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Home My WebLink About2300 RISING GLEN WAY; ; CB981246; PermitPERMIT APPLICATION FOR OFFICE USE ONLY ~/ PLAN CHECK NO. qe j;L~ CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. _________ _ x•·. Ad Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. # of Bathrooms 2. CONTACT PERSON (If different from appUcantJ Name Address 3. APPLICANT D Contractor D Agent for.Contractor D Owner Name Address >( 4. R PERTY OWNER Name 6. CONTRACTOR -COMPANY NAME City 0 Agent lor'Owner City State/Zip State/Zip Telephone# Fax# Telephone# -Oo2Ct\ (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 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). Name Address City State/Zip Telephone# State License # _________ _ License Class _________ _ City Business License # _______ _ Designer Name Address City State/Zip Telephone State License # _________ _ 8. WORKERS" COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 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. 0 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 issued. My worker's compensation insurance carrier and policy number are: Insurance Company______________________ Policy No. ____________ _ Expiration Date _______ _ !THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) 0 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 secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars 1$100,000), In addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, Interest and attorney's fees. SIGNATURE______________________________ DATE _________ _ -/.. 7. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 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. tf, 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 prope"y, 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). D I am exempt under Section ______ Business and Professions Code tor this reason: 1. 2. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO ~have not) signed an application for a building permit for the proposed work. 3. I have con racted w· h the fo owing pers! (firm) to provide t pro osed co truction (include name I address / phone num?er / contractors license number): 4. I plan to provide portions of the work, but I ve hired the following person to coordinate, supervise and provide the major work !inClude name I address I phone number I contractors license numbe.~•~1:,-----,-------------------------------------------- 5. I wi.ll.~p~,o~v=;=d~•~•~o=m=•:.:.o~f~th~•~w//4B11;ii~t:zf2=::=~~~l~h~;,~•d~)~t~h2e~f~o~ll~o~w~;n~g:.::p~•~rs~o~n~s~t~o~p~r~ov=;=d~•~•~h~•-w_o~r~k~;~n=d=;c=•~••=d~O~nc~l=u=d~•,,n=•~m~•~l=•~dd:r~•~•~•;l~p=h=o~n=•-n~u=m=b~er~/~ty~p=•~ of work):_ )( PROPERTY OWNER SIGNATURE --/,f:'S:.&,q,.~/4V...-:f--£J.",<'.i!l'.'.1'.l..L=-------·/'- COMPLETE THIS SECTION FOR NON 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 Act7 0 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 district7 D YES O NO ts the facility to be constructed within 1,000 feet of the outer boundary of a school site7 D YES D 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 AND THE AIR POLLUTION CONTROL DISTRICT. 8. 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 ________________________ _ 9. APPLICANT CERTIFICATION I certify that I have read the application and state thet 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 Citt 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 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 work authorized by such permit is suspended or abandoned at any time after the work is menced for a p riod 180 days (Section 106.4.4 Uniform Building Code). /J ... 1 P-Ot y J(.APPLICANT'S SIGNATURE ___ _,,'.J::lf::.YJ,:~'.'.l,,!'.__Jc._:(£B!C,~~~------*ATE ___ ':::J_,__(X=~Q_~-~'-10~--- WHITE: File YELLOW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB981246 FOR 04/29/98 DESCRIPTION: STATE REQUIRED POOL LIGHTING SAFETY INSPECTION TYPE: ELEC WY STE: INSPECTOR AREA PLANCK# CB981246 OCC GRP CONSTR. TYPE NEW LOT: JOB ADDRESS: 2300 RISING GLEN APPLICANT: PHOENIX AQUISITION CONTRACTOR: PHONE: 760 434-0200 OWNER: REMARKS: C/434-0200 SPECIAL INSTRUCT: TOTAL TIME: CD LVL DESCRIPTION ::g::: /l ~ 7) .,/J/J INSPECTO~bP:....::....~c;r;;.,,-~ __ ___;=.__c:'--- ACT COMMENTS 36 EL Electrical Repairs /tlL ft /J lh,,- --------------1----------- ------------------------------------ ***** INSPECTION HISTORY***** DATE DESCRIPTION ACT INSP COMMENTS