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Home My WebLink About1964 KELLOGG AVE; MULTI-PERMIT FILE; CB102313; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 12-03-2010 Plumbing Permit Permit No: CB102313 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 1964 KELLOGG AV CBAD PLUM 2120930200 Lot#: 0 Construction Type: NEW GIA: GAS LEAK REPAIR Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 12/03/2010 JMA 12/03/2010 12/03/2010 GEMOLOGICAL INSTITUTE OF AMERICA INC GEMOLOGICAL INSTITUTE OF AMERICA INC 5345 ARMADA DR CARLSBAD CA 92008 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Drain Install/Repair Water Line Water Heater and/orVent Gas Piping System Vacuum Breaker Other Plumbing Fees Master Drainage Fee Sewer Fee Additional Fees TOTAL PERMIT FEES Total Fees: $27.00 0 0 0 0 0 1 0 5345 ARMADA DR CARLSBAD CA 92008 $20.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 Total Payments To Date: -$27.00 Balance Due: . Inspector: ~" Clearance: _____ _ $0.00 NOTICE, Please take NOTICE thai approval of yourproject includes the "Imposition" offees, 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 fo11hin 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 thaj procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that·your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or 9ther ~imilar application processing or service fees ih connection with this project. NOR DOES IT APPLY to any f es/exaction f whi o hav r vi u I n iv n N Tl E simil r o thi or as to which th statute of limitations has reviousl otherwise x ired. ·~ ·«.,~ Building. Permit Application Plan Check No. CE:>102-313 Est. Value 1635 Faraday Ave·., Carlsbad, CA 92008 ~ CITY OF 760-602-2717 / 2718 /2719 Plan Ck. Deposit CARLSBAD Fax 760-602s8558 www.carlsbad_ca.gov Date l Z ( 8 I 1n lswPPP •JOB Al)DRESS SUITE#/SPACE#/UNIT# IAPN 1964 Kellogg Avenue --- CT/PROJECT#" ILOT# I PHASE# r OF UNITS r BEDROOMS #BATHROOMS I TENANT BUSINESS NAME I CONSTR. "TYPE I occ. GROUP DESCRIPTION OF WORK: lncl!lde Square Feet of Affected'Area(s) Re-certification of repair to gas line. EXISTING USE I PROPOSED USE' rARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE IAIR CONDITIONING I FIRE SPRINKLERS YESO No[] YES ONO D YESD NOD CONTACT NAME (If Different Fom Applicant) APPLICANT NAME Craig LaBahn ADDRESS ADDRESS 5345 Armada Drive CITY STATE ZIP CITY STATE ZIP Carlsbad CA 92008 PHONE PHONE IFAX 760-603-4229 IFAX 760-603-4034 EMAIL EMAIL clabahn@gia.edu . PROPERTY OWNER NAME Gemologic;tl Institute of America, Inc. CONTRACTOR"BUS. NAME N/A ADDRESS · ADDRESS 5345 Armada Drive CITY STATE ZIP CITY STATE ZIP Carlsbad CA 92008 PHONE IFAX PHONE IFAX 760-603-4000 760-603-4034 EMAIL EMAIL N/A ARCH/DESIGNER NAME & ADDRESS I STATE LIC. #' STATELIC.# I CLASS I Cl"TY BUS. UC.# (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permJt 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 tliat 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 exempttherefrom, 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 ($500})._ . _ -~,i~-~ ·-' . ' .. ,.,.,_ ~ ' 'i\l!l'.$-O /?(CE RS COMP ENS AT I O N . .· :.· .·. :,:.-,.~.= . . ... , Workers' Compensation Declaration: / hereby affirm under penalty of petjury one of the foflowing,dec/arations: D 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 1s issued. D 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 workers' compensation insurance carrier and policy number are: Insurance Co ________________ ~---Policy No. ___________ ~--Expiration Date _________ _ This section need not be completed if the permit is for'one hundred dollars ($100) or less. D Certificate of Exemption: I certify that ih the performance of.the work for which this permit is.issued, I shall not employ any person jn 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 cost of compensation, damages as.provided for in Section 3706 of the Labor code, interest and attorney's fee?. RS CONTRACTOR SIGNATURE OAGENT DATE ~~~~~~~ll'l!""'l!l~~!ll.lJ I hereby affinn that I am exempt from Contractor's Ucense Law for the following reason: o· I, as owne, 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, Bu~iness 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. U,-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 \o ~onstruct the project (Sec. 7044: Business and Prof~ssions 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 pursuan! to the-Contractor's License Law). D I am ex~mpt 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 prop~rty improvement. OYes 0No ~-I (have/ have not) signed an applicatio~ for a building permit.for the proposed work. 3:1 have contracted with the following person (firm) to' provide the proposed consfruction (include name add,ress /'phone/ contractors' license number): 4. I plan to provide portions of.the work, but I have hired the following person to coordinate, supervise and proviqe the major work (include name/ address/ phone/ contractors' license nuinber): 5. I will provide some of the work, but I have contracted (hired) the following per~ons to provide.the work indicated (include name/ address /'phone/ type of work): .fi5 PROPE~TY OWNER SIGNATURE DATE Is the applicant or future building occupant.required to submit a business~. acutely hazard6us·materiais registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D Yes WNo · . Is the applicant or future building occupant required to obtain a ·permit from the air pollution control district or a~ality management district? 0Yes [Z] No .Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0Yes. l.!'..JNo . 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 DtSTRtCT. 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 relatingto building construction. I hereby authorize representative of the City of Cartsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLS BAD 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 permitissued by the Building Official under the provisions of this Code shall expire by limitation and become null and voicj if the building or work authorized by such permit is not commenced within 180 days from the date of such pennit or if the build' 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 Unifonn Building Code). DATE t) ,"'-1 .,. .. City of Carlsbad Bldg Inspection Request Permit# CB102313 Title: GIA: GAS LEAK REPAIR Description: For: 12/07/2010 Type:PLUM Sub Type: Job Address: .1964 KELLOGG AV Suite: Lot: o· Location: APPLICANT GEMOLOGICAL 'INSTITUTE OF AMERICA INC Owner: GEMOLOGICAL INSTITUTE OF AMERICA INC Remarks: Total Time: CD Description Act Comments Inspector Assignment: Phone: 7606034162 :nsp~roc_f!_ Requested By: ASHTON Entered By: CHRISTINE 23· Gas/Test/Repai_rs _AL [p;t, .>"llf--t /lel~vMf Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date · Description Act lnsp Comments City of Carlsbad 08-10-2017 1635 Faraday Av Carlsbad, CA Building Permit 92008 Permit No:CB973463 Buiiding Inspection Request Line (760) 602-2725 Job Address: 1964 KELLOGG AV CBAD Permit Type: MECH Sub Type: Parcel No: 21209302-00 Lot #: Valuation: $0.00 Con~t Type: NEW OccGroup: Reference #: Project Title: INSTALL 5376 SF COOLER-INSIDE EXISTING BLDG-FLOREXPO Applicant: P,. COLD 5060 EUCALYPTUS AV CHINO CA 91710 909 517-1877 Total Fees: $0.00 Owner: BACA KEN $520. 00 Payments To Date: Status: EXPIRED Applied: 11/12/1997 Entered By: RMA Appr/Issued: Inspect Area: $520.00 Balance Due: Description Fee * MECHANICAL TOTAL 520.00 PERMIT APPLICATiON ·CITY OF CARLSBAD BUILDING DEPARTMENT ".2075 Las ·,=,aimas ·or., Carlsbad CA 92009 (760) 438-l161 520-00 :1·. Legal Description· · Lot No. 'Phase· No. Total # of units A_ssessor's Parcel # ·J Przo pns-e Existing Use . 2.57b_-t • Proposed Use, Description·of Work SO. FT.-#qt Storie·s :# of Bedrooms · # of Bathriioms ' :-: ~~:~:?°~::~~,,:!-~{~'tt{1: :,~:~~??\':-~~::,-_ -~:-,'?;,::·fi~/;(:-:~:=~~:-~-tr(!',: <' e,. ·_ , .. · 'tA CfO'ta'5°"l""J,.'\81 (Sec. 7031.5 Business and Profesllions 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 pursu_ant tci 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 exen)lltjon. An vi lation of Section 7031.5 by any applicant f a pe~mit subjects the applicant to a civil penalty of !lot mer~ than five hundred doll~rs [$5001). ·. \< · · 6060 UC:~ ~ ·Ave C)lu · · qn10 (P/. 5I .. 1877 Name State L~nse # tf '-/. 0 2.'2 · S- j <. .(o \cl. . .. Designer Name State License # Address ' City State/Zip Telephq_ne # License Class I?, C; 2...__. 'City Business License # f uc.-..1¥P..\-us. -kJe... · C..~1"1° -Cb: _q..,...:n~i~o--_~qoc.i · 517 · .IB.7) City State/Zip · Telephone 60b Q Address @,_,)Y.9.BJ1iBt'.:-eo'Mtit~moL~..:...........:..~~"""'--"· ~.;.;,,_ ___ ,;.;~-· .;:.,,.,.,:.::~~>~~~2:;.;:;_;_~;::2.G~::C;';~,~ il:,~;;:-;J.:.;.:..: L.:;;2=:J Workers' Compensation Declaration: I hereby affirm under penalty of perjury one ·of the following declarations: ·· · · D 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 compensJtion insµrance carrier and policy numbe~ are: '. _ · Insurance Company CA~ (' Q 1M f?· . Policy No.W9 J 11 S: I b '1 C, , , Expi~ation Date I • \ ' q PJ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS·[$100] OR LESS)· ·D CERTIFiCATE OF EXEMPTION: I certify that ih the performance of the work for which-this permit is:issued, ·I st1all 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 cost of compensation, damages as provided .for in Section 3706, of the Labor code, interest and ·attorney's fees. SIGNATURE. ______________________________ DATE _________ _ ~.S::::~w~VJJ.IP.m..i!ij:~lia.tf!i~.::E:-: :~=.::.·:: .. ~.:: ... ''":;"::2;:,5;··:;;·2!_''.t~·::_-::::-::"::~~:::: ;~;,~;::: ','2:.~I\"',~::::J~::'..!::f!d':Z?Z.:!{:if·:,::PisJ:-::::.F~'.'.}Yif{~'LJ I hereby affirm that I am exempt from the Contractor's License Law for the following 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, howev,er, 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 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 pursuao~ to.the Contractor's License Law). · , . 0 I am exempt under Section ______ Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for con~truction of the.-proposed property_impr_ovement. ,[l YES ONO. 2. I (have / have not) signed an application for a building permit ·for the proposed work: 3. ,1 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,. supervi'se and provide the major work (include name / address / phone ·number/ contr11ctors license numberl=--------------------------------------------- 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 ~~= . PROPERTY OWNER SIGNATURE _____________________ . DATE__,,---------- ~J,_'qfi:ttlllEOl'.fQfteQit~__m~J(JitDfN<t'.fJ.i\Nlifj,A~.,~t=::::::;:_:;r{:~,:;:;;:Ji'1[;l'f;-!'..p::;;:z:~]Z~~:,!:iI.:~;,';;1':Z~:'.':i2':S~:~"¥.;'J Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration~ or risk, m;mageme_nt and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES ~O · Is the applicant or future building occupant required to obtain a permit from the air pollution-control district or air_ tjuallty m<!_nagement district? D YES ~O ·is the facility to be-constructed within 1,000 feet of the outer boundary of a school site? 0 YES )8( NO IFANY 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. . . . f.!i1:L,9PN$JlY2tt..P.w1,iwt>,a<i.A.'.§ffl~~j,_::.:·:..:.:.:::: .. ·. ~-~:, .:..:..··~ :_ :::.,:.·,-,;,,·.~· : .. :::' :.:~ ~,;,_ ,,:.. .. ,:. i.:.-~'"f::.:~·:.1:::::. ~ :<-';;.:i:ti~ .t,:;{:_:1:7t.G~::::;.~.;;z::>i:~ ,:;;t7:::;:r·;z;1 I hen;iby·affirm tl)at there is a construction lending agency for the performance of the work for which this permit·is i~sued (Sec. 3097(i)· Civil-Code). LEN'ciER'S NAME !:ENDER'S ADDRESSi::::==:::;::==:;:;::;;.::::::::::;;::;::;:::;::::;;:::;:::;:;:::;;t .. ~:;;;:::::;::;'.;::=:;,:::::;:;:;-;::::;:;:;;::::;:::;:;;:,: [a~f.PJQC~t{FQ!ffi@!P,ATJ,QN0c:..