HomeMy WebLinkAbout1350 POINSETTIA LN; ; CO150039; Certificate of Occupancy05-12-2015
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Certificate of Occupancy Cert of Occ#:C0150039
Permit Type; COFO Related Bldg Permit#: CB133169
Bldg Address: 1350 POINSETTIA LN CBAD
Parcel No: 2150704900
Ht....om COPY
issue Date: 05/12/2015
Occupant Name: NORTH COAST CALVARY CHAPEL
Contact Name: JACK SHUBIN
Building Owner:
CALVARY CHAPEL NO COAST
Phone#:
Phone#: 760-929-0029
Phone#:
1330 POINSETTIA LN
CARLSBADCA 92011
Description of Use: YOUTH CENTER/ASSEMBLY CHAPEL
I certify that this building or portion complies with the California Building Code forthe group and division of
occupancy and the use for which the proposed occupancy is classified. The above information is true and
correct, and I make this statement under penalty of perjury.
Signature of Building Official ^^^^ Date 6h
Date Routed
Use Zone
FOR DEPARTMENTAL USE ONLY
Occupancy Group: A3 Construction Type: 3A
Inspected By
Inspected By
Inspected By
Date IZ-t^A*^ Z/otfS Approved
Date Approved
Date Approved
Disapproved
Disapproved
Disapproved
Comments:
1 l^OM<^l.S 7E THIS SECTION FOR N O N - R E $ I D E N T I A L BUILDINC P E R IVI I T S 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-Tannef Hazardous Substance Account Act? Yes No
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Yes No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Yes No
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPUCANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF
EMERGENCY SERVICES ANO THE AIR POLLUTION CONTROL DISTRICT,
CONSTRUCTION LENDING AGENCY
I hereby aflirm that there is a construction lending agency fbr the perfonnance of the work this pennit is issued (Sec, 3097 (i) Civil Code),
Lender's Name Lender's Address
APPLICANT CERTIFICATION
I ceitnythati have read the appllcatton and state that the abom biftamtatkm is oinect and IM
I hereby aulhofizB representative of the City of CarlstHd ID enter upon the atwve
AGAINST ALL UABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAD CfTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA pennit is required Ibr excavations over S'O'deep aid denwiition or constnx^
EXPIRATION: Bfiry pennit issued by the Building Oflicial under the ptovisions of this Code shajj^^
180 days from the date of such penni or if Ihe buMlng^vvDfk authorized by such pemiit Building Code),
ySTAPPllCANT'S SIGNATURE DATE
STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE.
Complete the following ONLY if a Certificate of Occupancy wili be requested at final inspection.
Fax (760) 602-^560, Email buildina(8)cai1sbadca,gov or Mail the completed fonn to City of Cartsbad, Building Division 163S Faraday Avenue, Carlsbad, Califbmia 92008,
C0#: (Offlca Use Only)
CONTACT NAME lUPANT NAME
ADDRESS IUILDIN6 ADDRESS
cmr STATE ZIP
^2t>l{
CITY STATE ZIP
Carlsbad CA
•PHONE FAX
OCCUPANT'S BUS. LIC. No.
DELIVERY OPTIONS
PICK UP: CONTACT (Listed above) OCCUPANT (Listed above)
CONTRACTOR (On Pg. 1)
MAILTO: (.CONTACT (Listed above) ^ OCCUPANT (Listed above)
CONTRACfOR (On Pg. 1)\
MAIL / FAX TO OTHER:
ASSOCIATED CB#-
NO CHANGE IN USE / NO CONSTRUCTION
CHANGE OF USE / NO CONSTRUCTION
NT'S SIGNATURE,
^ >
DATE