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Home My WebLink About1905 CALLE BARCELONA; 200; CB042960; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Commercial/lndustriaI Permit Permit No: CB042960 U Building Inspection Request Line (760) 602-2725 Job Address: 1905 CALLE BARCELONA CBAD St: 200 Permit Type: TI Sub Type: Parcel No: 2550120400 Lot #: Valuation: $63,000.00 Construction Type: Occupancy Group: Reference #: SHELL TO OFFICE Project Title: ESCROW TRANSFERS - 2,100 SF COMM 0 Status: ISSUED NEW Applied: 07/30/2004 Plan Approved: 08/25/2004 Issued: 08/26/2004 Entered By: KMT Inspect Area: Plan Check#: Applicant: ELSA BRENNAN 7540 METRO SUITE 101 61 9-293-0234 Owner: BORDERS INC <LF> FOURTH QUARTER PROPERTIES XXX L C/ BORDERS INC 300 VILLAGE GREEN CIR SE #200 SMYRNA GA 30080 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 Recl. Water Con. Fee $404.1 1 $0.00 $262.67 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $13.23 $0.00 $0.00 ~ ~ ~~~ ~~~~~ Meter Size Add'l Recl. Water Con. Fee Meter Fee SDCWA Fee CFD Payoff Fee PFF PFF (CFD Fund) License Tax License Tax (CFD Fund) Traffic Impact Fee Traffic Impact (CFD Fund) PLUMBING TOTAL ELECTRICAL TOTAL MECHANICAL TOTAL Master Drainage Fee Sewer Fee Redev Parking Fee Additional Fees TOTAL PERMIT FEES $0.00 $0.00 $0.00 $0.00 $1,146.60 $0.00 $0.00 $0.00 $0.00 $0.00 $34.00 $35.00 $24.00 $0.00 $0.00 $0.00 $0.00 $1,919.61 Total Fees: $1,919.61 Total Payments To Date: $262.67 Balance Due: . $1,656.94 9747 08/26/54 0002 51 02 BUJLDING PLANS \/IN STORAGE -ATTACHED CGF Clearance: k NOTICE: Please take NOflCE that approval of your project includes the 'Im&sition"(of fees, dedications, reservations, or other exactions hereafter collectively referred to as "feedexactions." You have 90 days from the date this permit was issued to protest imposition of these feeslexactions. 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. 1656 94 FOR OFFICE USE ONLY PLAN CHECK NOW&?@ EST. VAL. k ?)'m/ - Plan Ck. Deposit .b'7 Validated By- Date A? Name Address City Statelzip Telephone # (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, 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 ava--+inn An** ~iinl=+inn rl Car+inn 7n31 E hxr =-I# =.nnlirrn+ 4n-L na.mi+ ri*hiar+r +ha =.nnlicsn+ tn rn ~i.iil nan.l+.r n4 nnt --.a th-m li.,a hainrlrarl ArtI*.e rCEnnl\ I have and will maintain a certificate of consent to self-insure for uyorkers' compensation as provided by Section 3700 of the Labor Code, for the performance I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is / Expiration Date 5 ' / '05 e of the work for which this permit is issued, I shall not employ any person in any manner so as 0 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 (Sac. 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). 0 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). 0 1. 2. 3. I am exempt under Section I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES I (have I have not) signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction (include name I address I phone number I contractors license number): Business and Professions Code for this reason: UNO ~_____ ~~ ~_____ 4. number I contractors license number): 5. of work): 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 I address I phone I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name I address I phone number I type PROPERTY OWNER SIGNATURE DATE BUlLDlNB PERMIT8 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? 0 YES 0 NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 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 REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 0 YES 0 NO DING A I 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). LENDER'S NAME LENDER'S ADDRESS TC 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, 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 5'0" 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 i at any time after the work i APPLICANT'S SIGNATURE DATE City of Carlsbad Final Building lnsuection Dept: Building Engineering Planning CMWD St Lite Plan Check #: Permit #: CB042960 Project Name: ESCROW TRANSFERS - 2,100 SF SHELL TO OFFICE Address: 1905 CALLE BARCELONA #200 Contact Person: ED Phone: 951 7805572 Sewer Dist: LC Water Dist: 0 Lot: I FIre Date: Permit Type: Sub Type: 0 04/07/2005 TI COMM .......................................................................................................................................................... E;ected: f/z7./& Approved: A- Disapproved: Inspected Date By: Inspected: Approved: Disapproved: Inspected Date By: Inspected: Approved: Disapproved: Comments: ........................................................................................................................................................... City of Carlsbad Bldg Inspection Request For: 04/18/2005 Permit# CB042960 Inspector Assignment: PS Title: ESCROW TRANSFERS - 2,100 SF Description: SHELL TO OFFICE Type: TI Job Address: 1905 CALLE BARCELONA Suite: 200 Lot 0 Location: Phone: 9517805572 Inspector: !2z OWNER BORDERS INC <LF> FOURTH QUARTER PROPERTIES XXX L Owner: Remarks: DIDN’T STATE TYPE OF INSP Total Time: CD Description 19 Final Structural Requested By: ED Entered By: KAREN KOmment Y 29 Final Plumbing 7 39 Final Electrical r 49 Final Mechanical Associated PCRs/CVs PCR05012 ISSUED ESCROW TRANSFER-ADD A/C UNF, ON ROOF Date 0411 2/2005 0411 a2005 0411 2/2005 0411 a2005 04/07/2005 03/31 12005 03/21 12005 02/22/2005 02/17/2005 02/17/2005 02/15/2005 02/15/2005 02/07/2005 02/07/2005 InsDection Historv Description 19 Final Structural 29 Final Plumbing 39 Final Electrical 49 Final Mechanical 89 Final Combo 84 Rough Combo 44 RougtdDuctsIDampers 17 Interior LatWDrywall 14 Frame/SteellBoltingNVelding 44 RougtdDucts/Dampers 16 Insulation 24 RoughKopout 14 Frame/Steel/Bolting/Welding 34 Rough Electric Act lnsp Comments PA PS OK TO MOVE DESKS IN NR PS PA PS PA PS CA PS BYED AP PS T-BAR AP PS AP PD PA PS OK TO D.W. SOFFIT NR PS AP PS AP PS AP PS WALLSONLY AP PS INFORMED SUPER ABOUT NO DUCTS, PIPING, CONDUIT ON ROOF EsGil Corporation In !Partnership with Sjouernmcnt for BuiGfing Safety DATE: 8/24/04 JURISDICTION: Carlsbad PLAN CHECK NO.: 04-2960 0 APPLICANT 0 PLANREVIEWER 0 FILE Gu= SET: I1 PROJECT ADDRESS: 1905 Calle Barcelona PROJECT NAME: Escrows Transfers Office TI The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction’s building codes. 0 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. 0 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. 0 The applicant’s copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. 0 The applicant’s copy of the check list has been sent to: Esgil Corporation staff did not advise the applicant that the plan check has been completed. 0 Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Date contacted: (by: 1 Mail Telephone Fax In Person 0 REMARKS: Telephone #: Fax #: By: Chuck Mendenhall Enclosures: Esgil Corporation 0 GA 0 MB 0 EJ [7 PC 811 8/04 trnsrntl.dot EsGil Corporation rn In 2artmrship With Gowtmment for Building Safety DATE: 8/13/04 JURISDICTION: Carlsbad b PLAN CHECK NO.: 04-2960 2EY 0 PLAN REVIEWER 0 FILE SET I PROJECT ADDRESS: 1905 Calle Barcelona PROJECT NAME: Escrows Transfers Office TI The plans transmitted herewith have been corrected where necessary and substantially comply 0 The plans transmitted herewith will substantially comply with the jurisdiction’s building codes 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. 0 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: Elsa Brennan- R & A 7540 Metropolitan Dr., Suite 101 San Diego, CA 921 08 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: Elsa Brennan Telephone #: (61 9) 293-0234 Date contacted: f- /34 (by: (&w) F~x #: (619) 293-0484 Mail Telephoned Fax/ In Person 0 REMARKS: By: Chuck Mendenhall Enclosures: Esgil Corporation 0 GA 0 MB 0 EJ 0 PC 8/3/04 tmsmtl.dot 9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858) 560-1468 + Fax (858) 560-1576 Carlsbad 04-2960 8/13/04 PLAN REVIEW CORRECTION LIST TENANT IMPROVEMENTS PLAN CHECK NO.: 04-2960 OCCUPANCY: B TYPE OF CONSTRUCTION: V N ALLOWABLE FLOOR AREA: no change SPRINKLERS?: Yes REMARKS: DATE PLANS RECEIVED BY JURED l CTl ON : DATE INITIAL PLAN REVIEW COMPLETED: 8/13/04 JURISDICTION: Carlsbad USE: office ACTUAL AREA: 2496 TI Only STORIES: no change HEIGHT: no change OCCUPANT LOAD: 24 DATE PLANS RECEIVED BY ESGIL CORPORATION: 8/3/04 PLAN REVIEWER: Chuck Mendenhall 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 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, Le., plan sheet number, specification section. etc. Be sure to enclose the marked UP list when you submit the revised plans. TENANT IMPROVEMENTS WITHOUT SPECIFIC ENERGY DATA OR POLICY SUPPLEMENTS (1997UBC) tifonv.dot Carlsbad 04-2960 8/13/04 Please make all corrections on the original tracings, as requested in the correction list. Submit three sets of plans for commercial/industriaI 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 921 23, (858) 560-1 468. 