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Home My WebLink About1947 CAMINO VIDA ROBLE; 101; CB920509; PermitBUILDING PERMI 05/28/92 14:32 Page 1 of 1 Job Address: 1947 CAMINO VIDA ROBLE Suite Permit Type: MISCELLANEOUS Parcel No: Lot#: Valuation: . 0 Construction Type: NEW Occupancy Group: B2 Reference*: Description: ADD 4 ELEC CIRCUITS PER KELLEY T Permit No: CB920509 Project No: A9201325 Development No: 7836 05/28/92 0001 01 02 C-PRMT 15-00 Status: ISSUED Applied: 05/22/92 Apr/Issue: 05/28/92 Validated By: PK Appl/Ownr : KEVIN MACDONALD 4060 MORENA BLVD G-297 S.D. CA *** Fees Required *** 270-9892 cted & Credits Fees : Adjustments: Total Fees: Fee description Miscellaneous Fee * MISCELLANEOUS TO .00 .00 15.00 Ext fee Data 15.00 ELEC 15.00 * * * CITY Qfc CKRLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Palnas Dr., Carlsbad, CA 92009 (619) 438-1161 1. PERMIT TYPE A - U Commercial U New Building Ll Tenant improvement B - Q Industrial D New Building D Tenant Improvement C - D Residential D Apartment OCondo D Single Family Dwelling D Addition/Alteration D Duplex D Demolition D Relocation D Mobile Home ^B'Electrical D Plumbing D Mechanical D Pool D Spa D Retaining Wall D Solar D Other 2. PROJECT INFORMATION PLAN CHECK NO. EST.VAL PLAN CK DEPOSIT. VALID. BY DATE FOR OFFICE USE ONLY Address Nearest Cross Street siit Alr-.rtLEGAL DESCRIPTION uodivision Name/Numoer Phase No. LHbLK BtlAJW ir aUBMll Itlj: D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report 01 Addressed Envelope ASSESSOR'S PARCEL EXISTING USF.PROPOSED USE DESCRIPTION OF WORK /S&0 SQ. FT.# OF STORIES (JUN1AIL.1 NAME CITY JB+JJ in ainerem irom applicant) STATE ADDRESS ZIP CODE DAY TELEPHONE 4. AJfPLKJAN H 1 KAU 1UK LJ AUENT 1*UK UUN IKAU1UK LJUWlMfcK LJAUtJMI rUK UWNtKADDRESS CTTY 5. PROPER rt OWNER NAME /) CITY STATE G.A - ZIP CODE C^»/#f/*f *--rC<AlDDR] txxtf STATE C Jb . ZIP CODE DAY TELEPHONE NAME CITY DESIGNER NAME CITY , STATE STATE LIC. #$$£ ZIP CODE *1tl / / 7 DAY TELEPHONE ^LICENSE CLASS C - )& CITY BUSINESS LIC. # STATE ZIP CODE DAY TELEPHONE STATE LIC. # 7. WORKERS" OUMPENSAI1OW worKers u>mpensauon ueciarauon: i nereoy attirm tnat i nave a certincate ot consent to seit-insure issued by the Director ot 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 tttSi 4T POLICY NO.EXPIRATION DATE (-truncate ot txempuon: i cerury mat in the pertormance or me worn tor wmcn tnis permit is issued, i snail not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. SIGNATURE DATE B. UWNEK-UU11JJEK UtSUlAHAlUJH Uwner-Buiiaer Declaration: i Hereby artirm that I am exempt trom the Contractors License Law tor the tollowing 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 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 witt have the burden of proving that he did not build or improve for the purpose of sale.). O 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). 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])- SKNATURE DATE COMPLETE THIS SECTION FDR NON.-RES1DENT1AL 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 2S505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES ^-*JO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?a YES ^<NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES JTNO IF ANY OF THE ANSWERS ABE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSl^D AFTER JULY 1, 19W uTO£SS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I hereby attirm that tere s a construction lending agency tor e performance or the wont lor wnich this permit is issued (.sec 3097 (i) LJVII code). LENDER'S NAME LENDER'S ADDRESS _ IP. APPUCAHT mRTinCATlUti ' 1 certify that I nave read the application and state that the ai»ve information is correct. 1 agree to comply witn all city ordinances ana Mate 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 OTY OF CARLSBAD AGAINST ALLUABUJTIES, JUDGMENTS, CXKTS 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 5'0M 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 303 (d) Uniform Building Code). APPLICANTS SIGNATURE DATE: £> —. WHITE: tFile YELLOW: Applicant PINK: Finance