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HomeMy WebLinkAbout1905 CALLE BARCELONA; 217; CO140023; Certificate of Occupancy03-18-2014 Permit Type: Bldg Afddress: Parcel No: City of Carlsbad 1635 Faraday Av Carlsbad.CA 92008 Certificate of Occupancy Cert of Occ#:CO140023 RECORD COPY COFO Related Bldg Permit#; CB131200 1905 CALLE BARCELONA CBAD St: 217 2550120400 Issue Date: 03/18/2014 Occupant Name: ONE LIFE DIET INC Contact Name: ASHLEE HAYNES Building Owner: T-C FORUM AT CARLSBAD LLC TIAA-CREF 4675 MACARTHUR CT #1100 NEWPORT BEACH CA 92660 Description of Use: WEIGHT LOSS CENTER Phone#: Rhone*: (760)274-6920 Phone#: I certify that this building or portion complies with the California Building Code for the 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 // / lA-/^~^ t^^A C—^ Date. FOR DEPARTMENTAL USE ONLY Date Routed Use Zone Inspected By Inspected By Inspected By Occupancy Group: B/M Date. Date Construction Type: 5B Date ->\-^ Approved Approved. Approved. Disapproved Disapproved. Disapproved. Comments: CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717/2718/2719 Fax 760-602-8558 www.carlsbadca.gov Plan Check No. Est. Value Plan Ck. Deposit Date SWPPP JOBADDRESS SUITE*/SPACE#/UN(T# CT/PROJECT # LOT# # OF UNITS # BtDROOMS # BATHROOIVIS TENAIfT BUSINESS NAME DESCRIPTION OF WORK: Indade Square Foot of Affected Areafs) OCC GROUP EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPUCE YESQ*. N0| I AIR CONDITIONING YES ONO • FIRE SPRINKLERS YES| |NO| 1 APPU' WT>IET fN/. APPUCANTNAME (Secondary Cor)tact) CITY 2i STATE ZIP PHONE PROP^SS^BN5MB^^7T^"'^<T^~'^^ CONTO FAX CONTRACTOR BUS. NAME ADDRESS . , . . ADDRESS CITY STATE ZIP PHONE ARCH/DESIGNER NAME & ADDBEpS 11 STATE UC.# STATE LU FAX ARCH/DESIGNER NAME JcADfjafe \ 1 STATE LK CLASS CITY BUS. LIC* (Seo. 7031.5 Business and Professions Code: Any aty or Counly which requires a permit to construct, aiter. imBrove, dennolish 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 ofthe Contractor's License iLaw (Chapters, commending with SecUon 7000 of Division 3 ofthe Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 ty any applicant for a permit subjects the applicant to a civil perialty of not more than five hundred dollars ($500)). Workers' Compensalion Declaration: / hereby affm underpenalty oi perjury one ofthe tallowing dedarations: BI have and will maintain a certificate of consent to self-insure for wortcers' compensation as provided by Seaion 3700 of the Latwr Code, for the performance of the wort! fcr which this pennit is issued, I have and will maintain workers' compensation, as reauired by Section 3700 of the Lalx>rCoiJe, (brtheperibimanceof the work for whicti this permit is issued. Ii(y woAeis'compensation insurance carrier and policy nuniber are: Insurance Co, Policy No. Expiratioti Date Bsection need not be compteted tf the permit is for one hundred ddlars (S100)orless. Certificate of Exemption; 1 cenSy ffist in the perfomiance of the work for which this perniit is issued, 1 shall not employ any person in any manner so as to become subject to the Workers' Ck)mpe,isation Laws of Califomia. WARNING: Failure to secure workers' compensation coverage Is unlawful, and 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 Sedion 3708 of the L^ior cods, interest and attomey's fees. JS^ CONTRACTOR SIGNATURE •AGENT DATE I hereby affinn tnat I am exempt from Contractor's License Law for fhe following reason: I I I, as owner of the propeity or my employees with wages as their sole compensalion, will do the work and the stiuctuiE is not intended or offered fOr sale (Sec, 7044, Business and Professions Oode: The Contractor's License law dnes not appiy to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, pjovided that such ifnproveinents ars 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 buiW or improve for the purpose of sale). • • I, as owner of the property, ain exclusively contrKting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's Ucense Law does not apply to an owner of property who builds or improves thereon, and conhacts for such projects with contractor(s) licensed pursuant lo the Contractor's License Law). 