The URL can be used to link to this page

Home My WebLink About2865 RANCHO RIO CHICO; ; CB982481; Permit08/05/98 10=47 Pc.1ge 1 of 1 B U I L D I N G Job Address: 286~ RANCHO RIO CHICO Permit lype: MfSLELLANEOUS Parcel No= 222-612-25-00 Vdluation= 0 P E R M I T Suite= Lot#: 64 Permit No: C898 -~a Project No= A9803269 Devel opr11ent No: 9767 00/05/98 0001 01 C-PRHT Construction Tvpe: 02 50-00 0 ~upancy Group : Refprence#= Status: NEW ISSUED 08/0~,/98 08/05/98 RMA De~cription: TEMPORARY GA RAGE TO SA LES Applied: : OFFICE-VILLAGE iJ-CARRII LO RANCH Apr/Issue = Entered By= 509-6113 Appl/Ownr : UDC HOMES 11512 EL CAMINO REAL SAN DI[GO CA 92130 Fees Required Fees= Adj ustrnent!',: Total Fees= Fee description Miscellaneous Fee# * MISCELLANEOUS TOT AL ----619 STE 110 Fee_ Co llected & Credits .00 ,00 50 00 Ext fee Data 50.00 PERMIT FEE 50.00 .----..., . FINAL APF 1OVAL INSP. :y'k: CLEARANCE ________ _ CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 . ,. FOR OFFICE USE Of~Y PLAN CHECK NO. ff-2 Ylj PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. _________ _ Plan Ck. Deposit -----#sl---- Legal Description Business Name (at this addres Subdivision Name/Number Exis~ SO. FT. Unit No. Phase No. Total # of units # of Bathrooms D Agent for C u# ;> ......_J~~-.:::i..-~~:.......J..=d~V'-e..,= _ __.L..LL.-Ll.,,,.,..,____/_1.J.£l..i.::....L.::a...-¥,-~~~L...L..S,.~==---=-------___i,.;:~~~::..__=.;rf>d/3 Name State/Zip 4. PROPERTY OWNER Name Address City State/Zip Telephone# 5. CONTRACTOR a COMPANY NAME (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, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exem tion. An~~e ~ectio · subjectP6pplic Designer Name State License # Cf;o ·2.,7 6, WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: O I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. '1?f' I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is ~ed. My worker's ey::nsation insurance carrier and policy number are: -// /. /. d ~ Insurance Company ~ ::l ~--,Ole-'?'("\_ Policy No.5/ w ,BF ?.. 7 ce_cg ~ Expiration Date ;)_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) O 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. WARNING: Failure to aecure workers' compensation coverage la unlawful, and ahaN aubjact an employer to criminal penalties and civil fines up to one hundred thousand. doll .-,· 00,000)'. in . d to c ■t of~o ·penaetion, damages aa provided for In Section 3706 of th~co~~~nd attorney's feea. SIGNATURE • DATE 8° ~ ,. OWNER-~ DEROECLARATION .. · -· . --7"-=~7 ........ ---''-L--- I hereby affirm that I am exempt from the Contractor's License Law for the following reason: O 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). 0 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(sl licensed pursuant to the Contractor's License Law). O I am exempt under Section ______ Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO 2. I (have / have 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 (include name / address / phone number / contractors license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone number/ contractors license number): ______________________________________________ _ 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work): ________________________________________________________ _ PROPERTY OWNER 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? 0 YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES ANO THE AIR POLLUTION CONTROL DISTRICT. 8. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a /,:uction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME di~ LENDER'S ADDRESS ______________________ _ 9. APPLICANT CERTIFl&moN ' ,. I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Cit\' of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID 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 authorized by such permit is not commenced within 365 days from the date of such permit or if the building or wo~k auth rized by such permit is suspended or abandoned at any timp ttertne w9rk is com enced f r a period.ff 180 days 5ection 106.4.4 Uniform Building Code). k -bo/ APPLICANT'S SIGNATURE.. 1/. ,,__,__,, C ~ DATE _.:c.....,_/ ....-=:_::::,;,=-,.L.~-'-,~'-'-'-------- / WHITE: File YELLOW: Applicant PINK: Finance 7 I