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Home My WebLink About1901 CAMINO VIDA ROBLE; 120; CB951281; PermitBUILDING PERMI 09/18/95 11:22 Page 1 of 1 Job Address: 1901 CAMINO VIDA ROBLE Suite Permit Type: SIGN Parcel No: 212-092-20-00 Lot#: Valuation: 2,000 Occupancy Group: Reference*: Description: INSTALL NON-ILLUM. SIGN : "JOHN BURNHAM" Appl/Ownr : ULTRANEON 5458 COMPLEX STREET #40 SAN DIEGO, CA. 92123 *** Fees Required Fees: Adjustments: Total Fees: Fee description 619 T Permit No: CB951281 Project No: A9501894 Development No: 3714 09/18/95 0001 01 02 C-PRMT 74-00 Construction Type: VN Status: ISSUED Applied: 09/18/95 Apr/Issue: 09/18/95 Entered By: MDP 569-6716 Building Permit Plan Check * SIGN TOTAL llected & Credits *** .00 .00 74.00 Ext fee Data 45.00 29.00 74.00 CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMTT APPLICATION City of Carlsbad Building Department 2075 Las Palaas Dr., Carlsbad, CA 92009 (619) 438-1161 1. FEKMIT TYPE From List 1 (see back) give code of Permit-Type: For Residential Projects Only: From List 2 (see back) give Code of Structure-Type: Net Loss/Gain of Dwelling Units __^_^^^_^^^^^_ PLAN CHECK NO 2. PROJECT INFORMATION Address Nearest Cross FOR OFFICE USE ONLY Building or Suite No. Subdivision Name/Number Unit No.Phase No. CHECK BELOW IF SUBMITTED: D 2 Energy Calcs P 2 Structural Calcs D 2 Soils Report D1 Addressed Envelope ASSESSOR'S PARCEL USTING USE PROPOSED USE DESCRIPTION OF WORK SQ.FT.# OF STORIES # OF BEDROOMS # OF BATHROOMS 3. UJirracrTEHSUN (,ii aiijerem rrom applicant;NAME Oast name first)ADDRESS ATE Qfi, ZIP CODE PAY TELEPHONE ^APPLICANTKKCOPHTlAtJlUR NAME (last name first) GENT FOR CONTRACTOR v, J*.*'^ ADDRESS QTY - f S g g o. first)*t CITY STATE fl-- ZIP CODE STATE LIC. #521415 LICENSE CLASS DAY TELEPHONE CITY BUSINESS LIC. # DESIGNER NAME (last name nrstj cnv 7. WURKCK2P (JUMPENSAT1UN STATE ZIP CODE DAY TELEPHONE STATE LIC. # Workers' Compensation Declaration: I hereby attirm that I have a certificate oTconsent to self-insure issued by tne 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 on POLICY NO.EXPIRATION DATE Certificate or 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. SIGNATURE DATE 8. OWNER-BUILDER DEUAHAITUN uwner-uuuder Declaration: 1 nereoy arrirm that 1 am exempt rrom tne contractors License Law lor 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 for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who buildsor 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, die 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^) 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 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]). SIGNATURE DATE COMPLETE irtis sEciioN 1Y3U 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 Presley-Tanner Hazardous Substance Account Act? D YES D NOIs the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?a YES a NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? O YES D NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1,1999 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 9. UJHSTKUUIIUH UJHUiNG AGENCY i hereby attirm that there is a construction lending agency tor tne performance ot the work tor which uiis permit is issued (Sec 3097UJ uvii codej. LENDER'S NAME LENDER'S ADDRESS 10. APPLICANT I certify that I have read the application and state that the above information is correct. I agree to comply with ail 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 inspectionpurposes. I ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THEOTY OF CARI5BAD AGAWST ALL UABHJnES, 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 S'O" 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 365 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 for a period of 160 days (Section 303(d) Uniform BuildWCodel APPLICANTS SIGNATURE \7.,~ . \U .. V .K DATE: YL&1%& : File YELLOW: Applicant PINK: Finance