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. The floor plan shows that there are windows and doors on 3 exterior walls. See A-1 . However, the site plan on sheet TS-2 shows only 2 exterior walls. Please clarify the location of this TI within the existing building. 2. Energy form LTG-1 found on sheet E-3 must be signed by the principal lighting designer and documentation author. 3. The section view of all new interior partitions shown in 2/D-1 shows braces at the top of the wall at 8’-09’ OC. To comply with the UBC Section 161 1.5, the braces may not exceed 6’-0 OC (top track span of 6 ft) DISABLED ACCESS REVIEW LIST DEPARTMENT OF STATE ARCHITECT TITLE 24 e REMODELS, ADDITIONS AND REPAIRS a When alterations, structural repairs or modifications or additions are made to an existing building, that building, or portion of the building affected, is required to comply with all of the requirements for new buildings, per Section 11348.2. These requirements apply as follows: a) b) The area of specific alteration, repair or addition must comply as “new” construction. A primary entrance to the building and the primary path of travel to the altered area, must be shown to comply with all accessibility features. Carlsbad 04-2960 ' 8/13/04 c) Existing sanitary facilities that serve the remodeled area must be shown to comply with all accessibility features. 4. Show on the plans the location of the disabled accessible rest room serving this tenant. Provide notes and dimensional details on the plans to show compliance with the CBC for disabled access. a COUNTERS 5. The tops of counters shall be 28 to 34" from the floor. The disabled accessible section of counter shall be located at a section of counter that is at least 36 long and no more than 28 to 34 high. Section 1122B.4. To speed up the review process, note on this list (or a copy) where each correction item has been addressed, Le., plan sheet, note or detail number, calculation page, etc. The jurisdiction has contracted with Esgil Corporation located at 9320 Chesapeake Drive, Suite 208, San Diego, California 921 23; 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 Chuck Mendenhall at Esgil Corporation. Thank you. Carlsbad 042960 8/13/04 Plan Check Fee by Ordinance JURIS D l CTl ON : Carlsbad 7 VALUATION AND PLAN CHECK FEE PLAN CHECK NO.: 04-2960 DATE: 8/13/04 PREPARED BY: Chuck Mendenhall BUILDING ADDRESS: 1905 Calle Barcelona BUILDING OCCUPANCY: B TYPE OF CONSTRUCTION: V N t I Jurisdiction Code Icb By Ordinance Bldg. Permit Fee by Ordinance I I 7 Type of Review: Complete Review 0 Structural Only 0 Repetitive Fee ZEI Repeats 0 Other 0 Hourly 1-1 Hour * Esgil Plan Review Fee I $395.1 1 I $256.821 $221.261 Comments: Sheet 1 of 1 rnacvalue.doc PLANNING/ENGINEERINC APPROVALS PERMIT NUMBER CB p4 -25?@0 DATE 08- 0 2- o-”l RESIDENTIAL NANT IMPRO RESIDENTIAL ADDITION MINOR PLAZA CAMINO REAL * (< $10,000.00~ CARLSBAD COMPANY STORES VILLAGE FAIRE COMPLETE OFFICE BUILDING OTHER PLANNER DATE O$ - 0 2- - @-y ENGINEER Oocs/MISfannYPlanning Engineering Approvats Carlsbad Fire Department 042960 1635 Faraday .Ave. , Carlsbad, CA 92008 Fire Prevention (760) 602-4660 Plan Review Requirements Category: Building Plan Date of Report: 08/19/2004 Reviewed by: &g Name: Rague & Associates Address: 7540 Metropolitan Dr. Suite 101 City, State: San Diego CA 92108 Job#: 042960 Plan Checker: Job Name: Escrow Transfers Bldg #: CB042960 05- Job Address: 19pCalle Barcelona Ste. or Bldg. No. 200 0 Approved The item you have submitted for review has been approved. The approval is based on plans, information and / or specifications provided in your submittal; therefore any changes to these items after this date, including field modifications, must be reviewed by this office to insure continued conformance with applicable codes and standards. Please review carefully all comments attached as failure to comply with instructions in this report can result in suspension of permit to construct or install improvements. Approved Subject to The item you have submitted for review has been approved subject to the attached conditions. The approval is based on plans, information and/or specifications provided in your submittal. Please review carefully all comments attached, as failure to comply with instructions in this report can result in suspension of permit to construct or install improvements. Please resubmit to this office the necessary plans and / or specifications required to indicate compliance with applicable codes and standards. 