HomeMy WebLinkAbout1000 AVIARA PY; 110; CB063453; Permit01-16-2007
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Commercial/Industrial Permit Permit No
Building Inspection Request Line (760) 602-2725
CB063453
Job Address
Permit Type
Parcel No
Valuation
Occupancy Group
Project Title
Applicant
KAYWILIS
5838 EDISON PL
CARLSBAD 92008
431 7585
1000AVIARAPYCBADSI 110
Tl Sub Type
2120407000 Lot#
$83,825 00 Construction Type
Reference #
OLD REP TITLE- 2,395 SF SHELL
TO OFFICE
INDUST
0
VN
Status ISSUED
Applied 12/07/2006
Entered By LSM
Plan Approved 01/16/2007
issued 01/16/2007
Inspect Area
Plan Check#
Owner
KELLY CORPORATE CENTER II C L L C
C/0 THE ALLEN GROUP
5330 CARROLL CANYON RD #200
SAN DIEGO CA 92121
Building Permit
Add'l Building Permit Fee
Plan Check
Add'l Plan Check Fee
Plan Check Discount
Strong Motion Fee
Park Fee
LFM Fee
Bridge Fee
BTD #2 Fee
BTD #3 Fee
Renewal Fee
Add'l Renewal Fee
Other Building Fee
Pot Water Con Fee
Meter Size
Add'l Pot Water Con Fee
Reel Water Con Fee
$484 96 Meter Size
$0 00 Add'l Reel Water Con Fee
$31522 Meter Fee
$0 00 SDCWA Fee
$000 CFD Payoff Fee
$1760 PFF (3105540)
$0 00 PFF (4305540) '
$000 License Tax (3104193)
$0 00 License Tax (4304193)
$9,756 00 Traffic Impact Fee (3105541)
- $000 Traffic Impact Fee (4305541)
, $0 00 PLUMBING TOTAL'
$0 00 ELECTRICAL TOTAL
$0 00 MECHANICAL TOTAL
$0 00 Master Drainage Fee
Sewer Fee
$0 00 Redev Parking Fee
$000,' Additional Fees
HMP Fee
TOTAL PERMIT FEES
$000
$000
$000
$000
$1,52562
$000
$000
$000
$1,04400
$000
£5500
$3500
$5950
$000
$889 95
$000
$000
??
$14,18285
Total Fees $14,18285 Total Payments To Date $14,182 85 Balance Due $000
PLANS
STORAGE
ATTACHED
Inspector
FINAL APPROVAL
Date
NOTICE Please take NOTICE that approval of your project includes the Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as 'fees/exactions" You have 90 days from the date this permit was issued to protest imposition of these fees/exactions If you protest them, you must
follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3 32 030 Failure to timely follow that procedure will bar any subsequent legal action to attack,
review set aside void or annul their imposition
You are hereby FURTHER NOTIFIED that your nght to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes, nor planning zoning, grading or other similar application processing or service fees m connection with this project NOR DOES (T APPLY lo arty
fees/exactions qf which you have previously been given a NOTICE similar to this, orasto which the statute of limitations has previously otherwise_exmred
V
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave , Carlsbad CA 92008
FOR OFFICE USE ONLY
0~&O<0 3yS3PLAN CHECK NO
EST VAL
Plan Ck Deposit
Validated By
Date :/€*=>
IV - OL.D
Address (include Bldg/Suite #)&f Ptu/zej
9 I «*•
Business Name (at thjfe address)klO- fflin-
Lot No Subdivision Name/Number
Descnption of Work
' 5035
QlfAagrft^Ownqr
(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 Contractors License Law [Chapters, commending 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 more than five hundred dollars [$500])
Name
State License #
M&ftntJf Pr*
Designer Name
State License #
Address
License Class
a^3^//a-V^T ftyrJiJ j^s^t'S'
Address
City
% ft 2 ft &£
City
State/Zip Telephone #
Citv Business License #
*J**M PtA*. LwlSbAd. sA- q264ft
State/Zip Telephone # ~fo/) 4>$/-T
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
yf I have and will maintain worker's compensation, as required by Section 3700 of the labor Code, for the performance of the work for which this permit is issued My
workers compensation insurance carrier and policynumber are /> 1 I \,
Insurance Company ^Sv^At C_(VOA. f \V\b-C^-l XVA Policy No _f> 11,13%"~Uo Q - ^IlOO / Expiration Date O I |_0_LJ-0 J
