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Home My WebLink About1195 TAMARACK AVE; TP; CB970314; PermitAr pl Wt r : F R AJJustments: otal f'e€..,: Y f .r E Y t r T RICAL TO V "f t >. ... . L #: R rtn e#: RE ON "'V 0 t:r ct relit . ( Ext f • Fl APPROVAL A IN ~ j :,,c .. ,_DATE ? '2{ fl CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92()()() (619) 438-1161 V PERMIT APPLICATION FOR OFFICE USE ~ PLAN CHECK NO. (J)(L CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 EST. VAL. ----..,..--,,,--::--r.---- Plan Ck. Deposit~ 2d O 0 Validate.;.?±'"-'- Date ¥-,lf'{-ZZ ~C.UNB>RMAWN,:se.;;._;:.;;;;,'.~,;:;;~-~~~-, -~:-"1iit\?&:h44-::::-:m; & ··, 11r7£AAtKCi64~-'~~k'fi'tVfiP //'Cf, S:: "lJtuMA-,e..AL.,,,{ Address (include B dg/uite I) · Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total I ot units Assessor's Parcel I Existing Use Proposed Uae ;. Olfl(pl-0<1-om Description of Work: SO. FT. #of Stories I of Bedrooms # of Bathrooms re=Mr> PocJcR__ :2;_. CONTACT PERSON (lfdiffareni-from·appl.iC81ltJ;-:,~ Name Address Citv State/Zip Telephone# i;J;.c,A!1'UCAl',IT ' D _Con~acto,r" ;-A D:Aa-.nf(9i:C9nt(J_~t:":. O.0.wn,tto;..;.~O.Ag,nt f9r Q_1.,ma1 ::.:·wf/ififft',~:amrfr'fiWZ'2'·-;;_~·.,:::: .::.·. Name Address City State/Zip Telephone I Fax II ~~~~h';Jk!?5"GB;l,.,,Mllf"'ir ... <1. o«i'.~""~11,r~F~Y..?t Name Address lty W~R~COM~ {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, commending with Section 7000 of Division 3 of the Business and Professions Code] or that he is exempt therefrom, and the basis for the alleged exempti n. 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 ($500)). ~ /4.e ,g, /0 -,;>.O;). '{ Name Address City ate/Zip Telephone I State License # J.s::8 7 bs-' License Class ,P City Business License# /)..Q {ft/6J8 Designer Name Address City State/Zip Telephone State License # _________ _ ii.., :1_·_WQRKERS.~.,COMPENU110L.:.'i,;.,,,-•.. ·,M,l.,_,c.,_, ' ~.:~·,}:,i~•..;i__ ... ~_... --·""'---,·v,·.,":,~"1):.:\i.~-?>"'t:'8f.9'ri:ftiMS\i$"',•g0 ¾4"'~-'~~~--,·:~~S];j_-' -~c -.. -' Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: ~ I have and will maintain a certificate of consent to self•insure for workers' compensation as provided by Section 3700 of the Labor Code, tor the performance of the worlc for which this permit is issued. ~ .. pl.. I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is fV' issued. My worker's compensation insurance carrier and policy number are: Insurance Company (}0(.,0/!;.N 4h,t,t,f= /N$. 't) Policy No. ll/t1,1Q ';/WS:3,5'0,> Expiration Date // ..2.e (ff!s !THIS SECTION NEED NOT BE COMPI.ETED 1.F THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$1001 OR LESS) 0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is iuued, I shall not employ eny person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to aacwe•workers' compensatton coverage is unlawful, and shall 1ubject an employer to criminal penahiu ■nd civil fines up to one hundred thousand dollars I 00, 0), in ition to cost of compensation, damages aa provided for in Section 3706 of the LmMv code, interest and attorney's fMI. s,GNATUAE_--/S~M~.!::::'.~~CJ---------------:-:. DATE .::z.le:rLe 7 -7. OWNER.BUI .. -:~:.-i',~·i,~<,~~~~t;k;~.:r;~~z:;<t-: -. ontractor's License Law for the following reason: 0 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 ottered 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 worlc 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 ot completion, the owner•builder will have the burden of proving that he did not build or Improve for the purpoae of nle). D I, as owner of the property, am exclusively contraeting with licensed contractors to construct the p,ojllCt (Sec. 7044, Buainus and Prot ... lons Code: The Contractor's License Law does not apply to an owner of property who build& or improves thereon, and contracts for auch project• with contractor(a) licenaed pursuant to the Contractor's Ucenae Law). · 0 I am exempt under Section ______ Business and Professions Code tor this reason: 1. I personally pl8n to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO 2. I (have / have not) signed an application for a building permit tor the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name I address / phone number/ contractors license number): ________________________________________________ _ 5. I wilt provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name/ address/ phone number/ type of work): ___________________________________________________________ _ PROPERTY OWNER SIGNATURE ______________________ _ DATE Is th, a~plic::,t er future l::uilciir.ij o.;;cupant 1equirad 'i.O •ulJmit a bu~folfl:5ioli plan, acutely ha.r.ardous materials reg~tret1on form or risk management and prevention p,ogrsm under Sections 26605, 25633 or 25534 of the Presley.Tanner Hazardous Substance Account Act? 0 YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air Quality management district? 0 YES O NO Is the facility to be constructed within 1,000 fHt of the outer boundary of a school aite? D YES O NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCV SERVICES AND THE AIR POUUTION CONTROL DISTRICT. ilf~-:~-,~NSlRUCTION LENDING-AGENCY" ··-,.,. •. ;",, ·;_'..:';_~~'f1r~~_<!-]d~?:'.; 1 hereby affirm that thera is a construction lending agency for the performanca of the work for which this permit is issued (Sec. 30971i) Civil Code). LENDER'S NAME _______________ _ $_; APPLICANT CERTIFICATION I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Ca,lsbed 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, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over s•o• deep and demolition or construction of structuru 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 worlc 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 ah r e w k is co menced for · 0 of 180 days {Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE ~:J;t"::!..l&'.lJ2.~~-::J_)._____________ DATE ,;2)1 t It z YELLOW: Applicant PINK: Finance PERMIT# CB970314 DESCRIPTION: TEMP POWER DUE TO TYPE: ELEC CITY OF CARLSBAD INSPECTION REQUEST FOR 02/20/97 FIRE JOB ADDRESS: 1195 APPLICANT: SHORELINE CONTRACTOR: TAMARACK AV CONSTRUCTION OWNER: REMARKS: MW/JOHN/995-2808 SPECIAL INSTRUCT: TOTAL TIME: CD LVL DESCRIPTION ACT COMMENTS INSPECTOR AREA PLANCK# CB970314 OCC GRP CONSTR. TYPE NEW LOT: ~3-2-=--= =E=L ==C=o=n=s=t=·==S=e=rv==i=c=e=/=A=g=r=i=c=u=l=t=u=r=a=l== 1-f __ , _r\A __ M.,,, __________ _ ------------------ ***** INSPECTION HISTORY***** DATE DESCRIPTION ACT INSP COMMENTS