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HomeMy WebLinkAbout147 MAPLE AVE; ; CB960871; PermitPE;utIT APPLICATION ~ ~ PLAN CHECK NO. ~7/ City of Carlsbad Building Department 2075 Las Pal-Dr., Carlsbad, CA 92009 (619) 438·1161 I. Pi!.ltMJI hPR DATE From Llst I (see back) give code of Permit-Type: ___________ _ ----------------------. -------. ---. ---------------------- For Residential Profects Only: From list 2 (see back) give Code of Structure-Type: ___________________ _ Net Loss/Gain of Dwelling Units 2. PRWECf INFORMATION FOR OFFICE USE ONLY Address / y 7 "1 .l}l'L (_ Nearest Cross StreetC 4-< L J ,fdr.> BuHdmg or Suue No. CECAL DESCRiPI ION Lot No. Subd.lVJS1on Name/Number 0mt No. Phase No, CHECK BEWW IF SOBMI IIED: □ 2 Energy Gales □ 2 Structural Gales □ 2 Soils Report □ I Addressed Envelope ASSESSOR'S PARCEi. EXTS:ONG USE DESCRIPTION OF WORK ~~ l-,... #£· <... ~vt>.,._..t? <:e_. PROPOSED USE SQ. FT. # OF STORIES 3. WN IACI PFJtsl.JN (II duierent froffi ipphcanf) / NAME (last name first) /11 JI. /hC1 ADDRESS 1/ 7 ,PV1,#QC-., # OF BEDROOMS # OF BA1HROOMS CITY (",,.. // / STATE ZIP CODE 7µ,:; /; DAY TELEPHONE ',f J '-f 4. ~IRACIOR UAGENI FORWNJRACto"fr □OWNER UAGENI FOkOWNElt NAME (last name first) ,M < (; v Ck 1 .v ADDRESS / 77 CA (),.., v J s. <j;1;[.;PEfrjfaw~<-} STATE (4= ZIP CODE '7,4.)'1 DAYTELEPHONE 'f''(.J... f}/7 () NAME (last name first) /,/;:;,{r ADDRESS /'f' / /1'1,1/>L-c -L, STATE C ZIP CODE :;1-(, Cl[; DAY TELEPHONE ~ J . ,i' C y NAME (last name first) / e I/ U~/ 4 /JC ... ,.,,. tf '-;f', ADDRESS / / 7 C,,;J I) "'1 t,, f CITY L..o..,c~ STA~.~j_i-lPCODE qh..2-VDAYTELEPHONE 4'v..J-?/ 7 0 STATE UC.# LICENSE CLASS C 2 C, · C. / (, CITY BUSINESS UC.# DESIGNER NAME (last name hrst) ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE UC.# 7. WukJMtS-WMPENSA 110N Workers' Compensauon beclarauon: I hereby ail,rm that I have a cert1i1cate of consent to self-msure issued by the Director of lndustnal 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 Sr,)~ rvVD ru 1cate o xempuon: cert1 at m t e per ormance o e war or w so as to become subject to the Workers' Compensation Laws of California. SIGNATIJRE DATE 8. UWNE:A-DUllDEk DP.t.!DJt.\iiON Owner-Builder Oeclarallon: I hereby aihrm that I am exempt from the Contractor's license Law for the ioiiowmg reason: □ 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,). □ 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). □ I am exempt under Section _______ Business and Professions Code for this reason: (Sec. 7031.S Business and Professions Code: Any City or County which requires a pennit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such pennit 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.S by any applicant for a pennit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]). SIGNA1VRE DATE COMPLE lE l HIS SEcl ION FUR NON-RESIDEN I JAL BUI WING PERM I IS ONLY: ls the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration fonn or risk management and prevention program under Sections 25505, 25533 or 25534 or the Presley-Tanner Hazardous Substance Account Act? □YES □NO Is the applicant or future building occupant required to obtain a pennit from the air pollution control district or air quality management district? □YES □NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ YES □ NO IF ANY OF nm ANSWERS ARE YES, A FINAL CER11FICATI! OF oa:uPANCY MAY NCYf BE ~ AFTER JULY I, 1989 UNLESS nm APPLICANT HAS MET OR IS MEITING nm REQUIREMENTS OF 1HE OFFICE OF EMERGENCY SERVICES AND 1HE AIR POLLU1lON CDNTROL msnucr. 9. WNSI KOCI ION LHNDING AGENCY I hereby aiunn that there 1S a construcllon lending agency for the perfonnance of the work for whtch this penn1f 1s 1SSued (Sec 3097(1} CivU Code). LENDER'S NAME LENDER'S ADDRESS 10. APPUCANI CmtllFICAIION· I certify that I have read the application and stale that the above miormauon 1s correct. I agree to comply with all Caty ordmances 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 AISO AGREF.1U SAVE INDEMNIFY AND KEEP IIJ\RMU.5S 1HE CTIY OF CAR1SBAD AGAfNST AU. IJABlll11I!S, JUDGMENTS, <X>STS AND EXPENSES WIUQI MAY IN ANY WAY ACXlUJE AGAfNST SAID CITY IN CDNSl!QUENCI! OF 1HE GRANTING OF 1H1S PERMIT. OSHA: An OSHA pennit is required for excavations over S'O" deep and demolition or construction of structures over 3 stories in height. Expiration. Every pennit 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 sue rmit is not commenced within 365 days from the date of such pennit or if the building or work authorized by such pennit is suspended or a nd at any time after the work is commenced for a period of 180 days (Section 303(d) Unifonn Building Oxlel. APPLICANT'S SIGNATIJRE DATE:, C / ~ Wl-llTE: F e YEil.OW: App ,cant PINK: Fmance ----..---.. ,, PERMIT# CB960871 DESCRIPTION: REPLACE WALL TYPE: PLUM JOB ADDRESS: 147 CITY OF CARLSBAD INSPECTION REQUEST FOR 05/21/96 FURNACE STE: INSPECTOR AREA PD PLANCK# CB960871 OCC GRP CONSTR. TYPE NEW LOT: APPLICANT: LEUCADIA CONTRACTOR: MAPLE AV PLUMBING PHONE: 942-3649 OWNER: REMARKS: MW/PAT/942-8170 SPECIAL INSTRUCT: TOTAL TIME: CD LVL DESCRIPTION ~:=~ ACT COMMENTS _29 __ PL _F_i_n_a_1_P_1_umb __ 1_n_g _______ 'J/-------------- ------------------------------------ ***** INSPECTION HISTORY***** DATE DESCRIPTION 051596 Flues/Vents ACT INSP CO PD COMMENTS NOT EXPOSED