1 am exeinpt under Section Business and Professions Code for this reason: 1.1 personally plan lo provide the major labor and materials for constraction of the proposed propert/ improvement •Yes CUNO 2. i (have,' have not) signed an application for a building pennit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed oonsUucBon (include name address / phone / contractors' license number): 4,1 plan to prowds portions of tha work, but I have hired the Wowing person to coordinate, supenrise and provide ihe major work (include name / address / phone / contractors' Scense number): 5,1 will provide some of the v«rk, but 1 have contracted (hired) the folkwing persons to provide the work indcated (include name / address.' phone / type of work): ygS'pROPERTY OWNER SIGNATURE QAGENT DATE Is the applicant or fuhire building occupant reguired to submit a business Dian, act^ely hazaidous materials registration fomi or risk managennent and prevention program under Sectkins 25506,25533 or 25534 ot the Pi^sley-Tanner Hazanlous Substance Account Act? Yes No Is the applteant or futute building occupanl requred to obtain a pemiit from the air pollutkin control (Ssttia or air Quality management district? Yes No Is the feisty to be constricted 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 HAY NOT BE ISSUED UNLESS THE APPUCANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES ANO THE AIR POLLUTION CONTROL DISTiaCT. '-if." •i I hereby affinn that there Is a construction lending agency for the performance of the * ork 'nis p-^r-ni' is is'ii eri iSea 3097 (i) Civil Code). Lender's Nam Lender's Addres I certi^ttiatl have read the application and state thatthe above infbtmalk>n Is conect and tliattlw intone 1 heieby authorize leptesentafive of the City of Cartsbad to enter upon the above mentkmed propert/ for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARM1£SS THE CriY OF CARLSBAD AGAINST AI.1 LlABIUTIES, JUDGIVlENTS, COSTS AJMD EXPENSES WHICH mt IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMII OSHA: An OSHA permj is reguinsd for excavations over 5'0' deep and denxiition or tcnslJUiion of stiuctuiBS over 3stories in height, EXRFiATION: Every pennit issueO by the Buikiing Cfficiai under the ptovisbns of Ihis Code shall expire by limitafa and become null and void if the building or work authorized by such peimit Is not oommenced wilhin 180 days Item the date of such peimit a if the buiding orwork authorized by such permit is suspended or atiandoned at anytime afler the M)ik is oommenced fbr a period of 180 days (Section 106.4.4 UnHbmi BuikJing Oode). ^APPLICANT'S SIGNATURE DATE STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. CERTIFICATE OF OCCUPANCY | C o m in c r c i a i Projects Only Fax (760) 602-8560, Eitiail www.buildinq©carlsbadca,gov or Mall the completed fonm to City of Carisbad, Buildkig Division 1635 Faraday Avenue, Carisbad, Califomia 92008, C0#: (Office Use Only) CO ;qofc33 ADDRESS^ 1 - . .' T~ ... ^ , , STATE ^ ZIP ^ CITY ADDRESS STATE Carlsbad CA ZIP OCCUPANT'S BUS. LIC. NO. OR [J FAX TO: CONTACT (Listed above) OR rjpAXTDif ) BUSINESS ADDRESS [^CONTRACTOR (Usted on page 1 ot application.) • ASSOCIATED CB* l"^ 1^3^)6 Q NO CHANGE IN USE/ NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION ^€5"APPUCANT'S SIGNATUR! DATE IM H