(THIS SECTION NEED' NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [J100J OR LESS)
D 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
WARNING Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand
dollars($100 000), in addition to the cost of compensation, damages are provided for In Section 3706 of the Labor Code, Interest and attorney's I
SIGNATURE L/l/Fl ft Pft A G^\^ DATE f / / (0
OWHEtfBUQlDER DEOZAHATION
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 d the work and the structure is not intended or offered for sale (Sec 7044,
Business and Professions Code The Contractors 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 contraclor(s) licensed pursuant to the Contractor s
License Law)
D I am exempt under Section Business and Professions Code for this reason
1 | personally plan to provide the major labor and materials for construction of the proposed property improvement D YES D NO
2 I (have/have not) 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 / 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 /
/ontractors 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
WHITE File YELLOW Applicant PINK Finance
PERM!/ APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave .Carlsbad CA 92008
Page 2 of 2
:OOMPL£TC,T>HI3 SECT!ON FORNOW^S/D£NT1AL"BUILJ3ING PERMrrS'ONLY"h-.^—^A^—..Am^,|^^^.^-.m^^,»»aa«^.«»jm-^m,—^^^^a^^a^mm^^^a^^A^^^^f^r^^f.r,m
Is the applicant or future building occupant required to submit a business plan acutely hazardous materials registration for or nsk management and prevention program under
Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act7 D YES M 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 p£ NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES J?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
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
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, JUDGEMENTS, 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 lor excavations of 5 0" deep and demolition or construction of structures over 3 stones 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 if the building or work authorized by such permit is suspended or abandoned at any time after
the work is commenced fora period of 180 days (Section 106 44 Uniform Building Code)
APPLICANT'S SIGNATURE DATE 1-0
WHITE File YELLOW Applicant PINK Finance
City of Carlsbad Bldg Inspection Request
For 02/13/2007
Permit# CB063453
Title OLD REP TITLE- 2,395 SF SHELL
Description TO OFFICE
Inspector Assignment RB
1000 AVIARA PY
110 Lot
Type Tl Sub Type INDUST
Job Address
Suite
Location
OWNER KELLY CORPORATE CENTER II C L L C
Owner
Remarks
Total Time
Phone 7605356200
Inspector
Requested By JIM
Entered By CHRISTINE
CD Description
39 Final Electrical
Act Comment
Comments/Notices/Holds
Associated PCRs/CVs Original PC#
Inspection History
Dale Description
02/02/2007 84 Rough Combo
02/02/2007 98 BMP Inspection
01/30/2007 17 Interior Lath/Drywall
01/29/2007 17 Interior Lath/Drywall
01/25/2007 21 Underground/Under Floor
01/23/2007 14 Frame/Steel/Bolt ing/Weld ing
01/23/2007 2^ Underground/Under Floor
01/23/2007 24 Rough/Topout
01/23/2007 34 Rough Electric
Act Insp Comments
AP RB T-BAR SYSTEM
WC RB
AP RB
CA RB
AP RB
RB WALLS ONLY
OK EXCEPT TIE IN
AP
PA
AP
AP
RB
RB
RB WALLS ONLY
EsGil Corporation
In (Partners kip ivitH government for (Buififing Safety
DATE 1/10/07
JURISDICTION City of Carlsbad
PLAN CHECK NO O6-3453 SET II
PROJECT ADDRESS 1000 Aviara Pkwy Suite 110
PROJECT NAME. Old Republic Title - TI
U APPLICANT
a JURIS
a PLAN REVIEWER
a FILE
XI The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes
The plans transmitted herewith will substantially comply with the jurisdiction's building codes
when minor deficiencies identified below are resolved and checked by building department staff
The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck
The check list transmitted herewith is for your information The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck
The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person
The applicant's copy of the check list has been sent to
X] Esgil Corporation staff did not advise the applicant that the plan check has been completed
Esgil Corporation staff did advise the applicant that the plan check has been completed
Person contacted Telephone #
Date contacted (by ) Fax #
Mail Telephone Fax In Person
REMARKS
By Doug Moody
Esgil Corporation
D GA D MB D EJ D PC
Enclosures
1/8/06 trnsmtl dot
9320 Chesapeake Drive, Suite 208 4 San Diego, California 92123 4 (858)560-1468 4 Fax (858) 560-1576
EsGil Corporation
In Partnership with government for (ButCdtng Safety
(
DATE 12/19/06 Q APPLICANT
JURISDICTION City of Carlsbad a PLAN REVIEWER
a FILE
PLAN CHECK NO 06-3453 SET I
PROJECT ADDRESS 1000 Aviara Pkwy Suite 11O
PROJECT NAME' Old Republic Title - TI
The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes
The plans transmitted herewith will substantially comply with the jurisdiction's building codes
when minor deficiencies identified below are resolved and checked by building department staff
The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubrrntted for a complete recheck
X] The check list transmitted herewith is for your information The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck
The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person
XI The applicant's copy of the check list has been sent to
McArdle Associates Architects / Kay Wilis
5838 Edison Place, Carlsbad 92008
Esgil Corporation staff did not advise the applicant that the plan check has been completed
XI Esgil Corporation staff did advise the applicant that the plan check has been completed
Person contacted KayWilis Telephone # 760-431-7775 x/ o^f
Date contacted \^\^lo^(b\/ £_ ) Fax # 760-431-7585
Mail Telephone -*-^ Fax -"""in Person
D REMARKS
By Doug Moody Enclosures
Esgil Corporation
El GA D MB D EJ D PC 12/11/06 tmsmUdot
9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858)560-1468 + Fax (858) 560-1576
City of Carlsbad 06-3453
12/19/06
PLAN REVIEW CORRECTION LIST
TENANT IMPROVEMENTS
PLAN CHECK NO 06-3453
OCCUPANCY. B
TYPE OF CONSTRUCTION VN
ALLOWABLE FLOOR AREA
SPRINKLERS'? YES
REMARKS
DATE PLANS RECEIVED BY
JURISDICTION 12/7/06
DATE INITIAL PLAN REVIEW
COMPLETED 12/19/06
JURISDICTION City of Carlsbad
USE Office
ACTUAL AREA 2395
STORIES 2
HEIGHT
OCCUPANT LOAD 29
DATE PLANS RECEIVED BY
ESGiL CORPORATION 12/11/06
PLAN REVIEWER Doug Moody
FOREWORD (PLEASE READ):
This plan review is limited to the technical requirements contained in the Uniform Building Code,
Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state laws
regulating energy conservation, noise attenuation and access for the disabled This plan review
is based on regulations enforced by the Building Department You may have other corrections
based on laws and ordinances enforced by the Planning Department, Engineering Department,
Fire Department or other departments Clearance from those departments may be required
prior to the issuance of a building permit
Code sections cited are based on the 2001 CBC, which adopts the 1997 UBC
The following items listed need clarification, modification or change All items must be satisfied
before the plans will be in conformance with the cited codes and regulations Per Sec 106 4 3,
1997 Uniform Building Code, the approval of the plans does not permit the violation of any
state, county or city law
To speed up the recheck process, please note on this list (or a copy) where each
correction item has been addressed, i.e., plan sheet number, specification section, etc.
Be sure to enclose the marked upjist when you submit the revised plans.
