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Home My WebLink About1980 LA COSTA AVE; MULTI-PERMIT FILE; CB151354; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 05-08-2015 Sign Permit Permit No: CB151354 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 1980 LA COSTA AV CBAD SIGN Status: Lot#: 0 Applied: Valuation: 2165800800 $7,786.00 Construction Type: NEW Entered By: Reference #: Plan Approved: PC#: Issued: CHABAD AT LA COSTA-INSTALL Inspect Area: Project Title: 2 SETS OF CHANNEL LETTER SIGNS ONE ON FRONT OF Applicant: SIGNS FOR SAN DIEGO STE 116 3800 OCEANIC DR OCEANSIDE CA 92056 760 730-5118 Building Permit Add'I Building Permit Fee Plan Check Add'I Plan Check Fee Electrical Fee Renewal Fee Add'I Renewal Fee Other Building Fee Additional Fees TOTAL PERMIT FEES Owner: CHABAD AT LA COSTA 1980 LA COSTA AVE CARLSBAD CA 92009 ISSUED 05105/2015 LSM 05108/2015 05108/2015 $96.55 $0.00 $67.58 $0.00 $33.00 $0.00 $0.00 $0.00 $0.00 $197.13 Total Fees: $197.13 Total Payments To Date: $197.13 Balance Due: Inspector: f11. ~~ Date: 0 Clearance: $0.00 NOTICE: 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. 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 other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any I iv n N I r hi h' i n h h THE FOLLOWING APPROVALS REQUIRED PRIOR ro PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUR.DING DIRE □HEALTH 0HAZMATIAPCD Ccityof Building Permit Application Plan Check No.~ f ~13~ 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value '1.-"J~l, Carlsbad Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit . email: building@carlsbadca.gov www.carlabadca.gov Date 5'/ of I<., ISWPPP JOBADDIIESS 1980 La Costa Ave, Carlsbad, CA 92009 IAPN 216 -124 -22 -00 CT/PROJECT t, rv• ~ ll'I-L4.S£.# l#OFUNITS l#BEOROOM6 • I ,-..... -...... _ 1 OC:C:-QMuP· Chabad at La Costa DESCRIPTION OF WORK: Include Sqllar& Feet al Mfecterl ArlNI(•) Mount 2 Sets of Channel Letters. One set on front of building, one set on back of building. Building Size 6,361 sq ft. EXISTINu-E I PROPOSED USE I GARAGE [.:if) PATI,.,.,. I'" ) , ,..E',,,P\.) (SF) AREPLACE ! !AIR 1.NNDITIONING I ARE SPRINKLERS Synagogue Synagogue YESD N,0 YEsO•oD vesO•oO APPLICANT NAME Rabi Yorushum Eifort PROPERTY OWNER NAME Chadbad at La Costa Primary Contad AflDRESf ADDRESS 1980 La Costa Ave 1980 La Costa Ave CITY STATE ZIP CITY STATE ZIP Carlsbad CA 92009 Carlsbad CA 92009 PHONE: IFAX PI-IONE IFAX 760.612.9787 760,612.9787 EMAIL EMAIL Yeifort@gmail.com Yeifort@gmail.com DESIGN PROFESSIONAL CONTRACTOR BUS, NAME SIGNS FOR SAN DIEGO ADDRESS ADDRESS 3800 Oceanic Dr, Ste 116 CITY STATE ZIP CITY STATE ZIP Oceanside CA 92056 PHONE IFAX PHONE IFAX 760.730.5118p EW;L EMAIL frank@lsignsforsandiego.com I STATE LIC. # STATEUCM 1=c-45 !