~..;;..,..;_:;-.:.,;c,;,-,,.1.;i,,,,;J,:/ ,;._ :~ ·;:.:..~::,,;,,,:~-L .. ·. '. · :::-~,) .. 0;,.~;;,.,::,_, -~·->.·---'.~~ -:;,i\;:L::ii.::v:: . .:.. : j;;:;,S:i· . ....:r:Jt.:,; ~.:.:,,~:~:;;:;Y,4.;~ I certify that f·have· read-the application and state that the ·above Information is correct and that-the information on the· plans is adcurate. I agree to comply with all City ordinances· and· State laws relating to building ·construction. I hereby, authorize representatives 6f 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 CARL:SMD · AGAINST ALL LIABILITIES, JUDGMENts; COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRIJE AGAINST SAID CITY IN CONSEQUE'NcE OF THE GRANTIN'G OF THIS PERMIT •. PINK: Finance l.~41=-)l lacJ;l .Jr• . B U I L D I N G P E R M I T 05/20/97 :16:16 f>ctgEi 1 eif 1 .Job Addrezz: 1964 KELLOGG -Permit Type: Et,ECT.RJ.C.AL Parcel Np: 213-09~-02-on Yaluation: o . Occupancy Gr<.:•ui:,: AV Descr~ption :· TEMPORARY PO\vER Suite: Lot#: · Ref er0nc1~#: POLE Project N,1: Ji.'?.7(J'c"i',;,0, Development No: c-r .... r::MT .. construction Type: i'JEN Stat.u~: ISSUED .Appl/Ownr: TEMPORARY POWER SYSTEMS I . AppliE•ti:•, C5/2C/~~7 Apr /Issu'.e-: 65/20/97 E;ntered By: Rt'1,m 619439-'1999 APPROVAL · ·DATE-f#'z CLEARANCE -~ . . -~ ~ CITY OF CARLS$AD 2075 Las Pal'mas Dt., Carlsbad, CA .92009 (619) 438-1161 PERMIT APPLICATION FOR OFFICE USE OW, PLAN CHECK NO. +_f_ CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 · EST. VAL._\,.._ ______ _ Plan Ck. Deposit---....---,----- Validated By · , f/~ Date 5/J<CZ/q -=t- Business Name (at this address) Legal Description _lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Existing Usa Proposed Use SQ. ~T. #of Stories II of Bedrooms # of Bathrooms Name Address City State/Zip Telephone# ~l'l:: pijt;>p~ "f"'•": . ·, Name Address City State/Zip Talephona II 1.&f~fcoNTRACTOR~{'c'oMPANY,NAM~?~;~~~'.TT~~:'~!';,':':: ':"::~-?,,~~:;-~~ ·~~~';';,i"!?;,;t;~r:-,'t, ?~;~·~-~~~if~~~~"";;i,'3/~':f;:'::.,.~.::-_:~,: '· (Sac. 7031.5 Busines.s and Professions Coda: 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 basis for the alleged ex~. Anx.,_viol~ of Section 7031.5 by any applicant for a per_m~ SJ:1.9jects the applicant\~ civii panplty of not mora than five J?,~dr,Pp dollars I 00J}, 7\ P ,-~ 5-'YS~:S 7P> A4 &·r. . " " ~K y;e-y e~@o_ Cf ~2-S-~t9f '5 .. Name ~ 2 :4 ::::Z • Address e-}'/' City , . , , State/Zip • _ / T~hone # State .License # '::C£:!d ~;.,,-License Class _ ~V City Business License II /,;J..;CJ / 1,:::1~ 2.- Designer Name Address City State/Zip Telephone State License II _________ _ rs:'· ·,-'WORKERS;:coMPENSA Tiolii .';':'--: ,' :.::c:_/:,t:.-1:: ;:-:;;-:· :::;,: ~."~::-:::-;::-:;;-}~~:-,~~'.::-::::t:J;E~~'/ ::;:t:':t:"'.:::::'.::::t-::.::-::=:::.:Z~lt" :~':f:'.~-":/'.:.-r:t:.: 'J:r-__;:;_''. ,.:::-,t :::-:;_· : _· -:"· ''."" '· --·· :_:: Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:. D 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. -~ have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this per issued. My worker's c pensa~ion insur~nce c rrier and policy ~um.9er,,are: , · · ·/ t/2£:1'7,.., '72 Insurance Company ~ ,.-Y Policy No. A.ff.at') r_r ~ ~ Expiration Date __ ._._,_,._,__ {THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) 0 CERTIFICATE OF EXEMPTION: I certify tt,at In the performance of the work for which this permit is issued, I shall not employ eny person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure wor~ara' com nsatlon coverage la unlawful, and ahaR 1ubject en employer to criminal penaltlaa and c;lvll fine1 up to ona hundred thousand dollars ($100 ),_ in dlt to a co1t of compenaatlon, damages H provided for in Section 3706 of the~a r,,ee~. j,ij;,,,st end attorney'• fees. SIGNATURE '. . DATE _-&.o..._,.,.'AIY_ ...... r'--z'---- i;. -"---6wNi:Fi-BUiLOEFi·oi:ci:AiiA1'i6N-:~3'f;:":'..':-j~ :,~':}~'fi.;'~~f~":'/Y.