TENANT IMPROVEMENTS WITHOUT SPECIFIC ENERGY DATA OR POLICY SUPPLEMENTS (1997UBC)tiforw dot
City of Carlsbad 06-3453
12/19/06
Please make all corrections on the original tracings, as requested in the correction
list Submit three sets of plans for commercial/industrial projects (two sets of plans
for residential projects) For expeditious processing, corrected sets can be
submitted in one of two ways
1 Deliver all corrected sets of plans and calculations/reports directly to the City of
Carlsbad Building Department, 1635 Faraday Ave , Carlsbad, CA 92008, (760)
602-2700 The City will route the plans to EsGil Corporation and the Carlsbad
Planning, Engineering and Fire Departments
2 Bring one corrected set of plans and calculations/reports to EsGil Corporation,
9320 Chesapeake Drive, Suite 208, San Diego, CA 92123, (858) 560-1468
Deliver all remaining sets of plans and calculations/reports directly to the City of
Carlsbad Building Department for routing to their Planning, Engineering and Fire
Departments
NOTE Plans that are submitted directly to EsGil Corporation only will not be
reviewed by the City Planning, Engineering and Fire Departments until review by
EsGil Corporation is complete
1 Each sheet of the plans must be signed by the person responsible for their
preparation, even though there are no structural changes Business and
Professions Code
2 Provide a statement on the Title Sheet of the plans stating that this project shall
comply with the 2001 editions of the California Building/PIumbmg/Mechanical
Codes and the 2004 edition of the California Electrical Code, which adopt the
1997 UBC, 2000 UMC, 2000 UPC and the 2002 NEC
3 Please clarify the area of work the architectural plans and the permit application
show the area to be suite 110 yet the plumbing and mechanical plans show work
in suite 120? Please revise the permit application and the architectural to show
the work occurring in suite 120 or remove the scope of work from the plumbing
and mechanical plans
4 Please have the principle designer complete the appropriate box(s) in the
Statement of Compliance System Acceptance section of the MECH-1-C part 2 of
2 document to show the required forms for the new WSHP's and indicate the
persons responsible for providing the form to the city inspector (why isn't the
MECH-8-A form required?)
To speed up the review process, note on this list (or a copy) where each
correction item has been addressed, i e., plan sheet, note or detail number,
calculation page, etc
Please indicate here if any changes have been made to the plans that are not a
result of corrections from this list If there are other changes, please briefly
describe them and where they are located in the plans
City of Carlsbad 06-3453
12/19/06
Have changes been made to the plans not resulting from this correction list?
Please indicate
Yes Q No Q
The jurisdiction has contracted with Esgil Corporation located at 9320
Chesapeake Drive, Suite 208, San Diego, California 92123, telephone number of
858/560-1468, to perform the plan review for your project If you have any
questions regarding these plan review items, please contact Doug Moody at
Esgil Corporation Thank you
City of Carlsbad 06-3453
12/19/06
VALUATION AND PLAN CHECK FEE
JURISDICTION City of Carlsbad PLAN CHECK NO 06-3453
PREPARED BY Doug Moody DATE 12/19/06
BUILDING ADDRESS 100O Aviara Pkwy Suite HO
BUILDING OCCUPANCY. B TYPE OF CONSTRUCTION VN
BUILDING
PORTION
Tl
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code
AREA
( Sq Ft )
2395
cb
_.,_,-,
Valuation
Multiplier
3437
By Ordinance
Reg
Mod
VALUE ($)
82,316
82,316
$47211
Plan Check Fee by Ordinance
Type of Review
Repetitive Fee
Repeats
Complete Review
D Other
j—, Hourly
Structural Only
Hour*
Esgil Plan Review Fee
$306.87
$264.38
Comments
Sheet 1 of 1
macvalue doc
PLANNING/ENGINEERING APPROVALS
PERMIT NUMBER CB O.
!» ,- <•
RESIDENTIAL
RESIDENTIAL ADDITION MINOR
« $10,000.00)
OTHER
PLANNE
ENGINEER V-~—
TENANT IMPROVEMENT
, ,
PiAZA CAU1NO REAL
CARLSBAD COMPANY STORES
'5" ; *• ' 'j ' •
i
VHLACB FAIRB
COMMRTB OFFICE BUILDING
PATE \1~l(\
DAT!
I
/ ENGINEERING DEPARTMENT
FEE CALCULATION WORKSHEET
D ^Estimate based on unconfirmed information from applicant
\g Calculation based on building plancheck plan submittal
Address /^ /UV^V^ €&^tf . $\€ ffd Blda Permit No
Prepared by Date Checked by _Date-
EDU CALCULATIONS: List types and square footages for all uses
Q>J2je_ (?6*~*^&- ofi\ S^t^dG^^^'^-"^Types of Use _ Sq Ft/Units'.
Types of Use Sq Ft/Units'.
