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HomeMy WebLinkAbout1949 KELLOGG AVE; MULTI-PERMIT FILE; CB052530; Permit-~ ¢1.J., ~ity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 U-07-2005 Miscellaneous Permit Permit No: CB052530 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 1949 KELLOGG AV CBAD MISC 2120920800 $0.00 DEMOLITION OF INTERIOR Subtype: OTHER Status: Lot#: 0 Applied: Entered By: Plan Approved: Issued: Inspect Area: PARTITION WALLS AND CEILING, FLOORING Applicant: Owner: ROEL CONSTRUCTION CO INC .... , • . YUEN FAMILY·TRUST 09-13-95 . -~ 3366 KURTZ ST SAN DIEGO, CA 92110 619-297-4156 Miscelaneous Fee #1 Miscelaneous F!:!e #2 Additional Fees ; ' I TOTAL PERMIT FEES Total Fees: ! I ; I I I I ' / / 19;4IU<ELI.PGG .AVE CARLSBAD .CA 92008, . \ / d \ / I \ ' , ::. ..,r -~.\ t ,-,c. .--.. .. /,, ', \DEMO-PERMIT FEE ¾_,..,.,.,~ ·~-~ / ~~~~-~~~-~---:-.~. 1,•.-::~R:~~:,_:~••=~~~~ :~~:~_.,:·~: ~ ~: ~-~~,.-: < ISSUED 07/07/2005 KG 07/07/2005 07/07/2005 . $60.00 $0.00 $0:00 $60.00 $60.00 1S52 ,v• --····-·\ i ___ ,,.., -· '' ., \'\ . 21s1 .(Jr 10710s 0002 01 CGF" Inspector:~ ! i' i' '• J .,,_.,' Clearance: ------ NQT!CE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. 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. 02 60"00 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONL V PLAN CHECK N<Cett5:2S-32) EST. VAL _________ _ Plan Ck. Deposit --~-r-------- Valida:: By w < Date Z:-1-Q5 -p-- }.. Address (include Bldg/Suite #) ~ Business Name (at this address) L.oT '-Ii/ o,; t);.eL5t3A[2 7g4c.-r ;.J_o, ~I-:'(h UM II tJo, '6 1....l 'TH<Z Ct7Y o,=. CAtel..StJ-.Al~CA Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total# of units 712-092-0~ YAcAHZ o£Ftc<=.S Ado Lff:111;-17 .A:S~&tfJL7 Existing Use Proposed Use I )( # of edrooms # of athrooms Fax# Name Address City State/Zip Telephone# x: ... ~ ... 7--~-::-····-· ... :==·~:Nc::,.:_ .... ·~,u~..o:""'· ~,::i~e1o:-:~,:'-"·~""·~::;i:·'-:-':-=:!!l!:.:.a.:-~A-:;-,;-! ... ; ... : ... : .... ~_.:-:-:~.,.:~=-= .. :.::!J~ ... :,J,:-·,2 .... ::-:-.~ .... :"-'.~-·-:-:\-f;;.,,,r:;:::l.··~.:::,~·~~D-":...LJ,~--,~ .... ;,~ ... :~-;,,'-,,;-\\i-¾-"-=-:""f,;,;~~ .,,y-t-,.~r,,.:",'. ... :0-;c~,=--=:?~~.:~-~rt; i?A'f&Lo CHea;t,..t<='.' Yue.,..1 5cl'i'r= F'Ac.,Rc ere &VD 5*-J0,£'«o CAL91t:J.I C©i) s"-1/6-1?89':? Name . Address City Statl/Zip Telephone# X ~~!~~:!:==~!'~j;\J'~~I~:i:~\!;C~o:~ty 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 exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not mo e than five ~ndr d dollars ($500)1. r -. Address City State License# _________ _ X -~-lt:iLt~iJJ}:1ji';00;~')(;{,1J;\;J;'.}<;\,';'2;;i;:';,;i);},f;1,,i{t<,iiC::t:•.··;········".'.\ ;iit:,<i•0·0··~i·i\.:I•:,0'.i .• :i\)S,,i;,:0. Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Telephone 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 ~g!Q-{ A~ CAJ Policy No. 'y./c_ 3l,7{,(-;,l 'f -O 2 Expiration Date 2. ( lc:>b ~, (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: Failwa to secure workers' compensation coverage la unlawful, and shall subject an employer to crlmlnal penalties and civil fines up to one hundred thousand dollars ($100,0!)0l,J9.llddltion t oat o ompanaatlon, damages as provided for in Section 3706 of the Labor co , in rest and attorney's fees. v.~IGNATURE -c.,_. <••iD6AJTfEi,;-;,.:;;;;~r7I;'f)-:;,;:f;,tfifjl,:--::s:-I\I .. M..M :·, I hereby affirm th 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 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(sl licensed pursuant to the Contractor's License Law). 