~ -~~2,? ~;·~:'.:;:7;:i':~,>;:;;·~:'.l~~.~:;;,' ; ;~-~>=~2~~-'h~-~:~-{:..'i;'~-;..:~~-~;;;;;..~~--;>:;_£.i1c~:~·._>z-"-' :; ~,~-q·c,;,;_~Y,__ ',y I hereby affirm that-I am exempt from tha Contractor's License Law·for the foilowing-reasqn: 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 Coda: 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 suc:h 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 ha did not build or improve for tha purpose of sale). D , I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Cont_ractor' s License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor ls) licensed pursuant to the Contractor's License Law). · D I am exempt under Section ________ Business and Professions Code for this raason: 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 tha following person (firm) to provide tha proposed construction (include name / address / phone number / contractors license number): 4. I plan to provide portions of the work, but I hava hired the following person-to coordinate, supervise and provide the major work (include name / address / phone number/ contractors-license number): _________________ ·---------------------------------- 5. I will provide soma of the work, but I have contracted (hired) tha following persons to provide the work indicated (include name / address / phone number / typa of work):. __________ ...,. _______________________________ ...., ______________ _ PROPERTY OWNER SIGNATURE __________ ..._~----------DATE _________ _ icoMPtE're':tH1s:sec:ii_offfoifNoiUiiisiosmAi.'iOltoiNCtP.eiiMitj;:ci.NW~~~t.!"-'~~~l~~~'~l*.'.~Jf'~~-~~~lf,~!ES~~t;1~''"<:+::r:::~r·~'.;}'-:~0"~'~~,~~~~,; ' . Is the applicant or future building occupant raquirad to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under SectiC?ns 25505, 25533 or 25534'of tha Presley-Tanner Hazardous Substance Account Act? 0 YES O NO Is the applicant or future building occupant required to obtain a permit from tha air pollution control district or air quality management district? 0 YES O NO Is the facility to be constructed within 1,000 feet of tha outer boundary of a school site? D 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. I hereby affirm that'there is a construction landing 1gancy for the performance of the work for wh!ch this permit is issued (Sec. 3097(il Civil Code). I certify t~t I have read tha application and state that the above information ~ correct and that the information on the plans is accurate. I agree to comply with all City ordinancl!S and Sta;e laws relating to building ·construction. I hereby authorize represlmtatives of the Cltt 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" deap·and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Coda shall expire by limitation and become null and void if the building or work authorized by such permit is not commancad within 3 5 days from tha data of such permit or if the building or work authorize by sue permit is suspended or abandoned at any time after the work nee for period-of 180 days (Section 106.4.4 Uniform Building Code). WHITE: File YELLOW: Applicant PINK: Finance ~ ·•- CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB971318 FOR 06/04/97 DESCRIPTION: TEMPORARY POWER POLE TYPE: ELEC STE: INSPECTOR AREA PLANCK# CB971318 OCC GRP CONSTR. TYPE NEW LOT: JOB ADDRESS: 1964 APPLICANT: TEMPORARY CONTRACTOR: OWNER: KELLOGG AV POWER SYSTEMS REMARKS: BJN/BOB/439-1999 SPECiaL INSTRUCT: PHONE: 619 4392)1999 PHONE: PHONE: INSPECTOR-~-~--------- TOTAL T.IME: CD LVL DESCRIPTION 39 EL Final Electrical ----____________ ...__ ___ ___ ----------------~--- -------------------------,...- ACT COMMENTS A/' 7r-7,,P' ***** INSPECTION HISTORY***** DATE DESCRIPTION ACT INSP COMMENTS