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Home My WebLink About2605 REGENT RD; ; CB971188; PermitA / wnr * ---- I .... J +. r u : #, COVE PA f nc #: LE 76 4 FINAL ~ '0~- 27. ·a. 4 . 7 ')I; .. -4 INSP ~~ (#1D~E~----~ ~~ ~~~"i- CITY OF CARLSBAD 2075 Las Pahnas Dr., Carlsbad, CA 920()CJ (619) 438-1161 ---------- PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 1. PROjECT INFORMATION -1 ~OS' ~4Qe>(r Address (Include Bldg/Suite #I Business Name lat this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total I of units Assessor's Parcel I /3 w, t.,0 p,,,_ 7 / v G.-v (S'>f..- Existing Use ,./2 ~-rr, C-6' / '>-0 't' I Proposed Use Description of Work SO. FT. lot Stories I of Bedrooms I of Bathrooms '2. CONTACT PERSON ilf different from appNeantl -r.•·,. Name Address City State/Zip Telephone I Fax I Et "'~APPLICANf -6'1 Contracior···-□·.lgeot or E<lhtracior. 0 bwner "'.""'□' Ali~nt1of Own r"t r:--~ ~ .,_.,._,,,,. ,i;f'9 '°!';J• "" "c" ' T -De;A L. C-q N s:r rt-Ct.. Address City State/Zip Telephone I ,_,.,:\":~rr~:tr"".,.:!f'Jt:1rt,~"W'F ,,.•"?'f'"!"f'"'.,• •r:1 ;i 4<i':"'f ifr"'~"[ "i~t' .,,: t , .. f (l. Uit2..L?,, 0., 9Zo11J-" 7 Z-O, Zt, ',S City State/Zip Telephone I ISec. 7031 .5 Business and Professions Code: Any City or County which requires• permit to construct, alter, improve, demolish or repair any structure, prior to Its lnu1nce, also requires the applicent for such permit to file a signed statement th1t he is licensed pursu1nt 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, end the basis for the alleged exemption. Any violation of Section 7031.6 by any applicant for• permit au:;ects the applicant to a civil penalty of not more than five hundred dollars ($60011. 7-PlfA'-Cc,,w.s-r,z Z-953 M"l oL.Jo,.J f 7 ,,~; C,o/A!!,J~~ Clrl . q z ,:,"d"" ,;l.33_,:,~?o Name · Address City State/Zi!-7~1:one I State License I ~ Z/,_p,y License Class -S'~ / City Business License I ~ Designer Name Address City State/Zip Telephone State License I _________ _ 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain • 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 . .IZJ._ 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 co~sation insurance carrier and policy number are: . Insurance Company 'it/ 7S-~~-.::> Policy No. /o :; ~ ¢(f ·? 7 Expiration Date /-/-/ P-- ITHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1•100) OR LESS) 0 CERTIFICATE OF EXEMPTION: I certify that In the performance of the work for which this permit Is Issued, I shell not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to aecure worker•· compena■tlon coveraga II unllwful, end ah■I aubject ■n employer to criminal penaltlea and civil flnea up to one hundred thousand dollar• 1$100,000), In addition to the coat of compenHtlon, d■magea ea provldad for In Section 3706 of the labor code, lntereat end attorney'• feea. 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 ISec. 7044, Business and Professions Code: The Contractor's License Law does not apply to ■n 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 ■n owner of property who builds or improves thereon, and contracts for such proj■cts with contractorlsl licensed pursuant to the Contractor's License Lewi, 0 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 lhave / have not) signed an application for• building permit for the proposed work. 3. I have contracted with the following person lflrml 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 ind provide the major work !Include name / address / phone number/ contractors license numbarl:. ______________________________________________ _ 5. I will provide some of the work, but I have contracted I hired) the following persons to provide the work Indicated !Include name / address / phone number / type of work): _________________________________________________________ _ Is the applicant or future building occupant required to submit a business plan, ■cutely hazardous materials registration form or risk management and praventlon program under Sections 26505, 25533 or 25534 of the Presley-Tanner Hazardous Subst1nce Account Act? 0 YES O NO Is the applicant or future building occupant required to obtain • permit from the air pollution control district or air qualltv 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. la.-... CONSTRUCTioNUNbtNG'AGENCY°".'";'7_...,·~·~;: .'' ~~~ ,~r-....,"-~'.':'"'';. .:":,....."'.! •~r ~·~,---... -•. ~ ,-;_-.,,.... ........ •-:-· .,. I hereby affirm that there Is a consyuytion lending agency for the performance of the work for which this permit is Issued (Sec. 309711) Civil Code). LENDER'S NAME ~ 9-, LENDER'S ADDRESS _______________________ _ 19: -.-APPLICANT cERT1FICAnON~':;r .... tt .. Ir' .• : -~~~-=-7..1:;~~::->.-:::.~"t .~ .. ,.... .. "!!C';"":,ri.~;~ ~~'?"":;= z..~-.: ~r.-! ~:;:---,. "T :.'! •;,:-_:~-~"':•'t~ '° • ... '; ~ .. I certify thlt I hive reed the 1pplic.tion and st1te th1t the ebova Information It correct and that the information on the pl1ns is 1ccurate. I agree to comply with 111 City ordin1nces and State laws relating to building construction. I hereby authorize representatives of the Cltt ot C1rlsbad 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 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 Offlclal 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 n commenced within 366 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 e wor s comme e to period of 160 days !Section 106.4.4 Uniform Building Codel. APPLICANT'S SIGNATURE DATE 10/16/97 DATE 05/13/97 05/13/97 INSPECTION HISTORY LISTING FOR PERMIT# CB971188 INSPECTION TYPE Ftg/Foundation/Piers Ftg/Foundation/Piers INSP ACT COMMENTS RI DC RI AP BJN/IDEAL/438-0470 HIT <RETURN> TO CONTINUE .••