0 I am exempt under Section ______ Business and Professions Coda for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO 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): ________________________________________________________ _ 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 Act7 0 YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O 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. i1i:tilJ!IMll"JW.Pli:Otf:~JNR~~r,a0si:~11~;1;1,;,~:··0:;:t,!t%:,l>.;1;;:~;.iH .•••:+'.,;~'#i:',,iif.{:··. ·· I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(il Civil Code). LENDER'S NAME _____________ _ 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 Citt 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 i authori~ed by such permit !s 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 1s commenced for eriod 180 d · 4.4 Uniform Building Code). _ / APPLICANT'S SIGNATURE -7.~c:._7".-e=:....=~~7'"..t!!:;._.:s;;,.__=_..,...L_________ DATE -zl.7/o~ -, ,.,..~+----- PINK: Finance B tJ I L D I N G 10/29/96 13:15 Page 1 6f 1 Job Address: 1949 KELLOGG AV Permit Type~ SIGN Par'cel No: 212-092-08-00 Valuation: 2,000 .occupancy Group: Description: ONE WALL SIGN Appl/Ownr INTERGRA1'ED SIGN 1160 PIONEER WAY POWAY, CA.·, 92020 Suite: Lot#: Reference#: 619 CITY OF CARLSBAD Permit No: CB962085 ··Project No~ A960296·o Development No: Construction Type: VN ·status: ISSUED Applied: 10/29/96 .Apr/Issue: 10/29/96 Enter~d 'Byi .MDP 57,9-222 9 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 43$-1J61 ·,, PERMIT# CB962085 DESCRIPTION: ONE WALL SIGN TYPE: SIGN CITY OF CARLSBAD INSPECTION REQUEST FOR 11/27/96 STE: INSPECTOR AREA PLANCK# CB962085 OCC GRP CONSTR. TYPE VN LOT: JOB ADDRESS: 1949 KELLOGG AV APPLICANT: INTERGRATED SIGN CONTRACTOR: PHONE: 619 579-2229 PHONE: OWNER: REMARKS: MW/URRY/579-2229 SPECIAL INSTRUCT: TOTAL TIME: --RELATED PERMITS-- en LVL DE'SCRIPTION 38 EL Signs PERMIT# CB951811 SE950139 AS960058 FAD96029 RW960089 TYPE INDUST swow ASTI FADD ROW PHONE: INSPECTOR --~-,, -__,,,,_ __ , _____ _ STATUS ISSUED ISSUED ISSUED ISSUED ISSUED ----------------------------------------------------'-------------------__ . ' _, -· --------------------- ***** INSPECTION HISTORY***** DATE DESCRIPTION ACT INSP COMMENTS PERMIT APPUCATION City of Carlsl::!ad Building Department PIAN CHECK No. y b ,c:_(:) r r 2075 Las Palnias Dr., Carlsbad, CA 92009 (619) 438-1161 FSf. VAL.___ __________ _ , I. PERMIT TYPE PLAN CK DEPOSIT _______ _ VAI,lD.BY ___________ _ From Ljst i (see back) give code of Permit-Type:---~---------- DATE;__ ___________ _ For Residential Projects Only: From Llst 2 (see back) give Code of Structure-Type:------------.---------- Net Loss/Gain of Dwelling Units---------------,----- 2. PROJF.Cf INFORMATION FOR OFFICE USE ONLY Address l i'-\"\ t(GWG;G:-Pr\/~ Nearest Cross Street Buildmg or SUJte No. · LEGAL DESCRIPTION Lot No. Subd1vmon Name/Number Umt No. Phase No. cHECI{ BEIDW IF S0BMI'l'1'Eb: IJ 2 Energy Cales a 2 Structural Cales IJ i Soils Report IJ 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK SQ. Ff. # OF STORIES # OF BEDROOMS # OF I!ATHROOMS. ;{. c;:oN IACI PERSON (it different from apphcanO NAME (last.name first) ADDRESS , CI1Y STATE ZIP CODE DAY TELEPHONE '4. APPLICANT UCONTHAC"lUH. f!GEN'I'FOR CON'rMCIOR DOWNER , OAGENi FOR OWNER NAME (last name first) ~l't-t Pr,.I ~ ~~ ADDRESS l\ l,o O PJQ,Je,...,l-, (J,)f;---( CI1Y \8-~.I\J STATE ~ ZIP CODE ~1,Q"Z-(} DAY TELEPHONE Ce [ °i s. PRbP£R1Y o NAME (last name first) P OM J,..J 1G° p~~ ADDRESS Cl1Y STATE ZIP CODE DAY TELEPHONE 6. ooN'l'RAclUR NAME (last name first) }1'{1\:,-1,,a~ -:S.t&N A~K .. ADDRESS \ \l_qQ P10.1.J\~ 1,Jpr-(' CI1Y ~ C~Al STATE CA ZIP CODE c:rz.ow DAYTELEPHONE 57, ,..z,.2,7--i sTATE Lic. # ~Yo~ LICENSE cIASs e--10 I'+ r cI1Y BusmEss Lic. # "?a ~ t l{ ast name 1rst CI1Y STATE ZIP CODE DAY TELEPHONE STATE LIC. # 1. WORKERS' CDMPENSATION Workers' Compensation D'eclarauon: I hereby affirm that I have a ceruhcate of consent to self-msure issued by the Director of 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). POLICY NO. Cl.