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HomeMy WebLinkAbout2051 PALOMAR AIRPORT RD; ; CB982951; PermitB U I L D I N G P E R M I T Permit No: CB982951 11/12/98 09:26 Project No: A9803832 Page 1 of I Development No: Job Address: 2051 PALOMAR AIRPORT RD Suite: Permit Type: COMMERCIAL TENANT IMPROVEMENT 3320 11/12/98 0001 01 02 Parcel No: 213-050-39-00 Lot#: CPRMT 39400 Valuation: 12,600 Construction Type: NEW Occupancy Group: Reference#: Status: ISSUED Description: CTI 450 SF Applied: 09/02/98 Apr/Issue: 11/12/98 Entered By: JM Appl/Ownr : WHARTON LARRY 619 203-1773 639 BISON CT EL CAJON CA 92019 *** Fees Required *** Collected & Credits ----------------------------------- --------------------------- Fees: --- Adjustments: \ s: .00 Total Fees p Tot à'1(a i 91.00 394.00 Fee description it A it Ext fee Data Building Permit 40.00 -- Plan Check 91.00 Strong Motion Fee Each Plumbing Fix ure or ng if Enter "Y" for Plu ib.i~4 sue F 20. H Each Water Heater nd/kor n 7.0 Enter 'Y" for Elect ic Issu?\F / 10.00 Y Remodel/Alter Per A N INôoRPoRATED ,JYU 25 25.00 Enter 'V for Mechani a Ir3teFLee> 2 ç' 15.00 Y Each Exhaust Fan 6.50 13.00 FINAL, bVAi -ç CLEARP CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 4 1 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 ,1.PRQJEcTJNIE QRMA!IP1J - FOR OFFICE USE ONLY PLAN CHECK NO._______ EST. VAL. fl(J7,1 Plan Ck. Deposit Validated By_________________ Date cP2ci2 -qo t-,- Bldg/Suite #1 - Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use CE Proposed Use Description of Work '77--Z7. SQ. FT. #of Stories / # of Bedrooms # of Bathrooms L CONTAERN(1f entjr jt) 'W '''"M zzaiv Name Address City Oe/tJfQ2/9 1eJJj #01 02ex # D0rD Owsair - Name42!Z?fr 1MiA/Z1W Address rri c - 4CATW" p1OWER Zm Nami Address 9 City State/Zip Telephone # i CONTRACTOR COMPANYNAME (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 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 [$50011. - - - - , - 11tvmI O.2 12-1 ,",Q fv_ / Name I 1/' L.L)('-., Address f fVrT1101.7 ' - City - State/Zip Telephone State License # L1d4L ZI 7 License Class /"3 City Business License # Designer Name Address City State/Zip Telephone State License # 76 WORKERS.'9M DON $ - - - - Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: o 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 f th ork for which this permit is issued. V~ IT I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for whicti, this, per issued. My worker's comp a jrrier and Policy numbera Insurance Company re:— Pollcy No.' Expiration DateTf7' (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 181001 OR LESS) CERTIFICATE OF EXEMP ON: 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 t t Wor ers' Compen tion Laws of California. WARNING: Failure t u workers' c cation covera s unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars , ddltlo a atlon, damages as provided for in Section 3706 of the Labor code, inter and attorney's fees. SIGNATURE DATE bWNER ir15ibEoLARA,,o __ __ * I hereby affirm that I am exempt from the Contractor's License Law for the following reason: El 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 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: I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES F] NO I (have I have not) signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number I contractors license number): 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): 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 LET111SET1JIN 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? 0 YES 0 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 0 NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 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 Citu 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 withi 65 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 co ce a nArind of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE / Y ('f1,1A/ZTh AT DATE 9- 2-9 Ll~ WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Inspection Request For: 12/2211999 Permit# CB982951 '1,') Inspector Assignment: TP Title: CTI 450 SF Description: Type: CTI Sub Type: Job Address: 2051 PALOMAR AIRPORT RD Suite: Lot Location: APPLICANT WHARTON LARRY Owner: SUNROAD PALOMAR PARTNERS L P Remarks: PM PLEASE LE Total Time: Phone: 7604382131 Inspector: Requested By: JOHN LEACH Entered By: CHRISTINE CD Description 19 Final Structural 29 Final Plumbing 39 Final Electrical 49 Final Mechanical Act Comments Associated PCRs Inspection History Date Description Act Insp Comments 12/14/1999 89 Final Combo CO TP 12/9/1999 89 Final Combo CA TP RESET FOR 12/10 12/2/1999 89 Final Combo CO PD RESET FOR 12/9 9/15/1999 89 Final Combo CO TP 6/9/1999 84 Rough Combo WC TP NO lNSP THIS PERMIT 6/4/1999 32 Const. Service/Agricultural AP TP MAIN SWITCH GEAR 5/25/1999 84 Rough Combo CO TP REST RM HARD CElL 5/21/1999 22 Sewer/Water Service AP DH U.G. WATER METER TO BLDG 5/17/1999 14 Frame/Steel/Bolting/Welding AP TP RESTRMS 5/17/1999 17 Interior Lath/Drywall PA TP EXT REST RM WALLS 5/17/1999 24 