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Home My WebLink About2818 ROOSEVELT ST; ; CB930616; PermitCt#-I l3 o 7 fl, F M " W?U: : A ) , . .., ------ 1 ~n nt r .., C. '.Y • • w RV "' Jll .r c r-pt ... 0n , r VE: , N c l l't}(t:# F t : I • r-- r 2865 06/ 1/97 0001 01 ... i:wr I ; A ,' +-• 4-.:, b / . 'J • E-xt fr- .:. J . ( ... . u f • '1 . E AL APPROVAL IN~~-DATE -1-1------,.-,11 CLEARANCE _____ , CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 .(\ PERMIT APPLICATION ~ '1:3 PLAN CHECK NO. City Ot carLs'bac:i Building Departaent 2075 Las Pal-• Dr., Carlsbad, CA 92009 (619) 438-1161 I. P~l liPE l ~v:?i.nmik~ VAIID. BY __________ _ DATE A: mmerc1al U New Bu1ldmg D I enam Improvement B -□ Industrial □ New Building D Tenant Improvement C -□ Residential □ Apartment □ Condo □ Single Family Dwelling □ Addition/ Alteration □ Duplex □ Demolition □ Relocation □ Mobile Home □ Electrical □ Plumbing □ Mechanical □ Pool □ Spa □ Retaining Wall □ Solar □ Other 2. PRCllECT INFORMATION FOR OFFICE USE ONLY 14ti~ ecx:wv12 R-s+ Nearest Cross Street ('(W1SPO.v\ Butldmg or Suite No. mt o. CHECK BEWW IF SOBMI 11 ED: □ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ l Add~ Envelope ASSESSOR'S PARCEL EXISTING USE PHOPOSED USE DESCRIPTION OF WORK SQ. FT. 2ect) # OF STORIES 3. WN IACI PERSON (II dll[erenf from appJlcant) NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE 4. ~1ft?A~~1'.~1:x1~,(il Vr$2R 'i'b~k?s~l2 8 tf~~~M□~G,E~cl't'.f~WNG CITY =tvu 1~ STATE ZIP CODE 18 DAY TELEPHONE ( 1«)'5&6 ?)J'cJ Q vtA. li'l)rwlte r ADDREss Li U-0.;w ve <Su l +e s Io V V 1(/\.Q STATE C4 ZIP CODE 'Z I '8 DAY TELEPHONE !?-V\DJJkcAsscx:-1cti€J,Ji:1C ADDREss 2'15 J,b.M!Al\~/•<,-n+s.e G- cm .::rvv (~ STATE C4 ZIP CODE q-z-qtB DAY TELEPHONE c-q IC,\) 586 sol& STATE LIC. # 6s'ls<-lq LICENSE cLASs c-33 CITY ausINESs LIC. # DESIGNER NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. # 7. WORkERS' WMiif!NSXIION Workers• Compensation Declarauon: I hereby aUlnn that I have a cert1hcate of consent to self-msure issued by the Director of industnal 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 with the Building Inspection Department (Section 3800, Lab. C). INSURANCE COMPANY ~ fuvid POLICY NO. 068 2 5 -I-4 SIGNATURE DATE 8. OWNmt-BUllDEk IJECLARXliuN Owner-8u1lder beclarauon: I hereby affmn that I am exempt from the Contracto?s license Law for the followmg reason: D 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 co 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: 11te 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 Llcense Law). D 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 co 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, commencing 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). SIGNATURE DATE COMPLEIE IHIS SECIION FOR NON-RESIDEN IIAL BUILDING PERMIIS 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 2.!e95, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? □ YES )13 NO Is the applicant or future building occ~nc required to obtain a permit from the air pollution control district or air quality management district? □YES );IND Is the facility to be constructed within_.!,000 feet of the outer boundary of a school site? □ YES }',;'_ NO IF ANY OF llil! ANSWERS ARE YES, A FINAL CERTIFICATE OF CXDJPANCY MAY NOT BE ISSIJED AFl1lR JULY 1, 1989 IJNIJ!SS llil! APPUCANT HAS MET OR IS MEETING llil! REQUlREMENl'S OF TIIE OFFICE Of EMERGENCY SERVICES AND llil! AIR l'Ollll110N WNTROL lllSl'RICT. 9. WNS'IROCIIUN LENDING AGENCY I hereby afhrm that there 1s a constructmn lendmg agency for the performance of the work for which this pemuc 1s issued (Sec 3097(1) Civil Code). LENDER'S NAME IO. Al'PIJCAN I CF.kllFfinON LENDER'S ADDRESS ,....--·· I cemfy that I have read the apphcauon and state that the above mformauon 1s correct. I agree to comply wuh ail Luy ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I Al.50 AGREE ID SAVE INDEMNIFY AND KEEP HARMI1lSS llil! Cf1Y OF CARISBAD AGAINST ALL L1ABIUI'1ES, JUDGMENTS, CDSTS AND EXPENSES wmrn MAY IN ANY WAY MDUJE AGAINST SAID Cf1Y IN WNSEQUENCE Of llil! GRANTING Of nus PERMIT. OSHA: An OSHA permit is required for excavations over S'O" deep and demolition or construction of structures over 3 stories in height. Expiration. Every permit i~ued 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 che 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) Uni??:B:ilding Code). APPLICANTS SIGNATURE ~U,-#,,f--DATE: (W.5/q3 YELLOW: App 1cant PINK: Fmance ) f ~ DATE l ·;;.. 9. o/ 3 UNSCHEQULEIPNSI:::o~~d PERMIT • 1"3{) {pf b PLANCK # ____ _ JOB ADDRESS,..:d=-· .;;..B;_I g;;__.J-g......;.;(Jf)"-"~"-'€::....;_J.:::.t,..;;.'-...:.~---------- TIME ARRIVE: _____ TIME LEAVE: ____ _ CD LVL DESCRIPTION I S/2-. __ O""'l)----'-r--____ _ PERIIITS 6/15/89 -~ ACT COMMENTS ~--