\2,'2,I i~EXPIRATIQN DATE a·-lO·-,.. J SIGNATURE DATE s. oWNE1t-B0Jtrnm. bEcl.AllATION . Owner-Bmlder Declarauon: I hereby amrm that I am exempt from the ContractoPs License~ Law for the followmg reason: IJ 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 Llcense 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.). D I, as owner of the property, am exclusively contracting with license9 contractors to construct the project (Sec, 7044, Business and Professions Code: The Contractor's Llcense 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 Llcehse 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 apy 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 therefro~, 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]). SIGNATIJRE DATE COMPLETE THIS s'Ec11oN PoR NON-RESIDEN'11AL 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 Ac~qunt Act? IJ YES ONO Is the applicant or future building occupant required to obtain a ,permit from the air pollution control district or air quality management district? IJ YES IJ NO Is the facility to be constructed within 1,000 feet of·the outer boundary of a school site? IJ YES IJ NO IF ANY OF 11m ANSWERS ARE YFS, A FINAL CERTIFICATE OF cxx::liPANCY MAY NOT BE ISSUED AFrER JULY I, 1989 UNLESS nm APPLICANT HAS MET OR IS MEETING nm REQUIREMENTS OF nm OFFICE OF EMERGENCY SERVICES AND nm Am. POILUTION OONTROL DISTIUCT. 9. CDNS!RUCl10N I.ENDING AGENCY -. , I hereby affirm that there 1s a construction lendmg agency for the performance of the work for which this pemut 1s issued (Sec 3097(1) Civil Code). LENDER'S NAME LENDER'S ADDRESS to. APPIJCAN I CER:liFtcMiON I cerufy that I have read the apphcauon·and state that the above mformatton 1s correct. I agree to comply with all City ordmances 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 10 SAVE INDEMNIFY AND KEEP HARMLESS nm CTlY OF CARISBAD AGAINST AIL LIABILITIES, JUDGMENTS, CDSTS AND EXPENSES WIIlCH MAY IN ANY WAY ACx:IUJE AGAINST SAID CITY IN OONSEQUENCE OF THE GRANTING OF TIIlS PERMIT. OSHA:· An OSHA permit is required for excavations over 5'0" deep and demolitjon or construction .of-structures over 3 stories in height. Expiration. Every permit issued by the Building Official undei; 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 comme ithin 365 ys (rom the date·of such permit or if the building or work authorized by such permit is suspended or abandoned a any time after ork is !!Om n ed for a period of 180 days (Section 303(d) Uniform Building Code).{ _ APPLICANT'S SIGNATURE .....,.,1-,----r1 < DATE: /IJ-Zq-CJ VJ BUILDING 12/21/95 12.: 44 Page 1 of 1 PERMIT Permit No:. CB950461• Project No: A9500664 Development No: Job Address: 1949 KELLOGG AV -Permit Type: INDUSTRIAL BUILDING Parcel No: 212-092-08-00 Valuation: o Suite: Lot#: Occupancy Group: B-2 Reference#: Construction Ty Stat Description: 10687 SF BUILDING-WITHDRAWN & : REPLACED W/21,964 SF BLDG-SEE CB951811 Applie • Apr/Issue: Aipl/Ownr: SMITH, KEN . 