Rough/Topout WC TP 5/17/1999 34 Rough Electric AP TP REST RMS 5/12/1999 13 Shear Panels/HD's CO TP SHR WALLS © RESTRM 5/12/1999 13 Shear Panels/HD's CO TP 5/12/1999 84 Rough Combo WC TP 5/11/1999 24 Rough/Topout AP TP 5/10/1999 14 Frame/Steel/Bolting/Welding AP TP EXT. FRM @ REST RMS OK TO D W. City of Carlsbad Inspection Request I I For: 12/22/1999 Permit# CB982951 5/10/1999 24 RoughiTopout 5/10/1999 34 Rough Electric 5/10/1999 44 Rough/Ducts/Dampers 5/7/1999 84 Rough Combo 1/28/1999 21 Underground/Under Floor 1/27/1999 21 Underground/Under Floor 1/19/1999 11 Ftg/Foundation/Piers 1/12/1999 21 Underground/Under Floor 1/11/1999 22 Sewer/Water Service 1/5/1999 17 Interior Lath/Drywall 12/18/1998 84 Rough Combo 11/23/1998 84 Rough Combo 11/16/1998 14 Frame/Steel/Bolting/Welding Inspector Assignment: TP WC TP WC TP WC TP CA DH WANTS MONDAY AM AP OH CO DH PROVIDE C/O AT 411 & PERMIT FOR NEW AREA AP OH FOR PLB TRENCH AP OH APONI/Il AP OH AP OH AP DH CA OH CO OH FINISH WALL Tu - @ U electo tort GROUND FAULT SYSTEM TEST REPORT 2r! 4A— CLIENT: H -A ENGINEER: . ANToir ETI JOB NUMBER: 2-q4495 LOCATION: 2,4zal'(Cpi-t-- WITNESS: DATE: -1ELLGc* 1c7T Airivr Q. 7-000 6-4IF LT /271i SWITCHGEAR DESIGNAT1ON TEST EQUIP. ASSET # CALIBRATION DATE: 4Qut DATA SWITCHBOARD MANUFACTURER SHOP ORDER NO. UL NO. C4kx ?t(er 6.0 SeA MAIN OVERCURRENT DEVICE MFGR. ii LI CIRCUIT BREAKER E3 FUSED SWITCH it - ,.... r r- %J L L- TYPE MODEL/CAT. NO. CURRENT RATING SYSTEM VOLTAGE 1 VOLTAGE RATING 32S 4-4o -C,c. 4000A 49oy/--7 GROUND FAULT SYSTEM MFGR. NEUTRAL-GROUND STRAP .jjiRO-SEQUENCE MODEL ITX CAT. NO. PICK-UP RANGE io—ioA TIME RANGE o. SENSOR/C.T. AS FOUND SETTING AS LEFT SETTING CURPICKRENT 00A TIMES I CURRENT' ç TIMEOV SETTINGS SUPPLIED BY INSPECTION SERVICE ENTRANCE CONDUCTORS MAIN BONDING JUMPER GROUND ELECTRODE CONDUCTOR 144 PER PHASE _____ 4/ JIwo 0 MCM NEUTRAL-GROUND LOCATION CONTROL POWER TRANSFORMER 0'ORRECT 0 INCORRECT D CORRECTED BYCONTRACTOR VA MONITOR/TEST PANEL OPERATION OTHER .EPRRECT INCORRECT 0 CORRECTED ELECTRICAL TESTS BREAKER/SWITCH REACTION TIME (FIT) REDUCED VOLTAGE TEST (55% RATED VOLTAGE) I1C0NDS DCYCLES .1JORRECT INCORRECT PICK-UP CURRENT PICK-UP CURRENT MINUS 25% ( AMPS) AMPS .IINO TRIP (CORRECT) 0 TRIP (INCORRECT) SYSTEM NEUTRAL INSULATION RESISTANCE TO GROUND OTHER MEGOHMS PRIMARY CURRENT PERCENT TOTAL REACTION RELAY MFGR. AMPERE-TURNS PICK-UP TIME TIME TIME TOLERANCE % 0. 07 0- 0 TIME-CURRENT CALIBRATION c, ol ou oo-i 0. 011 ilox TESTS REMARKS c- _scd2 GFSTR/90 01990 ETI PAGE ______ OF %/7&6 "o 4 C f '' irrfl. Co,,, 3/as Fa;~-Iae- t4lneln 1 -- 4of ESSj041 co ICIP -... A. 0", 1 0 • NO. 9395 ' g UJ cr-EC.31.2O0fl EXP.DATE *d c,v_ OF CM.Y C'wic,F/c ae- CLARENCE A. MAGNUSEN, P.E. Consulting Civil Engineer 4683 Majorca Way OCEANSIDE, CA 92056 (619) 726-0853 FAX (619) 726-9384 JOB /'Te//e I SHEET NO OF CALCULATED BY £ DATE - CHECKED BY DATE SCALE 7r't/ r /, TP2c) viP -7c/v rs 14 1 ii') Alit ~1;ej c// City of Carlsbad Final Building Inspection Dept: Building Engineering Planning CMWD St Lite Fire Plan Check #: Date: 9/15/99 Permit #: CB982951 Permit Type: CTI Project Name: CTI 450 SF Sub Type: Address: 2051 PALOMAR AIRPORT RD Lot: Contact Person: JOHN Phone: 0000000000 Sewer Dist: CA Water Dist: CA lnspecte By: Ci- Date /10//F M Approved: k' Inspected: Disapproved: Inspected Date By: Inspected: Approved: Disapproved: Inspected Date By: Inspected: Approved: Disapproved: Comments: SOUTHERN CALIFORNIA SOIL & TESTING, INC. 6280 RIVERDALE STREET, P.O. BOX 600627, SAN DIEGO, CA 92160-0627, Phone (619) 2804321, FAX (619) 2804717 FIELD INSPECTION REPORT FOR: D REINFORCED CONCRETE D REINFORCED MASONRY DWELDING 13FIREPROOFING 0 P. T. CONCRETE DPDXY ANCHORS OH. S. BOLTING D PROJECT TITLE /'l//S,-,Z -0 24 7 SCS&T FILE No. qgj 2. :;?-2..i6 PROJECT LOCATION -26 2 57 / 'rAà'pô-t ERMIT No. .2,9 ,/ PLAN FILE No. ARCHITECT (' /b(4ENGINEER 1ti-- ij1 GENERAL CONTRACTOR SUB CONTRACTOR / v MATERIAL CLASSIFICATION a17 yj DATE DESCRIPTION OF WORK INSPECTED Vc/'9 P,-ov'ded tiri'uws sp-( 1tTYI 7 ± 6e I hereby certify that have inspected the above reported work.-Uss noted otherwise, the work Inspected is to ti(iest of my knowledge in compliance with the approved plans, specifications and applicable sections of the governing building laws. / -, 7/VC& .21rc .5b, 'SI'NATURE REGISTRA N No. ./ -2c)+\- Thte' XT SUPRINANtS SIGNATURE DATE EsGil Corporation In Partnership with gove rnment for Building Safety DATE: 10/16/98 JURISDICTION: Carlsbad PLAN CHECK NO.: 98-2951 SET: III O APPLICANT JURI 0 REVIEWER 0 FILE PROJECT ADDRESS: 2051 Palomar Airport Rd. PROJECT NAME: Tenant Improvement The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. LI The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff. El The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. El The applicant's copy of the check list has been sent to: Esgil Corporation staff did not advise the applicant that the plan check has been completed. Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Telephone #: Date contacted: (by: ) Fax #: Mail Telephone Fax In Person LI -, REMARKS: By: Mike Puckett Enclosures: Esgil Corporation 0 GA MB EJ Pc 10/9/98 trnsmtLdot 9320 Chesapeake Drive, Suite 208 • San Diego, California 92123 • (619) 560-1468 • Fax (619) 560-1576 EsGil Corporation In Partner.cIiip with government for Building Safety DATE: 1015/98 O APPLICANT JURI JURISDICTION: Carlsbad O PLAN REVIEWER O FILE PLAN CHECK NO.: 98-2951 SET: II PROJECT ADDRESS: 2051 Palomar Airport Rd. PROJECT NAME: Tenant Improvement The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. E11 The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff. fl The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. Elil The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. The applicant's copy of the check list has been sent to: Larry Wharton 639 Bison Ct. El Cajon, Ca. 92019 Esgil Corporation staff did not advise the applicant that the plan check has been completed. LIII Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Telephone #: Date contacted: (by: ) Fax #: Mail Telephone Fax In Person Li REMARKS: By: Mike Puckett Enclosures: Esgil Corporation 0 GA 0 MB 0 EJ 0 PC 9/24/98 trnsmtl.dot 9320 Chesapeake Drive, Suite 208 • San Diego, California 92123 • (619) 560-1468 • Fax (619) 560-1576 Carlsbad 98-2951 10/5/98 GENERAL PLAN CORRECTION LIST JURISDICTION: Carlsbad PLAN CHECK NO.: 98-2951 PROJECT ADDRESS: 2051 Palomar Airport Rd. DATE PLAN RECEIVED BY DATE REVIEW COMPLETED: ESGIL CORPORATION: 9/24/98 10/5/98 REVIEWED BY: Mike Puckett FOREWORD (PLEASE READ): This plan review is limited to the technical requirements contained in the Uniform Building Code, Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state laws regulating energy conservation, noise attenuation and disabled access. This plan review is based on regulations enforced by the Building Department. You may have other corrections based on laws and ordinances enforced by the Planning Department, Engineering Department or other departments. The following items listed need clarification, modification or change. All items must be satisfied before the plans will be in conformance with the cited codes and regulations. Per Sec. 106.4.3, 1994 Uniform Building Code, the approval of the plans does not permit the violation of any state, county or city law. Please make all corrections on the original tracings and submit three new sets of prints to: ESGIL CORPORATION. To facilitate rechecking, please identify, next to each item, the sheet of the plans upon which each correction on this sheet has been made and return this sheet with the revised plans. Please indicate here if any changes have been made to the plans that are not a result of corrections from this list. If there are other changes, please briefly describe them and where they are located on the plans. Have changes been made not resulting from this list? LI Yes 0 N Item #26 Provide complete energy designs for the proposed changes in envelope, lighting, and mechanical systems. Provide the completed ENV-, LTG-, and MECH- forms showing energy compliance. The new restrooms have new lighting please provide the LTG- calculations for the added lighting. Item # 28 The completed and signed ENV-1, LTG-1, and MECH-1 forms must be imprinted on the plans. Please make the LTG-1 form a permanent part of the plans Carlsbad 98-2951 10/5198 The jurisdiction has contracted with Esgil Corporation located at 9320 Chesapeake Drive, Suite 208, San Diego, California 92123; telephone number of 619/560-1468, to perform the plan review for your project. If you have any questions regarding these plan review items, please contact Mike Puckett at Esgil Corporation. Thank yQu. Carlsbad 98-2951 9/21/98 VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PLAN CHECK NO.: 98-2951(Revised 10/5/98) PREPARED BY: Mike Puckett DATE: 9/21/98 BUILDING ADDRESS: 2051 Palomar Airport Rd. BUILDING OCCUPANCY: B/Fl/Si TYPE OF CONSTRUCTION: VN BUILDING PORTION BUILDING AREA (ft.2) VALUATION MULTIPLIER IF VALUE ($) Tenant Improvement 450 28.00 Contract Est. 12,600.00 72,829.00 Air Conditioning Fire Sprinklers TOTAL VALUE 12,6094)0-72,829.00 fl 1994 UBC Building Permit Fee Bldg. Permit Fee by ordinance: $ 139.83 502.95 LI 1994 UBC Plan Check Fee Plan Check Fee by ordinance: $ 90.89 326.92 Type of Review: LI Complete Review fl Structural Only LI Hourly fl Repetitive Fee Applicable LI Other: Esgil Plan Review Fee: $ 72.71 261.53 Comments: Sheet I of I macvaue.doc 5196 EsGil Corporation 1n fPartners/iij, with government for Building Safety DATE: 9/21/98 U APPLICANT U JURIS. JURISDICTION: Carlsbad U N REVIEWER U FILE PLAN CHECK NO.: 98-2953L SET: I PROJECT ADDRESS: 2051 Palomar Airport Rd. PROJECT NAME: Tenant Improvement El The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. LI The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff. The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. LI The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. The applicant's copy of the check list has been sent to: Larry Wharton 639 Bison Ct. El Cajon, Ca. 92019 Esgil Corporation staff did not advise the