HomeMy WebLinkAbout1373 CYNTHIA LN; ; CB931275; PermitBUILDING PERMIT
11/18/93 10:04
Page 1 of 1
Job Address: 1373 CYNTHIA LN Suite:
Permit Type: MISCELLANEOUS
Parcel No: 156-230-79-00 Lot#:
Valuation: 0
Construction Type: NEW
Occupancy Group: Referenced:
Description: GAS AND ELEC. LINE FOR FUTURE
: SPA
Permit. No: CB931275
Project No; A9301798
Development No:
4778 11/18/93 0001 01 02
C-PRMT 47-00
Status: ISSUED
Applied •• ll/18/y..f
Apr/Issue: 11/18/93
Entered Ev: MOP
Appl/Ownr : RAMIREZ, JOSEPH
1373 CYNTHIA LANE
CARLSBAD, CA.
*** Fees Required
Fees :
Adjustments:
Total Fees:
Fee description
619 720-0227
Miscellaneous Fee
Miscellaneous Fee
* MISCELLANEOUS T
Credits * * *
^ . UO
. 00
47. 00
Ext fee Data
27.00 PLUM
20.00 ELEC
47, 00
FWALAPPROVAL
INSP. *£ DATE
CLEARANCE
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
, PERMIT APPLICATION
City of Carlsbad Building Department
2075 Las Palms Dr., Carlsbad, CA 92009 (619) 438-1161
I. PERMIT TYPE
A - U Commercial U New Building D Tenant Improvement
B - D Industrial D New Building D Tenant Improvement
C - D Residential D Apartment PCondo D Single Family Dwelling D Addition/Alteration
D Duplex D Demolition D Relocation D Mobile Home D Electrical D Plumbing
D Mechanical DPool D Spa D Retaining Wall D Solar D Other
2. PROJECT INFORMATION
PLAN CHECK NO.\*i.7 ^
EST.VAL
PLAN CK DEPOSIT.
VALID. BY
DATE
FOR OFFICE USE ONLY
,3-73
Nearest Cross Street
Building or Mme NO.
LEGAL DESCRIFnON LorNo. 'Mitxiivision Name/Number Phase No.
CHECK BELOW it bUUMll ItD:
D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D1 Addressed Envelope
ASSESSOR'S PARCEL FXISTINOUSEG*USE
VtiO,
PROPOSED USF.
DESCRIPTION OF WORK
SQ.FT.# OF STORIES
3. UJNTAUT ftHSON (.it aiiierent irom applicant;
NAME
CITY STATE
ADDRESS
ZIP CODE DAY TELEPHONE
7 APPLICANTNAME
CITY
UCONTRACTOR DAGLN1 hOR CONTRACTOR
ADDRESS
ZIP CODE
U AOtNl FOK UWNhK
STATE DAY TELEPHONE 6>/?-~?2£) -OZ2?
5. PROPERTY U1
NAME
CITY STATE ZIP CODE DAY TELEPHONE
t>. UUW IHAU1UK
NAME
CITY STATE
STATE LIC. #
ADDRESS
ZIP CODE
LICENSE CLASS
DAY TELEPHONE
OTY BUSINESS LIC. #
LJb&lUNfcK WANIt
CITY
7. WUHKKKS' UUMPENSAiKON
STATE
AULIHKri*
ZIP CODE DAY TELEPHONE STATE LIC. #
workers Compensation Declaration: I hereby affirmthat I have a certificate otconsent to self-insure issued by 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 or Exemption: I cerury that in the performance of the work lor which tms pentm 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-HuiJder Declaration: I hereby affirm that I am exempt from the Contractors License Law Tor the following reason:
f2_ 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).
D 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
COMPLETE THIS SECTION FOR NON-RESlUjiirnAL BUILDING PtRMITSi 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 25534 of the Presley-Tanner Hazardous Substance Account Act?
D YES D 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?
D YES D NO
IP ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUTO AFTraJl^Y 1,1989 UNl£SS THE APPLICANT
HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE Am POLLUTION CONTROL DISTRICT.
9. UUHSTKUulfiUH LENDING AGENCY
1 hereby aturm that there is a construction lending agency tor tne performance ot the work lor which" this permit is issued (sec 3O9!?UJ Civil Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPL1CAN1 CKRnFICATION
I certify that I have read tne application and state that tne above information is correct. I agree to comply with alTCiry orauiances 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 CTTY OF CARLSBAD AGAINST ALL LtABILTnES, 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 shaft 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).
APPLICANTS SIGNATURE DATE:
WHITE: File YELLOW: Applicant PINK: Finance
.UNSCHEDULED
DATE //-JLJ- %3 INSPECTOR
PERMIT * y^ PLANCK *
JOB ADDRESS
TIKE LEAVE:
CD LVL DESCRIPTION ACT COMMENTS
PEIUTIT3