HomeMy WebLinkAbout1711 LOBELIA CT; ; CB910300; Permit.,
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B U I L D I N G P E R M I T Permit
Project
Development
No: CB91L 100
No: A89J2C rJfi
No: DEV89108 Job Address: 1711 LOBELIA CT
Permit Type: SIGN
Parcel No:
Valuation: 5,000
Construction Type: NEW
Occupancy Group: Class Code: Description: MONUMENT SIGN PAVOREAL
Appl/Ownr : WESTERN NATIONAL HOMES
19700 FAIRCHILD DRIVE #230
IRVINE, CA 92715
*** Fees Required -------------------------Fees:
Adjustments:
Total Fees:
Fee description -------------------Building Permit
Plan Check
* BUILDING TOTAL
Str:
714
Fl: Ste:
1078 02/2~/91 qoo· n,
"'
Sta
Appl1eu:
Apr/Issue:
Validated By:
476-3031
nJ,lected & Credit~;
(, ~/.,: t> / )1
0 2/2. 6 / Cj L
DC'
t< * >\ ---------------------------
.00
. () 0
119.0(,
Ext fee Data ------------------
72.0U
47.00
119.Cll
l APMOVAL ft(
INS~....,__-DAT~J.L/;;i-.'l I If ,.Jf r<. i
CLEARANCE ................. --1
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161
PERMIT APPLICATION
11\ .. City of Carlsbad Building Department EST. VAL·---.==io'?.,_.Jc1:::r:;;.L=c)-(",:=i,..J)c_ __ _ 2075 Las Palmas Dr., Carlsbad, CA 92009 c•1•1 438~!161
PLAN CK DEPOSIT ___________ _
VALID. BY _____________ _
1. PERMIT TYPE DATE ______________ _
A
B
C
COMMERCIAL
0 INDUSTRIAL
0 RESIDENTIAL O APARTMENT
0 DUPLEX O DEMOLITION
□MECHANICAL □POOL
CHECK BELOW IF SUBIIIUTTED:
THIIANT IMPROVEMENT
0 TENANT IMPROVEMENT
□CONDO QSINGLE FAMILY DWELLING QADDITION/AL TERATION
QRELOCATION □MOBILE HOME □ELECTRICAL □PLUMBING
□SPA □RETAINING WALL OsoLAR □OTHER
pz Energy Cales qz Structural Cales Q2 Soils Report 0 1 Addressed Envelope
ASSESSOR'S PARC~---EXISTING USE
5t6N
# OF STORIES
Un1 t No, Phase No.
PROPOSED USE
3. CONTACT PERSON
4.
NAME
CITY
SIGNATURE
APPLICANT
NAME
CITY
Q CONTRACTOR
STATE
ADDRESS
ZIP CODE
0 AGENT FOR CONTRACTOR
ADDRESS
STATE ZIP CODE
DAY TELEPHONE
QOWNER 0 AGENT FOR OolNER
DAY TELEPHONE
5. Y OWNER .I-OI/NER □LESSEE □TENANT -.Snn?AJ IJAnl>NAv ffCJIYll!:S ADDRESS / q700 ;::,~ / RCl-/t i.,0 D ::Z. 3 ()
V//vG" STATE~ ZIPCOOE 9,).]/S° DAY TELEPHONE t'-f-47(,,-303
6. CONTRACTOR
7.
8.
NAME
CITY STATE
ADDRESS
ZIP CODE DAY TELEPHONE
SIGNATURE
DESIGNER NAME
CITY
STATE LIC. # ____ _
STATE
WORKERS' COMPENSATION
LICENSE CLASS _____ _
TITLE
ADDRESS
ZIP CODE
CITY BUSINESS LIC. #
DATE
DAY TELEPHONE STATE LIC. #
Workers• Corrpensat1on Declaration: hereby affirm that have a certificate of consent to self•1nsure issued by the Director of Industrial Relations,
or a certificate of Workers' Corrpensat ion Insurance by an aani tted insurer, or an eKact copy or duplicate thereof cert if i eel by the o i rector of the
insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C).
INSURANCE COMPANY POLICY NO. EXPIRATION OATE
Certificate of Exeq:,tion: I certify that in the performance of the work for which this permit is issued, I shall not errploy any person in any manner
so as to become subject to the Workers' Coq:>ensation Laws of California.
SlGNATURE DATE
OWNER-BUILDER DECLARATION
Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractor's license Law for the following reason:
DI as owner of the property or my eJ!Ployees with wages as their sole compensation, will do the work and the structure ls 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 il!proves thereon,. and who
does such work himself or through his own efll)loyees, provided that such il!provements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of COl'll)letion, the o,mer·builder will have the burden of proving that he did not build or il!prove for the purpose
of sale.).
D I, as owner of the property, am eKclusively 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 il!proves thereon, and contracts for such projects with contractor(s)
licensed pursuant to the Contractor's License Law).
0 I am ex~t 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, coomencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exefll)t 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 [S500]),
SIGNATURE DATE
COMPLETE THIS SECTION FOR NON-RESIOENTIAL 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 Act?
□YES □NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
Ores □No
Is the fac i l i ty to be cons truct!!d within 1 , 000 feet of the outer boundary of a school site?
□YES 0,0
If ANY Of THE ANSWERS ARE YES, A FINAL CERTIFICATE Of OCClJPANCY MY NOT BE ISSUEO AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS fl:T OR JS MEETING THE REQUIREMENTS
OF THE OfFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
9. CONSTRUCTION LENDING AGENCY
hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(i) 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 COJ!PlY with all City ordinances 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. ALSO
AGREE TO SAVE JM)ENNIFY AM) KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JWGNENTS, COSTS ANO EXPENSES WHICH MAY IN ANY MAY ACCIIUE AGAINST SAID
CITY IN CONSEQUENCE Of THE GRANTING Of THIS PERMIT.
EKpiration. Every permit issued by the Suilding Official under the provisions of this Code shall eKpire by limitation and become null and void if
or work authorized by such permit is not coomenced within 180 days from the date of such permit or if the building or work authorized by such permit
or abandoned at any time after the work is coomenced for a period of 180 days (Section 303(d) Uniform Building Code).
the building
is suspended
~NER □ CONTRACTOR □ BY PHONE APPROVED BY: _______ _
DATE:
WHITE: File YELLOW: Applicant PINK: Finance