applicant, except by mail, that the plan check has been completed. LI Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Telephone #: Date contacted: (by: ) Fax #: Mail Telephone Fax In Person LI REMARKS: By: Mike Puckett Enclosures: Esgil Corporation 0 GA 0 MB 0 EJ 0 PC 9/8/98 trnsmtidot 9320 Chesapeake Drive, Suite 208 4 San Diego, California 92123 • (619) 560-1468 • Fax(619)560-1576 Carlsbad 98-2951 9/21/98 PLAN REVIEW CORRECTION LIST TENANT IMPROVEMENTS PLAN CHECK NO.: 98-2951 OCCUPANCY: B/Fl/SI TYPE OF CONSTRUCTION: VN ALLOWABLE FLOOR AREA: SPRINKLERS?: REMARKS: DATE PLANS RECEIVED BY JURISDICTION: 9/2/98 DATE INITIAL PLAN REVIEW COMPLETED: 9/21/98 JURISDICTION: Carlsbad USE: Office/Mfr/Whrse ACTUAL AREA: No Change STORIES: 2 HEIGHT: OCCUPANT LOAD: No Change DATE PLANS RECEIVED BY ESGIL CORPORATION: 9/8/98 PLAN REVIEWER: Mike Puckett FOREWORD (PLEASE READ): This plan review is limited to the technical requirements contained in the Uniform Building Code, Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state laws regulating energy conservation, noise attenuation and access for the disabled. This plan review is based on regulations enforced by the Building Department. You may have other corrections based on laws and ordinances enforced by the Planning Department, Engineering Department, Fire Department or other departments. Clearance from those departments may be required prior to the issuance of a building permit. Code sections cited are based on the 1994 UBC. The following items listed need clarification, modification or change. All items must be satisfied before the plans will be in conformance with the cited codes and regulations. Per Sec. 106.4.3, 1994 Uniform Building Code, the approval of the plans does not permit the violation of any state, county or city law. To speed up the recheck process, please note on this list (or a copy) where each correction item has been addressed, i.e., plan sheet number, specification section. etc. Be sure to enclose the marked up list when you submit the revised plans. LIST NO. 40, TENANT IMPROVEMENTS WITHOUT SPECIFIC ENERGY DATA OR POLICY SUPPLEMENTS (1994UBC) tiforw.dot Carlsbad 98-2951 9/21/98 1. Please make all corrections on the original tracings, as requested in the correction list. Submit three sets of plans for commercial/industrial projects (two sets of plans for residential projects). For expeditious processing, corrected sets can be submitted in one of two ways: Deliver all corrected sets of plans and calculations/reports directly to the City of Carlsbad Building Department, 2075 Las Palmas Drive, Carlsbad, CA 92009, (619) 438-1161. The City will route the plans to EsGil Corporation and the Carlsbad Planning, Engineering and Fire Departments. Bring one corrected set of plans and calculations/reports to EsGil Corporation, 9320 Chesapeake Drive, Suite 208, San Diego, CA 92123, (619) 560- 1468. Deliver all remaining sets of plans and calculations/reports directly to the City of Carlsbad Building Department for routing to their Planning, Engineering and Fire Departments. NOTE: Plans that are submitted directly to EsGil Corporation only will not be reviewed by the City Planning, Engineering and Fire Departments until review by EsGil Corporation is complete. 2. Indicate on the Title Sheet of the plans, the name of the legal owner and name of person responsible for the preparation of the plans. Section 106.3.3. 3. Each sheet of the plans must be signed by the person responsible for their preparation, even though there are no structural changes. Business and Professions Code. 4. Please revise the code editions as shown on the Title Sheet item # 9 to 1993 NEC edition in lieu of the 1990 shown. 5. On the first sheet of the plans indicate: The floor area of the remodeled area, Type of construction of the existing building, Present and proposed occupancy classifications of the remodel area, The floor where the tenant improvement is located, The occupant load of the remodel area(s). Whether or not the building is sprinklered. 6. The demising wall suggests the creation of a new tenant space within the building please describe the activities and the processes being done within this tenant space. 7. Please describe the scope of the work to be done under this permit application. Is it solely the restrooms and demising wall or more? Carlsbad 98-2951 9/21/98 UBC Section 107.2 requires the Building Official to determine the total value of all construction work proposed under this permit. The value shall include all finish work, painting, roofing, electrical, plumbing, heating, air conditioning, elevator, fire extinguishing systems and any other permanent equipment. Please provide a signed copy of the designer's or contractor's construction cost estimate of all work proposed. Indicate the use of all spaces adjacent to the area being remodeled or improved. Please dimension the new tenant space. Please provide an exit analysis for the new tenant space. Show two complying exists and rated corridors from the office area per UBC requirements. Show the construction