435 W. BRADLEY AVE EL CAJON, CA. 92020 *** Fees Required *** *** 619 Entered By: 444-2182 Fees Collected & Credits MOP *** --------------------------------------------Fees: Adjustments: Total Fees: Fee description 773.00 .oo 773.00 Total Credits: Total Payments: Balance Due: Units Fee/Unit .oo 773.00 .oo Ext fee Data ----------~----------------------------------------------------------------. Other > 773.00 773.00 PLNCK F * BUILDING TOTAL 773.00 • F ~h-#fBb& PERMIT APPUCATION PLAN CHECK NO. City of Carlsbad-Building Department 2075 Las Palms Dr •• Carlsbad, CA 92009 (619) 438-1161 1. PERMIT TYPE From list 1 (see back) give code of Permit-Type: ___________ _ For Residential Projects Only: From list 2 (see back) give Code of Structure-Type: _____________________ _ 1343 04/04/95 0001 01 02 Net Loss/Gain of Dwelling Units _________ ....,.. _____ ..._ __ _ C-PRMT 773a00 FOR OFFICE USE ONLY Building or suite No. mt o. CHECK BElbW IF susMl'I l'EO: D 2 Energy Cales D 2 Structural Cales D 2 Soils Report ASSESSOR'S PARCEL ·"z..._ \.IL ~ 0 et L --0 8 01 Addressed Envelope DESCRIPTION OF WORK ) O, (;;, ~1 (/5 fJ ~w ,I ""'5 PROPOSED USE SQ. FT. # OF STORIES # OF BEDROOMS # OF BATHROOMS NAME (last name, first) Qrch. ADDRESS -465 t{J. (3r<?d}ey LJt:. CITY 8"} ~t-J STATE l-4-. ZIP CODE 9 202b DAY TELEPHONE :444-2J 8 2.. s. =EifiZt~::dirst) V ut:JJ , ((A-ye,' Qhlli~J4DRESS sq4-S Pa&t:u C.. t.o?ter bltd. CITY 1MJ STATE • ZIP CODE q2-,2.--, DAY TELEPHONE . ~ 5'4 -88'i NAME (last name first) l+cimann ~'o-hl.Lcit'Oh ADDRESS A~'5 w. f!Jraollttj,, CITYia uJoi0 STATE CA. ZIP CODE c,w20 DAYTELEPHONE 4L1D-t-f'42-4 STATE UC. # UCENSE CLASS CITY BUSINESS UC. # DESIGNER NAME ~~astnamehrst) Ken &_mi+h OIChitel ADDRESS ~5 w. Bra.dle.y 1_ ~~ ~J->TION sTATE • _ zIP coDE 120 zo DAY TELEPHONE 4'14-21 <c !'J. sTATE uc. # C 2'3 315 Workers' compensation Oeclaration: 1 hereby affirm that I have a certificate of consent to self-insure issued by the Director of lndustnal 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 L r ~ :-k POUCY NO. wt.,_, 1e,-ll?1~ttii?~lf DATE 1z. -o , -qs rt! 1cate o xemption: cert! at I e pe o anc o e wor or w 1c 1s permit 1s issue , s a not emp oy any person in any manner so as to become subject to the Workers' Compensation Laws of California. SIGNATURE . DATE 8. OWNER-BOllDER DECLARATION D D [] uwner-tlullcter .uectaration: I hereby afhrm that I am exempt from the Contractor's License Law for the following reason: 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.). 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 Llcense 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). 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]). SIGNATURE DATE COMPLE'I'E Tilts SECTION FOR NON-RES!DEN'11At 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? C YES ONO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? C YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? DYES ONO IF ANY OF TIIE ANSWERS ARE YFS, A FINAL CERTIFICATE OF ocx:tJPANCY MAY Nor BE~ AFfER JULY 1, 1989 UNLESS TIIE APPUCANT HAS MET OR IS MEETING TIIE RF.QUJREMENTS OF TIIE OFFICE OF EMERGENCY SERVICES AND TIIE AIR POU.UTION CDNTROL DISfRICT. 9. wNSliOCIIDN mNDING AGF:Nci' I hereby affirm that there 1s a construcuon lendmg agency for the performance of the work.for whtch this permit 1s issued (Sec 3097(1) C1VIl Code}. LENDER'S NAME LENDER'S ADDRESS to. APPl1CAN I .CERuFICA'liON I certify that 1 have read the application and state that the above information 1s correct. 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 AISO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS TIIE CflYOF CARISBAD AGAINSf All. IJABILlTIES, JUDGMENTS, CDSTS , AND EXPENSFS WIIlCH MAY IN ANY WAY ACX:J.UJE AGAJNSf SAID CflY IN CDNSEQUENCE OF TIIE 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 303(d) Uniform Building Code). APPUGANTSSIGNATURE DATE: ___ _ WHITE: File YEIJ..OW: Applicant PINK: Finance 0 / ! I I· I I I ' f ~~·I. :r __ } 0/ ~ . cQ / ! I /: 1 r f I 1 I ' i ' r l I -----~ ....