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Home My WebLink About1051 PALM AVE; ; CB900263; Permit• B U I L D I N G P E R M I T 02/15/90 14:01 Permit No: CB900263 Project No: A9000358 Development No: Page 1 of 1 Job Address: 1051 PALM AV Str: Fl : Ste: Permit Type: ELECTRICAL Parcel No: 205-191-02-00 Valuation: O Construction Type: NEW .,,,7a 02115/'7 A01 01 02 Q,fi-11= I w i PRHT 18-0o Occupancy Group : Class Code: Status: ISSUED 02/15/90 02/15/90 JPY Description: ELEC UPGRADE ADD 50 AMPS CONTRACTOR DENNIS ELECT. CO 1945 S. RANCHO SANTA FE RD SAN MARCOS, CA 92069 *** Fees Required *** *** Fees : Adjustments: Total Fees: Fee description 18,00 ,00 18 .00 Lie. C NO Applied Apr/Issue Validated By: 744-5989 Fees Collected & Credits *** Total Credits: Total Payment;s: Balance Due: Units Fee/Unit ,00 ,00 18.00 Ext fee Data --------------------------------------------------------------------------- Enter "Y" for Electric Issue Fee > Single Phase Per AMP > * ELECTRICAL TOTAL ($10 Minimum) 50,00 .25 5.00 Y 12.50 18.00 IN • cLEAIWIII------... -~-J CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 PERMIT APPLICATION ~ '1P City of Carlsbad Building Department EST. VAL·-----,,---------- PLAN CK DEPOSIT_/.._..%'----------- 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 4Ja-11s1 1. PERMIT TYPE ::~~D-Btff!,,;: _.q:;:s A COMMERCIAL TENANT IMPROVEMENT B O INDUSTRIAL ONEIi □TENANT IMPROVEMENT C ~RESIDENTIAL □APARTMENT □CONDO □SINGLE FAMILY DI/ELLING 0 ADDITION/ALTERATION □PLUMBING D DUPLEX D DEMOLITION D RELOCATION □MOBILE HOME □MECHAN ICAL □POOL OSPA □RETAINING IIALL 2. PROJECT INFORMATION PLAN CHECK No. Address I O~J ¥.4-LN\ A.-vTE, ~6 ~1ld ng Nearest Cross Streets ,aftiiJ; Pto Pt<=--- LEGAL DESCRIPTION Lot No. Subdivision Name/Nurber Unit Mo. Phase No. CHECK BELOII IF SU814ITTE0: D 1 Addressed Envelope 3. 4. 5. 7. 8. 02 Energy Cales 02 Structural Cales ASSESSOR'S PARCEL BLOG. SC. FTG. CONTACT PERSON NAME DE.N b-J1 S L. ~,:;:::, N. CITY ;s"'J'b'¥ M~ ~ SIGNATURE APPLICANT i6coNTRAc10R NAME /)~I$ 1.....C/),z_,;;,t{ CI TY -frlMe.o ~ PROPERTY OWNER ~A- NAME ..:,VtJ6-SA.J()~cj~ .s. CITY ~/34-0 0 2 Soi Is Report # OF STORIES STATE ~ EXISTING USE PROPOSED USE ADDRESS ZIP COOE 114-S ~-~ .s,4,vV,4---re_ /2P. 'f' 1...0 6, 1 DAY TELEPHONE 7 #-s, @; D AGENT FOR CONTRACTOR D OIINER D AGENT FOR OIINER /2A-fv44--0 s~ A£. ~ . ADDRESS /Cf 4C-S, STATE c+-ZIPCOOE 'f?.c)6 DAY TELEPHONE 74 ¢,-~ e STAIE C4- ADDRESS ZIP COOE □LESSEE □TENANT 10'-'S ,P~ ,4-v-~ 9 24?&:J t3 DAY TELEPHONE ADDRESS ZI P COOE 14 «-S". J21.r,/M-D S~Pt.£ ea . 9 '20 6 1 DAY TELEPHONE 7 44 --s-'i f3 '7" SIGNATURE ~ DESIGNER NAME CI TY STATE LICENSE CLASS C-/ CJ TITLE ADDRESS ZIP COOE CITY BUSINESS LIC. # DATE 0 DAY TELEPHONE STATE LIC. # WORKERS' COMPENSATION Workers• COfll)ensat1on Oeclarat1on: hereby affi rm that I have a cert1ficate of consent to self-insure issued by the Director of Industrial Relat1ons, or a certif icate of \.lorkers • COfll)ensat ion J nsurance by an ad'ni tted insurer, or an exact copy or duplicate thereof cert ified by the Di rector of the insurer t hereof filed with the Building Inspection Department (Section 3800, Lab. C). INSURANCE COMPANY 6 57!:-h./A,/Q POLICY NO.; /7.::,'9/1-7QxPIR~TION DATE Certificate of Ex~tion: certify that in the performance of the work for which this permit 1s issued, I shall not so as to become subject to the \lorkers• COlll)ensation Laws of California. SIGNATURE DATE OWNER-BUILDER DECLARATION Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractor•s License Law for the following reason: 0 I as owner of the property or my efrl)loyees with wages as the1r sole compensation, will do the work and the structure is not 1ntendcd 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 irrproves thereon,, and who does such work himself or through his own errployees, provided that such irrprovemcnts are not intended or offered for sale. If, however, the building or irrprovement is sold within one year of corrpletion, the owner-builder will have the burden of proving that he d1d not build or irrprove 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 irrproves thereon, and contracts for such projects with contractor(s) ti censed pursuant to the Contractor's License Law). 0 I am exenl)t 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, irrprove, 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, corrmencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is ex~t therefrom, and the basis for the alleged ex~tion. 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 THIS SECTION FOR NON-RESIDENTIAL BUI LDING 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 Presley-Tanner Hazardous Substance Account Act? DYES □No ts the applkant or future building occupant required to obtain a permit from the air pollution control district or air quality management district'? □YES O NO Is the facility to be const ructed within 1,000 feet of the outer boundary of a school site? OYES If ANY Of THE ANSWERS ARE TES. A FINAL CERTIFICATE OF OCaJPANCT MY NOT BE I SSUED AFTER JULY 1, 1989 UNLESS THE APPllCANT HAS NET OR IS MEETING THE REQUIREIIENTS OF THE OFFICE OF EMERGENCY SERVICES ANO THE AIR POLLUTION CONTROL DISTRICL 9. CONSTRUCTION LENnING AGENCY hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(i) Civil Code). LEN0ER' S NAME LENDER'S ADDRESS 10. APPLICANT'S SIGNATURE 1 certify that I have read the application and state that the above informat ion is correct. I agree to c~ly with all Ci ty ord1nances and State laws relating to build1ng construction. I hereby authorize representatives of the City of Carlsbad to enter upon the above rocnt1oncd property for inspection purposes. I ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND EXPENSES IIHICH KAY IN ANY IIAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT- El(piration. Every permit issued by the Building Official under the provisions of this Code shall expire by limitation ard become nvll and void if the building or work authorized by such pcrmi t is not corrmenced within 180 days from the date of such pcrmi t or if the bui ld1 ng or work author I zed by such pcrmi t is suspended or abandoned at any time after the work is cOfllTICnced for a period of 180 days (Section 303(d) Umform Building Code). O OIINER gGoNTRACTOR D BY PHONE APPROVED BY: _______ _ DATE: __________ _ WHITE: File YELLOW: Applicant PINK: Finance