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HomeMy WebLinkAbout1079 SEAHORSE CT; ; CB970286; Permit.., u. #. an 021 9 n·e# A L . & LFC A Apt,1/ wn1 .9 ] & ,.. lt A ~ ~ (.: 1< ec e A ~ I< -------- Fe 'le .. l TRI ALT TAL INSP. __ _ CLEARANCE ____ _ CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. <J 1ozfJ~ CITY OF CARLSBAD BUILDING DEPARTMENT ·2075 Las Palmas Dr., Carlsbad CA 92009 '(619) 438-1161 EST. VAL. ---~:,-:00,...--,.----- Plan Ck. Deposit •7/_/4@ Validate~ ~,,....a;Jk. .... 1 ~'""'.~------- Date ¥£7(/£7 Address !include Bldg/Suite I) B { Business Name lat this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total II of units Ass85$or's P7cel I as ; n.1. Existing Use Proposed Use e cription of Work SQ. FT. /lot Stories II of Bedrooms I of Bathrooms ~~o~~);W11i/1$~1/Wti7+€W«Wfilliffl\'Ff:J Wfffi® · .. Name 0-f-=f/ . Address City State/Zip Telephone II lli!~~I ·COIJe ~ !Sec. 7031.5 Business and Professions Coda: Any City or County which requires• permit to construct, elter, improve, demoliah 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 Contrector' s License Law (Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he js 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)1. Name Address City State/Zip Telephone II State License I _________ _ License Class _________ _ City Business License II _______ _ Designer Name Address City State/Zip Telephone State License I _________ _ ~Wj)_ftKE,RSl_.COMPENS. TI_ONJ~ .• ~~~:._:~J.n-~~i;.~~~l .. .'.-~~.11 !~:'°t~~::~ ... ~~;::_it5);~~ 0;,~t;~~.,:~ ·.3: :_;,;,::~ ,. .i: Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain a certificate of consent to self-insure for workers' compensation H provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 0 I have and will maintain workers' compensation, es required by Section 3700 of the Labor Code, for the performance of the work for ·which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company_____________________ Policy No._____________ Expiration Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1noo1 OR LESS) 0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is iaaued, I ahall not employ any person in any manner so es to become subject to the Workers' Compensation Laws of California. WARNING: Flilure to aecure•workera" compenution coverage is unlawful, end shall subject an employer to criminll penaltlea and civil fines up to one hundred thousand doUara ($100,000), in addition to the coat of compensation, damages as provided for In Section 3706 of the Labqr code, lnterast and attorney's fees. SIGNATURE. ________________ """."" ___________ """'.'""'.'.".-DATE _________ _ ',J,. -~,OWNER-BUILDER DECLARATION ,:;r, , ". ; '.',• . . ,~i-1.'?.~~~~~~~!:rn~[~.{i~-:a~Jr,~~~~ i reby affirm that I am exempt from the Contractor's License Law for the following 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 c. 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 purposa of salel. 0 I, as owner of the property. am exclusively contracting with licensed contractors to construct the project !Sec. 7044, Buainau and Profaaaions Code: The Contractor's Ucense Law does not apply to an. owner of property who builds or improves thereon, ■nd contracts for such projects with contractor(■) licensad pursuant to the Contractor's License Law). 0 I am exempt under Section ______ Business and Professions Code for this reason: 1 . I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO 2. I !have / have notl signed an application for a building permit for the proposed work. 3. I have contracted with the following person !firm) to provide the proposed construction (include name / addraas / phone number / contractors license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone number/ contractors license number): ______________________________________________ _ 5. I will provide some of the work, but I have contracted !hired) the following persons to provide the work indicated !include name / address / phone number / type of work):. ___________ "'t"-r-r--t-=-t:::-::-:r'--------------------7-t--rt-:::::-=----------- PROPERTY OWNER SIGNATURE :.CO~'.SECTIOt{.FQR N.O DATE I,, th,i a:,plic::it or future tuildir,,. ant raq1Mr■.:l to ,iubmit a bu"i"""" 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? 0 YES O NO Is the applicant or future building occupant required to obtain • permit from the air pollution control district or air quality management district? 0 YES O NO Is the facility to be constructed within 1 ,000 feat of the outer boundary of a school site? 0 YES O NO IF ANY OF THE ANSWERS ARE YES, A ANAL CERTIRCATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFACE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. ~~O_NSTRUCTION LENDING-~GENCY ..;;: :~';_~~ ... ~Jt:''. '· ,..,-~f,f,;£;; :_;: :: · ·:;::::;J~ff....';l(ij iL~.,~i'.;V;;?,:;)"'. . · ''\,:,'. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued (Sec. 3097(il Civil Code). LENDER'S NAME ______________ _ !9.: APPLICANT CERTIFICATION I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. 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, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, 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 shall 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 t e w rk is omm nc for a · d of 180 days !Section 106.4.4 Uniform Building Code). I I APPLICANT'S SIGNATURE --7t'---_;;;__.,.,...__,_ __ .._.________________ DATE __ d-_+-~\ Y_l-ot_7 _____ _ YELLOW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB970286 FOR 03/17/97 DESCRIPTION: GAS LINE & ELECTRICAL INSPECTOR AREA PLANCK# CB970286 OCC GRP CONSTR. TYPE NEW TYPE; ELEC JOB ADDRESS: 1079 SEAHORSE CT APPLICANT: COBBS, JOYLYNN CONTRACTOR: STE: LOT: OWNER: REMARKS: BJN/431-5561 SPECIAL INSTRUCT: TOTAL TIME: CD 11 LVL DESCRIPTION ST Ftg/Foundation/Piers PHONE: 619 431-5561 PHONE: PHONE: ,NSPE// ACT COMMENTS ~--------------------------------------------- ***** INSPECTION HISTORY***** DATE DESCRIPTION 022097 Gas/Test/Repairs ACT INSP AP PY COMMENTS