APT CALCULATIONS: List types and^quare footages for all uses
Types of Use Sq Ft /Units
EDU's
EDU's
ADT's .
ADT's-
FEES REQUIRED:
WITHIN CFD D YES (no bndge & thoroughfare fee in Distnct #1, reduced Traffic Impact Fee)
PARKIN-LIEU FEE,-"
FEE/UNIT
2 TRAFFIC IMPACT FEE
ADT's/UNITS
PARK AREA & #
X NO UNITS.
FEE/ADT
3 BRIDGE AND THOROUGHFARE FEE (DIST #1
XPT's/UNITS 3 £> X FEE/ADT,
FACILITIES MANAGEMENT FEE ZONE - 5
UNIT/SQ FT
5 SEWER FEE
EDU'S
DIST #2
X FEE/SQFT/UNIT
X * FEE/EDU
l^NEFITAREAr' EDU's
iK/0/06 SEWER LATERAL ($2,500)
GrC7 DRAINAGE FEES PLDAu
ACRES
^
X FEE/EDU
HIGH
X FEE/AC
/LOW
=$.
8 POTABLE WATER FEES
UNITS CODE CONNECTION FEE
DNO
METER FEE SDCWA FEE SDCWA FEE
1 Of 2
F \FE£ CALCULATION WORKSHEET doc Rav 7/14/00
Carlsbad Fire Department
Plan Review Requirements Category TI, INDUST
Date of Report 12-11-2006
Name
Address
Reviewed by
Permit# CB063453
Job Name OLD REP TITLE- 2,395 SF SHELL
Job Address 1000 AVIARA PY CHAD St 1 10
adequately conduct a review to
carefully all
oi icview and approval
Conditions:
Cond CON0001768
[MET] No Comments
Entry 12/11/2006 By MS Action AP
for review is
the necessary plans and/or specifications, witn
review
FROM GSDftC FAX NO '6194697621 Dec 26 2006 ll'42ftM P2
CERTIFICATE OF COMPLIANCE (Parti of2) MECH-1-C
I PROJECT NAME
PROJECT ADDRESS
Old Republic Title
lOOCKAviara Parkway Suite 110 Carlsbad
PRINCIPAL DESIGNER /MECHANICAL
Greater San Diego Air Conditioning Co Inc
DOCUMENTATION AUTHOR " '
Greater San Diego Air Conditioning Co Inc
TELEPHONE(619)469-7818
TELEPHONE(619)469-7818
DATE
12/26/2006
Building Permit «i
•Checked-by/Datb
t-nforaemfcnt Agancy
GENERALJNFORMAT10N
DATE OF PLANS
11-21-06
BUILDING CONDITIONED FLOOR AREA
2,35QsqFt
CLIMATE ZONE
7
BUILDING TYPE [XI NONRESIDENTIAL [ | HIGH RISE RESIDENTIAL HOTEL/MOTEL GUEST ROOM
PHASE OF CONSTRUCTION [X] NEW CONSTRUCTION [^J ADDITION pj ALTERATION [I] UNCONDITIONED (File Affidavit)
METHOD OF MECHANICAL I~X] PRESCRIPTIVE
COMPLIANCE
PERFORMANCE
PROOF OF ENVELOPE COMPLIANCE PREVIOUS ENVELOPE PERMIT I 1 ENVELOPE COMPLIANCE ATTACHED
STATEMENT OF COMPLIANCE
This Cortlflcate of Compliance lists the budding features and performance specifications needed to comply with Title 24,
Parts 1 and 6 of the California Code of Regulations This certificate applies only to building mechanical requirements
The documentation prepgrer hereby certifies that the documentation is accurate and complete
DOCUMENTATION AUTHOR
T.L. Harmon . ^
The Principal Mechanical Designer hereby certifies thai the proposed Building design represented in this set of construction
documents is consistent with the other compliance forms and worksheets, with the specifications, and with any othor
calculations submitted with this permit application The proposed building has been designed to mert the mechanical
requirements contained in the applicable parts of Sections 100, 101. 102, 110 through! 15, 120 through 125, 142, 144, and 145
[ j The plane & specifications meet the requirements of Part 1 (Sections 10-103a)
f7~) the installation certificates miiflt the requirements of Part 1 (10-103a 3)
"j Thu operation & maintenance information meets the requirements of Part 1 (10-103C)
Please check one (These sec ttonsof the Business and Professions Coda are printed In full m the Nonresidenlial Manual)
I I I horeby affirm thai J am eligible under the provisions of Division 3 o1 the Business and Professions Code to sign this document as the
