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Home My WebLink About1945 CAMINO VIDA ROBLE; K; CB972914; PermitBUILDINGPERMIT Permit No: CB972914 10/08/97 12:27 Project No: A9703713 Page 1 of 1 Development No: Job Address: 1945 CAMINO VIDA ROBLE Suite: K Permit Type: COMMERCIAL TENANT IMPROVEMENT <W2B 10/06/97 0001 01 02 Parcel No: 212-092-17-00 Lot#: C-fHHT IflS-OO Valuation: 7,800 Construction Type: NEW Occupancy Group: Reference*: Status: ISSUED Description: CTI 300 SF, ' Applied: 10/03/97 : Apr/Issue: 10/08/97 Entered By: JM Appl/Ownr : WILLIAM HAWKINS 760 438-4021 2206 PLAZA BONITA CARLSBAD, CA 92008 _^^^_^ *** Fees Required *** .^^tf^^^^^^toftfi. Collected & Credits *** Fees: Adjustments: Total Fees: Fee description Building Permit Plan Check Strong Motion Fee * BUILDING TOTAL Enter "Y" for PI Enter "Y" for Elec Enter "Y" for Remo * ELECTRICAL TOTAL Enter 'Y' for Mechari 185 .00 .00 185.00 Ext fee Data 99.00 64.00 2.00 165.00 N 10.00 Y 10.00 Y 20.00 N CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL.~ Plan Ck. Deposit Validated By Date tieyxr Address (include Bldg/Suite #)r* /, />~> fcc^i^c rs.Business Name {at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel #Existing Use ft & /-I Proposed Use Description of Work SO. FT. $AM& V? ^.«, ,5- f?..£,f,,£. #of Stories # of Bedrooms # of Bathrooms Name Address City State/Zip Telephone #Fax # Address City State/Zip Telephone # Name Address City State/Zip 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 basts 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 14500]). Name ' ' ' Address State License # / "? 0 2. / <? License Class & y Dt=f/6s/ Designer 'Name Address State License # mK^mmtimMmimftoH City State/Zip / Telephoife */' / City Business License # rv/Qtfl //-CX3 "T/7,/ City State/Zip Telephone Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: (~1 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. Q 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. Expiration Date (THIS, SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) [3 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($ 100,000), In addition to the/jpst of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE [A}4SC(L^' <^7 ^ff^O^r^^t DATE " "~ I hereby affirm that I am exempt from the Contractor's License Law for the following reason: n 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). Q 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). O I am exempt under Section Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. Q YES QNO 2. I (have / have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction {include name / address / phone number / contractors license number): 4. 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 / address / phone number / contractors license number): 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work): PROPERTY OWNER SIGNATURE DATE NO 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? Q YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? CI YES Q 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. 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 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 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 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE /o- 3-17 WHITE: File YELLOW: Applicant PINK: Finance DEPT: BUILDIKG FINAL BUILDING INSPECTION ENGINEERING FIRE PLANNING U/M PLAN CHECK*: CB972914 PERMIT*: CB972914 PROJECT NAME: CTI 300 SF, WATER DATE: 11/06/97 PERMIT TYPE: CTI ADDRESS: 1945 CAMINO VIDA ROBLE SUITE* K CONTACT PERSON/PHONE*: C/WILLIAM/929-0015 AM PLEASE SEWER DIST: CA WATER DIST: CA INSPECTED BY: I/^. INSPECTED BY: INSPECTED BY: DATE INSPECTED: DATE INSPECTED: DATE INSPECTED: APPROVED APPROVED APPROVED DISAPPROVED DISAPPROVED DISAPPROVED COMMENTS: PERMIT* CB972914 DESCRIPTION: CTI 300 SF, CITY OF CARLSBAD INSPECTION REQUEST FOR 11/06/97 TYPE: CTI JOB ADDRESS: 1945 CAMINO VIDA ROBLE APPLICANT: WILLIAM HAWKINS CONTRACTOR: OWNER: REMARKS: C/WILLIAM/929-0015 AM PLEASE SPECIAL INSTRUCT: PHONE: PHONE: PHONE: INSPECTOR AREA PD PLANCK* CB972914 OCC GRP CONSTR. TYPE NEW STE: K LOT: 760 438-4021 INSPECTO TOTAL TIME: CD LVL DESCRIPTION 19 29 39 49 ACT COMMENTS ST Final Structural PL Final Plumbing EL Final Electrical ME Final Mechanical ***** INSPECTION HISTORY ***** DATE DESCRIPTION 102497 Rough Combo 101597 Rough Combo 101097 Interior Lath/Drywall 100997 Frame/Steel/Bolting/Welding 100997 Rough Electric ACT INSP AP PD AP PD PD PD AP AP AP PD COMMENTS CEILING WALLS