HomeMy WebLinkAbout1148 KNOWLES AVE; ; CB900745; PermitCitv of Carlsbad
RESIDENTAL ADD/ALT (UNDR Permit No: CB900745
Job Address: 1148 KNOWLES AV Status:
Permit Type: RAD Applied:
Parcel No: 1552521900 Lot#: Approved:
Reference No: Issued:
PC#: Inspect Area:
Project Title: ADD NEW GARAGE, REMODEL BEDRM OLD GARAGE CONVERTED(CODE ENFORCE VIOL)
Applicant:
STILWELL, ANNE
1148 KNOWLES AV
CARLSBAD, CA
9449777
00136104885 Plan Check
Owner:
STILWELL ANNE
$185.00
EXPIRED
05/07/1990
05/17/1990
05/17/1990
Fees: $185.00 Additional Fees: $0.00 Total Fees: $185.00 Balance: $0.00
PERMIT APPLICATION
•
City of Carlsbad Building Department
2075 Las Pal mas Dr., Carlsbad, CA 92009 {619) 438-1161
1. PERMIT TYPE .
A COMMERCIAL TENANT IMPROVEMENT
8 0 INDUSTRIAL □TENANT IMPROVEMENT
C -~RESIDENTIAL □APARTMENT □CONDO □SINGLE FAMILY DWELLING □ADDITION/ALTERATION
□DUPLEX □DEMOLITION □RELOCATION □MOBILE HOME QELECTRJCAL □PLUMBING
OMECIIANICAL □POOL □SPA □RETAINING WALL □SOLAR
2. PROJECT INFORMATION PLAN CHECK No.
LEGAL DESCRIPTION Lot No. Subdivision Name/Nl.llt>er unit No. Phase No.
3.
NAME
CITY
SIGNATU
STATE ZIP COOE
PROPOSED USE
DAY TELEPHONE
94¥--9777
4. APBUCANT • ..,..L.. .OCQNTRACTOR
NAME /,IA,//¥6 ~, I, WSZL_
0 AGENT FOR CONTRACTOR
ADDRESS
NER O AGENT FOR OWNER
II"' ,<::;v,..w~I= .r t<J~E
5.
CITY C /9-£{ a 60-cl
PROPERTY OWNER A /J6ove. NAME
CITY
STATE Cr! ZIP COOE
OWNER
STATE
ADDRESS
ZIP CODE
92,oe>/-DAY TELEPHONE -¥'.J 1/°
0 LESSEE □TENANT
DAY TELEPHONE
6. CONTRACTOR ADDRESS
ZIP COOE
7.
8.
NAME , /0 ..L/rU<. rtot.J '1
CITY STATE DAY TELEPHONE
STATE LIC. # ____ _ LICENSE CLASS _____ _ CITY BUSINESS LIC. #
SIGNATURE TITLE DATE
DESIGNER NAME ADDRESS
ZIP COOE CITY STATE DAY TELEPHONE STATE LIC. #
WORKERS' COMPENSATION workers• Corrpensation Declaration: hereby affirm that have a certificate of consent to self-insure issued by the Director of Industrial Relations,
or a cert i ti cate of Workers' Corrpensat ion Insurance by an aalli tted insurer, or an exact copy or dupl i cate thereof certified by the Di rector of the
insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C),
INSURANCE COMPANY POLICY NO. EXPIRATION DATE
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.
SIGNATURE DATE
OWNER-BUILDER DECLARATION
Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
0 J as owner of the property or rrry 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 to an owner of property who builds or inl)roves thereon,, and who
does such work himself or through his own employees, provided that such i~rovements are not intended or offered for sale. If, however, the building
or i~rovement is sold within one year of c~letion, the owner-builder will have the burden of proving that he did not build or i~rove for the purpose
of sale.).
D 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 License Law does not apply to an owner of property who builds or i~roves thereon, and contracts for such projects with contractor(s)
I icensed pursuant to the Contractor's License Law).
0 I am exe,rpt 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, i~rove, demolish, or repair any structure,
prior to its issuance, al so requires the applicant for such permit to f i le a signed statement that he is licensed pursuant to the provisions of the
Contractor's licen Law (Chapter 9, corrmencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exe,rpt therefrom,
and the basis for e alleged e tion. Any vi ction 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not
sx:~~;~nR~ve k cl/ /CJ 90
COMPLETE THIS SECTION FOR NON·RESIOENTIAL BUILDING PERMITS ONLY:
Is the appt i cant or future building occupant required to submit a business pl an, acutely hazardous materials reg i strati on form or risk management and prevention
program under sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Accou,t Act?
□YES ONO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
□YES ONO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
□YES □ND
IF ANY OF TIE ANS\ERS ARE TES, A FINAL CERTIFICATE OF OCCl.l>ANCT NAT NOT BE ISSll:D AFTER JULT 1, 1989 UNLESS THE APPLICANT MAS NET OR IS MEETING THE RECIUIREMENTS
OF THE OFFICE OF ENERGENCY SERVICES AND TME AIR POLLUTION CONTROL DISTRICT.
9. CONSTRUCTION LENDING AGENCY
hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued ( Sec 3097( i ) Civil Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPLICANT'S SIGNATURE I certify that I have read the application and state that the above information is correct. I agree to co~ly with all City ordinances and State laws relating
to building construction. l hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO
AGREE TD SAVE INDEMNIFY AND KEEP HARIILESS THE CITT OF CARLSBAD AGAINST All LIABILITIES, Jll)Q4ENTS, COSTS All) EXPENSES WICH MT IN ANT WAT ACCRUE AGAINST SAID
CITY IN CONSEQUENCE OF THE GRANTING Of THIS PERMIT.
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 by such permit is not corrmenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended
or abandoned at any time after the work is coomenced for a period of 180 days (Section 303(d) Uniform Building Code).
APPL! CANT'S SIGNATURE □ OWNER □ CONTRACTOR D BY PHONE APPROV£D BY: ______ _
DATE:
WHITE: File YELLOW: Applicant PINK: Finance