HomeMy WebLinkAbout144 REDWOOD AVE; ; CB981042; PermitFOR OFFICE USE ONLY
PERMIT APPLICATION PLAN CHECK No. fBlottv
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(760) 438-1161
EST. VAL.----.._-,,--.,.,,.:,:--
Plan Ck. Deposit ~--'-L--L.,L..J.<:....i..<-_
Validated By,_--',,ffJ<:::,,.._,___,.~=-:~-,,,
Date, ________ --4~~~-/lr'-)
Address (include Bldg/Suite #) Business Name (at this address)
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units
I._ P/4 Proposed Use
#of Stories # of Bedrooms # of Bathrooms
2. CONTACT PERSON (If different from applicant)
Name Address
3. APPLICANT O Contractor D Agent for Contractor O Owner
Name Address
4. PROPERTY OWNER
Name Address
6. CONTRACTOR -COMPANY NAME
City
0 Agent·for Owner·
City
City
State/Zip
State/Zip
State/Zip
Telephone# Fax#
Telephone#
Telephone#
(Sec. 7031.5 Business and Professions Code: Any City or County which reciuires 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 ~ivi~nalty 9f n9t mor,-,,than f.iYI pu~dred r !,Ui0-.0~1,;)·, /.//
A/ .S -Cl c/, e L..e..,--r,• ~ / b Z-
Name
State Ucense # ~/2~1/~f~5',_6~f~--License Class _ __,.8'="-------
City State/Zip Telephone II
City Business License II _______ _
Designer Name Address City State/Zip Telephone
State License # _________ _
6. WORKERS' COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
D 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.
D l 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 ($1001 OR LESS)
D 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 ($100,000), in addition to the cost of compensation, damages aI provided for In Section 3706 of the Labor code, Interest and attomey'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:
D I, as owner of the property or my employees with wages es 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).
D 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).
D 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. D 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 I address / phone number I 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-RESJDENT1AL BUILOINO 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 26534 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? D YES D NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 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 ANO 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. 30970) Civil Code).
LENDER'S NAME _____________ _ LENDER'S ADDRESS. ________________________ _
9. APPLICANT CERTIFICATION
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 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 wor · commenc d for eriod f 180 ys (Section 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE OATE ____________ _
WHITE: File YELLOW: Applicant PINK: Finance
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB981042 FOR 04/16/98
DESCRIPTION: UNDERGROUND PLUMING ONLY
TYPE: PLUM
JOB ADDRESS: STE:
INSPECTOR AREA
PLANCK# CB981042
OCC GRP
CONSTR. TYPE NEW
LOT:
APPLICANT: P
CONTRACTOR:
144 REDWOOD AV
& G CONSTRUCTION PHONE: 760 729-7447
OWNER:
REMARKS: C/GARY/967-2400 AM PLEASE
SPECIAL INSTRUCT:
TOTAL TIME:
--RELATED PERMITS--
LVL DESCRIPTION
PERMIT# TYPE
RW980093 ROW
CD
21 PL Underground/Under Floor
::~:~; /( L-D
INSPECTO~~'.:¥;~t:;:.:::::::~:::::=:::::===
STATUS
ISSUED
ACT COMMENTS
&_
--------------------
***** INSPECTION HISTORY*****
DATE DESCRIPTION ACT INSP COMMENTS