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Home My WebLink About1752 TAMARACK AVE; ; CB970545; PermitFOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK No. q ?a ;Sy s CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 EST. VAL. _________ _ Plan Ck. Deposit ----,-,----- Validated ~; / j>k Date ;,11,\9=7 Phase No. Total # of units Ass8SSor' s Parcel # Existing Use Proposed u.. ion of Work # of Bathrooms (I,' [ ' Fax# Name Address City State/Zip Telephone I Name Address City State/Zip Talephone I (Sec. 7031.5 Business and Professions Code: Any City or County which requires • 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 CodeJ or that he ia: exempt therefrom, and the balls 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 Jt500I). Name Address City State/Zip Telephone# State License # _________ _ License Class ________ _ City Buaineu Ucenn I ______ _ Designer Name Address City State/Zip Telephone State License # _________ _ L~;;w_QRK£8StCOMPENU:no~.J..~~~Jr~~;~-£~~'.~~: . ...::.;.;.:~lZ~~~::.,.,~~j'.~J:iijt'!,'f=ffl1i =~'#ffl~&:~<;::..I.:~ ........ Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: O I have and will maintain a certificate of consent to aelf-insure for workers' compenution as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit ia issued. 0 I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work fo, .'which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company____________________ Policy No. Expiration Date. _______ _ !THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLJ.ARS (e100J OR LESSI O CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit ia iaaued, I shall not employ any person in any manner ao as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure• workers' compensation coverage ia unlawful, and ahaH subject an employw to criminal penaltiea and dvll finn up to OM hundred thousand dollars ($100,000), in addition to the COit of compensation, damages as provided for In Section 3708 of the LabQr code, Interest and attomey'a fHa. SIGNATURE,_____________________________ DATE,,,.----,,,----- ;], 'cJ>WNER0BUILDER DECLARATION ,:, .. · t. : ;';;,,', .. ,:s,,.'.'.~;i&lf".':erse•~'!''it'.if~~'o~.l!?;.· I hereby affirm that I am exempt from the Contractor'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 offered for aale (Sec. 7044, Business and Professions Code: The Contractor's Ucansa Law does not apply to an owner of property who builds or Improves thereon, and who don such work himself or through his own employees, provided that such improvements are not Intended or offered for Hie. It, however, the building or improvement I• sold within one Y••r of completion, the ownar-buildar will have the burden of proving that he did not build or Improve for the purpose of Hie), tzL I, u .owner of the propeny. am exclusively contracting with licensed contractor• to construct thll protect CSec. 7044, Bulineu and Profualona Coda: The 'tomfllctor'a License Law does not apply to an owner of property who builds or improves the,-on, and contrlctl for auch projects with contractore■) lice1111ed pursuant to the Contractor's Ucenae Law). 0 I am exempt under Section ______ Business and Professions Code for this reaaon: 1 . )..P!~-nally plan to provide the major labor and materials for construction of the proposed property Improvement. 0 YES ,llNO 2. ~~v!,.f)lave not) signed an application for a building permit for the proposed work. 3. I hiv~ cont~acted. with the f llowing person (firm) to provide the proposed construction (include name / addrua / phone number / contractors license number): 4. I plan to provide portions of the work, but I have hired the following parson to coordinate, supervise and provide the major wont (include name / addreu / phone number I contractors license number).:_--------------------------------------------- 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name/ addreu / phone number / tvP• of wotk):. ___________ --,'--+----:--------------------------,-~----------- PROPERTY OWNER SIGNATURE ~iRCllOIU'QII Ni <~ LiL_. DATE clUlt.DWO,ft.RMIU~N'-'YiliPt~ '\"ltiPtF?RWfflif ~«~c{ CJ 7 ®WfflWr'ltl!?~' L l:! th~ •~::li::::::1t er future tuildii';.;i occupant 111tql,Mr,W i.u i>1.ol..mit a bw.i~ pi11n, acutely haz.ardoua materials regmratlOf'I form or riak management and prevention program under Sections 26605, 25533 or 26534 of the Pruley.Tanner Huardout Substance Account Act? 0 YES O NO la the applicant or future building occupant required to obtain a permit from the air pollution control dlstrict or air quality management diatrlct7 O YES □ NO Is the facility to be constructed within 1,000 feet of the outer boundary of a •chool •ite7 0 YES O NO IF ANY OF THE ANSWERS ARE YES, A ANAL CERTIRCATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFACE OF EMERGENCY SERVICES AND THE AIR POUUTION CONTROL DISTRICT. I hereby affirm that there is a construction lending agency for the performance of the work for which thia permit ia iaaued (Sec. 309711) Civil Code). LENDER'S NAME--------,------- /'1i'c APPUCANTCERTIFICATION 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. \ agree to comply with all City ordinances and State laws relating to building construction. J hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection purposas. I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO 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 ovar s•o• deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit iaaued by the Building Official under the provisions of thi• Coda shall expire by limitation and become null and void if the building or work authorized by such permit is~menced within 366 days from the date of auch permit or 1f the building or work authorized by such permit 1s suspended or abandoned at any time a her the ork s commenced f6r a period of 1 80 days ISecbon 106.4.4 Uniform Building Code), / APPLICANT'S SIGNATURE (. Q,l,r_ h DATE 3 J // -q 7 , • I WHITE: File YELLOW: Apphcant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB970545 FOR 03/18/97 DESCRIPTION: GAS REPAIR-GARAGE TO POOL HEAT TYPE: PLUM JOB ADDRESS: APPLICANT: CONTRACTOR: OWNER: 1752 TAMARACK AV VITALE, GERI PHONE: PHONE: PHONE: INSPECTOR AREA DC PLANCK# CB970545 ace GRP CONSTR. TYPE NEW STE: LOT: 619 729-2976 REMARKS: BJN/ SPECIAL INSTRUCT: INSPECTOR ....... ~---------- TOTAL TIME: CD 23 LVL DESCRIPTION PL Gas/Test/Repairs DATE DESCRIPTION 031497 Gas/Test/Repairs 031397 Gas/Test/Repairs ACT COMMENTS ***** INSPECTION HISTORY***** ACT INSP CO DC CA DC COMMENTS NEED 10# PRESSURE PER OWNER