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Home My WebLink About1373 CYNTHIA LN; ; CB920542; PermitBUILDING PERMIT 06/04/92 10:46 Page 1 of 1 Job Address: 1373 CYNTHIA LN Suite: Permit Type: ELECTRICAL Parcel No: 156-230-79-00 Lot#: Valuation; 0 Construction Type: VN Occupancy Group: Description: TEMPORARY POWER : LOT 80 Permit No: CB920542 Project No: A9200552 Development No: 7935 06/04/92 0001 01 C-PRHT 02 20-00 Reference#: Appl/Ownr : DAVIS, MICHAEL 493 QUAIL GARDENS DRIVE ENCINITAS, CA 920 A A* Fees Required 619 Status: ISSUED Applied: 06/04/92 Apr/Issue: 06/04/92 Validated By; DC 436-8038 Fees : Adjustments: Total Fees: Fee description. Enter' "Y" for Elec Enter "Y" for Temp * ELECTRICAL TOTAL cted & Credits * * A .00 . 0 0 20.00 Ext fee Data 10.00 Y 10,00 Y 20. 00 OTY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las PaI BBS Dr., Carlsbad, CA 92009 (619) 438-1161 1. PERMIT TYPE A - U Commercial U New Building LJ Tenant Improvement B - D Industrial D New Building D Tenant Improvement C - D Residential D Apartment D Condo D Single Family Dwelling D Addition/Alteration D Duplex D Demolition D Relocation D Mobile Home D Electrical D Plumbing O Mechanical D Pool D Spa D Retaining Walt D Solar D Other 2. PROJECT INFORMATION PLAN CHECK NO. EST.VAL PLAN CK DEPOSIT. VALID. BY DATE FOR OFFICE USE ONLY Address buuamg or suite NO. LEGAL DESCRIPTION uMivision wame/JNQmDer nit No.Phase No. CHECK BELOW IF SUHMH IbD: D 2 Energy Calcs D 2 Structural Gales D 2 Soils Report D1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK # OF STORIES OV\ " NAME CITY NAME CITY FtKMJN (.ir tnnerem irom appucantj STATE »— =a ADDRESS ZIP CODE L" U UJN 1 KAtJIUK U AUENT HJK UJN IKAtJIUK ADDRESS STATE ZIP CODE DAY TELEPHONE UOWNtK LJAUtNl FUKOWNEK DAY TELEPHONE 5. PHOPER'IT ADDRESS -4?3> &s*<"\ STATE Cl4" ZIP CODE ^l^Xtl DAY TELEPHONE b. ). UUMUACIUH NAME CITY STATE STATE LIC. # ULSlUIMtK WAMb CITY WUKKEKS' CUMFtMSAllON STATE ADDRESS ZIP CODE LICENSE CLASS AUIJKbiJiJ ZIP CODE DAY TELEPHONE CITY BUSINESS LIC. i DAY TELEPHONE * STATE LIC. # _. Workers'Compensation Declaration: I hereby atlirm that I have a certificate or consent to selF-insure issued oy the Director of Industrial 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 Exemption: I certify that m the pertormance ot tne work tor 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 8. OWNER-BUILDER DECLARATION Owner-Builder Declaration: I hereby atnrm that 1 am exempt tram the Contractors License Law tor the lollowmg reason: D 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.). 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 improves thereon, and contracts for such projects with contractors) licensed pursuant to the Contractor's License Law). n 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 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]). SIGNATURE DATE COMPLETE THIS SECTION FOR N ON -RESIDENTIAL BUILDING PERMITS ONLY: 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 25S34 of the Presley-Tanner Hazardous Substance Account Act?a YES a NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES D NO IF ANY OF THE ANSWERS ARE YES, A FIN AL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. V. tjJNSTKUC'llUN LEND1NU AGENCJY ereby attirm that there is a construction lending agency tor the pertormance ot tne work tor which this permit is issued (Sec uvil (Joaej. LENDER'S NAME LENDER'S ADDRESS 10. APPLICANT CERTlFICAnON I certity that I have read the application and state that the above information is correct. I agree to comply with all City ordinances and State laws relating to building construction. 1 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 OTY 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 work is commenced for a period of 180 days (Section 303(d) Uniform Building Code). DATE: WHITE: File YELLOW: Applicant PINK: Finance CITY OF CARLSBADINSPECTION REQUESTPERMIT* CB920542 FOR 06/10/92 INSPECTOR AREA PYDESCRIPTION: TEMPORARY POWER PLANCK* CB920542LOT 80 OCC GRPTYPE: ELEC CONSTR. TYPE VNJOB ADDRESS: 1373 CYNTHIA LN STR: FL: STE:APPLICANT: DAVIS, MICHAEL PHONE: 619 436-8038 CONTRACTOR: PHONE:OWNER: PHONE: REMARKS: MH/MICHAEL INSPECTOR SPECIAL INSTRUCT: GFI BREAKERS IN AS REQUESTED TOTAL TIME: —RELATED PERMITS— PERMIT* TYPE STATUS CB920198 SFD ISSUED SE920027 SWRSD ISSUED CD LVL DESCRIPTION ACT COMMENTS 32 EL Const. Service/Agricultural Af ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP COMMENTS 060592 Const. Service/Agricultural CO PY ND GRI BREAKER FOR PIGTAILS