°'TY BIJSBL14-024869 996506 (SOO, 7031.5 Business and Professions Code. Any CilY or Coumy Wtilch requires a permit to construct, alter, Improve, demolish or repair any structlN'e, prior to Its Issuance also requires the applicant for such permit to file a signed statement tl'iat he Is lloensed pursuant to the provisions Of the Contr8ctor's Ucense Law fCMPT£r"9, CQmmending with 5ection 7000 of DiVlsiOn 3 Oftne BWiloes& ami ProfessioM Code} or lhat he is exemJ!:t ther~rom. and the basis for the alleged eiwmption,lury violation of Section 7031.5 by ariy applicanffor a permit sul)Jeets the applic4nt to a civil penalty of not more than five hundred dollars {)$500}). WORKERS' COMPENSATION Workera' Comparmtion Decluatlon: I hereby sffirm underpenaly ol pe,jlxyooe otth& ~ der.laratlofl8: DI hne arKI will maintain a oartiflcat8 of con110tto aelf-in1un1 far workers' compenulion as pro'ffded by Section 3700 of the labor Code, forlM performa!'IC9 of the wor1i: brwhlch this permit is Ml.led. 0 I have and will maintain workers' compemllfon. 11& required bv Section 3700 oflhe labor Code. for ltleperfom,ance of the worx for wllk:h lhis oennil Is ls5ued. Myworker1' cornpenmkm insurance celrier and policy number are: Insurance Co. Trawlat11n1ursnca Policy No. USSDMt331 Expiration Date 11125120t5 ll».section need not be completed if the permit is for one hundred oollal's ($100) or less. LJ certificate Of Exemption; I cerlity that In tne '"!!!.,..."" or Iha work tor Whleh this permit iS Issued. I SN.II not ernplOy ary person In any mMner so as IO bec:orrle Sllb;ect 10 tne Worker.ii' Garpensation I.aw of califomia. WARNWG: Falu re to secure wo compim1ation coverage II unlawful, and shall aubject an employer to criminal penalties and civU fines upta one hllndll!d thou!lland do/Iara (&100.0IMIJ, In ~ for in ·on 3708 ofth• L.bor code, int.mt and .ttom.,-. .,._, I hetelly Mfitm that I am exempt from Contractor's l.it:ense Law for the followmg raasoo: D I, as owneroflho ~ or my ernpklyees wih ~ u theirffle oompensaliOn, 'Ml do Iha work a-id lhe lllruCU& is nol intended or offered b HID {Sec. 7044, Business and Pro&l&sions Code: The Conlnldor's tJcensa l-dolts oot llpply to an owner of P£OpEll1y who builds or Improves lhereon, and Who 0085 suet\ WO!k hmself ot through his ow-11 employeeg, prOllided lhat auc:11 improvements are not il'lfendlld or offered for Ulla. If, however, the bulking er mpl'Ollemenl: Is SOid within one year at complellon, the owner-butlclerWII have the burden atprcMng Iha! ha did not build or lmprt1,l8 Jorthe purpose Of sale). 0 l, • owner Of Ile property, am adushlely contraoling 'Rh~ contra<tffl to 0J111b'uct lhe prqact (Sec, 7044, BLISlnea and Profe81iona Code: The Contractor'• License Law does not apply IO an OM'l9I' Of Jl"operly who buicls or inproves thereon, and cootracts for sueh projecls With contractor(&) licensed pursuant to Iha r.ootractor's license 1..awi □ I am exempl ullder Secllon ___ JBuslness and Profe8sions Code for !his reason: 1. I pe!'S(lnally plan to prowte dle major labor and materials fOr construction oflhe proposed propa,I)' improvanent □Yes °"'° 2. I (have I have not} Gigrled en application b" a buicing permit for lhe proposed work. 3. I have oontraded 'Mlh the folla.mg person (finn) to pr<Mdeth& proposed CC111truct:ia, ~nclude name &dcwesl/ ~a I contractorl' lica\$e number): ,. I plan to prlMde porto/11 ot Iha work, but r have hired Iha following person to