of the corridors if applicable and show the location on the plans. Show all exit light locations on the plans. Please revise the detail J/3.2 to be consistent with the ICBO report 2274 as shown. There is no 24 ga. joist shown nor a 6" deep joist. Please show correct size, gauge, and spacing for the span shown on the plans per the report. Submit plan showing location of all panels. Submit panels schedules and loads new and existing. Indicate wiring method, i.e. EMT, metal flex. Per the City of Carlsbad request please note on the plans that "No AC cable or Romex wiring methods are allowed." Please show mechanical ventilation capable of 5 air changes per hour in each on the restrooms. UBC Section 1202.2.1 Show ducts vented to the outside. Provide complete plumbing plans, including: Complete drain, waste and vent plans. Provide gas line plans and calculations, showing pipe lengths and gas demands. UPC Section 1217.0, if applicable for water heater. Provide complete water line sizing calculations, including the water pressure, pressure losses, water demands, and developed pipe lengths. UPC Section 610.0 Show water heater size, type and location on plans. UPC, Section 501.0 Show that water heater is adequately braced to resist seismic forces. Provide two straps (one strap at top 1/3 of the tank and one strap at bottom 1/3 of the tank). UPC, Section 510.0 Show P & T valve on water heater and detail drain line route from P & T valve to the exterior. UPC Section 608.5. Carlsbad 98-2951 9/21/98 Show 1/4" per 12" slope on drain and waste lines. UPC Section 708.0. Provide a note on the plans: In showers and tub-shower combinations, control valves must be pressure balanced or thermostatic mixing valves. UPC Section 410.7 Show the size, location and type of all heating and cooling appliances or systems. Provide mechanical plans showing existing and proposed HVAC equipment, ducts and access to equipment. Provide plans, calculations and worksheets to show compliance with current energy standards. Provide complete energy designs for the proposed changes in envelope, lighting, and mechanical systems. Provide the completed ENV-, LTG-, and MECH- forms showing energy compliance. On the plans clearly show the wall and roof insulation locations, thickness, and R- values, as per the energy design. The completed and signed ENV-1, LTG-1, and MECH-1 forms must be imprinted on the plans. DEPARTMENT OF STATE ARCHITECT NON RESIDENTIAL TITLE 24 DISABLED ACCESS REQUIREMENTS The following disabled access items are taken from the 1995 edition of California Building Code, Title 24. Per Section 101.17.11, all publicly and privately funded public accommodations and commercial facilities shall be accessible to persons with disabilities as follows: Any building, structure, facility, complex, or improved area, or portions thereof, which are used by the general public. Any sanitary facilities which are made available for the public, clients, or employees in such accommodations or facilities. Any curb or sidewalk intended for public use that is constructed with private funds. All existing accommodations when alterations, structural repairs or additions are made to such accommodations. NOTE: All Figures and Tables referenced in this checklist are printed in the California Building Code, Title 24. Carlsbad 98-2951 9/21/98' REMODELS, ADDITIONS AND REPAIRS When alterations, structural repairs or modifications or additions are made to an existing building, that building, or portion of the building affected is required to comply with all of the requirements for new buildings, per Section 11 34B.2. These requirements apply only to the area of specific alteration, repair or addition and shall include: A primary entrance to the building and the primary path of travel to the area in question, and include the following items which serve the area in question: Sanitary facilities. Drinking fountains. Public telephones. 32. If an unreasonable hardship finding is granted, priority should be given, to those elements that will provide the greatest access, per Section 113413.2.1 Exception #1. The order of priority shown below should be followed: An accessible entrance. An accessible route of travel. At least one accessible restroom for each sex. Accessible telephones. Accessible drinking fountains. When possible, additional accessible elements such as parking, storage and alarms. On the site plan please show the disabled accessible path of travel from the disabled accessible parking space(s) to the tenant space entrance. Please show all the existing doors and hardware to be disabled accessible complying. In the multiple accommodation restroom please show a 60" clear space in front of the disabled accessible stall. To speed up the review process, note on this list (or a copy) where each correction item has been addressed, i.e., plan sheet, note or detail number, calculation page, etc. Please indicate here if any changes have been made to the plans that are not a result of corrections from this list. If there are other changes, please briefly