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Home My WebLink About2769 SOUTHAMPTON RD; ; CB891733; PermitB U I L D I N G P E R M I T 1 1/02/89 15:04 Page 1 of 1 Permit No : CB891733 Project No: A890 2937 Develo pment No : Job Address: 2769 SOUTHAMPTON RD Str: Fl: Ste : 1122 11/02/89 0001 01 02 Permit Type: RESIDENTAL ADDITION/ALTERATION Parcel No: 208-140-24-00 Valuation: 780 Construction Type: NEW Occupancy Group: Class Code: Description: PATIO COVER 120 SF C-PRMT 36-00 Status: ISSUED Applied 11/02/89 Apr/Issue Validated By : CD *** Fees Required *** *** Fees Collected & Credits *** Fees: Adjustmen ts: Total Fees: Fee description Building Permit Plan Check Strong Motion Fee * BUILDING TOTAL 36.00 .oo 36.00 Total Credits: Total Paymen ts: Ba lan ce Du e: Units Fee/Unit IN CLEARAta CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 .oo .00 36.00 Ext fee Data 21 .00 14.00 1.00 36.00 PERMIT APPLICATION A V City of Carlsbad Building Department EST. VAL ______________ _ 2075 Las Palmas Dr., Carlsbad, CA 92009 (6191 438-1161 1. A B C 2. PERMIT TYPE COMMERCIAL TENANT IMPROVEMENT 0 !,NDUSTRIAL □NEW QTENANT IMPROVEMENT / lifRESIOENTIAL □APARTMENT □CONDO □SINGLE FAMILY DWELLING l2fADDITIOtrl/ALTERAT!ON □DUPLEX □DEMOLITION □RELOCATION □MOBILE HOME □ELECTRICAL □PLUMBING □MECHANICAL □POOL OSPA □RETAINING \,IALL □SOLAR PLAN CK DEPOSIT, ___________ _ VALID. BY ______________ _ DATE _______________ _ LEGAL DEsatlPTIOl Lot No, Subdivision Name/Nunber • II() 7i1/vl1/tfl<--K. f'd//iTf Un, t No. Phase No. CHECK BEL<M IF SUINITTED: Q2 Energy Cales Q2 Structural Cales BLDG. S0, FTG. 0 2 Soi ls Repcrt # OF STORIES D 1 Addressed Envelope EXISTING USE PROPOSED USE 3. CONTACT PERSON ""' NON(..,-ADDRESS cny STATE ZIP CODE DAY TELEPHONE SIGNATURE 4. APPLICANT 0 CONTRACTOR 0 AGENT FOR CONTRACTOR D AGENT FOR O'wNER NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE 5. PROPERTY OWNER NAME t'l-f'f'YJ -:;. t-l()t?Al( OWNER □LESSEE □TENANT ADDRESS ,m i1v, ~.J.hh (rn STATE C'f. ZIP COOE 001 DAY TELEPHONE 6. CO_NTAA~T,O,R-'"' NAME Ktc.4l--l"UA .fl C !TY CA rl s b J) ST ATE C«.,. ADDRESS Jf) VVLl/f"e.,Y 4' 'l ZIP COOE qwo$ DAY TELEPK0NE JJ.1-/<j 17 7. 8. SIGNATURE DESIGNER NAME CITY WORKERS' COMPENSATION STATE LICENSE CLASS -~!l;L-'-C.,.I __ TITLE AD0RESS ZIP COOE CITY BUSINESS LIC. # DATE DAY TELEPHONE STATE LIC. # Workers• C~nsat1on 0eclaration: hereby affirm that I have a certificate of consent to self·1nsure issued by the Director of Industrial Relations, or a certificate of Workers' Coq,ensat ion Insurance by an di tted insurer, or an e11act copy or dupl i cate thereof certified by the Di rector of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C). INSURANCE COMPANY POLICY NO. E>CPIRATION DATE Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not eq:>loy any person in any manner so"~' -;r,,,:"'"''. t~ ')' Mo,km' '"""/"/S::1200 L:• :· ;·:·"'""· SIGNATURE u ~ DATE I I OWNER-BUILDER DECLARATION 0wner·Bu1lder Declaration: I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 t as owner of the property or my employees with wages as their sole c~nsation, 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 COOllletion, the owner-builder will have the Wrden of proving that he did not Wild or improve for the purpose of sale.). D t, 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 Wilds 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, a L so requires the appl i cant for such permit to f i Le a signed statement that he is licensed pursuant to the provisions of the contractor's License Law (Chapter 9, conmencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is e11empt therefrom, and the basis for the alleged e11emption. Any violation of Section 7031.5 by any applicant for a permit sl.bjects the applicant to a civil penalty of not more than five hundred dollars ($500]). SIGNATURE DATE COMPLETE THIS SECTION FOil. NON·RESIDENTIAL BUILDING PERMITS ONLY: Is the applicant or future building occupant required to sub'nit a Wsiness 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? □YES ONO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? OYES ONO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □YES IF MY OF THE AIISUERS ARE YES, A FINAL CERTIFICATE Of OCClJPANCT MT NOT Bf ISSUED AFTER JULT 1, 1989 UNLESS THE APPLICANT HAS fl:T OR IS fl:ETING THE REQUIREMENTS OF THE OFFICE OF ENERGENCT SERVICES Ml> THE AIR POLLUTION mNTROL DISTRICT. 9. CONSTRUCTION LENDING AGENCY hereby affirm that there is a construction lending 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 INDE,.UFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST All LIABILITIES, JlDGMENTS, COSTS AND EXPENSES WHICH MT IN ANY WAT ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. Expiration. Every permit issued by the Building Official under the provisions of this Code shall e11pire by limitation and become null and void if the Wilding or work authorized by such permit is not conmenced within 180 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 work is conmenced for a period of 180 days (Section 303(d) Uniform Building Code). APPLICANT'S SIGNATURE D ()l,jNER □ CONTRACTOR OBY PHONE APPROVED S.Y: ______ _ DATE: WHITE: File YELLOW: Applicant PINK: Finance PERMIT# CB891733 CITY OF CARLSBAD INSPECTION REQUEST FOR 01/09/90 DESCRIPTION: PATIO COVER 120 SF TYPE: RAD RD STR: PHONE: 729 1817 INSPECTOR AREA MP PLANCK# CB891733 OCC GRP CONSTR. TYPE NEW FL: STE: JOB ADDRESS: 2769 SOUTHAMPTON APPLICANT: HODAK, TERRY J CONTRACTOR: OWNER: ~:g~~: /} 11_ I'\ ~ INSPECTOR~~__;t~::......:....::....:J,}_,,:...__~~Cl<C..------REMARKS: Tl/MH/TERRY/434-3901/757-8111 SPECIAL INSTRUCT: TOTAL TIME: CD 19 LVL DESCRIPTION ST Final Structural -------------------- -------------------- -------------------- ACT COMMENTS kl _____ _ ***** INSPECTION HISTORY***** DATE DESCRIPTION 110689 Ftg/Foundation/Piers ACT INSP AP MP COMMENTS j '2,... I A p ----~---l sv. ____ _ ~I L1 .• ~ 1989 City of CARLSBA&, liUILDING DEPT G'"l ~v:-~ f_L -., 12.,0'