coorrinal8, StJpervise and prO\UI Iha major won:: (inoodll nall'l8 /address/ phone/ contractors' l!cense number): 5. I wil proy,da some oflhe wort, but I have contracted (hi'ed) Ille fobmg pasoos lo provkje the wort. .ncticated {lncilde name f ackt8sa /phone/type of work): .,es' PROPERTY OWNl:R SGNATIJRE (]AoEHr DATE I COMPI.ETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY ~ ttie appbml or future bul<fing occupant recp.iired to submit a _b1Rii'185S plan, 8CUteJy hazardous materials 1'{98•alia, brm or risk managemerrt.nd prevaillon p-~ran oodar Seelions 25505, 25533 or 25534 of the Flresley-T avi• Haurdous Subs1anoe ~nt />d1 · · Yes No b flCI applicant or ruture buiWmg OOCUpartl. reqWred looblail e pormit from ttus airpollulkln control disbict or at(J.la(ty m111agement lislrict1 Yes :_.:· No II lhsfllcWlyto be cmstrucled wittin 1,000 foot ol'lhe oulllr boondaty of■ scbool 811e? Ylll!I No F ANY OF THE ANSWERS ARE YES, A ANAL CERTFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS TH.E APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMEAGENCY SERVICES ANO THEAIR POLLUTION COHTROl DISTRICT. I eertiyttlat I hMle IUd IIMI llppllcallofl aild stala tbat:IM abclrile lllformation ISCOllllld:all(I tlletthe infonnallon 0G Hie pllnsis IIOCUlale. l&g,ee 'Im c:ocnplywlth ■n °" od11111C8S&lld Slale laws llllatillC ID bulldinC constrootloo. I lmlr;---oflie ~olc..tsbadlo-upon lheabowmrionedl>'OPOrtyi>r~ pu,pose,.1 ALSO AGREE TO SAVE, tlOEM-IFY #fl l4cEP HARIII.ESS TfE CIIY OF CARLSBAD AGt\NST N.l.LW3ll.ITIES, JLOGMENTS, COSTS AND EXPENSES WHCH MAY IN/i,H( WAY ACCRUE AGAtlST Stl.lJ CITY IN CONSEClJENCE OF THE GRANTNG OF TtlS PERMIT. OSHA: AA OSHA pem,i is 1'8(Jli'ed tr excevali(m(M!JJ 5'0' deep and den'lfjition a-eoos1luclior, of snJCllxe6 fMI{ 3 skll'IQg 11 f18Jdhl EXPIRATIOI< E!lety pennl-byh, EIJl<lng . '"'""' thepro,,;,klnsof"8 Cooesh,le,cpieby m""1 and beoome ... tandvoid llhabulfu,i<rwal< '""""'8dby ouch -.no1~,;f1in 180 days ion lhe dao, of OJdi penni er W file "II crwal< aut, by such p,nrif is ,uspencled .--,. llljl Im& afiartt,e wak • """""1Ced b-a P""'l of 180 days (Secticn 106 4.4 u-.ibm 8"....., Coos) . .es' APPLICANT'S SM!NATURE DATE 3/ .3 1 1 s • STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. FIX (760) 602-ll560, Emal building@carlsbadca.gov or Mail lfle completed fonn fo City of Carlsbad, &~ding DMsion 1635 Faraday AV811uo, Carlsbad, Cailbmia 92008. CO#: (Office Use Only) CONTACT NAME PANT NAME ADOR£55 BUILDLIIIG ADDRESS CIJY STATE ZIP CITY STATE Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. UC. No. DELIVERY OPl10NS PICK UP: CONTACT (Listed above) OCCUPANT (Usted above) CONTRACTOR {On Pg. 1) MAIL TO: CONTACT (LISle<f llbove) CONTRACTOR (On Pg.1) OCCUPANT (Listed above) MAIL/ FAX TO OTHER: _______________ _ A!APPUCAHTS SIGNATURE ASSOCIATEDC------------ NO CHANGE IN USE/ NO CONSlRUCTION CIIANOE OF USE/ NO CONSTRUCTION DATE ZIP Inspection List Permit#: CB151354 Date lns.,ection Item 08/20/2015 38 Signs 08/20/2015 38 Signs 08/20/2015 39 Final Electrical Thursday, August 20, 2015 Type: SIGN Inspector Act MC RI Fl RI CHABAD AT LA COSTA-INSTALL 2 SETS OF CHANNEL LETTER SIGNS ON Comments AM PLEASE SIGNAGE ONLY AM PLEASE Page 1 of 1 • 4 04/~t-/Y..! 1::1, r' 1gf' ot ,•ob Ad 1r0 ·:;: rPrm t ,,,Yb, f-drcel ~o: 1 bllI.uPINl; LA r·u~)· A AV ~ f ~ vu \/cllUdtlC•tl: SCll Cl>r.s<::ruc t 1 c n ~ype: NEW :, E R M I 1' Str: Ec.::n.1i: N,,: i:-.r v •ec .. Nn: U('Ve l opmen t No: Fl: Ste>: 7257 04/16/92 0001 01 C-PRMT l"}O))l/> A .:i, C, I l 4 l 02 25-00 r 1t rupc-HlC y l,rou::,: Cl,,s ,olP: s [H•scrii:.,t.cn: srr;N "CHABAD" At,pl/0wr.r : EILFORT, YEE lJCtlEM { RAPB::'' 141:l0 LA COS:'A AV Fees: Ad~L..~;tment..;: 'otal I-ee;: CARLSBAD, CA F-eP des,ripti0r. Est.i .... chng Perrr1 t :1 ld11 Chevk * SIGN ':'OTAL 94)tl~'1 Appl11;.;,1: )4,,.t:,' Apr / : ~· UP : l 4 1 r, 1 Va ~ ( I ct t <~(. f y : C 1 • t) ;J . ( J 2 ':>, (' l Ext fee Dr .. d 1 C,. [ ) 10,0r) 2.s.o~i HLA~PROVAL -~s?._,_ __ DATE ,;, 11~1) ~L[ARANCE ____ _ CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPIJCATION PLAN CHECK NO. City of carlsbad Building Depart111ent 2075 Las Pal'""s Dr., carlsbad, CA 92009 (619) 438-1161 EST.VAL r;/ QC) PLAN CK DEPOSIT _______ _ VAIJD. BY __________ _ I. PkilMI I ii PR DATE A -U Commercial U New Butldmg Li I enant Improvement B -□ Industrial U New Building □ Tenant Improvement C -□ Residential □ Apartment □ Condo □ Single Family Dwelling D Addition/Alteration □ Duplex □ Demolition □ Mechanical □ Pool □ Relocation □ Mobile Home □ Electri~ Plumbing □ Spa □ Retaining Wall □ Solar 11'15ther 5 l<dir: 2. PRClJF.C'f INFORMATION FOR OFFICE USE ONLY Address t9PO L-11 CcJ-nq ,/Jvc Bu1@mg or Smte No. Nearest~ Street El-Cl1'41NI/C /47'1-t,. LEGAL DEsCRIJi'IION Lot No. Suix:11V1s1on Name/Number CHECK BEWW IF SOBMII 1£D: □ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope DESCRIPTION OF WORK St611/ SQ. IT. '-f 0 3. WN IACI PFJISON (tf dulerenl from applicant) NAME /(1/6{9/ 1/€/l.l,/tHp,, 'fl1.-F1,<r ADDRESS (51-1"1C IH #-2-) Unit No. Phase No. CITY C Ad..'--" IJ/1/) STATE C-1/ ZIP CODE 7 ).OC''j DAY TEIJ:PHONE 9 </ .J -J'S '7 / 4. APPLICANf UCONIRXCIOR □AGENI FORWNIRACIOR □OWNER LIXCENI FOROWNElt NAME ;:;Tc,HN th(IZ,vrf"1,._, ( C..O ADDRESS CITY STATE ZIP CODE DAY TELEPHONE NAME L II ( ~$Ti'9 d,-so,<r ADDRESS CITY STATE ZIP CODE DAY TELEPHONE NAME ADDRESS ()w/llC",Z CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. # LICENSE CLASS CITY BUSINESS LIC. # CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. # 7. WOR.RF.RS' WMPENSAIION Workers' Compensation Oeclaratmn: I hereby aftlrm that I have a ceruJlcate of consent to self-msure 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 POLICY NO. EXPIRATION DATE Cert1hcate of Exemption: I cerufy that m the performance of the work for which this penmt 1s issued, I shall not employ any person m any manner so as to become subject to the Workers' Compensation Laws of California. SIGNATURE DATE 8. OWNER-BUllDEK DHCCARA'JIUN Owner-Builder Declaration: I hereby afftnn that I am exempt from the Contracto?s Lcense 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, 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 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]). SIGNATURE DATE COMPLETE IRIS SEGIION FOR NON-RESIDEN IIAL B0ILbING PERMil's 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? □YES □NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? CYES □NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □YES □NO IF ANY OF THE ANSWERS ARE YES, A FINAi.CERTIFICATE OFoa:IJPANCY MAYNITT BE ISSUED AFIERJULY 1, 1989UNUlSS THE APPLICANT HAS MIIT OR IS MEimllG 11IE REQIIIREMENTS OF nm OFFICE OF EMERGENCY SERVICES AND 11IE AIR POILUTION CJONTII.OL DIS111IGJ". 9. WNSIRUCIION IP.NDMG AGENCY I hereby afhrm that there ts a construction lendmg agency for the performance of the work for which tfos permit 1s tssued (Sec 3697(i) CIVIi Code). LENDER'S NAME LENDER'S ADDRESS id. XPPllCXNI dlltliFR!AliON I cenify that I have read the apphcat1on and state that the atx>ve mformauon 1s correct. I agree to comply with ail 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 AI.SO AGREE ID SAVE INDEMNIFY AND KEEP IIARMIJlSS THE CTIY OF CARISBAD AGAINST ALL LIABIIJTIES, JUDGMENTS, CXJSTS AND EXPENSES wmcu MAY IN ANY WAY NXJUJE AGAINST SAID CTIY IN CJONSF.QUENCE OF um GRANTING OF TIIlS PERMIT. OSHA: An OSHA permit is required for excavations over S'O" 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) Unifonn Building Code). APPLICANTS SIGNATURE l£ L- ~TE: File YEIJ.OW: Applicant PINK: Finance DATE: 'flt, /,;L r I Cl) z 0 ~ a: j (.) Ill a a: i[ 8 a: Ill a ... 5 I Ill z ~ 0 z 0 ;;:: C Cl) z Ill A. 2 0 (.) Cl) iz: "' :.:: a: 0 ~ 1[ O I hef . "affirm that I am licensed under provisions 'of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. Lie No ______ Class I hereby alfinn that I am exempt from the Con- ~tn~!f ,:'; ~ .:::;,~:~c::::f.'.~i~ county which requires a penni1 to construct •lter. improve, demolish, Of repair any structure. ~ t~i~s~e a•l:::Ju~t~~::narr~r:efrs licensed pursuant to the provisions of the Con· tractOf's license Law (Chapter 9 commencing with Section 7tXlO of OiY1s1on 3 of the Business and Pro- fessions Code) or that Is exempt therefrom~ the basts for the alleged uernphon. Any vt<>fation of Sect.on 7031.S by an applicant for a permit subjects tne applicant to a ctvil penalty of not more than five hundred dollars ($500). \... •• as owner of the property. or my employees ~ wages as their sole compensation, will do the wonc. and the structure is not intended Of offered for sale (Sec. 7044, Business and Professiotts Code: The Contractor's L,cense Law does not apply to an owner of pre>perty who builds Of 1mpr0WtS thereon and who does such work himself or through his own employees. provided that such 1mproveme;its •e not intende1 or offered for sale. 11, however, the buHding or improvement 1s sold within one year of completion, the owner-builder will have the burden of proving that he did not build Of improve for the purpose ot sale). □ I, as ownef of the prop,erty, am exclusively contractifli with licensed contr~tors to conslruct the prOjeet (Sec. 70.U. Business and Professions Code: The Contractor's License Law does not apoly to an owner of prOC)erty who builds Of Impr0Yes ~:'~i~ 7:~cin~r:!~~~ ~~~~r~~~~::.: Lteense law). D I am exempt under sec _____ , B. & P.C. tor this reason □ I hereby affirm that I ha;,,e a certificate of consent to self-insure, or a certificate of Workers· Compensation Insurance. or a certified copy thereof (Sec 3800. labor Code). POLICY NO __ COMPANY □ Copy IS hied Wllh the Cit)' □ Certtfled c0py 1s hereby furnished CERTIFICATl OF EXEMPTION FROM WORKERS" COMPENSATION INSURANCE (This section need not be completed 11 the permit 1s tor one hundred dollars (S 100) or less) •1 certify that in lhe performance of the wont tor wh~h this permit 1s issued, I shall not emplO'f any person In any manner so as to become subIect to the Worlters · Compensation Laws of Gahforma NOTICE TO APPLICANT fl. after maktn~ lhts Cen1-f1ca1e of Exemphon, you should become subject t,:, the Won<.ers· Compensation provIs1ons of the Labor ~ . y must tor1hw1th comply with such prov1s1 7~s _pe;m1t shall be deem: revoked r u/~ .. ,,.,,..- 0 I hereby affirm that there 1s a construction tending agency tor the perlormance of the work fOJ which this perm11 1s issued (Sec J097. Ctvll Codel Lende(s Name ___________ _ Lencter·s Address __________ _ USE BALL POINT PEN ONLY & PRESS HARD CARLSBAI ~UILDING DEPARTMENT 1200 Elm, Carlsbad, California 92008 (714) 438-5525 APPLICANTT '1LL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. • APt--.llCATION & PERMIT (I) JOB ADDRESS L . ------AV:ST. DATE OF Al'f'l.lCATION 9'S-O ~ 110. _'!S _ BUSINESS LICENSE ,t VALUATION PERMIT NUMBER 7 ::: LL . /5t) CONTRACTORS PHONE • ZONE I >-cro ol 0 a. E (I) OWNER'S MAILING ADDRESS V /Y_'to 1...a,.-,.'4: At1~. ~ ... '-1.fCi 9.INfl~NTRACTDR'SADDtU!_. ---- LICENSE NO. PLAN 1.0. # LOT I BLOCK I SUBDIVISION I ASSE5SOR PARCEL NO DESIGNER STATE LICENSE I# DESCRIPTION OF WOR STANDARD PLAN # BLOG USE CODE I- ~i&N I -0 ~G;.FOOTAGE 0 (!) -,,,...,_ r..ol!:,.,.vr DESlGNEll"S ADDRESS F/P FLA ELEV. NO OCC GP EDU I DESIGNER'S PHONE c tll .!2 a. a. CENSUS TRACT I GP LANO USE I PARK ING SPACE RES UNITS 1 GRADING f'.ERMIT ISSUED YO N □ YO NO REDEVELOPMENT AREA STORIES TYPE I DCC LOAD I FIRE SPR CONST ~/0~ /~i2~§~~ 000.1.!~~e :3;031 a? <;( ,.1.00 I r,p 17,oo -n YO NO YO NO Nor Valid Unlffs Machine Ct!rtifitd QTY. PLUMBING PERMIT -ISSUE QTY. MECHANICAL PERMIT -ISSUE SUMMARY/ACCOUNT NUMBER EACH FIXTURE TRAP I I I INSTALL FURN. DUCTS UP TO 100.000 BTU EACH BUILDING SEWER I I I OVER 100,000 BTU EACH WATER HEATER ANO/OR VENT I BOILER/COMPRESSOR UP TO 3 HP BUILDING PERMIT 01·000-4220 SIGN PERMIT 01·000·4221 PlAN CHECK 01-000-4806 fr/M I,_,,::::.(} EACH GAS SYSTEM 1 TO 4 OUTLETS I I I BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01-000·4222 -- EACH GAS SYSTEM 5 OR MORE I I I METAL FIREPlACE ELECTRICAL 01-000-4223 --- EACH INSTAl .. ALTER, REPAIR WATER PIPE I I I VENT FAN SINGLE DUCT MECHANICAL 01-000·4224 I I EACH VACUUM BREAKER I I I MECH EXHAUST -HOOD/DUCTS WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME 01 ·000-4225 MOBILEHOME PARK INSP EACH ROOF DRAIN (INSIDE) SOLAR 01-000-4226 TOTJ;L MECHANICAL STRONG MOTION 65-640-0519 150 TOTAL PLUMBING l FIRE SPRINKLERS 01-000-4227 QTY. ELECTRICAL