HomeMy WebLinkAbout1048 CARLSBAD VILLAGE DR; ; CB950008; PermitBUILDING PERMIT
01/03/95 13 2b
Page 1 of 1
Job Address 1048 CARLSBAD VILLAGE OR Suite:
Pern'it Type. SIGN
Parcel No: 203-320-32-00 Lot#
Valuation 8,300
Construction Type NEW
Occupancy Group Referenced:
Description: DENNY'S SIGN-REFUEBISH FACE &
: CABINETS
Permit No CB950Qu«
Project No- A9500009
Development No
0161 01/03/95 0001 01 02C-PRMT 178-00
Status ISSUED
Applied 01/03/9CJ
Apr/Issue- Oi/0J/95
Entered By RMA
Aopl/Ownr • SUPERIOR ELECTRIC ADVERTISING 800-995-9099
1700 W ANAHEIM ST . _
LONG BEACH, CA 90813 ' " •
x ** Fees Required * *,*
Fees- ^'78,00'
Adjustments- / -,.00
Total Fees: - 178'. 00' " '
' " /Fee descriDtioii • '-- ' •' -
V A A .•' Fees- Collected ix Ciedits >-A
To.tal Credits",
Total Payments:',
^ ' Balance"' Due: \
/ ' Fee/Unit
00
.00
178 00
Ext fee Data
Building Permit
Plan Check
^ SIGN TOTAL
108 00
70 00
178 00
1Q5?
CITY OF CARLSBAD
2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION
City of Carlsbad Building Department
2075 Las Palmas Dr., Carlsbad, CA 92009 <619> 438-1161
I. PLKMJT TYPE
From List 1 (see back) give code of Permit-Type *±
For Residential Proiects Only From List 2 (see back) give
Code of Structure-Type
Net Loss/Gam of Dwelling Units
PLAN CHECK NO-C&V-
EST VAL /
PLAN CK DEPOSIT.
VAUD BY/
DATE \T
2. PROJECT INFORMATION
Address l/\ 11 o
FOR OFFICE USE ONLY
or Suite No
Nearest Cross Street
LEG" AL DESCRIPTION Lot No Subdivision Name/Number Unit No Phase No
CHKJK BEloW It SUBMITTED
D 2 Energy Gales D 2 Structural Gales D 2 Soils Report D 1 Addressed Envelope
ASSESSOR'S PARCEL EXISTING USE PROPOSED USE
DESCRIPTION OF WORK
SQ FT # OF STORIES
UUNTALT PtHyJN (i[ dilterent trom applicant)
OF BEDROOMS # OF BATHROOMS
NAME (last name first)
CITY STATE
ADDRESS
ZIP CODE DAY TELEPHONE
4 AFPUCAN 1 Jfl LJUN 1 KACTOK
NAME (last name first) ^GixjE-f
Cn"YOP./3'vV-ie- "
5 PROPERTY OWNDl 1% - _
NAME (last name first)
CITY Co >u_i <fc^ o
tt^GEN 1' FOR COM'l RAU1UR
v<^ ADDRESS
STATE CO ZIP CODE ^2j
STATE C'3 • ZIP CODE
UOWNEK U AGENT FOR OWNER
C, 4 *) DAY TELEPHONE *7 9 5~ '^ J<£ 7
ADDRESS ^ y% C'^O /6 v O LA e t . -N-X yQ NJ
DAY TELEPHONE
V-AJII i n/u_. i \jn f, «- , _^
NAME (last name first) ^^p-f«.vO«^ (SCtCr /^,fi)t/' ADDRESS f^^O (Aj
CITY Z.0^\ A, «,^t\ STATE Qn ZIP CODE ^ Od"'3 DAY TELEPHONE $OO "f^S*
STATE LIC # ^") ' S"*! P LICENSE CLASS C/V^ CITY BUSINESS IJC #
NAMk tlast name lirstj ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE STATE LIC #
WORKERS' CXJMPhNSAnON
Workers'TJompensauon Declaration ITiereby aTfirm that 1 have a certificate ot consent to self-insure issued by the Director of Industrial
Relations, or a certificate of Workers' Compensation Insurance by an admitted 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 fi POLICY NO EXPIRATION DATE
Certificate or
so as to beo
.xemption I certify that in the performance ol the work tor which this permit is issued, I shall not employ any person in any manner
to the Workers' Compensation Laws of California
SIGNATUR DATE />/3/95
8 OWNER-BU BECLARATION
Owner-builder Declaration rnereby attirm mat l am exempt trom the Contractors License LawTor the following reason
n 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 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)
D 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, commencing with Section 7000 of Division 3 of die Business and Professions Code)
or that he is exempt dierefrom, 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])
SIGNATURE DATE
COMPLETE THIS "SECTION FOR NQN-RESIDENTIAL BUILDING PERMITS ONLY
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or nsk management and
prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act?
D YES HI NOIs the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
D YES D NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
D YES D NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT
HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT
9.
I hereby attirm that there is a construction lending agency tor the performance ot the work: for which this permit is issued (Sec 3097UJ Uvil Code)
LENDER'S NAME LENDER'S ADDRESS
10. APPLICANT mk'lTf RA'IIUN ~
Fcertily that 1 have read the application and state that the above intormation is correct I agree to Comply with all Oty 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 CARISBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS
AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID OTY 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 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 sucb permit is notcemmenced 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 wfie/after the work is commenced for a penod of 180 days (Section 303(d) Uniform Buildmj
APPLICANTS SIGNATURE / I ^ / / DATE
File YELLOW: Applicant PINK: Finance
DATS
PERMIT *
JOS ADDRESS
INSPECTOR
PLAWCX «
TIKZ ARRIVE:TIME LEAVE:
CO LVL DESORIPTIOM ACT COMKZ;MTS
CMU