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L APPROVAL
INSP. Ja.--DATE {-27-t:
CLEARANCE _____ !
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
/
/
PERMIT APPLICATION ~ ~
PLAN CHECK NO.
City of Carlsbad Building DepartRnt
1
:-.!;.V~ DEPOSIT _______ _
2075 Las Pal .... Dr., carlsbad, CA 92009 (619) 438·1161
I. PPJtMII hPE VAIID. BY __________ _
DATI! From Llst 1 (see back) give code of Permit-Type: ___________ _
For Residential Projects Only: From Ust 2 (see back) give
Code of Structure-'I)'pe: ___________________ _
Net Loss/Gain of Dwelling Units
2. PROJECT INFORMATION FOR OFFICE USE ONLY
Bu1ldmg or Suite No.
nt[ o.
CHECK BEWW If S0BMII IED:
□ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ I Addressed Envelope
ASSt:SSOB'S PARCEi, EXISTING mrn PBOPPSEP USE DESCRIPTION OF WORK
SQ. FT. # OF STORIES # OF BEDROOMS # OF BAlHROOMS
3. WN iACI PFJ&JN (II dnlerenf from apphcanO
NAME (last name first) ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
4. XPPilCANI UWNIRACIOR UAGENI FOR WNIRACIOR
ADDRESS
DOWNER UAGENI FOR OWNER
NAME (last name first)
CITY STATE ZIP CODE DAY TELEPHONE
5. PKUPER IY OWNER
NAME (last name first) )/te,,lfU15'!l: 71.--i1A-~s
CITY (./c~S 44-0 STATE C4-ZIP CODE 9:ioo-z DAY TELEPHONE L/16-57):17
g_ ~~~.1~:me first) -{A-t..tJ,OT (J.}S1fiWJ /3LIJ ' ADDRESj'"-7, 6,01--"( c,.,f,li5&4i) 6/1 •
CITYeA/l,f.!'yj4'b STATE t!A-. ZIP CODE ?-z.o,:,'j DAY TELEPHONE 1-IY-GJ'd7
STATE LIC. #~_3~ LICENSE CLASS /$ CITY BUSINESS LIC. #
CITY STATE ZIP CODE DAY TELEPHONE STATI! LIC. #
7. WORklllts WMPENSAIION
□
□
□
Workers' t.Zmpensauon Oeclarat1on: I hereby a limn ffiat I have a cerullcate of consent to seif •msure issued by the Director ol 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 wich the Building Inspection Department (Section 3800, Lab. C).
EXPIRATION DATE
1c t 1s penmt 1s 1ssu , s a not emp oy any person m any manner
ara on: ere ya 1rm a am exemp rom e n ac o s cense w or e o owmg 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.).
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, ilnd 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 {$5001).
SIGNATURE DATE
WMPLEIE IRIS SECIION FOR NON-RESIDENIIAt BUILDING PERMIIS ONLY:
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration fonn or risk management and
prevention program under Sections 25505, 25533 or 25534 or the Presley·Tanner Hazardous Substance Account Act?
C 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?
□ YES □ NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
C YES □ NO
IF ANY OFTimANSWERS ARE YES, AFINALCERTIFICATI!OF oex:t/PANCY MAY NOT BE~ AFTER JULY I, 1989 UNLESS nm APPLICANT
HAS MET OR IS MEIITING nm REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND nm AIR POLLUTION ffiNTI!.OL DIS11\1Cf.
9. WNSIR0CI IUN i.£NDING AGF.NCY
I hereby afhrm that there IS a consfrucUon iendmg agency for the performance of the work ior which this penml 1s issued (Sec 3097(1) Civil Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPIJCANI C£Ri0:ICAIJON
I certify that I have read the appUcabon and state lhat lhe above mlormat1on 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 C.arlsbad to enter upon the above mentioned propeny for inspection
purposes. I AlSO AGREE 10 SAVE INDEMNIFY AND KEEP HARMLESS nm CITY OF CARlSBAD AGAINST AIL LIABILITIFS, JIIDGMENTS, CDSTS
AND EXPENSES WIDCH MAY IN ANY WAY AUJIUE AGAINST SAID CITY IN ffiNSEQUENCE OF THE GRANTING OF nus 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 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 commenced within 36S 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).
APPLICANTS SIGNATURE DATE: ___ _
WHITE: File YEll.OW: Applicant PINK: Finance
0
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB960865 FOR 06/27/96
DESCRIPTION: ADD SINK, SHOWER AND WATER CLS
TO LAUNDRY AREA MOVE WAS.JORY. ADD DOOR
INSPECTOR AREA TP
PLANCK# CB960865
OCC GRP
TYPE: PLUM
JOB ADDRESS: 2815 LEVANTE ST
APPLICANT: TALBOT CUSTOM BUILDING
CONTRACTOR:
OWNER:
PHONE:
PHONE:
PHONE:
STE:
CONSTR. TYPE VN
LOT:
619 944-6807.
REMARKS: MW/LOU
SPECIAL INSTRUCT:
1-(//
INSPECTOR --JI-----------,
TOTAL TIME:
CD
29
LVL DESCRIPTION
PL Final Plumbing
------------------------------------------------------
ACT COMMENTS
***** INSPECTION HISTORY*****
DATE
052196
052196
DESCRIPTION
Rough/Topout
Underground/Under Floor
ACT INSP
AP TP
PA TP
COMMENTS
ND C/0@ 5 1 TO BLDG