PERMIT -ISSUE QTY. I SOLAR -ISSUE PUBLIC FACILITIES FEE 25·000-4933 BRIDGE FEE NEW CONST EA AMP/SWT/BKR COLLECTORS SCHOOL FEE -DISTRICT 1 PH j PH STORAGE TANKS Carlsbad 65-623-0519 EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE Encinitas 65-624·0519 1 PH 3 PH PUMP San Dieguito 65-625·0519 REMODEL/ALTER PER CIRCUIT PLAN CHECK FEE San Marcos 65-626-0519 TEMP POLE 200 AMPS OVER 200 AMPS TEMP OCCUPANCY (30 DAYS) 1---1---------------------1--------+----t--------------------+--------tll----------------------+-----------l TOTAL ELECTRICAL l TOTAL SOLAR TOTAL FEES PAYABLE l /7,00 I HAVE CAREFULLY EXAMINEOTHE 00MPLETED "APPLICATION AND PUNT''.-00 -...o::-,,:r:::::,:::-o(t":: * AN OSHA PERMIT IS REQUIRED FOR EJCCAVATIONSCMII CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEMOIJ.•UIIINlllli . ...11:11 .. ,• .. •lfa..• .. 11Ddapllomthectarec:i:>c11 s·crDEEPANODEMOUTIONORCONSTRUCTIONOF DECLARATIONS ARE TRUE ANO CORRECT ANO I FURTHER CERTIFY AND-IS,' 1119 ........ 4i 11ii, _., pannit le or STIIUC1UMS OV£fl 3 STOAIES IN HEIGHT ISSUED: TO COMPLY WITH AU CITY, COUNTY ANO STATE LAWS GOVEIINQt8 , , •lliitailir a STRUCTION,WHETHERSPECIFIEOHEREINORNOT. IALSOAGRl!E~ -•. -_ -. •-_ •.. -.'. .... -□ APPROVED BY DATE KEEP HARMLESS THE CITY OF CAflLSBAD AGAINST ALL UABILITll',S, ·• . · · • . . • . •.' ....,_.. ~all EXPENSESWHICHMAYINANYWAYACCAUEAGAINSTSAIDCITYIN _ · ": .. --:::·' :_~;; .•. -~-BYPHONE O --7_%,_Q,~ GRANTING OF THIS PERMIT • ,.... • J • • • • '' .' •• " ' l D ~ LJ ~ • .,,,._. .. ':.! .. _ '., . .. -.. ·--·' ~ a: 0 (/) (/) (I) (/) (/) ~ I ~ .2 a; >- (/) (/) (I) 0 0 a: tll cii 0 ~ (I) 0 C: as C: u: C: (I) ~ (!) 0 0 (I) a. (/) C: ~ .c ~ "' INSPECTION TYPE DATE INSPECTOR BUILDING FOUNDATION ..!..:R!..=E:.!.!I Nc!:F!....:O!,!.R!...!:C~E=.!D!:!.....,:S!....!.T-=E-=E-=-L--------=------11----+I ---- MASONRY GUNITE OR GRQ_UT ~LOOR & CEILING SUB FRAME SHEATHING FRAME EXTERIOR LATH lNSULATION INTERIOR LATH & DRYWALL PLUMBING SEWER AND BL/CO PLUMBING UNDERGROUND PLUMBING TOP OUT TUB AND $HOWER PAN GAS TEST ELECTRICAL TEMPORARY POWER ELECTRIC UNDERGROUND ROUGH ELECTRIC ELECTRIC SERVICE BONDING G. F. I. -SMOKE DETECTOR MECHANICAL DUCT & PLEM., REF. PIPING ~ HEAT -AIR COND. -SOLAR SYSTEMS VENTILATING SYSTEMS CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ITEMS ABOVE HAVE BEEN-APPROVED. JOB SITE FINAL . " ~, ,... -.._ ~ t t ' PLUMBING I - ELECTRICAL I ' O· \ ' \,~~ MECHANICAL ' -' 'l GAS ' -~ ' --.. BUILDING ' ' ..... -~ SPECIAL CONDITIONS I CERT OF OC[" '0 ANCY ISSUED ; --' FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS INSPECTION REQ IF INSPECTOR"S CHECKED APPROVAL SOILS COMPLIANCE PRIOR TO FOUNDATION INSP STRUCTURAL CONCRETE OVER 2000 PSI PRES TRESSED CONCRETE POST TENSIONED CONCRETE FIELD WELDING HIGH STRENGTH BOLTS SPECIAL MASONRY PI LES CAISSONS . l -~ , - ~\. . . .. ~ ... '"' - - I .. \ . -~-,..., . ~-:~ '\ ,. .. i~•I <>c~\r~ ., . ~ . , < I 1 -~ ~,,. ~. . \ _~ -,, - ' i ---.., -' ' INSPECTOR"S NOTES . ' DATE \ ._. -. \ ... = -- -·.,,. \ ' ·.._ .:, r-\ "."' '""· ~~~--~~ ·- . 'Sc~.._ ,-; .. ~ . 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