The URL can be used to link to this page

Home My WebLink About2310 SUNNY CREEK RD; ; CB931276; Permit4781. 11/1 /9"7 0 1 1 1-i~ A APPROVAL INSP. ~::::::::::_-DATE L~ -6¥5- CLEARANCE _____ I CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION PLAN CHECK NO. City of carlsbad Building Department 2075 Las Pal•s Dr., Carlsbad, CA 92009 (619) 438-1161 PINI CK DEPOSIT _______ _ I EST. VAL VAIID. BY __________ _ I. PER.M1i IYPR A -Li COmmerc1al U New Buildmg B -□ Industrial □ New Building Li tenant Improvement □ Tenant Improvement C -□ Residential □ Apartment □ Condo □ Single Family Dwelling □ Addition/ A1teration □ Duplex □ Demolition □ Relocation □ Mobile Home }(Electrical □ Plumbing □ Mechanical □ Pool □ Spa □ Retaining Wall □ Solar □ Other DATE 2. PROJECT INFORMATION FOR OFFICE USE ONLY Jo ...s u ,11 ''•"t earest Cross Street C "Y-"'.,, ck.. klc-1 . Ul~g;. uote o. Loe No. Subd1vis1on Name/Number Onn No. Phase No. □ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING HSE PROPOSED USE DESCRIPTION OF WORK SE.€.. ~l\~l~ lwu_ i::,,a'\ro.""'- SQ. FT. # OF STORIES /.v.Stac< -HJ MJ';4 /4f:tff@4 z~ $Sr: 3. WN iACI PEJtSON (Ir dnlerent from apphcant) NAME ADDRESS CITY ST A TE ZIP CODE 4. APPLICANI UWfJIRACIOk □AGENI FURCUNIRACIOH DAY TELEPHONE )(oWNEk □AGENI FOR OWNER NAME l:vje .._,,, " K"1,,,.,._ os ADDREss CITY C11,ls,"7,11d STATE (!'1 ZIPCODE qzood'.'.DAYTELEPHONE ?zq-9619 S. :;!{~~=:_ ~ ADDRESS -5""~'.::,""t) ~ ,E._,c,,...,14<6 CITY ~5'3:-?Q STATE 6. WNI NAME ..] It'll\ 1,.)(:, f;>,LE.. STATE CA STATE !JC.# b201"12 ZIP CODE 1Y?FC DAY TELEPHONE •/3tS" 3/</ / ADDRESS 2,(.,,2, i'tJ.{ Ml) •.IT,-\ i> '<.. ZIP CODE 'l20'63 DAY TELEPHONE {e30-l~"\Q IJCENSE CIASS C,. -I 0 CITY BUSINESS !JC. # CITY STATE ZIP CODE DAY TELEPHONE STATE !JC.# 7. WOitkRRS' WMPENSAI iUN Workers• Compensation beclarauon: I hereby afimn that I have a certificate of consent to self-msure issued. by the Ulrectorof lndustnal 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 POIJCY NO. EXPIRATION DATE Ceruhcate of Exemption: I cerufy that m the performance of the work for which this permit 1s issued, I shall not employ any person m any manner so as to become subject to the Workers' Compensation Laws of California. SIGNATURE DATE 8. OWNmt-B0nntk bPlDJtAl'ION bwner-Bmlder Oeclarat1on: I hereby affmn that I am exempt from the Contractor's Llcense Law for the foliowmg reason: Li 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. 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.). □ 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: (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, 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 pennit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]). SIGNATURE DATE COMPLE'IE IRIS SEGIION FOR NON-RESIDEN'IIAL BOIWING 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 2550~, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? □ YES lil""NO Is the applicant or future building occup..9,nt required to obtain a permit from the air pollution control district or air quality management district? CJ YES llll""NO Is the facility to be constructed within 1,0Q.P feet of the outer boundary of a school site? □ YES EM'l"O IF ANY OF TID!ANSWERS ARI! YES, A FINAL CERTIFICATE OFOCx:tJPANCY MAYNITTBE ISSUEDAFrnR.JIJLY I, 1989 UNLESS TID!APPIJCANT HAS MET OR IS MEfillNG 1HE REQUIREMENTS OF TIIE OFFICE OF EMERGENCY SERVICES AND 1HE AIR POll.lTllON WNTROL D!SfRICT. 9. WNSIROCIION IENDING AGENCY I hereby ailmn that there 1s a constructmn lendmg agency for the perlormance of the work for which lh1s pennn 1s issued {Sec 3097(IJ CIVIi Ccxle). LENDER'S NAME LENDER'S ADDRESS IO. AWilcANI cmtfflit!Al'ION I certify that I have read the apphcat1on and state that the above mformauon 1s correct. I agree to comply with all City ordmances 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 1U SAVE INDEMNIFY AND KEEP IIARMIJ'.SS 1HE QTY OF CARISBAD AGAINST ALL 1JAB1U11F.S, JUDGMENTS, CDSTS AND EXPENSES WHICH MAY IN ANY WAY A£DUII! AGAINST SAID QTY IN WNSEQlll!NCE OP TIIE GRANTING OP 11IlS 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 · in 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 th ork 1s ommenced for a period of 180 days (Section 303(d) Uniform Building Code). APPIJCANTS SIGNATURE DATE: )/ -) / -7' _J ' PINK: Fmance ~ "7'°"::' ,, _.,., A ----,_. .., _________ _ ?L\.:iCF: 6 ------'------ ..:-:: !J ,\:Jc n.::s s_--"'s?c..,:'a...:>...1...(,_ c')'-----~S-a:::,v"-'c,->"'-C,'1]"'4--....:C~&~e JS/s..____:_:Qj=-..:-· _________ _ i\.!"'-.'l.I VE: _______ T IttC LEA 'IE : ________ _ L·iL DESCRIP'I'IOII 9:-==P I 1,,.C'fu" P Eit. ""il 'I :l G/l!:l/05> ~· - ., . ,\CT CC:!lllE?lTS