describe them and where they are located in the plans. Carlsbad 98-2951 9/21/98 Have changes been made to the plans not resulting from this correction list? Please indicate: Yes NoU The jurisdiction has contracted with Esgil Corporation located at 9320 Chesapeake Drive, Suite 208, San Diego, California 92123; telephone number of 619/560-1468, to perform the plan review for your project. If you have any questions regarding these plan review items, please contact Mike Puckett at Esgil Corporation. Thank you. I Carlsbad 98-2951 9/21/98 VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PLAN CHECK NO.: 98-2951 PREPARED BY: Mike Puckett DATE: 9/21/98 BUILDING ADDRESS: 2051 Palomar Airport Rd. BUILDING OCCUPANCY: B/Fl/Si TYPE OF CONSTRUCTION: VN BUILDING PORTION BUILDING AREA (ft. 2) VALUATION MULTIPLIER VALUE ($) Tenant Improvement 450 28.00 12600.00 Air Conditioning Fire Sprinklers TOTAL VALUE 12,600.00 0 1994 UBC Building Permit Fee R Bldg. Permit Fee by ordinance: $ 139.83 El 1994 UBC Plan Check Fee • Plan Check Fee by ordinance: $ 90.89 Type of Review: El Complete Review El Structural Only El Hourly El Repetitive Fee Applicable El Other: Esgil Plan Review Fee: $ 72.71 Comments: Sheet I of I macvalue.doc 5196 FROM : Panasonic FAX SYSTEM PHONE NO. : May. 06 1999 04:03PM P1 MS S MacDonald-Stephens, Engineers, Inc. A CIVIL ENGINEERING COMPANY May 6, 1999 Mr. Ted Shifflert Matrix Engineers & Contractors, Inc. 475 Production Street San Marcos, CA 92069 RE: Melles Griot 2051 Palamar Airport Road Carlsbad, CA 92008 Dear Mr. Shifllett: We have reviewed several of the construction items you have brought to our attention. After consideration, we take no exception to the following: Using a #4/0 AWG bare copper conductor encased in concrete below a concrete slab for the "UFER." ground. Main switch may be fusible "bolted pressure switch". 200A fused switches may be used in lieu of circuit breakers for transformers "TA]" through "TA6'. Should there be any questions, please call. Sincerely, MACDONALD-STEPHENS, ENGINEERS, INC. Robert Parsons, P.E. 24741 Cririsanta Drive. Suite 100, Mission Viejo. California 92691-4812 (949) 459-8844 FAX: (949) 458-8266 Matrix Engineer's & Contractors Inc. Lic.# 541170 475 Production Street San Marcos Ca, 92069 Phone (760)744-4600 Fax (760)744-4607 To whom it may concern regarding the Project Melles Grlot Located at 2051 Palomar Airport Road Carlsbad California 92008 Plan Check #982951, 990039, and 990127. Please let this letter serve Is a guarantee that on 6/3/99 all the Electrical Service Wire Terminations Torque is to Manufacture specifications and were done by Calibrated Torque Wrench by qualified LB.E.W. Personal with the following settings. 1/8" Allen type 43-47 Inch Pounds '/4 Allen type 62-68 Inch Pounds 3/8" Allen type 18-22 Foot Pounds 1/2" Allen type 47-53 Foot Pounds 9/16" Allen type 52-55 Foot Pounds All terminations not listed here are also completed to specifications. Including but not limited to Transformers, Distribution Boards, Panel Boards, SwitchBoards, Disconnects, and Equipment Terminals. If you have any questions please do not hesitate to call our office 991010.LTR PLANNING/ENGINEERING APPROVALS PERMIT NUMBER CB 9 ?J? 51 DATE _g c ADDRESS Z-o~( A IL RESIDENTIAL TENANT IMPROVEMENT RESIDENTIAL ADDITION MINOR PLAZA CAMINO REAL (<$10,000.00) VILLAGE FAIRE COMPLETE OFFICE BUILDING OTHER PLANNER DATE DATE ziJ C:WP51FILES\8LDG.FRM Rev 11115190 - City of Carlsbad 98310 Fire Department • Bureau of Prevention Plan Review: Requirements Category: Building Plan Check Date of Report:Friday, November 6, 1998 Reviewed by:_ Contact Name Larry Wharton Address 639 Bison Ct City, State EI Cajon CA92019 Bldg. Dept. No. CB982951 Planning No. Job Name Spec Suite Job Address 2051 Palomar Airport Ste. or Bldg. No. 10 Approved The item you have submitted for review has been approved. The approval is based on plans; information and/or specifications provided in your submittal; therefore any changes to these items after this date, including field modifica- tions, must be reviewed by this office to insure continued conformance with applicable codes. Please review carefully all comments attached, as failure to comply with instructions in this report can result in suspension of permit to construct or install improvements. O Disapproved - Please see the attached report of deficiencies. Please make corrections to plans or specifications necessary to indicate compliance with applicable codes and standards. Submit corrected plans and/or specifications to this office for review. For Fire Department Use Only Review 1St 2nd 3rd Other Agency ID CFD Job# 98310 File#__________ 2560 Orion Way 0 Carlsbad, California 92008 (619) 931-2121 B U I L D I N G P E R M I T PCR No: PCR98236 12/17/98 11:38 Project No: A9803832 Page 1 of 1 Development No: Job Address: 2051 PALOMAR AIRPORT RD Suite: Permit Type: PLAN CHECK REVISION Parcel No: 213-050-39-00 Lot#: Valuation: 0 Occupancy Group: Ref erence#: Description: REVISION-DETAIL AT CEILING Appl/Ownr : WHARTON LARRY 639 BISON CT EL CAJON CA 