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Home My WebLink About1709 BLACKBIRD CIR; ; CB911659; PermitI I ! , I I i I i 1 I I BUILDING PERMIT Permit No: CB911659 12/09/91 12:53 Project No: A9102107 Page 1 of 1/70? Job Address:- BLACKBIRD CR Str: F1: Ste: Permit Type: ELECTRICAL Parcel No: Valuation: 0 Construction Type: NEW Occupancy Group: Class Code: Status: ISSUED Description: TPP MOVED TO NEW LOCATION Applied: 12/09/91 Apr/Issue: 12/09/91 Development No : 67 r> CK mJll oe&:mc 02 Appl/Ownr : TEMPORARY UTILITY SERVICE 619 471-5491 C4bwT 20.00 -_ 1167 LAW STREET SAN MARCOS, CA *** Fees Required * ....................... Fees : Adjustments: Total Fees: Fee description ------------------- . Enter. "Y" for Elec Enter "Y'l for Temp * ELECTRICAL TOTAL , .oo .oo 20.00 'Ext fee Data 10.00 Y 10.00 Y 20.00 ---------------- b I '*. . m*w 2075 Lps Pahas Dr., CdhI, CA 92009 (619) 438-1161 a . .,-_ .- B - 0 INDUSTRIAL ONEW OTENANT IMPROVEMENT C - nRESlDENTlAL OAPARTMENT OCONOO DSlNGLE FAMILY DWELLING ~ADD1T10N/ALTERATION ODUPLEX ~OEMOLITION ORELOCATION OMOBlLE HOME PLECTRICAL OMECHANICAL UPOOL USPA ORETAlNlNG WALL OSOLAR DOTHER UPLUMBING I- -c, ~ ,<. ,, -/ ..__ .. , - *_ . PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 9/- /6 5 y I CITY BUSINESS LIC. # s T LIC. # n3s546. LICENSE CLASS SIGNATURE sx TITLE f- DATE /2- c-q/q DESIGNER NAME ADDRESS STATE LIC. # CITY STATE ZIP CODE DAY TELEPHONE 7. WORKERS' COMPENSATION Yorkers' Compensation Declaration: I hereby affirm that I have a certificate of consent to self-insure issued by the Director of Industrial Relations, or a certificate of Workers' Compensation Insurance by an adnitted 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 <+&& F& POLICY NO. 306-35 27 EXPIRATION DATE ( 1 - 1- q2 ' Certificate of Exemption: I certify that in the performance of the uork for uhich this permit is issued, I shall not employ any person in any manner so as to becane subject to the Workers' C-nsation Laus of California. SIGNATURE DATE 8. OWNER-BUILDER DECLARATION Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 I as owner of the property or my err~loyees with wages as their sole compensation, uill do the uork and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractorls License Law does not apply to an owner of property nho builds or improves thereon,, and nho does such uork himself or through his ow employees. provided that such improvements are not intended or offered for sale. If, however. the tuilding or improvement is sold uithin one year of completion, the owner-builder uill 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 uith licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an ouner of property uho krilds 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 (Sec. 7031.5 Business and Professions Code: Any City or County uhich 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, comnencing 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 mre than five hundred dollars ['65001). Business and Professions Code for this reason: SIGNATURE DATE CONPLETE THIS SECTION FOR WON-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 25534 of the Presley-Tanner Hazardous Substance Account Act7 Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Is the facility to be constructed uithin 1,000 feet of the outer boundary of a school site7 0 YES NO OYES 0 NO OYES 0 NO IF ANY OF THE AYSYERS ARE YES, A FINAL CERTIFICATE OF OCaJpAYCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS ET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTlOY CONTROL DISTRICT. 9. CONSTRUCTION LENilING AGENCY I hereby affirm that there is a construction lending agency for the performance of the uork for which this permit is issued (Sec 3097ci) Civil Code). LENDER'S NAME LENDER'S ADDRESS 10. APPLICANT'S SIGNATURE I certify that I have read the application and state that the above information is correct. I agree to comply with all City ordinances and State laus 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 CARLSBM) AGAINST ALL LIABILITIES, JWGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY NAY ACCRUE AGAINST SAID CITY IN CCMEQIENCE OF THE GRANTING OF THIS PERUIT. 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 cmenced within 180 days fran the date of such permit or if the building or work authorized by such permit is susperded or abandoned at any time after the work is cmenced for a period of 180 days (Section 303(d) Uniform Building Code). APPROVED BY: DATE: APPLICANT'S SIGNATURE OBY PHONE WHITE: File-YELLOW: Applicant PINK: Finance 4 CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB911659 FOR 12/10/91 INSPECTOR AREA MP DESCRIPTION: TPP MOVED TO NEW LOCATION PLANCK# CB911659 TYPE: ELEC CONSTR. TYPE NEW JOB ADDRESS: 2067 BLACKBIRD CR STR: FL: STE : APPLICANT: TEMPORARY UTILITY SERVICE PHONE: 619 CONTRACTOR: PHONE : OWNER: PHONE : REMARKS: MH/MICHELLE/471-5494 INSPECTOR SPECIAL INSTRUCT: AS LATE IN THE DAY AS POSSIBLE OCC GRP TOTAL TIME: --RELATED PERMITS-- PERMIT# TYPE CB901454 SFD STATUS ISSUED CD 32 LVL DESCRIPTION EL Const. Service/Agricultural DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS