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HomeMy WebLinkAbout2056 PALOMAR AIRPORT RD; MULTI-PERMIT FILE; CB140610; Permit03-18-2014 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB140610 Building Inspection Request Line (760) 602-2725 Job Address: 2056 PALOMAR AIRPORT RD CBAD Permit Type: PME Status: ISSUED Parcel No: 7602212100 Lot #: 0 Applied: 03/18/2014 Entered By: LSM Reference #: Plan Approved: 03/18/2014 PC #: Issued: 03/18/2014 Inspect Area: Project Title: JET SOURCE- REPLACE APPROX 50 FT OF EXISTING DRAIN LINE DUE TO DAMAGE FROM BUILDING INTO PARKING LOT Applicant: Owner: JOHN STEVENSON PLUMBING RIECK DENNIS <DBA QUALITY AIRCRAFT CARE> STE C103 6355 CORTE DEL ABETO 2056 PALOMAR AIRPORT RD CARLSBAD CA 92011 CARLSBAD CA 92011 760 918-0456 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES $158.00 $0.00 $0.00 $0.00 $158.00 Total Fees: $158.00 Total Payments To Date $158.00 Balance Due: $0.00 FINAL APPROVAL Inspector: (Z ' Date: 2/'1 Y Clearance: 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 Carisbad 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 THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: D PLANNING M ENGINEERING F-1 BUILDING 0 FIRE M HEALTH J HAZMATIAPCD Building Permit Application Plan Check No. (2%0- 14 (0 Est. Value 1635 Faraday Ave., Carlsbad, CA 92008 C I i y 0 F Ph: 760-602-2719 Fax 760-602-8558 Plan Ck. Deposit email: buildingcarlsbadca.gov Date 3) swPPP I c:i\R LSBIAD www.carlsbadca.gov JOB ADDRESS aZ ,epor £cL. I SUITE#/SPACE#/UNIT# I APN - - - CT/PROJECT U LOT U PHASE U U OF UNITS U BEDROOMS U BATHROOMS I TENANT BUSINESS NAME CONSTR. TYPE 0CC. GROUP I I DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) 11 L/ 4- i-h rt 15 EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) I FIREPLACE I AIR CONDITIONING 1 FIRE SPRINKLERS 1 1 YES [3#. N0I YESDNOE YESDNOE APPLICANT NAME (Primary Contact) Jeff Heyveld APPLICANT NAME (Secondary Contact) ADDRESS ADDRESS 6355 Corte Del Abeto C-103 CITY STATE ZIP - CITY STATE - ZIP Carlsbad Ca 92011 PHONE FAX PHONE FAX 760-918-0456 EMAIL EMAIL Jeffjsphvac.com PROPERTY OWNER NAME CONTRACTOR BUS. NAME John _Stevenson _Plumbing_&_Mech_Inc ADDRESS ADDRESS 6355 Corte Del Abeto C-103 CITY STATE - ZIP CITY STATE ZIP Carlsbad Ca 92011 PHONE FAX PHONE 760-918-0456 IF' _760-918-0352 EMAIL _________ EMAIL lnfojsphvac.com ARCH/DESIGNER NAME & ADDRESS STATE LIC. U STATE LICe CLASS 588895 _C-3620 _I_1208637 CITY BUS. LICe (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair anystructure, prior to its issuance, also requires tire applicant for such permit to tile a signed statement that he is licensed pursuant to the provisions of the Contractors License Law IChapter 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 ,-j.,ii nnit, nf nnt mnra than fl,, h,,n,lrprl dnllxrx (SCOOtI. Workers' Compensation Declaration: I hereby affinn under penally of perjury one of the following declarations: El I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 370001 the Labor Code, for the performance of the work for which this permit is issued. LII 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 Dale This section need not he completed if the permit is for onl 100) or. [J 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 10 the Workers' Compensaon 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 o ,interest and attorney's fees. CONTRACTOR SlGNATURE ;;;;;:i:,_e___4P AGENT DATE 3 QOWDO thereby affirm that lam exempt from Contractor's License Law for the following reason: [] I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply loan owner of properly 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 Contractors License Law does not apply loan 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 Eyes ENo 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! contractors' license number): I plan to provide portions of the work, bull have hired the following person to coordinate, supervise and provide the major work (include name! address/phone! contractors' license number): twill provide some of the work, bull have contracted (hired) the following persons to provide the work indicated (include name! address! phone! type of work): ,PROPERTY OWNER SIGNATURE []AGENT DATE Mm : 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 I - No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Yes 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 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 this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name - Lender's Address - -- I certify that l have mad the application and state thatthe above information is correct and thatthe Information on the plans is accurate. I agree to complywtth all City ordinances and State laws relating to building construction. I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspection purses. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAiNST SAID CITY INCONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA An OSHA permit is required for excavations over 50' deep and demolition or construction of structures over 3 stories to height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation a me null and void it the building or work authorized by such permit is not commenced within -180 days from lire date of such permit or if the building or work authorized by such permit is suspended orabandon at ytime after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code).. APPLICANT'S SIGNrT9/ 7 DATE -'-- : STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. 'Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. CERTIFIC A T E OF OCCUPA .w P roje c ts Fax (760) 602-8560, Email buiIdingäcarlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. co#: (Office Use Only) CONTACT NAME -. - OCCUPANT NAME - - ADDRESS - - BUILDING ADDRESS - CITY - STATE - ZIP - CITY STATE -. ZIP Carlsbad CA PHONE - EMAIL - -. - . OCCUPANT'S BUS. LIC. No. - DELIVERY OPTIONS 'J PICK UP: !j CONTACT (Listed above) r'i OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) ' - .- MAIL TO: CONTACT (Listed above) OCCUPANT (Listed above) ASSOCIATED CB I CONTRACTOR (On Pg. 1.) NO CHANGE IN USE / NO CONSTRUCTION '-MAIL/ FAX TOOTHER: - CHANGE OF USE/ NO CONSTRUCTION APPLICANT'S SIGNATURE. - DATE THE FOLLOWINd APPROVALS REQUIRED PRIOR TO PERmrr ISSUANCE: DPLANNING DENGINEERING DBUILDING [!]FIRE [--]HEALTH DHAZMAT(APCDI C I I V 0 F C 1\RLSBAD. Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building©carlsbadca.gov , www.carlsbadca.gov Plan Check No. Est. Value Plan Ck. Deposit Date JSWPPP I JOB ADDRESS SWTEC/SPACE#/UNIT# APN CT/PROJECT S LOT S PHASE B S OF UNITS I B BEDROOMS S BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE DCC. GROUP DESCRIPTION OF WORK: include Square Feet of Affected Area(s) EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) s FIREPLACE YESEI# N6I1 AIR CONDITIONING .YES N0E FIRE SPRINKLERS YES[:] NO[:] APPLICANT NAME (Primary Cntact) APPLICANT NAME (Secondary Contact) ADDRESS ADDRESS - CITY STATE ZIP . CITY STATE ZIP PHONE - FAX PHONE FAX EMAIL - EMAIL PROPERTY OWNER NAME CONTRACTOR BUS. NAME . . ADDRESS . . ADDRESS CITY . STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL . EMAIL - ARCH/DESIGNER NAME & ADDRESS STATE LIC. S . STATE LIC.# CLASS . CITY BUS. LIC.# (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, commendingwith 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)). Workers' Compensation Declaration: (hereby affirm underpena6 of pe4ury one of the following declarations: U 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. F-11 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. - - []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 Califomia. 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, CONTRACTOR SIGNATURE . , 0 AGENT DATE (hereby affirm that lam exempt from Contractor's License Law for the following mason: [j 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). [J 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: - (personally plan to provide the major labor and materials for construction of the proposed property improvement. EYes [:]No - ((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/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 contractors' license number): (will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name! address! phone! type of work): .PROPERTY OWNER SIGNATURE . . DAGENT DATE Inspéction List Permit#: C13I40610 Type: PME JET SOURCE- REPLACE APPROX 50 FT OF EXISTING DRAIN LINE DUE TO Date Inspection Item InspectorAct Comments 05/20/2014 21 Underground/Under Floor - RI SEWER PIPE REPLACEMENT! UNSURE OF CODE 05/20/2014 21 Underground/Under Floor PB AP 05/20/2014 29 Final Plumbing PB AP Wednesday, May 21, 2014 Page 1 of 1 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 01-06-2014 Permit No: CB140006 Building Inspection Request Line (760) 602-2725 Job Address: 2056 PALOMAR AIRPORT RD CBAD Permit Type: PME Status: ISSUED Parcel No: 7602212100 Lot #: 0 Applied: 01/06/2014 Entered By: RMA Reference #: Plan Approved: 01/06/2014 PC #: Issued: 01/06/2014 Inspect Area: Project Title: PALOMAR AIRPORT-REPLACE EXISTING 100 AMP METERED PEDISTAL WI NEW 100 AMP PEDISTAL-USED FOR LIGTING & GATE Applicant: Owner: NATIONAL ELETRIC WORKS INC. RIECK DENNIS <DBA QUALITY AIRCRAFT CARE> STE 101 4440 RAINIER AVE 2056 PALOMAR AIRPORT RD SAN DIEGO CA 92120-3319 CARLSBAD CA 92011 619-528-2880 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES $0.00 $158.00 $0.00 $0.00 $158.00 Total Fees: $158.00 Total Payments To Date $158.00 Balance Due: $0.00 FINAL APPRØVAL Inspector: q' Date: i/3o/iy" Clearance: NOTICE: Please take NOTICE that Oproval 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 rlght 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 APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: DPLANNING DENGINEERING DSUILDING EJFIRE DHEALTH DHAZMAT,APCD Building Permit Application Plan Check No. (( Fz , 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value C I TV OF Ph: 760-602-2719 Fax: 760-602-8558 CARLSBAD email: buildingcarlsbadca.gov Plan Ck Deoslt V~ _- www.carlsbadca.gov Datellb I I -f Fswpp 1 JOB ADDRES§ '1 cr5 b f'ctIo'( (+ )' SUITE#/SPACEI/UNITI I I - - CT/PROJECT # I LOT U PHASE U # OF UNITS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP 7 i J#BEDROOMS I DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) 00 #4ri# 1204,'o v me+er lee (J€vJ XW€ EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONINGFIRE NOI SPRINKLERS IYESD! YES DNo J YESD NOD APPLINTN, (PMary C,ontact) j.)vuf APPLICANT NAME (Secondary Contact) ADDRESS L14L40 R7-Vi t- ,4e. ADDRESS CIV STATE ZIP CITY STATE ZIP )eAVl PON bI-?p-2) Lo I 'FAX PHONE FAX I EM,AI c5 EMAIL PROPERTY OWNER NAME CONTXp;0111 BUS. NAME M461 ADDRESS ADDRESS hW q Li LIU AI,U' CITY STATE ZIP C?ZIP PHONE FAX PHONE FAX EMAIL - EMAIL ARcH/DESIGNERNAME&AODRESS ]STATELIC.# A TE UC.# ST 5J)I,i CLASS I - io I CITY BUS. LIC.# I /2 /"c, -i# (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 ($500)). Compensation Dediratlon: I hereby affirm unier penalty of perjury one of the following declarations: I have and wIll maintain a certificate of consent to aelf.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 reqoired 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. _/v'S l"S, D, Expiration Date i section need not be completed if the permit Is for one hundred dollars ($100) or less. 4' hdtortificate 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 civIl fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensadonamages as provided for In Section 3706 of the Labor code, Interest and attorneys fees. CONTRACTOR DAGENT DATE 1/0 I hereby affirm that! am exempt from Contractor's License Law for the following reason: I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure Is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon,.and who does such work himself or through his own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's 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). [J 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 DYes [:]No 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/ contractors' license number): I plan to provide portions of the work, bull have hired the following person to coordinate, supervise and provide the major work (Include name/address/ phone / contractors' license number): I will prode some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address! phone! type of work): ZPROPERTY OWNER SIGNATURE - []AGENT DATE Is the applt or future building occupant required to submit a business plan, acutely hazardous materlais 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? Yes No Is the facility to be constructed within 1,000 feet of the outer boundary ofaschool site? Yes 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 construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address Iceitfythati have madth application andsbstathatthe above bdomralion Is comectandthattlhe In nationontheplansteacanata. IagmetaipIywith all CIty ordInances and State laws retatingfobuildIngconstiuton. I hereby aulhorrze representative of the City of Carlsbad ID enter upon the above rnentbned property for inspedlan purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEB' HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID C11'Y' INCONSEQUENCE OF THE GRANTING OF THIS PERMfl,. 09-IA An OSHA permit is required for excavations over 69 deep and demolition or construction of structures over 3stories in height. EXPIRATiON: Every permit issued by the Biding OIal under the provisions of this Code shall expire by limitation and become null and void if the building orwork authorized by such permit isnot commenced within 180 days from the data of such permit or if the taifuirrgproik authorized by such permit is suspended or abandoned at any time afterthe work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). DATE STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. Fax (760) 6024560, Email buiIdinQ(Cartsbadca.Qov or Mall the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME . ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE FAX 0 EMAIL OCCUPANTS BUS. LIC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (listed above) CONTRACTOR (On Pg. 1.) ASSOCIATED CB# MAIL TO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On P. 1) NO CHANGE IN USE / NO CONSTRUCTION MAIL/ FAX TO OTHER: CHANGE OF USE / NO CONSTRUCTION APPUCANVS SIGNATURE DATE , .. Inspection List Permit#: CB140006 Type: PME PALOMAR AIRPORT-REPLACE EXISTING 100 AMP METERED PEDISTAL Date Inspection Item InspectorAct Comments 01/29/2014 32 Const. Service/Agricultural - RI 12-1 PM PLS 01/29/2014 32 Const. Service/Agricultural PY AP 01/29/2014 39 Final Electrical PY AP Thursday, January 30, 2014 Page 1 of 1 2098 PaIomirJtRd m.tnrr.dihu1 YA on (7)47 v c 1$ad it -DTBCOflRPC uliding 6fl PalOmarArrpottRb JAN 01 U E B Y -L:2aXr— Pkees call your $eeCcardl,rctec kurrew Castro st76o.4Th.pl4 with quexuopse ebouLlnspecUcn cuucticnhrsl.thflon and to schedule aciere, To minimize theelactiieitOutage. you gig advised to scbedulea moridngdlsxnnecl aflhan afternoon re onrre.Thsre1s no charqe lorihis service. Uelorwyotz cangeoul your meter conlderSDE wit nofzexnecdnm service withoutmunlclpalspprovalcnthe new parre?.Pleaee contactUreCtty tegaullng permits end lnspectlons.C11 Inspection should be received puerto 2:00 p.m. on the sarnedayasthedlsconnectfon of seiviceto allow the SDG2F crew enough time for reconnectlonoftheservics on iheserne day. im24I mee seWcbmi .alPw 5001E tbWVe .bbi5m oseezmcea4ur1tw,, IDGeE. ,IO,,wA eilvbr Mt meknseeb serirlmmee Ic..p Cbnosei1U,taihip AREILNO a - Co I so GO ASThEW2!U1W w,1 , fl,i (ihi tncncrlini P4edKm 354597 - I Joblo: 010 Pirsect im. CO OF SAN DIEGO (S01) UG RAN ThectAddresr 2056 PIMAR ARPR1 RD PyoJectC CARLSBAD CusiomerPhomit 160-9663272 Ccnlad W1WE VASQIJEZ CcnactPAoreI 760-966-3272 JJefflc Conbo PetndtRdred. Ex o&EnczcecirnerI Pdte Req4edBy Se Attethtiai Mete? Lore6ee: Replace existing rusted 100-amp meter pedestal at existing location over existing conduit and service conductors. NO UPGRADE ALLOWED. Customer assumes responsibility for existing conductor condition. Call Andrew at 760.476.5614 to schedule a morning disconnect with an afternoon reconnect provided that the City releases inspection to SOME by 2-.00 PM on the same day the crew is scheduled. To avoid delays with reconnection, your permit should read (Customer Outage Involved). 0 SOG6EApp1ca&r ReØed-C MeekflIInPeCfl0A Reqi*ed Sy City of Carlsbad Il.IgM-4 n.(30cn. d 5plom.Wkctd -63• ,.-- FrcmNshisde leecfmerba?e. PMNI me rc.rimd bbs mW#j icoeeilbb 24 hGas psr day. iMbrs mW be bcaisd tea sals ares to ci aiw poie?f hazedce c i1angeuI widNrn. Pmide $4L X3lliArtnwrn eare vkb sps 1ufrdntc1rct& vflrere mete? icarir te prepesed. ccniacI(hsmma eeame1SOO8ErIbe. bbMrbuuaedceWemdredissclISnhulbe bealadaloredjMbaaehotherplbd bsbntltedslai1rese lid urtrunberIiawt PROCEDURE FOR INSTAliMION I. PHONE DIG ALERT 1-600-227-2600 AT LEAST TWO DAYS PRIOR TO TRENC+IG FOR LOCATION OF UNDERGROUND UT1UJIES. 2. Phone SUG&E at760-476-5614 (or the bllovAng 3 worklM days prior lo kenthlre ba1r1n05 peIwIir Inspoeft ancl lAsto troacav preceas. Atre,cava0on of varwk krsleliaiioa Of OCIidIITtand ere4ca enfrence equ,mmitsI meter Iocetfon CA I FORINSPECTION. Do rid cover condalitIecpectofb wilOen oppmal to backfli 'Aflrnn ItemdI Is beotihed and retnpsd4 CALL FOR INSPECTION. If ieratoa entrance eqitpmenLb 1mted eAse bectNl CALL FOR INSPECTION OF THE EIIJPMENT. 3 Meteicsernathie sell aIeepeetor has appeoved Installation, including iendceequlinti. and rece%il of dIyuntyIaie hpecn deasnos. PowecSaurte? 1269-155 I SbuweNienbec D1UE309 Joint Trench W11C Kandhoie Inubeled by Stairderds Pe# If encircle (Al Steal Re: LaddvAarne? 1 S1,Trenc!c ecmpote I Riser Oua& Band frrc%edby Type: CndiâtIisteJIedby Cbo&ItS1za 8eMcePairadRdleg: 100 Number/Size ci Main Ewlith: 10100 Amp VdIe 1201240 #clWres 3 Phaw SlnTe Uhntiee Maximum OØIItJIbU2On locate Cwrenl 42000 Ampa tIW,s RnI - IMierCipx 4 TeSrvlcec)erqeOueon FhtBiII ELECTRIC UNDERGROUND METER & SERVICE LOCATION Customer Copy MrTucw hG Rawim (no trenchinn Commercial C— c ' T.R. -1127-03_ c : etePrupemd 0510212013 r. 19,2 02 60-00 N - N / / \ 041 06/10/05 0002 01 c6P Cf., City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 0610-2005 Electrical Permit Permit No: CB052178 Building Inspection Request Line (760) 602-2725 Job Address: 2056 PALOMAR AIRPORT RD CBAD Permit Type: ELEC Status: ISSUED Parcel No: 7602212100 Lot #: 0 Applied: 06/10/2005 Entered By: RMA Reference #: Plan Approved: 06/10/2005 Issued: 06/10/2005 Project Title: JET SOURCE-CONSOLODATE 12 ELEC Inspect Area: RB METERS IN TO ONE Applicant: Owner: SOCAL ENERGY - . RIECK DENNIS <DBA QUALITY AIRCRAFT CARE> -, 2056 PALOMAR AIRPORT RD 23542 CAMPESTRE 92691 /' CARLSBAD CA 92008 949 540-0350 / .. Electric Issue Fee " $10.00 Single Phase per AMP - .' 0- N , $0.00 Three Phase per AMP 0 - 0 , $000 \ \'"' Three Phase 480 Per AMP : ,, $0.00. Remodel/Alteration per AMP 0 $0.00 Remodel Fee N $0.00 Temporary Service Fee "$0 00 /Z'$0.00 Test Meter Fee . $0.00 Other Electrical Fees \. . L $50.00 Additional Fees - '- ' $0.00 * TOTAL PERMIT FEES r \, '. f 7 -- -: -'- $60.00 / Total Fees: $60.00 Total Payments To Date: .. $0.00 Balance Due: $60.00 FINAL APPROVAL Inspector: J (T Date: 6 5C'- Clearance: 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 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK N0.(',/30 EST. VAL. Plan Ck. Deposit Validated By ,- Date 1. PROJECT INFORMATION c,.fAr '&,rtor occ C cscb ('ci 7,rr 59C)C2 Address (include 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 1100 r Q(C U (,pzoseyse Description of Work SQ. FT. Stories- # of Bedrooms # o Bathrooms 2.. CONTAcT, PERSON (if different, from applicant) To.p tec-a, 13s q-.. C ?TI q9' -5•'1 V7I - Name Address V City 14 State/Zip Telephone # Fax # APPLICANT R Contraçtor D..Agent for Contractor DOwner 0 Agent for GwneL Sc.( eItr F j4otr a c, T. iic C, ? V 9 95V17f Name Adffreqrf tity - State/Zip \J Telephone # 4. PROPERTYOWNER sc urce .. aDs rr & (&rfb 76c Name ' ' Address City State/Zip Telephone # 5... '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 ($5001). soC( s1 QL r 4plrcc t. .3 5— CV Iso' - 01c Ca... 99 54o &Js Name C/(dess City State/Zip Telephone # State License # U. 9 ? (Q7 License Class CCC) 6.0 £ 'f lo City Business License # /2... 1 1 .37 Designer Name Address City State/Zip Telephone State License # A. ..WQRKERS COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company S"rceJ't '' -r C.'.Q Policy No3a 10 1103i f 160, Expiration Date - - (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) o 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 civil fines up to one hundred thousand doers ($100,000), in addition to the o t of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATUR ca,ai,4, DATE to -(6-0-5 7. OWN UlLDERDECLARATION' ' . . 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). 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 ((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 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. NON-RESJDENT/AL'BUILDING,pERMITSONLY 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. 8. . CONSTRUCTIONLENDINGAGENCY I hereby affirm that there is a construction (ending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). - LENDER'S NAME LENDER'S ADDRESS__________________________________________________________ 9. ',;'APLICANT 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 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 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any tin - after the work is commenced for a peto4,of 180,4Section 106.4.4 Uniform Building Code). APPLlCti .r's SIGNATURE—...Ca.e-...a 'Ttt.._4f!J?X . DATE _ to - (p..- 0 WHITE: File YELLOW: Applicant PINK: Finance ILG~ - 'n; -1 R I City of Carlsbad Bldg Inspection Request' For: 06/14/2005 Permit# CB052178 Inspector Assignment: RB Title: JET SOURCE-CONSOLODATE 12 ELEC Description: METERS IN TO ONE Type: ELEC Sub Type: Phone: Job Address: 2056 PALOMAR AIRPORT RD Suite: Lot 0 Location: Inspector: APPLICANT SOCAL ENERGY Owner: RIECK DENNIS <DBA QUALITY AIRCRAFT CARE> Remarks: REQUESTED AN ELECTRIC INSPECTION Total Time: Requested By: JIM EntereqJ By: CHRISTINE CD Description Act Comment P .( 34 Rough Electric ,P '1 'AD _4 6 , p 32 / 37 Associated PCRs/CVs V Inspection History Date Description Act Insp Comments C4L t7 3 B U I L D'I N G P E P ? I I Permit No CB971788 06/30/97 15 59 Project No A9702290 Pae 1. of i " " - Development No: Job Address: 2056 PALOMAR AIRPORT RD Suite: Permit Type PLUMBING 6561 07/0297 0001 Of ' 02 20 'Parcel No: '. - Lot#: C-PRHI -; Valuation 0 Conruct.cn Type NEW Occ.upancy Group: ReferenceI: ' ;- .' • ' Status':- ISSUED. Description-: WATER HEATER REPLACEMENT. .• ' Aplied:. 06/30/97 ' Apr/Issue:: •06/30/97 EfltCi.d By 3M 'Appl/Ownr CINEMA AIR JET CENTER 760 438-0877 2056 PALOMAR AIRPORT ROAD .. - CARLSBAD, CA 92009 ' Fees Required' Ak Fee b1lected & Creth€b-- Fees:. H 2 .0 • -• . Adjustments:: . Total Fees: 27.01 To t . .00 - . a Ci' J?4 27.00 Enter IU for 'P1 ir ue - • 20.00 Y Each WaterHeaterc /b 6 i 1. 0 7.00 PLUMBING TOTAL 27 00 ' t::z:\ INCORPORATED 1952 4 ? I k 1 '• - . • • : • . : I • • .a' ' ., • - . . - FINAL APPROVAL PATE CLEAfiA_9E_,,.* 7. CITY OF CARLSBAD 2075 Las Palmas Dr, Carlsbad CA 92009 (619),438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING 2075 Las Palmas Dr., Carlsbad (619)438-1161 DEPARTMENT CA 92009 FOR OFFICE USE ONLY PLAN CHECK NO. T7/7?'k' EST. VAL. Plan Ck. Deposit Validated By_ Date 2056 Palomar Airport Rd. Address (include BldgISuIte) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total S of units SFR Assessor's Parcel I Existing Use Proposed Use Description of Work SQ. FT. #01 Stories I of Bedrooms I of Bathrooms Cinema Air Jet Center 2056 Palomar Airport .icu. utu Name Address City State/Zip Telephone S Fax S 3iAPUCANT/iiD SHEt,T'i JOHNIS FOSTER 13706B HWY 8 BUS. EL CAJON, LPJ. UZ1 j'u-'i'*,' Name Address City State/zip Telephone S Cincrna Air Jet Ce-*r N1S6 Palomar Airport Center CARLSBAD CA. 92008 Name Address City . State/Zip Telephone I (Sec. 7031.6 Business and Professions Code: Any City or County which requires a permit t o C o n s t r u c t , a l t e r , I m p r o v e , d e m o l i s h o r r e p a i r a n y s t r 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 tha t h e i s l i c e n s e d p u r s u a n t t o t h e p r o v i s i o n s o f t h e C o n t r a c t o r ' s L i c e n s e L a w (Chapter 9, commending with Section 7000 of Division 3 of the Business and Prof e s s i o n s C o d e ) o r t h a t h e i s e x e m p t t h e r e f r o m , a n d t h e b a s i 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 a permit subjects the appli c a n t t o a c i v i l p e n a l t y o f n o t m o r e t h a n f i v e h u n d r e d d o l l j s 1 $ 5 0 0 I ) . A J FOSTER PLUMBING 17fl(S-R HWY S BUS, EL CAJON CA. 92021 390-447i '14ame Address City State(ZJ Telephone S State License 3O12O License ci05c36 City Business Ucense L 00354 Designer Name Address City State/Zip Telephone State Ucenae 'N/A S ,, WORkERS C0MPENSATi0N /1* 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' compensatio n a s p r o v i d e d b y S e c t i o n 3 7 0 0 o f t h e L a b o r C o d e , f o r t h e p e r f o r m 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 Co d e , f o r t h e p e r f o r m a n c e o f t h e w o r k f o r w h i c h t h i s p e r m i t i s X issued. My worker's compensation insurance carrier and policy number are: Insurance CompappMcP TNSTRANCE Policy N12007-5651 Expiration QTNGO US (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$ 1 1 0 0 1 O R L E S S ) CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for whi c h t h i s p e r m i t i s i s s u e d , I s h a l l n o t e m p l o y a n y p e r s o n 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 eecure worker,' compensation coverage is unlawful, and shall subject an employer to criminal 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 p r o v i d e d f o r i n S e c t i o n 3 7 0 6 o f t h e L a b q r c o d e , i n t e r e s t a n d a t t o r n e y ' s f e e s . SIGNATURE • DATE 7 OWNER BUILDER DECLARATION 1I1XJ -, I hereby affirm that I am exempt from the Contractor's License Law for the following reason: I. as owner of the property or my employees with wages as their sole compensation, w i l l d o t h e w o r k a n d t h e s t r u c t u r e I s n o t i n t e n d e d o r o f f e r e d f o r s a l e (Sec. 7044, Business and Professions Coda: The Contractor's License Law does not apply to a n o w n e r o f p r o p e r t y w h o b u i l d s o r i m p r 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 I n t e n d e d o r o f f e r e d f o r s a l e . I t . h o w e v e r , t h e b u i l d i n g 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 t h a t h e d i d n o t b u i l d o r i m p r o v e f o r t h e p u r p o s e o f s a l e ) . C] I, as owner of the property, am exclusively contracting with licensed contractors to c o n s t r u c t t h e p r o j e c t ( S e c . 7 0 4 4 , B u s i n e s s a n d P r o f e s s i o n s C o d e : T h e Contractor's License Law does not apply to an owner of property who builds. or Impro v e s t h e r e o n , a n d c o n t r a c t s f o r s u c h p r o j e c 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). I em exempt under Section Business and Professions Coda for this reason: I personally plan to provide the major labor and materials for construction of the proposed pr o p e r t y i m p r o v e m e n t . 0 YES Ohio 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 n a m e / a d d r e s s / p h o n e n u m b e r I contractors license number): I plan to provide portions of the work, but I have hired the following person to coordinate, super v i s e a n d p r o v i d e t h e m a j o r w o r k ( i n c l u d e n a m e / a d d r e s s I phone number I contractors license number): I will provide some of the work, but I have contracted (hired) the following persons to provid e t h e w o r k I n d i c a t e d ( i n c l u d e n a m e / a d d r e s s / p h o n e n u m b e r / t y p e of work): PROPERTY OWNER SIGNATURE DATE COM.EJJHIS SEC110NFOR NO1.RcIDEN174LBUjiDIjG PERMlU7I ili3Ji 4{i Is the applicant or future building occupant required to submit a business plan, acutely hazardo u s m a t e r i a l s r e g i s t r a t i o n f o r m o r r i s k m a n a g e m e n t a n d p r e v e n t i o n program under Sections 26505. 25533 or 25534 of the Presley-Tanner Hazardous Substance A c c o u n t A c t ? 0 YES 0 NO Is the applicant or future building occupant required to obtain a permit from the air pollu t i o n c o n t r o l d i s t r i c t o r a i r q u a l i t y m a n a g e m e n t d i s t r i c t ? 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 T H E A P P L I C A N T H A S M E T O R I S M E E T I N G T H E REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 8 CONSTRUCTiON LENDING AGENCY t '199W I hereby affirm that there Is a construction lending agency for the performance of the w o r k f o r w h i c h t h i s p e r m i t I s i s s u e d ( S e c . 