92019 **k Fees Required *** --------------------------- ------ Adjustments 47 Total Fees: Toi Fee description Plan Check Revision ' 02 ON val, a W, " 1 0; 0; M, i INSP. __ DATEI. I CLEARANCE- CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 Construction Type: NEW Status: ISSUED Applied: 12/03/98 Apr/Issue: 12/17/98 Entered By: JM 619 203-1773 Collected & Credits ------------------------- NO OEM .00 .00 55.00 Ext fee Data 96-O0Of--01---02-- 61?M1O0 50.,00 44/12/17/98 0001 01 CPRMT PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 I. 1. PROJECT INFORMATION PAZZAAA;t A10 FOR OFFICE USE ONLY PLAN CHECK NO. ii33l3t EST. VAL. Plan Ck. Deposit Validated By_ Address (include Bldg/Suite I) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total 9 of units Assessor's Parcel 9 Existing Use Proposed Use Description of WorkZf 7 Bedrooms #of Bathrooms - . CONTAcTPERSON Of different from appllcantj - .-.-- - Telephone 9 Fax 9 Name Address City State/Zip APPLICANT 0 Contractor 0 Agent for Contracor 0 Ôwne O Ageiji ior Owner ' Name Address City State/Zip Teihone# PROPERTY OWNER Name Address City State/Zip Telephone 9 S CONTRACTOR COMPANY NAME (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 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 185001). 02 144 Name /? Address City State/Zip Telephone I State License I License Class City Business License I Designer Name Address City State/Zip Telephone State License I 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 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 Policy No. Expiration Date___________________ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 191001 OR LESS) 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 cIvU 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 7. OWNER-BUILDER DECLARATION I hereby affirm that 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(s) licensed pursuant to the Contractor's License Law). I am exempt under Section Business and Professions Code for this reason: I personally plan to provide the major labor and materials for construction of the proposed property Improvement. 0 YES DNO I (have / have not) signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction (Include name / address / phone number I contractors license number): 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 I phone number / contractors license number): 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 coMPLETE THIS SECTION FOR NÔN-RESIDENTZ4L BUILDtNG PEAI'AIT oNL T'' ,.. ................ 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? 0 YES 0 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 0 NO Is the facility to be constructed within 1.000 feet of the outer boundary of a school site? 0 YES 0 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. - CONSTRUCTION LENDINd AGEIicy ' - .' • - - -. - -. -, ,, - - - 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 APPLICANT CERTIFICATION '- 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 Cit%' 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 p visions 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 day m the date of such permit or If the building or work authorized by such permit is suspended or abandoned at anytime after the work is commenced for a at of 180 days (Section 108.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE /2 —3 '-P ? WHITE: File YELLOW: Applicant PINK: Finance Carlsbad PCR98-236(Orig.98-2951) 12114/98 EsGil_Corporation 1n Partnership with government for Building Safety DATE: 12/14/98 [~l ~APNT JURI II L4 JURI JURISDICTION: Carlsbad Q PLAN REVIEWER D FILE PLAN CHECK NO.: PCR98-236(Orig.98-2951) SET: I PROJECT ADDRESS: 2051 Palomar Airport Rd. PROJECT NAME: Plan Revision/ Partition Attachment I1 The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified in Remarks below are resolved and checked by building department staff. LI The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. LI The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. fl The applicant's copy of the check list has been sent to: U Esgil Corporation staff did not advise the applicant that the plan check has been completed. LII Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Telephone #: Date contacted: (by: ) Fax #: Mail Telephone Fax In Person U REMARKS: Please make notes as in red on sheet 3.1 of the Owner I Revision to the City I Revision. By: Mike Puckett Enclosures: Esgil Corporation 0 GA lJ MB 0 EJ 0 PC 12/7/98 trnsmtl.dot Carlsbad PCR98-236(Orig.98-2951) 12/14/98 VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PLAN CHECK NO.: PCR98-236(Orig.98-2951) PREPARED BY: Mike Puckett DATE: 12/14/98 BUILDING ADDRESS: 2051 Palomar Airport Rd. BUILDING OCCUPANCY: B TYPE OF CONSTRUCTION: VN BUILDING PORTION BUILDING AREA (ft.2) VALUATION MULTIPLIER VALUE ($) Plan Revision No Change See Comments See Comments Air Conditioning Fire Sprinklers TOTAL VALUE See Comments LI 199 UBC Building Permit Fee LI Bldg. Permit Fee by ordinance: $ LI 199 UBC Plan Check Fee LI Plan Check Fee by ordinance: $ Type of Review: LI Complete Review LI Structural Only • Hourly LI Repetitive Fee Applicable fl Other: Esgil Plan Review Fee: $ 43.58 Comments: Esgil Fee = 1/2hr. at $87.15/hr. = $43.58 Sheet I of I macvalue.doc 5196 ON of Carlsbad Plan Check Revision Job Address: 2051 PALOMAR AIRPORT RD Permit Type: PCR Parcel No: 2130503900 Lot #: Reference No: CB982951 PC #: Project Title: STRUCT. PLNS FOR BATHRM UPGRAD Permit No: PCR99042 Status: EXPIRED Applied: 01/28/1999 Approved: Issued: Inspect Area: Applicant: Owner: HOSFORD, MARK SUNROAD PALOMAR PARTNERS L P 475 PRODUCTION ST 1455 FRAZEE RD #1000 SAN MARCOS CA SAN DIEGO CA 760-744-4600 Fees: $0.00 Additional Fees: $0.00 Total Fees: $0.00 Balance: $0.00 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Pamas Dr., Carlsbad CA 92009 (760)438-1161 FOR OFFICE USE ONLY PLAN CHECK 04z EST. VAL. Plan Ck. Deposit Validated By Date (include Bldg/Suite #) - Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use Proposed Use 9cnption of Work #of Stories - - # of Bedrooms # of Bathrooms Address - City State/Zip Telephone.5r, j7 Rx Name - Address City State/Zip Telephone # Name Address City State/Zip Telephone I (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any str u c t u r e , p r i o r t o i t s issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the C o n t r a c t o r ' s L i c e n S e L a w (Chapter 9, commanding with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basi s f o r t h e a l l e g e d exemption. Any violation of Section 7031.5 by any applicant for,9ermit s9bjects the applicant toe civil penaltVpt not more than five h u n d r e d d o l l a r s I $ 5 0 0 1 ) . Name - Address ' City State/Zip Telephone IF State License I è'7 / 2O License Cie ssf City Bus!pess License I ____ / nJcei-t. //o83 /'/ ,tijca da ci ~fo 7 Z4 Designer hIme Address .1 City State/Zip Telephone State License I Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 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 perform a n c e 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 t h i s p e r m i t i s 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 ($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 i n a n y m a n n e r s o a s 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 crknlnal penalties and civil fines up to o n e h u n d r e d thousand dollars ($100,000). In addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code. Interest and a t t o r n e y ' s f e e s . SIGNATURE DATE I hereby affirm that I em 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 in t e n d e d o r o f f e r e d f o r s a l e (Sac. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or impr o v e s t h e r e o n , a n d w h o d o e s such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the buildin Ô o r i m p r o v e m e n t i s 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 : T h e Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projec t s w i t h c o n t r a c t o r ( s ) l i c e n s e d pursuant to the Contractor's License Law). - 0 I am exempt under Section Business and Professions Code for this reason: I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO I (have / have nOt) signed an application for a building permit for the proposed work. I have contracted With the following person (firm) to provide the proposed construction (include name / address / phone number / contractors lice n s e n u m b e r ) : 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 / a d d r e s s / p h o n e number I contractors license number): I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / pho n e n u m b e r / t y p e of work): PROPERTY OWNER SIGNATURE DATE ai Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk man a g e m e n t a n d p r e v e n t i o n program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act O--ss__D. 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 0 NO lathe facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0. NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET O R-IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTIONCONTROL DISTRICT. - I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 30970) Civil Co d e ) . LENDER'S NAME LENDER'S ADDRESS - - I certify that I have read, the application and state that the above information i correct and that the Information on the plans Is accurate. I agree to co m p l y w i t h a l l City ordinances and State laws relating to building construction. I hereby authorize representatives of the Clt' of Carlsbad to enter upon th e a b o v e m e n t i o n e d - property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST A L L L I A B I L I T I E S , JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING O F T H I S P E R M I T . 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 vo i d i f t h e b u i l d i n g o r work authorizea .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 s u s p e n d e d or abandoned at any time after t Mark Is commen dIor a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE .- DATE, WHITE: File YELLOW: Applicant PINK: Finance