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HomeMy WebLinkAbout1265 CYNTHIA LN; ; CB973772; PermitBUILDING PERMIT 12/09/97 12 50 Pace 1 of 1 Job Address. 1265 CYNTHIA LN Suite. Permit Type MISCELLANEOUS Parcel No. 156-230-19-00 Lot# Valuation- 26,400 Occupancy Group•' Referenced Description- BUILD UP TRUSS FRAMING SYSTEM . OVER FLAT ROOF Permit No Project No Development No Appl/Ownr * ** MCCOMAS, AUDREY 1265 CYNTHIA LN CARLSBAD CA 92008 Fees Required *** *'** 2117 .12/09/97 0001 01 C-PRMT Construction Type Status: Applied- Apr/Issue. Entered By 760 729-3010 Fees Collected & Credits CB973772 A9704860 02 426-00 NEW ISSUED 12/09/97 12/09/97 RMA *** Fees 426.00 Adjustments. 00 Total Fees: 426.00 Fee description Total Credits Total Payments Balance Due: Units Fee/Unit 00 00 426.00 Ext fee Data Miscellaneous Fee #1 * MISCELLANEOUS TOTAL 426 00 426 00 PERMIT 426 00 CLEARANCE. CITY OF CARLSBAD 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr, Carlsbad CA 92009 (760)438-1161 1. PROJECT INFORMATION '*;:: ~* FOR OFFICE USE ONLY PLAN CHECKING EST VAL QJL Plan Ck Deposit Validated JBy^ Date * Address (include Bldg/Suite #)Adress \? Business Name (at this address) Legal Description • _Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor's Parcel tt Existing Use Proposed Use Description of Work///'/) /?o o F 2 CONTACT PERSON (if different from applicant) SQ FT #of Stories 2^/00 # of Bedrooms # of Btffhrooms W. Name Address CityMOM 1C miUl COO - ^jn.y 3^ '^APPLICANT'" D Contractor °"O Agent for Contractoijni EjC'wnerj. Q Agent foMOwner ,-i State/Zip Telephone #Fax # Name 4 ISPROPERTY OWNER Address City State/Zip Telephone Name Address City State/Zip Telephone # CONTRACTOR - COMPANY NAME (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, commending with Section 7000 of Division 3 of the Business and Professions CodeJ 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]) Name State License # Address License Class City State/Zip City Business License # Telephone # Designer Name State License # ' Address City State/Zip Telephone 6/:s"sWORKERS' COMPENSATION '"^K,,^ ,,.4i,:, "v '-If ,^,:: '*"" •-;••:••:;,. Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations n 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 |~| 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 [$100] OR LESS) |B^ 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 secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000) in addition to the cost of compensation damages as provided for in Section 3706 of the Labor code interest and attorney s fees SIGNATURE DATE 7j: OWNER-BUILDER DECLARATION J, . /..;',. ""- ...;/ I hereby affirm that I am exempt from the Contractor's License Law for the following reason l~l 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 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) l~l 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 improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor s License Law) 0 I am exempt under Section Business and Professions Code for this reason 1 I personally plan to provide the major labor and materials for construction of the proposed property improvement l~l YES I""|NO 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 / address / phone number / contractors license number) 4 I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone number / 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 / address / phone number / type of work) PROPERTY OWNER SIGNATURE DATE COMRUlfETHiS SECTION FOR /VO/V-/?£S/0£/Vr//U BUILDING PERMITS ONLY L T 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? Q YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES l~l NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? l~l YES l~l 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 8.* ^CONSTRUCTION LENDING AGENCY ^; V".. :''<• i I... '" sO-iil I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(0 Civil Code) LENDER'S NAME LENDER'S ADDRESS 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 I agree to comply with all City 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 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 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 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 or abandoned at any time after the w/ink is commenced for a pjsiod o? 180 daysJSection 106 4 4 Uniform Building Code) APPLICANT'S SIGNATURE jJL*^ 6(A .1^^. /{/ /fl^^f^T^ f!L^^ DATE _ File YELLOW Applicant PINK Finance PERMIT* CB973772 DESCRIPTION: BUILD UP TRUSS OVER FLAT ROOF TYPE: MISC JOB ADDRESS: 1265 CYNTHIA APPLICANT: MCCOMAS, AUDREY CONTRACTOR: OWNER: REMARKS: C/AUDREY/729-=3010 SPECIAL INSTRUCT: CITY OF CARLSBAD INSPECTION REQUEST FOR 01/20/98 FRAMING SYSTEM LN PHONE: PHONE: PHONE: INSPECTOR AREA PS PLANCK* CB973772 OCC GRP CONSTR. TYPE NEW STE: LOT: 760 729-3010 INSPECTOR TOTAL TIME: CD LVL DESCRIPTION 19 29 39 49 ACT COMMENTS ST Final Structural PL Final Plumbing EL Final Electrical ME Final Mechanical ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP 010598 Exterior Lath/Drywall AP PS 123097 Roof/Reroof AP PS 122997 Frame/Steel/Bolting/Welding PA PS 121097 Ftg/Foundation/Piers AP PS COMMENTS ROOF FRAMING PARTIAL PIERS 01o m CO 3DO oom CO Dm Vd O COroo01 CD O) X oN«^ CD \J 00 ooo si I'D OJ Hcx (Dp O(I) STONE TRUSS COMPANY STONE TRUSS CO. CERTIFIED INSPECTION ICBO EVALUATION SERVICE INC. AA-583 IN STRICT ACCORDANCE WITH UBC 2343 PREFABRICATED WARNING * WARNING * WARNING BE SURE ERECTION CONTRACTOR UNDERSTANDS HIB-91. SUMMARY SHEET ENCLOSED 507JONES ROAD • OCEANSIDli. 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