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HomeMy WebLinkAbout1057 LIGHTHOUSE RD; ; CB972189; Permit8 U I L D I N G 08/05/97 11:50 Page 1 of 1 Job Address: 1057 LIGHTHOUSE RD Permit Type: PATIO/DECK Parcel No: 214-531-24-00 Valuation: 810 P E R M I T Suite: Lot#: Permit No: CB972189 Project No: A9702764 . Development No: Construction Type: Occupancy Group: Reference#: Status: Applied: NEW ISSUED 08/05/97 08/05/97 RMA Description: 120 SF COVERED PATIO & GAS : LINE TO BBQ-NOT UNDER STRUCTURE/PATIO Apr/Issue: Appl/Ownr : WEBB, RICHARD 1057 LIGHTHOUSE RD CARLSBAD CA 92009 *** Fees Required *** Fees: Adjustments: Total Fees: Fee description Building Permit Plan Check Strong Motion Fee Other * BUILDING TOTAL Entered By: 760 804-9597 Fees Collected & Credits • Total Credits: Totar Payments: Balance Due: .00 .00 66.00 *** Units F.ee/Unit Ext fee Data 23.00 15.00 1.00 27. 00 GAS PERM: 66.00 [JJ\'1 L:. ----... ~--~ f.;ARANCE --------- CITY OF CARLSBAD 2075 Las Palrnas Dr., Carlsbad, CA 92009 (619) 438-1161 •ERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Pal mas Dr., Carlsbad CA 92009 (760) 438-1161 1, PROjECT INFORMATION 120. FOR OFFICE USE ONLY PLAN CHECK NO. q7 irt1 EST. VAL. _________ _ Plan Ck. Deposit--!\-=~~---- Validated e-,.,,..b....-::--=-ll~---- Date, __ ,4-+J.+.!4---+------ [(hl: I .ltd-\:t Hol.)Sf_. Address (include Bldg/Suite I) " Business Name lat this address) Legal Description Subdivision Name/Number Unit No. Phase No. Total I of units Assessor's Parcel # Proposed Use L./>-!t. #of Stories I of Bedrooms # of Bathrooms Name Address City "(,.:'•·?r :';!"V :""' -r··•· ,-, C{t,.. ' q 20 2t CJ'-'?) '14'2 S,,,22 5ia/Zip etephone # Fax # 13.--'liPPl.lc.i>.iiit D lialiiiioiar '"C)'Ailen!"f6f'l::anfri~ ~ o~, . Name Address City 4 " PAOP~fY'OWN!ll '"!f •. ,,~_:p'li·~"pn~:~"'•rr,;rr.~·~'M"f':1"~·•w!"""~"f<~~;n~~r=··~~:,.y•-'"'1'' ·-c·:t;,:\~.:~-i~ts,"'1'~:"lrf:r :-:~~;,<".;,r ,., :1(-·•,_,-,: =-, -~~ µ>..J&a • 1oii L,i~~Q£{ et'· ' (',.$: ~, "f2DO't (,r,,o) 60'f-'7<_;,'f1- Name Address City State/Zip Telephone # (Sec. 7031.6 Business and Profe1&ions Code: Any City or Countv 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 exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penahy of not more than five hundred dollars ($600)1. Name Address City State/Zip Telephone# State License # _________ _ License Class ________ _ City Business License # _______ _ Designer Name Address City State/Zip Telephone State License # _________ _ 8. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit Is issued. D 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 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 DOLLARS 1'1001 OR LESSI D CERTIFICATE Of EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to Hcure workers' compenNtion coverage Is unlawful, and lhal subject an employer to criminal penllltiaa and clvU fines up to one hundred thou1and dollars ($100,000), In addition to th■ cost of companution, damagu a, provkled fot' In Section 3708 of th■ Labor coda, Interest and attorney's fH•. SIGNATURE______________________________ DATE _________ _ 7. OWNER•BUILDER DECLARATION . ''""··"~' ' !"," I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D I, as owner of the property or my emptoyees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale CSec. 7044, Business and Profes1ions 