HomeMy WebLinkAbout2519 LEVANTE ST; ; CB921038; Permitl<!
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FINAf1PPROVAL
INSP.~DATE~____. CLEARANCE ____ __
CITY OF CARLSBAD
Cl +
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION
•
City of Carlsbad Building Department EST. VAL. ______________ _ 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 43B-ll6l . . PLAN CIC DEPOSIT, ___________ _
VALID. BY, ______________ _
PERMI TYPE DATE _______________ _ . A COMMERCIAL "" TENANT IMPROVEMENT
' 0 !NOUSTRJAL □NEW □TENANT IMPROVEMENT
D RESIDENT !Al 0 APARTMENT □CONDO IXJS!NGLE FAMILY DWELLING OADDITI0N/ALTERATION
Q0UPLEX ODEMOL1TJON □RELOCATION QM0BILE HOME □ELECTRICAL [XIPLUMBING
0 ME CHAN I CAL □POOL QSPA □RETAINING WALL □SOLAR QOTHER, _____ _
2. PROJECT INFORMATION PLAN CHECK No.
Address Building or Suite No. 2519 LEVANTE Nearest Cross Streets LACOSTA AV•
LEGAL DESCRIPTION Lot No. subdivision Name/Nurtler un, t No. Phase No,
CHECK BELOW If SUBMITTED:
Q2 Energy Cales 02 Structural Cates Qz Soils Rep0rt p 1 Addressed Envelope
ASSESSOR'S PARCEL EICISTING USE RES. PROPOSED USE
REPLACE GAS LINE.
BLDG. SO. FTG, # OF STORIES
3. CONTACT PERSON
NAME ADDRESS
ZIP CODE
4.
5.
6.
7.
8.
CITY
SIGNATURE
APPLICANT JO CONTRACTOR
MAHE KMP PLUMBING co. INC.
CITY SOLANA BEACH
PROPERTY OWNER
NAME KEN KALBFELL
CITY LA COSTA
CONTRACTOR
MAHE KMP PLUMBING co. INC.
CITY SOLANA BEACH
STATE
0 AGENT FOR CONTRACTOR
ADDRESS
QOWNER
435 s.
STATE CA ZIP CODE 92D7 5
X OWNER
DAY TELEPHONE
D AGENT FOR OWNER
CEDROS AVE.
DAY TELEPIIDNE 2 5 9 g 3 0 0
□LESSEE □TENANT
STATE CA
ADDRESS
ZIP CODE
2519 LEVANTE
9;rngg DAY TELEPII0NE
ADDRESS
STATE CA 435 s.
ZIP COOE 9207 5 CEDROS AVF, DAY TUEP~t 259-9300
STATE LIC. # 294]] Q LICENSE CLASS c J g CITY BUSINESS LIC. # 9 5 28846 SQ
SIGNATURE
DESIGNER NAME
CITY
--
WORKERS' COMPENSATION
STATE
TITLE V.
ADDRESS
ZIP CODE
PRESIDENT DATE 9/29/92
DAY TELEPIIONE STATE LIC. #
Workers' Conp!nsat1on 0eclarat1on: hereby affirm that I have a certlf1cate of consent to self-insure issued by the Director of Industrial Relat1ons,
or a certificate of Workers' Coq,ensation Insurance by an aatlitted 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 TRANSAMERICA POLICY NO. EXPIRATION DATE
Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall
so as to become subject to the Workers' Conp!nsation Laws of California.
SIGNATURE DATE
OWNER-BUILOER DECLARATION Owner-Builder Declaration: I hereby affirm that I am exempt from the contractor's License Law for the following reason:
rson in any manner
0 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 c~letion, the owner-builder will have the burden of proving that he did not build or iffl)rove for the purpose
of sale.).
O 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).
O 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, coomencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is e.1ter1')t therefrom,
and the basis for the alleged e11emption. 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 ($5001).
SIGNATURE DATE
COMPLETE TIIIS SECTICMII FOR NON-RESIDENTIAL BUILDING PERMITS ONLY:
Is the applicant or future bui ldi ng occupant requi red to submit a business plan, acutely hazardous materi at s regi strati on form or risk management and prevention
program under Sections 25505, 25533 or 25534 of the Presley-Tanner llazardous Substance Accouit Act?
□YES ONO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
□YES ONO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
□YES ONo
If ANY Of THE ANSWERS ARE YES, A FINAL CERTIFICATE Of OCC1.IPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 l.llLESS THE APPLICANT HAS tl:T OR JS tl:ETING THE REQIJIREMEITS
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(1) 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 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 ALSO
AGREE TO SAVE INDENNIFT AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JLl)QIENTS, COSTS ANO EKPENSES WHICH MAY IN ANY ~y ACCRUE AGAINST SAID
CITY IN COISf.QUENCE Of THE GRANTING OF THIS Pt:RMIT.
EKpiration. 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 conmenced within 180 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 corrmenced for a period of 180 days (Section 303(d) Uniform Building Code).
APPLICANT'S SIGNATUR4 ________ _ D ()l,jNER IJ CONTRACTOR OBY PHONE APP-ROVED SY; _______ _
DATE:
WHITE: File YELLOW: Applicant PINK: Finance