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Home My WebLink About169 TAMARACK AVE; MP; CB920115; PermitPERMIT APPLICATION PLAN CHECK NO. City of carlsbad Building Depart11ent 2075 Las Pal..,.. Dr •• Carlsbad, CA 92009 (619) 438-1161 EST. VAL'.-----==--------PLAN CK DEPOSIT _______ _ VAIID. BY ___________ _ A7mmerc1al I. ~I ni;- DNewBU1idmg □ New Building LI lenant Improvement □ Tenant Improvement DATE B -□ Industrial C -□ Residential □ Apartment □ Condo □ Single Family Dwelling □Addition/Alteration □ Duplex □ Demolition LI Mechanical □ Pool LI Relocation LI Mobile Home □ Electrical □ Plumbing □ Spa □ Retaining Wall □ Solar □ Other 2. PR<lll!CT INFORMATION FOR OFFICE USE ONLY Address /fj<{7,¢?1,4~1K#, /Hie.. Nearest Cross Street ,e. Pe,/,_ :S (' BuUdmg or Suite No. ntt o. CHECK BEWW If S0BMll lill: □ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ l Add~ Envelope ASSESSOR'S PARCEI.xcf;y,-0 ~ -ts: l{i:J~;l}._E DESCRIPTION OF WORK 1/tn /11e-Tei!ed PROPOSED USE SQ. FT. # OF STORIES ADDRESS ZIP CODE 9~0 'if DAY TELEPHONE {:!VI~ lo '7 aTYt2Hls/Jlk:i STATE e.11- ADDRESS Pt!). o>< J''-FI ZIPCODE'f;.LJOt DAYTELEPHONE q3tf~-5"o1,,Y/ CJTY STATE ADDRESS ZIP CODE DAY TELEPHONE ADDRESS CITY STATE STATE UC.# ZIP CODE LICENSE CLASS DAY TELEPHONE CITY BUSINESS UC. # CITY STATE ZIP CODE DAY TELEPHONE STATE UC.# &e 11?/Jr 7. WOkkERS' tfiMPENSAIION Workers' Compensation Deciarat1on: 1 hereby affirm that I have a certificate of consent to self-msure issued by the Director of 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). ~.c-; (!.. }t, I roe!ficfNfl: j 7 i? l><f d--(, EXPIRATION DATE ceru t ac m t pe rmance o t e war or w Workers' Compensation laws of California. -f-</,3 emp oy any person m any manner SIGNA □ □ □ ere ya at am exempt w or t e o owmg reason: 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). 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 co the provisions of the Contractor's License law (Chapter 9, commencing with Section 7000 of Division 3 of the Business and Professions Code) or chat 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 [S500]). SJGNATIJRE DATE COMPLEIE IHIS SEGIION FOR NON-RE51DEN IIAL BUILDING PERMil'S 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 255051 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? □YES □NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □YES CNO ls the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ YES □ NO IF ANY OF nm ANSWERS ARE YES, A FINAL CERTIFICATE OF <Xx:IJPANCY MAY NOT Bl! ISSUED AFTER JULY I, 1989 UNIBSS nm APPUCANT HAS Mfil OR IS MEETING nm RF.QUIREMENTS OF nm OFFICE OF EMERGENCY SERVICES AND nm AIR POLLIJTION CONTROL DISfRICI". 9. WNSIRUCIION LENDING AGENCY I hereby afhrm that there ts a construction lending agency for the performance of the work for which this permit 1s issued (Sec 3097(1) Civil Code). LENDER'S NAME LENDER'S ADDRESS lo. APPLICANI CEJdfi!ICAIION I certify that I have read the appJJcat1on and state that the above mformauon 1s 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 HARMLF.SS nm CflY OF CARISBAD AGAINST ALL IJABIUl1ES, JUDGMENTS, CDSTS AND EXPENSES WIIlCH MAY IN ANY WAY A£DUJE AGAINST SAID CflY IN CONSEQUENCE OF nm GRANTING OF nns 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 work is commenced for a period of 180 days (Section 303(d) Uniform Building Code). DATE: / -J/ -Cjd-- WHITE: p· e YEIJ.OW: Applicant PINK: Fmance l> 1-b' 11 CL_------- T~K A\JE . POWER. ~PPL'f ~ 51 T.B. 1~,F-S PRo:!E.c:..,. ~: ~ow PP6P06EP ~ \ .. t>"T»lt>·&Y/ ~ ..........-.::,.,. (;;•)...... ' "5UPPL'f w ,--·~ \..;r'-? l"'CU:-. :Z,OCZ)\I() ✓ I I I I ~ ~ ·~ 25M / 6 7 "TAM.AP.AC~ Av I ,... 5S'-1 \-"2,.~-~