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Home My WebLink About1000 MERGANSER LN; ; CB961910; Permit4/ 1 : 1 of Ad :i: ess: ion: ancy Gou : CONVERT ETUR 1 T ,G PERM I eference GARA E TO SALES OFFICE Su te: Lo ·J 'O GARAGE AT PROJECT C MPLETION ons p evel No: Nu: No: o 3 101041 6 ooo_ 01 C-T Appl ii:> l: Apr/Issue:: NEW ISSUE 1 l/04/9 10/04 9 RMA Appl/Ownr : RIC MOND AMERICAN 714 7 6 Enter l B 7 373 17 0 RED ILL V STE J20 IRVINE CA 92014 F es equ1 Fee.:1: A JU-mens: To l Fe s: Fee e...,c 1ption Miscellaneous Fee MISCE~LANEOU TOT CITY OF CARLSBAD • 0 .OU 3 . 00 * Ex fe-Da1: 30.00 PE MI 30.00 Fl AL APPROVAL --DATE CE ----..;;:..._ 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 EE PERMIT APPLICATION City of Carlsbad Buildi~ Department PLAN CHECK NO. {D 2075 las PallES Dr., Carlsbad, CA 92009 (619) 438-1161 l.l'£ilMIT1YPE From List 1 (see back) give code of Permit-Type; ____________ _ For Residential Projects Only: From Llst 2 (see back) give ct C/o-3?> Code of Structure-Type: _____________________ _ Net Loss/Gain of Dwelling Units __________________ _ 2. PRCl.lECT INFORMATION FOR OFFICE USE ONLY Address ']/sh_ -TIP,~ Bu1ld7 253£5e Np}\ VJ._b;fJ'\J f..A. IJV nit O, 0 2 Soils Report □ l Addressed Envelope ,r...XN5"J.Ez;.j,w~ ~U':?'-.q S'daa F- IES # OF BEDROOMS # OF BATIIROOMS ADDRESS Cl1Y STATE ZIP CODE DAY TELEPHONE 4. APPUCANI OCON IRAClOR □AGEN I FOR CONlRACiOR □OWNER OAGENI FDR OWNER NAME (last name first) /.2... ll:I-/MDµ IJ ~ ~1c.A:JDDRESS { r ~ I O ~tu.. k°'Jc Sf£ 3 2 o CITI /ILV{lv£ STATE cA:-ZIP CODE '12C.lt DAYTELEPHONE 'l /Cf,-JS'"G, ~73')3. S. PltOPElt'l'Y oWRElt £'.:~ .:- NAME (last name first) 7 "' ADDRESS CITY STATE ZIP CODE DAY TELEPHONE 6. WN"i'IW:::Juk NAME (last name first) ADDRESS CITI STATE STATE LIC. # ZIP CODE LICENSE CIASS DAY TELEPHONE CITI BUSINESS LIC. # DESIGNER NAME (last name hrst) ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. # 1. womrnru.., rnMPt:NSA11oN Workers' Compensation Declaratmn: I hereby affirm chat I have a cernhcate of consent to self-msure issued by the Director o! Industnal 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 Certificate of Exempuon: I certify that m the performance of the work for which this penmt 1s issued, I shall not employ any person m any manner so as to become subject to the Workers' Compensation Laws of California. SIGNATURE DATE A_ oWNElt-s0fiDEK OE.Cl.ARA'i10N Owner-Bullder Declaration: I hereby affmn ffiat i am exempt from the Contractors Llcense Law for the following reason: □ r, 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 Llcense 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 Llcense 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). 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, 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, commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is e mpt therefrom, the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the lica to a civi lty of not more than five hundred dollars ($5001). SIGNATURE DATE lei'/ 4 t:f " Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration fonn or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 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 □ NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school she? □ YES □ NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICA.TK OF oa:uPANCY MAY NOT BE~ AFTER JULY 1, 1989 UNLESS THE APPIJCANT HAS MET OR IS MEETING TIIE REQUIREMENTS OF 1lIE OFFICE OF EMERGENCY SERVICES AND 1HE AIR POU.lfl1ON ffiNTROL DISTRICT. 9_ wNS'IRUCnON LE'.NbiNG AGENCY I hereby afftrm that there is a construction lending agency for the performance of the work for which clus permit 1s issued (Sec 309?(1) C1VII C&:iej. LENDER'S NAME LENDER'S ADDRESS 10. APPIJCAN I CERIMCAfiON J certtfy that I have read the apphcatlon and state that the above mformauon 1s correct. I agree to comply with all Caty 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 KERP HARMLESS 1llE CTIY OF CARISBAD AGAINST AIL IJABIIITIF.S, JUDGMENTS, CDSTS AND EXPENSES WIIlCH MAY IN ANY WAY ACXJUJI! AGAINST SAID CflY IN CDNSF.QUENCE 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 such permit · not commenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended nd ed at time after the work is commenced for a period of 180 days (Section 303(d) Unifonn Buil ·ng )q /_ APPLICANTS SIGNA DATE: 0 L IP YELLOW: Applicant PINK: Finance 0 ING INSPECTION DEPT: BUILDING ENGINEERING PLANNING CMWD ST LITE PLAN CHECK#: CB960729 PERMIT#: CB960729 PROJECT NAME: 2642+589 SF GAR,PLAN 1,MODEL RICHMOND AMER HOMES,CT90-30,PA-30 ADDRESS: 1000 MERGANSER LN CONTACT PERSON/PHONE#: C/MARK/603-9294 SEWER DIST: CA WATER DIST: CA Lot# 3 DATE: 08/14/98 PERMIT TYPE: SFD =================--------=-===~ ~===============================-============ IN~EC~ BY: - DATE / INSPECTED: !?, 'µ'-( (' t APPROVED I._/ DISAPPROVED INSPECTED DATE BY: INSPECTED: APPROVED DISAPPROVED INSPECTED DATE BY: INSPECTED: APPROVED DISAPPROVED =-=----------------------------------------------------===================== COMMENTS: