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HomeMy WebLinkAbout1351 NIGHTSHADE RD; ; CB973165; Permitz2i3 B U I L D I N G P E R M.I T Permit No: CB973165 10/21/97 15:56 Project No: A9704043 Page 1 of 1 Development No:. Job Address: 1351 NIGHTSHADE RD Suite: Permit Type: PATIO/DECK Parcel No: 215-641-32-00 Lot#: Valuation:. . 3,375 Construction Type: NEW Occupancy Group: Reference#: Status: ISSUED Description: 500 NSF COVERED PATIO-PER CITY 0527 10/1:110/1/97 SPECS Apr/IsF4T 10/13 00 Entered By: RMA Appl/Ownr : FUJISAKI LANDSCAPING 619'566-99 - 55 9630 BLACK MOUNTAIN RD SAN DIEGO CA 92106 *** Fees Required Fees Collected & Credits Fees: 105/60 zo Adjustments: /.00 .' '\ '-'Total '/ Cedits: .00 f I 'J - Total Fees: 105.00 j Total Payments': .00 / Era-1. 105.00 Fee description its ~~OyUn *,t Ext fee Data ------ Building Permit / / \c') \ 63.00 Plan Check ZD 41.00 Strong Motion Fee U' . 1\ 1 1.00 * BUILDING TOTAL 105.00 RIT WITH UIB.0 SEbTiON 3031d) GNAThREJ FINAL APPROVAL DATE_____ 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 FOR OFFICE USE ONLY PLAN CHECK NO. ¶7 .31' EST. VAL. Plan Ck Deposit PROJECT INFORMATION S.! N 1630h0 i-D. Address (include Bldg/Suite 1) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total I of units Assessor's Parcel I Existing Use . Proposed Use Rrr,o Descriptionof Work SO. FT. .. lot Stories I of Bedrooms I of Bathrooms CONTACiRSb*diffsijiinjijint) ........ ./../(fo-yy/ FITS1Ui gi1e /I4fl' £i, 72) Cp Name . - Address City StatelZip Telephone I. Fa APPUÔANT Contractor 0Agent for C Owni Name Address City StstelZip Telephone I Name - - Address City -. - - StatelZlp Telephone I. s. - COI crOR -coMPANv NAME F&tA t .7. - ; -DrL '€J ' (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 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 1$5000. FRi7SArt LO'41',',wC, 9(O '//6 f4?W iO. S) C/ Name Address City StetelZlp TilphoneI j State License I . 306 6-09 License Class C - 2 City Business License I i242Ø J4 -2 .f / "L J1tCuvwi I(J1 ,4-&I I' /)/ çj ig ..-00/3 S - Designer Name Address State License I 20 (cof WORKERS' COMPENSATION ....-... .-- ......:::. .. .... Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self-Insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit Is issued. My worker's compensation insurance carrier and Policy number are: Insurance Company if6J1€4'Id e _.t-ii 5V'" Policy No. 'CA)VZO Z V Expiration Date IL _91 (THIS SECTION NEEDNOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 101001 OR LESS) CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Fallurejo secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to ens hundred thousand dollars ($fl90.000). In atlon to cost of compensation, damages es provided for In Section 3706 of the Labor code, Interest and attorneys fees. SIGNATURE 44J4._1)t _/_A.-" DATE /O-_Z I' 7 OWNER-SUMI,bER DECLARATION I hereby affirm tIt I am exempt from the Contractor's License Law for the following reason: E211-1, 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 (Sac. 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 dose such work himself or through his own employees, provided that such Improvements are not Intended or offered for ule. 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 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 Licence Law). I em exempt under Section . Business and Professions Code for this reason: I personally plan to provide the major labor and materials for construction of the proposed property Improvement. IB's DNO I (have I have not). signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction (Include name I address I phone number I contractors license number): 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 I address I phone number I contractors license number): /i Li,. I will provide some of the M work, Put I contracted (hired) the following persons to provide the work Indicated (Include name I address I phone number I type of work): FWIf5tH? f,')(4 ñ79(,t1,' PROPERTY OWNER SIGNATURE fA,7.&J_94_'--- DATE /"l1 COMPLETE THIS SECTION FOR NON.f4ID81TIAL BUILDING PERMITS ONLY Is the applicant or future building octupant 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? 0 YES II NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES 0 NO Is the facility to be constructed within 1.000 feet of the outer boundary of a school site? 0 YES 0 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. 18 CONSTRUCTION LENDING AGENCY "' I hereby affirm that there is a construction landing agency for the performance of the work for which this permit Is issued (Sec. 3097(1) Civil Code). LENDER'S NAME ______ LENDER'S ADDRESS___________________________________________________ W. AppLcANT CERTIFICATION . : 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 CIO 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 nIr ommenced within 385 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 is commcada pen d f 180 days (Section 108.4.4 Uniform Building Code). - APPLICANT'S SIGNATURE .444A..- DATE 10--/-- WHITE: File YELLOW: Applicant PINK: Finance 07/27/98 INSPECTION HISTORY LISTING FOR PERNIT# CB973 165 DATE INSPECTION TYPE INSP ACT COMMENTS 10/23/97 Ftg/Foundation/Piers PY AP 10/23/97 Roof/Reroof PY WC H HIT <RETURN> TO CONTINUE... CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB973165 FOR 10/23/97. INSPECTOR AREA DESCRIPTION: 500 NSF COVERED PATIO-PER CITY PLANCK# CB973 165 SPECS 0CC GRP TYPE: PATIO CONSTR. TYPE NEW JOB ADDRESS: 1351 NIGHTSHADE RD STE: LOT: APPLICANT: FUJISAKI LANDSCAPING PHONE: 619 566-9955 CONTRACTOR: PHONE: OWNER: PHONE: REMARKS: C/619/989-4523 566-9955 INSPECTOR / SPECIAL INSTRUCT: f / TOTAL TIME: CD LVL DESCRIPTION ACT COMMENTS 15 ST Roof Reroof IL ** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP COMMENTS