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HomeMy WebLinkAbout1210 STRATFORD LN; ; CB020136; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 01-10-2002 Miscellaneous Permit Permit No:CB020136 Building Inspection Request Line (760) 602-2725 Job Address: 1210 STRATFORD LN CBAD Permit Type: Parcel No: MISC Subtype: OTHER 1561644400 Lot #: 0 Status: Applied: Valuation: $1,700.00 Entered By: Reference #: Plan Approved: Issued: Project Title: BLASA RES/REPLACING SIDING & Inspect Area: NEW R-13 INSULATE,A BOVE GARAGE &FANT Applicant: Owner: ALBAUGH CONSTRUCTION 1350 E ROWLAND BLASA FAMILY TRUST 01-05-01 ISSUED 01/10/2002 CB 01/10/2002 01/10/2002 WEST COVINA AV CA 91710 742 FARBEN DR DIAMOND BAR CA 91765 8569 01/10/02 0002 01 02 626-536-1344 Total Fees: $58.00 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees Total Payments To Date: $0.00 PERMIT FEE Balance Due: $58.00 $0.00 $0.00 TOTAL PERMIT FEES $58.00 CGP 58-00 $58.00 . . PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NoC-!?O.?Ol3(f? EST. VAL. _________ _ Plan Ck. Deposit--~------ Validated By C--f!;::, Date /-JC)-Q2_ Business Name (at this address) Legal Description Subdivision Name/Number D 2. Name Address 3. APPLICANT O Contractor D Agent for·Contrae1:or D 0.wn8r #of Stories City Ag·ent for Owner Unit No. Phase No. Total # of units Proposed Use # of edrooms # of Bathrooms Name Address City State/Zip Telephone# I :i, ir> ¢.NJL.$8A!2 lt,o 2 10-C!!'-f<-f 3 State/Z1p~Telephone # Address 6. CONTRACTOR· COMPANY NAME C, ~'J /A-~-13 ~ (Sec. 7031.5 Business and Professions Code: Any City or County which reqU1res a permit to construct, alter, improve, demohsh or epa1r a~tr~ure, prior to its J 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, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the besis for the alleged Any violation of Section 7 31.5 by any applicant for a permit ubjects the applicant to a civil penalty of not more than five hundred dollars 1$5001). cJ µ O~k 4 (!,4 i.f:J4 Address City State/Zip Telephone State License II _________ _ 6. WOR~ERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the labor Code, for the performance of the work for which this permit is issued. D I have and will maintain workers' compensation, as 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 carr¥1r and policy number ar,e: Insurance Company C~P s--1-/i µc./,o µ ,5 ~L ...,, ,..~Polley No. loo 3 7 3/ :2. C. (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE mJl'JDRED DOLLARS [$1001 OR LESS) Expiration Date ¥,~/_2c;n<_ ~ CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California. erage la unlawful, and ahall aubject an employer to criminal penaltiea and civil finea up to one hundred ompenaatlon, damage, aa provided for In Section 3706 of the L r code, tereat and ettomey·• fee,. OATE Z) ~ 0CJ 7. J..CDO:L I hereby affirm that I am exempt from the Contractor's license law for the following reason: D 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 tor 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). D 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), □ 1. 2. I am exempt under Section ______ Business and Professions Code for this reason: I personally plan to provide the major labor and materials for construction of the proposed property improvement. ~ 1 (have / have not) signed an application for a building permit for the proposed work, ONO 3. I have contracted with the following person (firm) to provide the proposed construction (include name/ address/ 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): ______________________________________________________ _ PROPERTY OWNER SIGNATURE ______________________ _ DATE _________ _ COMPLETE'THIS SECTION-FOR NON-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 Pres1ey•Tanner Hazardous Substance Account Act? 0 YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES D NO If ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 8. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction tending agency tor the performance of the work for which this permit is issued (Sec. 30970) Civil Code). LENDER'S NAME _____________ _ LENDER'S ADDRESS. ________________________ _ 9. APPI.ICANT 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 Citt 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 180 days from the date of such permit or it the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced r a period 80 da s (Section 106.4.4 Uniform Building Code). ~APPLICANT'S SIGNATURE \ City of Carlsbad Bldg Inspection Request For: 01/24/2002 Permit# CB020136 Inspector Assignment: PY --- Title: BLASA RES/REPLACING SIDING & Description: NEW R-13 INSULATE,A BOVE GARAGE &FRNT Type:MISC Sub Type: OTHER Job Address: Suite: Location: 1210 STRATFORD LN Lot 0 APPLICANT ALBAUGH CONSTRUCTION Owner: BLASA FAMILY TRUST 01-05-01 Remarks: Total Time: CD Description Act Comments Phone: 6265361344 Inspector: ----- Requested By: BALSA RES/ GREG ALBA Entered By: CHRISTINE 19 Final Structural +-:.2_ ______ _ Associated PCRs Inspection History Date Description 01/16/2002 16 Insulation 01/16/2002 19 Final Structural Act lnsp Comments AP PY WC PY _________ .. ,. ... _,,