees Required ***!/>! ***
Lie. C 491503
Collected & Credits
Fees:
Adjustments:
Total Fees:
Fee description
Enter "Y" for Eleo'
Single Phase Per
* ELECTRICAL TOTAL
.25
***
.00
.00
30.00
Ext fee Data
5.00 Y
25.00
30.00
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161
PERMIT APPLICATION
City of Carlsbad Building Department
2075 Las Palmas Dr., Carlsbad, CA 92009 (519) 438-nsi
1.PERMIT TYPE
A - ^COMMERCIAL QNEW gjTENANT IMPROVEMENT
B - Q INDUSTRIAL QNEW QTENANT IMPROVEMENT
C - [^RESIDENTIAL DEPARTMENT dCONDO QSINGLE FAMILY DWELLING ^ADDITION/ALTERATION
DDUPLEX DDEHOLITION QRELOCATION DMOBILE HOME gl£LECTRICAL DPLUMBINO
QSPA QfiETAINING WALL QSOLAR
EST. VAL
PLAN CK DEPOSIT
VALID. BY.
DATE 73.'LA
-f-
2 . PROJECT
Address *L^J*3£,
Nearest Cross St
INFORMATION
'J2S2£
PLAN CHECK No. .J
.3w44*4&fr4.
FORBrTig^!FWHWII^*w OFFICE USF ONI Y
LEGAL DESCRIPTION
CHECK BELOW IF SUBMITTED:
Q2 Energy Calcs
ASSESSOR'S PARCEL
DESCRIPTION OF WORK
Lot No. Si
D2 Structural
jbdivision Name/Number
Gates D? Soits Report
Unit Ho.
Ql Addressed Envelope
EXISTING USE
Phase No.
PROPOSED USE
6LDG. SO. FTG.,* OF STORIES /
3. CONTACT PERSON
NAME
CITY
SIGNATURE
STATE ZIP CCOE DAY TELEPHONE
4. APPLICANT D AGENT FOR CONTRACTOR
ADDRESS
DOWNER
CITY &ZIP CODE
D AGENT FOR OWNER
DAY TELEPHONE ~7373
5.PROPERTY
NAME jtyt'/i'U
CITY
pWNER OWNER
STATE
ADDRESS
ZIP CODE
DLESSEE
DAY TELEPHONE
£] TENANT
6. CONTRACTOR -
CITY
SIGNATURE
STATE L1C. »
ADDRESS
ZIP CXE
LICENSE CLASS
A&
DAY TELEPHONE
cm BUSINESS LIC. a
DATE /
DESIGNER NAME
CITY DAY TELEPHONE STATE LIC. #
7. WORKERS' COMPENSATION
Workers1 Compensation Declaration: I hereby affirm that I have a certificate of consent to self-insure issued by the Director of Industrial Relations,
or B 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 Exemption: 1 certify that in the performance of the work for yhich this permit is issued, 1 shall not employ any person in any manner
so as to become subject to the Workers' Compensation Laws of California.
SIGNATURE
8. OWNER-BUILDER DECLARATION
the Contractor's License Law for the following reason1 hereby affirm that 1 am exempt from
eir sole compensation, will do the work and the structure is not i
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7QM, 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).
I am exempt under Section Business and Professions Code for this reason:
(Sec. 7031.5 Business and Professions Code: ftrvy City or County which reQuires a permit to corstruct, 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
more than five hundred dollars [$5001).
the applicant to a civil penalty of not
SIGNATURE DATE
COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS 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?
DYES DNO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
DYES D"o
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
DYES QNO
IF AMT OF THE ANSWERS AJtE TES, A FINAL CERTIFICATE OF OCOJPAMCT MAY MOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS
OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
9. CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(i) Civil Code).
LENDER'S NAME LENDER'S ADDRESS --
10. APPLICANT'S SIGNATURE
1 certify that 1 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. 1 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 AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH HAY IN ANY WAY 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 shad expire by limitation and become null and void if the building
or work authorized by such permit is not commenced within 180 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).
CONTRACTOR QBY PHOME APPROVED BY:
DATE: ,
WHITE: File YELLOW: Applicant PINK: Finance