HomeMy WebLinkAbout2735 TIBURON AVE; ; CB930344; PermitCj!Jt 3J'/7
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CITY OF CARLSBAD
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2075 Las Palmas Dr., Carlsbad, CA 92()()() (619) 438-1161
C-PRMT 72-00
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PERMIT APPLICATION PLAN CHECK NO. Cf J · 3 '-1 '-\
City of Carlsbad Building Depart1Aent
FSf. VAL ~ Z. ") S-
PIAN CK DEPOSIT
2075 Las Palms o,., Caclsbad, CA 92009 (619) 438-1161
VAIJD. BY :--;::--.p_~-----
DATE
LI New Bmldmg U I enant Improvement
B -D Industrial □ New Building D Tenant Improvement
C -lj1Residential O Apartment O Condo O Single Family Dwelling /4 Addition/ AJteration
□ Duplex O Demolition □ Relocation D Mobile Home □ Electrical □ Plumbing
□ Mechanical □ Pool □ Spa □ Retaining Wall □ Solar D Other
2. PRQJECT INI-URMATION FOR OFFICE USE ONLY
A..,. L Bu!Jdmg or Suite No.
Nearest Cross Street
LEGAL DESCR!M ION Lor No. Sub<l1vis1on Name/Number Ona No. Phase No.
□ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report D l Addressed Envelope
SQ. FT. # OF STORIES
eren ram app 1can ye-> ADDRESS 41 S'tB Va.lo, r.
CITY \M_v r--1,?7-(•70
NAME ADDRESS '-t(S-'tl'l Vq_ r
CITY STATE CA-ZIP CODE 2.r-, L DAY TELEPHONE
jJ STATE(A.
ADDRESS
ZIP CODE
Z 73 5 !chi nl"\.
DAY TELEPHONE
worlc--l.,t'f·728'•7'-/C/L
2JJ-3305""
NAME l f:kr..1 ADDRESS <t'.l ,l{ B
CITYV\A_u('/'t'.e.~ STATE c;4 ZIP CODE '1~'"" L. DAY TELEPHONE
sTATE uc. # L-/7 3 °t'-1 ucENsE cLASs D CITY BUSINESS UC. #
CITY STATE ZIP CODE DAY TELEPHONE STATE UC.#
7. WOitRFltS' WMPENSAiiON
Workers' Compensation Declaration: I hereby all1rm that I have a cert1hcate of consent to seli-1nsure 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).
INSURANCE COMPANY POLICY NO. EXPIRATION DATE
□
□
□
Ceruhcate of Exemption: I certify that 1n the perlormance ol the work lor which this permit 1s issued, I shall not employ any person m any manner
so as to become sub· t tot Workers' Compensation Laws of California.
DATE
ya irm l 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 roan 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 Llcense Law does not apply co 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 pennit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requires the applicant for such pennit to file a signed statement that he is licensed pursuant to the
provisions of the Contractor's License Law (Chaprer 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 permit
subjects the applicant to a civil penalty of not more than five hundred dollars [$500]).
SJGNATIIRE DATE
COMPLEIE iHlS SECllbN FOR NUN-HESIDt'.NIIAt BUILDING 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 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act?
□YES □NO
Is the applicant or future building occupant required to obtain a pennit from the air pollution control district or air quality management district?
□ YES □ NO
Is 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 OFOCr.lJPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UN1P.SS nm APPUCANT
HAS MET OR IS MElmNG nm REQIJlREMENTS OF 111E OFFICE OF EMERGENCY SERVICES AND nm AIR POl1.IJTION CON1ROL DIS11UCT.
9. WNSIR0CIIUN lliNDING ACENCY
I hereby aftlrm that there 1s a construction lending agency ior the perlormance of the work for which this permit 1s issued (Sec 309)(1} CivU Ccxie).
LENDER'S NAME LENDER'S ADDRESS
10. APPUCAN'f cmt'iiFK!klioN
I certify that I have read the apphcat1on and state that the alxwe information 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 co enter upon the above mentioned property for inspection
purposes. I ALSO AGREE TO SAVE INDEMNIFY AND KF.F.P IIARMIBSS nm CITY OF CARLSBAD AGAINST ALL UABIUTIES, JUDGMENTS, CDSTS
AND EXPENSES WlllCII MAY IN ANY WAY ACX:RIJE AGAINST SAID CITY IN CONSEQUENCE OF Tim GRANTING OF TillS PERMIT.
OSHA: An OSHA pennit is required for excavations over S'O" deep and demolition or construction of structures over 3 stories in height.
Expiration. Every pennit issued by the Building Orficial 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 pcnnit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code).
APPLICANTS SIGNATURE [M ~ DATE, <f-=J..£)-<t3
TE: File YELl.OW: Applicant PINK: Fmance
PERMIT# CB930344
DESCRIPTION: 91 SF
LIGHT
CITY OF CARLSBAD
INSPECTION REQUEST
FOR 04/28/95
DECK/ FRENCH DOORS &
CITY SPECS
TYPE: PATIO
JOB ADDRESS:
APPLICANT:
2735 TIBURON AV
CLAYTON, BILL PHONE:
CONTRACTOR: PHONE:
OWNER: PHONE:
INSPECTOR AREA TP
PLANCK# CB930344
OCC GRP R-3/M-1
CON IBR. TYPE NEW
LOT:
REMARKS: MW/BILL INSPECTOR SPECIAL. INSTRUCT: EXPIRED PERMIT HE SAYS TIM SIGNED I_T ___________ _
AGAIN IF YOU WANT/NOBODY HOME
TOTAL TIME:
CD
19
LVL DESCRIPTION ACT COMMENTS
ST Final Structural
---------------------------------------------------------
***** INSPECTION HISTORY *****
DATE DESCRIPTION ACT INSP COMMENTS
062593 Frame/Steel/Bolting/Welding co TP SEE JOB CARD
061693 Ftg/Foundation/Piers AP TP 4 12X12 PIER
050493 Ftg/Foundation/Piers AP TP .
042893 Ftg/Foundation/Piers co TP SEE JOB CARD
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lily APireaVIED
· APR 2 0 1993
City of CAnL~ilAD
BUILDING DEPT
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