HomeMy WebLinkAbout2379 TERRAZA RIBERA; MP; CB900480; PermitB U I L D I N G P E R M I T
03/22/90 14:29
Page 1 of 1
Job Address: 2379 TERRAZA RIBERA Mf Str :
Permit Type : ELECTRICAL
Parcel No: 215-480-15-00
Valuation: 0
Construction Type: NEW
Occupancy Group: Class Code:
Description: ELEC IRRIG PEDESTAL LOT 244
: FIELDSTONE CORPORATION Lie.
Permit No: CB900480
Project No : A8902095
Development No: DEV89063
Fl: Ste:
' " 03/2 (\ 1 OJ 02
C-PRMT 15-00
Status: ISSUED
Applied 03/22/90
Apr/Issue
Validated By: DC
OWNER
*** Fees Required *** *** Fees Collected & Credits ***
Fees:
Adjustments:
Total Fees:
Fee description
15.00
,00
15.00
Enter "Y" for Electric Issue Fee >
Other >
* ELECTRICAL TOTAL ($10 Minimum)
Total Credits:
Total Payments:
Balance Due :
Units Fee/Unit
10 .00
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161
,00
.00
15 .00 Ext fee Data
5 .00 Y
10 . 00 IRRPEDESTJ
15.00
PERMIT APPLICATION
City of Carlsbad Building Department EST. VAL. ______________ _ 2075 Las Palmas Dr., Carlsbad, CA 92009 1,1,1 43a-11,1
1.
A
C
2.
PERMIT TYPE 0 COMMERCIAL
0 INOUSTRIAL
0 RESIDENTIAL
ONE',/
0 APARTMENT
□DUPLEX □DEMOLITION
□MECHANICAL □POOL
TENANT IMPROVEMENT
0 TENANT IMPROVEMENT
0C□NDO □SINGLE FAMILY DWELLING 0ADOITION/ALTERATION
□RELOCATION □MOBILE H~E )i,'eLECTRICAL □PLUMBING
OsPA □RETAINING WALL □SOLAR □OTHER
PROJECT INFORMATION PLAN CHECK No.
Address Building or
Nearest Cross Streets
PLAN CK DEPOSIT ______ ~,_e::_ __ _
VALID. BY _____ -c,_,::::_ ______ _
DATE
LEGAL DESCRIPTION Lot No. Subdivision Name/NIJl"ber Unit No. Phase No.
CHECK BELOII IF SLIIMITTED:
Q2 Energy Cales Oz Structural Cales
ASSESSOR'S PARCEL
cLEC.
BLDG. SC. FTG.
3.
N
CITY
SIGNATURE
4. APPLICAN 0 CONTRACTOR
NAME
Cl TY
5. PROPERTY OWNER
NAME
CITY
0 2 Soi ls Report D 1 Addressed Envelope
EXISTING USE PROPOSED USE
1/ZJZ,
# OF STORIES
ADDRESS
STATE ZIP CODE DAY TELEPHONE
D AGENT FOR CONTRACTOR O0'wNER D AGENT FOR OWNER
ADDRESS
STATE ZIP CODE DAY TELEPHONE
OWNER □LESSEE □TENANT
ADDRESS
STATE ZIP CODE DAY TELEPHONE
6. CONTRACTOR
7,
:::: ~ e) Js /o/UE C::,(-f' ADDRESS
ZIP COOE
SIGNATURE
DESIGNER NAME
CITY
STATE L!C. # _____ _
STATE
WORKERS' COMPENSATION
LICENSE
TITLE
ADDRESS
ZIP COOE
DAY TELEPHONE
CLASS Cl TY BUSINESS LIC. #
DATE
DAY TELEPHONE STATE LIC. #
Workers' Compensation Declaration: hereby affirm that have a certificate of consent to self-insure issued by the Director of Industrial Relations,
or a certificate of Workers' COl!l)ensation Insurance by an adTiitted 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 POLICY NO. EXPIRATION DATE
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.
SIGNATURE DATE
8. OWNER-BUILDER DECLARATION
Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractor's License law for the follo1oing reason:
0 ! as owner of the property or my employees 1,ith 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 la1o does not apply to an owner of property 1oho 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 1oithin one year of c~letion, 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 proiect (Sec. 7044, Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who builds or i~roves thereon, and contracts for such projects 1oith contractor(s)
licensed pursuant to the Contractor's License Law).
0 I am ex~t 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 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, coomencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom,
and the basis for the alleged ex~tion. 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
CCJolPLETE THIS SECTION FOR Nmo/-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'
DYES ONO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
□YES 0NO
Is the facility to be constructed with in 1,000 feet of the outer boundary of a school site"
OYES
If ANY Of THE AN5'.IERS ARE YES, A FINAL CERTIFICATE OF OCaJPANCY MAY NOT BE ISSUED AFTER JI.K.Y 1, 1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS
OF THE OFFICE Of EMERGENCY SERVICES Ml) THE AIR POLLUTION CONTROL DISTRICT.
9. CONSTRUCTION LENDING AGENCY
hereby affirm that there is a construction tending agency for the performance of the work for which this permit is issued (Sec 3097(i) Civil Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPLICANT'S SIGNATURE
I certify that I have read the application and state that the above information is correct. I agree to comply with all City 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 ALSO
AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JLOGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID
CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
Every permit issued by the Building Official under the provisions of this Code shall e~pire by limitation and become nul\ and void if the building
orized by such permit is not comnenced 1oithin 180 days from the date of such permit or if the building or work authorized by such permit is suspended
time after the work is coornenced for a period of 180 days (Section 303(d) Uniform Building Code).
D OWNER □ CONTRACTOR D BY PHONE APPROVED BY: _______ _
DATE:
WHITE: File YELLOW: Applicant PINK: Finance