0 Incomplete The item you have submitted for review is incomplete. At this time, this office cannot adequately conduct a review to determine compliance with the applicable codes and / or standards. Please review carefully all comments attached. Please resubmit the necessary plans and / or specifications to this office for review and approval. Review 1 st 2nd 3rd Other Agency ID FD Job # 042960 FD File # Carlsbad Fire Department 042960 1635 Faraday Ave. Fire Prevention Carlsbad, CA 92008 (760) 602-4660 Plan Review Reviewed by: Name: Rague & Associates Address: 7540 Metropolitan Dr. Suite 101 City, State: San Diego CA 92108 Plan Checker: 042960 Job Name: Escrow Transfers Job Address: 1923 Calle Barcelona Ste. or Bldg. No. 200 Review requirements carefully, these changes are necessary, resubmittal is not necessary as these changes will be field verified. Requirements Category: Building Plan Requirement: Pending 05.21 Exit Doors Exit doors shall be of the pivoted type or side hinged swinging type. Exit doors shall swing in the direction of exit travel when serving an occupant load of 50 or more. Special Doors - Revolving, sliding and overhead doors shall not be used as required exits. Power-operated doors complying with UBC Standard 7-8 may be used for exit purposes. Additional Doors - When additional doors are provided for egress purposes, they shall conform to all the provisions of UBC Chapter 10. See item 32 for specific requirements for your exit doors. Exit doors if other than shell are installed, manual flush bolts shall not be permitted. Requirement: Pending 05.22 Exit Door Hardware Exit doors shall be openable from the inside without the use of a key or any special knowledge or effort. Exception: In group B occupancies, key locking hardware may be used on the Main Exit when the main exit consists of a single door or pair of doors if there is a readily visible, durable sign on or ' adjacent to the door stating, "This door to remain unlocked during business hours." For State Fire Marshal, sign shall read, "This door to remain unlocked whenever the building is occupied." See item 32 for additional exit door hardware requirements. Builders thumb turn dead-bolt lock on front entrance shall be required to be replaced with 'Doublecylinder' deadbolt lockset. Requirement: Pending 05.25 Exit Signs Section 101 3.1 Where Required. When two or more exits from a story are required by Section 1013.4, exit signs shall be installed at stair enclosure doors, horizontal exits and other required exits from the story. When two or more exits are required from a room or area, exit signs shall be installed at the required exits from the room or area and where otherwise necessary to clearly indicate the direction of egress. need not be signed when approved by the building official. EXCEPTIONS: 1. Main exterior exit doors which obviously and clearly are identifiable as exits 2. Group R, Division 3, and individual units of Group R, Division 1 Occupancies. 3. Exits from rooms or areas with an occupant load of less than 50 when located within a Group I, Division 1.1, 1.2 or 2 occupancy or a Group E, Division 3 Day-care occupancy. Illumination: Signs shall be internally or externally illuminated by two electric lamps or shall be of an approved self-luminous type. Power Supply: Current supply to one of the lamps for exit signs shall be provided by the premises' wiring system. Power to the other lamp shall be from storage batteries or an on-site generator set. Add EXIT sign in hallway at end towards front entrance visible from rear offices. I Page 1 0811 9/04 e City of Carlsbad 01 -27-20b5 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: Applicant: ELSA BRENNAN STE 101 1635 Faraday Av Carlsbad, CA 92008 b Plan Check Revision Permit No:PCR05012 Building Inspection Request Line (760) 602-2725 1905 CALLE BARCELONA CBAD St: 200 PCR Status: ISSUED 25501 20400 Lot #: 0 Applied: 01/24/2005 $0.00 Construction Type: NEW Entered By: RMA Plan Approved: 01/27/2005 Issued: 01/27/2005 ESCROW TRANSFER-ADD A/C UNIT ON ROOF Inspect Area: Owner: BORDERS INC <LF> FOURTH QUARTER PROPERTIES XXX L C/ BORDERS INC 300 VILLAGE GREEN CIR SE #200 7540 METROPOLITAN DR 92108 SMYRNA GA 30080 61 9 293-0234 Plan Check Revision Fee $0.00 Additional Fees $0.00 Total Fees: $0.00 Total Payments To Date: $0.00 Balance Due: $0.00 FINAL APPROVAL I Inspector: Date: Clearance: NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "feesiexactions." You have 90 days from the date this permit was issued to protest imposition of these feesiexactions. 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 right to protest the specified feesiexactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or selvice fees in connection with this project. NOR DOES IT APPLY to any feesiexactions of which vou have Dreviouslv been atven a NOTICE similar to this, or as to which the statute of limitations has Dreviouslv othewise exDired. PERMIT CITY OF APPLICATION CARL'SBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO. 0 Yw2, EST. VAL. Date 1. PROJECT INFORMATION Addreks (include BldglSuite #) CA?-Lf?z /~Od+- Jrn7 / 909- Business Name (at this address) Legal Description Lot No. Subdivision NamelNumber Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use Proposed Use #of Stories # of Bedrooms # of Bathrooms PPLICANT 0 Contractor 0 Agent for Contractor 0 Own fescrJt;x &b SO. FT. #of Stories # of Bedrooms # of Bathrooms 2. C NTAGT PER ON (if different from applicant) n PI city State/Zip Telephone # Name Address OWNER Name Address city Statelzip Telephone # (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, commending with Section 7000 of Division 3 of the Business and Professions Codel 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 [$5001). Name Address City Statelzip Telephone # State License # License Class City Business License # Designer Name Ahress city State/Zip Telephone State License # NTRACTOR - COMPANY NAME RK co ereby affirm under penalty of perjury one of the following declarations: 0 of the work for which this permit is issued. 0 issued. My worker's compensation insurance carrier and policy number are: Insurance Company Policy No. Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS) 0 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, end 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 as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE DATE 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 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). 0 1, 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). 0 1. 2. 3. 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 I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is NE I am exempt under Section I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES I (have I have not) signed an application for a building permit for the proposed work I have contracted with the following person (firm) to provide the proposed construction (include name I address I phone number I contractors license number): Business and Professions Code for this reason: UNO 4. number I contractors license number): 5. of work): PROPERTY OWNER SIGNATURE DATE 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 I address I phone I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name I address I phone number I type IS SECTION FOR NON-R&SlDENTIAL 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? YES 0 NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district7 Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 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 R 8 TlON LENDING AGENCY I 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). 0 YES 0 NO 0 YES 0 NO OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. ER'S NAME LENDER'S ADDRESS APPLICANT 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 Citv 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, 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 5'0" 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 authorize 1 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 tin after the work is comme APPLICA T'S SIGNATURE +?/k ?& - d for a period o 180 days (Section 106 4 4 Uniform Building Code). DATE WHITE: File YELLOW: Applicant PINK. Finance