peibcm responsible for its prapsration and thai I am licensed In the State of California as a civil engineer, or mechanical engineer or I
am a licensed architect
r "i I affirm that i am eligible under the exemption to Division 3 of the Business end Professions Code by Section 5537 2 or 6737 3 to sign
thle documpnl RS the person responsible for Its preparation and thai I am B licensed contractor performing this work
I I t affirm thai I am eligible under the exemption lo Division 3 of the Business end Professions Code to sign this document because it pertains to a
— structure or type of work flenrnbed pursuant lo Business and Professions Code sections 5537 S&36, and G7S7 1
PRINCIPAL MECHANICAL DESIGNER - NAME
.Greater San_Di£gaAir Conditioning
Inc
INSTRUCTIONS TO APPLICANT
MECH-1-C Certificate of Compliance Part 1, 2, 3 of 3 are required on plans for all submittals
i r- AirA'Vater/Servi re/Water Poats Requirements Part 1 of 3, 2 of 3 3 of 3 are required for all aubmittals, but may be on-
\$ MECH-3-C Mechanical Veintitation and Reheat is required for ell subrnittals with mechanical ventilation, but may be on plans
C5 MECH-4-C HVAC Misc Prescriptive Requirements is required for all prescriptive submitted, but may be on plans
Ci MECH-5-C Mechanical Equipment Details are required for sll performance submittals
4 3 by EnergySo'l Number fi?72
V
Slate Of California
.B-. CONTRACTORS STATE LICENSE BOARD
ACTIVE LICENSE
Afhwx
452513 CORP
S P WHITE CONSTRUCTION INC
02/29/2008
THIS DOCUMENT HAS A TRUE DEFENSA™ WATERMARK AND VISIBLE FIBERS DISCERNIBLE FROM BOTH SIDES
l
BUSINESS NAMEff
THIS DOCUMENT IS ALTERATION PROTECTED AND REFLECTS FLUORESCENT FIBERS UNDER UV LIGHT
KEEP FOR YOUR RECORDS
BUSINESS TAX RECEIPT
BUS NO 1202380
DATE ISSUED
/ 12/19/2006
08 070G $8000
BALANCE $000-
TAXES PAID IN ACCORDANCE WITH CITY
BUSINESS TAX ORDINANCE
CITY OF CARLSBAD
POLICYHOLDER COPY SD
COMPENSATION
INSURANCE
PO BOX 420807, SAN FRANCISCO,CA 94142-0807
FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE 01-01-2007
CITY OF CARLSBAD
ATTN BUILDING DEPARTMENT
1635 FARADAY AVENUE
CARLSBAD CA 92008
SD
GROUP 000046
POLICY NUMBER 0008760-2007
CERTIFICATE ID 61
CERTIFICATE EXPIRES 01-01-2008
O1-01-2007/01-01-2008
JOB ALL OPERATIONS
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated
This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer
We will also give you ^Q days advance notice should this policy be cancelled prior to its normal expiration
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policy listed herein Notwithstanding any requirement, term or condition of any contract or other document
with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance
afforded by the policy described herein is subject to all the terms exclusions, and conditions, of such policy
(7KWv
THORIZED REPRESENTATIVE^
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS
PRESIDENT
$1,000,000 PER OCCURRENCE
ENDORSEMENT #1600 - STEVE WHITE, PRESIDENT, SECRETARY, TREASURER - EXCLUDED
ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01-01-2000 IS
ATTACHED TO AND FORMS A PART OF THIS POLICY
EMPLOYER
P WHITE CONSTRUCTION, INC DBA WHITE
^/CONSTRUCT I ON
5937 DARWIN CT STE 100
CARLSBAD CA 92008
(REV 2-05)
SD
M0410
PRINTED 12-15-2006
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