HomeMy WebLinkAbout2802 CARLSBAD BLVD; ; CB940857; PermitBUlLUlJMtJ FtKMlX
07/15/94 07:33
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Job Address: 2802 CARLSBAD BL Suite:
Permit Type: MISCELLANEOUS
Parcel No: 203-173-01-00 Lot#:
Valuation: 0
i Construction Type: NEW
Occupancy Group: Reference*:
Description: SHORING FOR TUNNEL, TEMPORARY
fermit wo:
Project No: A9401208
Development No:
Status: ISSUED
Applied: 07/15/94
Apr/Issue: 07/15/94
Entered By: MDP
Appl/Ownr : GRIGORAS, LUDWIG
2802 CARLSBAD BL.
CARLSBAD, CA. 92008
*** Fees Required ******
619 729-0110
Fees Collected & Credits ***
Fees :
Adjustments:
Total Fees:
edits
ts
.00
.00
.00
FINAL APPROVAL
:JSP. DATE_
1EARANCE
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPUCATION
City of Carlsbad Building Department
2075 Las Palms Dr., Carlsbad, CA 92009 (619) 438-1161
1. PERMIT TYPE
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
PLAN CK DEPOSIT.
VALID. BY .
DATE
FOR OFFICE USE ONLY
AddrC
Nearest Cross Street
Building or Suite No.
LEGAL DESCRIPTION Lot No.Subdivision Name/Number Unit No.Phase No.
CHECK BELOW U- bUBMlI'ltL):
D 2 Energy Calcs O 2 Structural Calcs D 2 Soils Report D 1 Addressed Envelope
ASSESSOR'S PARCEL EXISTING USE
SQ. FT.# OF BATHROOMS
3. uurriAL.1 PtHiUM in diiterent from applicant]
NAME (last name first)
CITY STATE
ADDRESS
ZIP CODE DAY TELEPHONE
4. APPLICANT U CONTRACTOR EJAGENT FOR CONTRACTOR
NAME (lastxfame.firstU ADDRESS
«*^B>*^t J&>* \*&s^*- -, vCITY X^-yS^Lio^ STATE c^Xf7 ZIP CODE
WNER D AGLN T FOR OWNER
DAY TELEPHONE
5. PROPERTY OWNER
NAME (last name first)
CITY STATE
ADDRESS
ZIP CODE DAY TELEPHONE
6. CONTRACTOR
NAME (last name first)
CITY STATE
STATE LIC. #
ADDRESS
ZIP CODE DAY TELEPHONE
LICENSE CLASS CITY BUSINESS LIC. #
DESIGNER NAME
CITY
ADDRESS
STATE ZIP CODE DAY TELEPHONE STATE LIC. #
7. WORKERS' COMPENSATION
Workers'Compensation Declaration: I hereby affirm that I have a certificate or consent to self-insure issued by the Director ol 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 of 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
uwner-Bunder Declaration: 1 hereby attirmtnai ram exempt trorn the Contractors License Law lor the following 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 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
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:D
(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 die-applicant for such permit to file a signed statement that he is licensed pursuant to the
provisions of the Contractor's License Law (Chdpter^, commencing with Section 7000 of Division 3 of the Business and Professions Code)
or that he is exempWirierefrom, apd the^jasis JOT the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the appKednt tojrciviLtfena)gfQf nef^nore than five hundred dollars [$500]).
SIGNATURE j^T JT ^ / ^S\' DATE
^L*COMPLhUjXHIs btC
Is thejfpffticant or future
prewntion program under Sections
JUlLDINO FtKMUs UNLY:
required to submit a business plan, acutely hazardous materials registration form or risk management and
05, 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 ENNO
Is the facility to be constructed within.1,000 feet of the outer boundary of a school site?
O YES HsNO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT 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 ~~~
1 hereby attirm tnat there is a construction lending agency tor the performance of the work tor which this permit is issued (Sec 3097(.U Civil (jodej.
LENDER'S NAME LENDER'S ADDRESS
1O. APPLICANT CLH11FICATION
I certify that 1 have read the application and state that the above information is correct. T 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 CTTY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS
AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SATO CTTY 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 theJJnilding Official under the provisions of this Code shall expire by limitation and become null and void if the
building or work authorized by sud*"perjnit is not commenced within 365 days from the date of such permit or if the building or work authorized by
such permit is siu*pendjgd qr^flbajadonaa.at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code).
DATE: ~7~. '
O
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