The URL can be used to link to this page

Home My WebLink About1923 CALLE BARCELONA; 140; CB041212; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Building Inspection Request Line (760) 602-2725 04-08-2004 Sign Permit Permit No: CB041212 Job Address: Permit Type: SIGN Status: ISSUED Parcel No: Lot #: 0 Applied: 04/08/2004 Valuation: $3,800.00 Construction Type: NEW Entered By: RMA Reference #: Plan Approved: 04/08/2004 Issued: 04/08/2004 1923 CALLE BARCELONA CBAD St: 140 .- .. . Project Title: ANNE TAYLOR-3 SIGNS (1 ILLUM) Inspect A@&? .;+~c$,,TG~ s~~.? ..-.. 'i. n: a:. ..)A I i Applicant : AMERICAN NEONICS 5542 SATSUMA NORTH HOLLYWOOD, CA 91601 213-875-1815 Owner: Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Electrical Fee Renewal Fee Add'l Renewal Fee Other Building Fee Additional Fees TOTAL PERMIT FEES $53.49 $0.00 $34.77 $0.00 $20.00 $0.00 $0.00 $0.00 $0.00 $108.26 Total Fees: $108.26 Total Payments To Date: $0.00 Balance Due: $1 08.26 PERMIT APPLICATION PLAN CHECK NO. CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 Legal Description Lot No. Subdivision NameINumber Unit No. Phase No. Total # of units sessor's Parcel # Proposed Use . \ch) Description ofdZlork I' #of Stories # of Bedrooms # of Bathrooms Name Address city Statelzip Telephone # Fax # (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 Code1 or that he is exempt therefrom, and the basis for the alleged five hundred dollars [$50011. &\? qg203/6 Telephone # Statelzip Name State License # S ?. 0 \8\ License Class City Business License # Designer Name Address City Statelzip Telephone State License # 0 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 of the work for which this permit IS Issued. @ 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 issued. My worker's compensation insurance carrier and policy number are: Insurance Company Policy NO^ $0 82 e\ -2-3 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS lClOOl OR LESS1 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, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (~~OO,qbpl.@t@dition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. Expiration Date / a 0 1 c) y SIGNATURE \-' \-- DATE $ - 3. OY Ed;B 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 am exempt under Section I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ON0 I (have I have not1 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: ~_______ 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 Thl 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 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 0 YES DIN I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Code). LENDERS NAME LENDER'S ADDRESS I certify that I have reed 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 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 time after the work is commence 106.4.4 Uniform Building Code). APPLICAN SIGNATURE DATE 4 - .oy WHITE: File YELLOW: Applicant PINK: Finance ". . Inspection List Permit#: CB041212 Type: SIGN ANNE TAYLOR-3 SIGNS (1 ILLUM) ~~ Date Inspection Item Inspector Act Comments 04/23/2004 38 Signs PS AP FINAL Friday, April 23, 2004 Page 1 of 1 POLICYHOLDER COPY sc STATE P.O. sox 807, SAN FRANCISCO,CA 94142-0807 COMPENSATION IN SURA N CE FU N D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 12-01-2003 GROUP POLICY NUMBER: 0780889-2003 CERTIFICATE ID 12 CERTIFICATE EXPIRES: 12-01-2004 12-01-2003/12-01-2004 DEPT OF CONSUMER AFFAIRS sc LICENSE NUMBER: LIC #520181 CONTRACTORS STATE LICENSE BOARD INCEPTION DATE: 12-01-2003 P 0 BOX 26000 D.O.: sc SACRAMENTO CA This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30days' advance written notice to the employer. We will also give you 30 days' advance notice should thrs policy be cancelled prior to its normal expiration. This certificate of insurance is not an tnsurance policy and does not amend. extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any Contract or other document with respect to which this certificate of insurance may be issued or may pertain. the insurance afforded by the policies described herein is subject to all the terms, excfusions and conditions of such poticies. AUTHORIZED REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 12-01-2003 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER LEGAL NAME AMERICAN NEONICS AMERICAN NEONICS INC 11273 GOSS ST SUN VALLEY CA 91352 INC