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 _?hln 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). (R"'" I, as owner of the property, am exclusively contracting wh:h licensed contractors to construct the project (Sec. 7044, Busineu 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). D I am exempt under Section ______ Business and Professions Code for this reason: 1 . I personally plan to providt the major labor and materials for construction of the proposed property Improvement. D YES ONO 2. I (have/ have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (include name I address I phone number / contractors license number): I will provide some of tlle work, but I have contracted (hired the following persons to provide the work Indicated Cindude name I address / phone number / type of work):, _________ ,,..-:>---+--,l'-+,r.-#'tf------------------::acl'--1-------------- DATE ~€}4".~_-L,c=.._-,-,,--,--PROPERTY OWNER SIGNATURE COMPLETE THIS •ecttoN FOR 1"'"'·11':,;l:,.tj,;i,w•"-'·,r':'1'P'l'~-,:t::[''~~~1f?~', · ·r:··~rc:· .,,~,,.·;:<••-•; ·' 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 215505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES D NO Is the applicant or future b1.llding occupant required to obtain • permit from the air pollution control district or air qusll~y managamant district? D YES O NO Is ths facility to be constructed within 1,000 feet of the outer boundary of• school site7 D YES D 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 EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. :e. CONSTil.uCTioN taiD1Nii'·AGENCY .,,,,i,_, •. :,,..,._'r"'. ··• <:=::. ,-,-:-~--~~, ;!!~•• ::n,~..,,._,. ,,., ... ," ~ -,, ··7:--,-~-:, ' I hereby affirm that there is a construction lending agency for the performance of the work for which this permit ls i1Sued ISec. 3097(1) Civil Code). LENDER'S NAME_____________ LENDER'S ADDRESS, _______________________ _ ;9, APPLICANT cERTiFlcATiON:~•u:i,:··;7 ·;:1;&; .-:~c;r:,f~.fl:1'.'·.~.,~·--:,.i.:c~.~rF':T'.~C1,ii:iT,!~t~1:'-:'..:'J,~~-c;:_·: .·z;:t-;p ;.:. ',Y'')~,;;· !"';>,;;=::"~;,>,l"J:'::z:r;'tt •• ~~:-~ '''.'"'".7~"f:---"' ·::~· ,• ·, I certify that I have reed tha 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 end State laws relating to building construction. I hereby authorize representatives of the Citt of Carlsbad 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 6'0'" deep and demolition or construction of structures over 3 stories In height. EXPIRATION: Every permit issued by the Blrilding Official under the provisions of this Code shall expire by limitation end 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 o, abandoned at any time ofto, the wo,k lo cod for • po,lod of 1 BO days (Section 108.4.4 Unlfo,m Bull ding Code I~ j /7 '1-- APPLICANT'S SIGNATURE :~~~~~rn,~~===~==:==~====~= DATE -~=cjt,--s:-=~t'-'-i'--'--/ _____ _ 07/27/98 DATE 08/15/97 08/13/97 08/07/97 08/07/97 INSPECTION HISTORY LISTING FOR PERMIT# CB972189 INSPECTION TYPE Gas/Test/Repairs Gas/Test/Repairs Ftg/Foundation/Piers Gas/Test/Repairs INSP ACT COMMENTS PD PD PD PD co co AP co HIT <RETURN> TO CONTINUE ..• -·-·· .. ·----·-------- 0 I \------,o t---, S' -0 '=sj ~ () ~ :~ i I 91 p s ~, I I 1. r Q _J r .. __j ~ \ ~ ~ ~ i go¾~ -t1 ~g I -0 \Y < "' 0 !e, r~~ II ~~ 'J' I.. !I (' & ~ ~ it ,, f 0 ~ ! ~-0 'N ~i f... 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