3 0 9 7 ( 1 ) C i v i l C o d e ) . LENDER'S NAME LENDER'S ADDRESS___________________________________________________ _ _ _ _ _ 9 t*?PUCANT CERTWICA'floN ' 4.t3A 1- ' "10 - I certify that I have reed the application and state that the above information is correct en d t h a t t h e i n f o r m a t i o n o n t h e p l a n s i s a c c u r a t e . I a g r e e t o c o m p l y w i t h a l l City ordinances and State laws relating to building construction. I hereby authorize represe n t a t i v e s o f t h e C i t y o f C a r l s b a d t o e n t e r u p o n t h 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 H A R M L E S S T H E C I T Y O F C A R L S B A D A G A I N S T A L L L I A B I L I T I E S , JUDGMENTS; COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST S A I D C I T Y I N C O N S E Q U E N C E O F T H E G R A N T I N G 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 constru c t i o n o f s t r u c t u r e s o v e r 3 s t o r i e s i n h e i g h t . EXPIRATION: Every permit issued by the Building Official under the provisions of this C o d e s h a l l e x p i r e b y l i m i t a t i o n a n d b e c o m e n u l l a n d v o i d i f t h e b u i l d i n g o r work authorized by such permit is not commenced within 365 days from the date of such p e r m i t o r i f t h e b u i l d i n g o r w o r k a u t h o r i z e d b y s u c h p e r m i t i s s u s p e n d e d or abandoned at any time after the work is c menced for a erlod of 180 days (Secti n 106.4 . 4 U n i f o r m B u i l d i n g C o d e ) . APPLICANT'S SIGNATURE ( _'he '- I__,4.L&J'( DATE "1 WHITE: File YELLOW: Applicant PINK: Finance I CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB971788 FOR 06/16/98 DESCRIPTION: WATER HEATER REPLACEMENT TYPE: PLUM JOB ADDRESS: 2056 PALOMAR AIRPORT RD APPLICANT: CINEMA AIR JET CENTER CONTRACTOR: OWNER: REMARKS: C/BILL! SPECIAL INSTRUCT: SEE BILL THE CONTROLLER. WAS NOT DONE LAST TIME. INSPECTOR AREA TP PLANCK# CB971788 0CC GRP CONSTR. TYPE NEW STE: LOT: PHONE: 760 438-0877 PHONE: PHONE: INSPECTOR ______________________ DOES NOT UND STAND WHY INSPECTION LOCATION IN AT/ON THE AIRPORT @PAR TOTAL TIME: CD LVL DESCRIPTION ACT COMMENTS 25 PL Water Heater/Vents ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP COMMENTS 052098 Water Heater/Vents NS TP 071697 Water Heater/Vents CO TP SEISMIC, DISCONNECT 071497 Water Heater/Vents NR TP RE-CALL/MAKE CONTACT 2_- B U I L D I N G P E R M I T Permit No: CB950519 04/19/95 11:59 Project No: A9500762 Page 1of 1 Development No: Job Address: 2056 PALOMAR *AIRPORT RD Suite: Permit Type: PLUMBING Parcel No: Lot#: Valuation: 0 Construction Type: NEW Occupancy Group: Reference#: Status: ISSUED Description: REPLACE WATER HEATER Applied: 04/19/95 Apr/Issue: 04/19/95 Entered By: RMA Appl/Ownr : A & J FOSTER INC 619_6971 4151 2819 CENTRAL AV SPRING VALLEY, CA 91-9i7 Fees Required NI C - Fees: \ Adjustments: /Total Fees- o Tl&\\ : Fee description LInits n, i Ext fee Data or 00 PLUMBING TOTAL 27.00 .1566 04/19/95 000101 02.. - INCORPORATED 1952 AF1 A PPROVAL DATE CLEARANCE CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMiT APPLICATION City of Carlsbad Building Department 2075 Las Patinas Dr., Carlsbad, CA 92009 (619) 438-1161 From List I (see back) give code of Permit-Type: PLAN CHECK NO. CM 5 51'i i1II 'ULII For Residential Projects Only: From List 2 (see back) give Code of Structure-Type: si'r Net Loss/Gain of Dwelling Units 2. PROJECT INFORMATION FOR OFFICE USE ONLY Address Building or Suite No. 2os Palamar Airport Rd. Nearest Cross Street LEGAL DESCRIPTION Lot No. Subdivision Name/Number Unit No. Phase No. CHECK BELDW IF SUBMIITED: 02 Energy Calcs 02 Structural Calcs 02 Soils Report 0 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK Water Heater Replacement 40 Gallon SQ. Fr. # OF STORIES # OF BEDROOMS # OF BATHROOMS S. WN lACI FEHUN (it different from applicant) NAME (last name first)Cjnerp.a Air ADDRESSPalamar Airport Rd. CITY r'-,.-1 _1_4 STATE t-A ZIP CODEcyn)o DAY TELEPHONE NAME (last name flrstisty Fester ADDRESS2819 Central Ave. CITY Sorinlley STATE CA ZIP C0DE91977 DAY TELEPHON97_4151 PROP$T(TY 0 NAME (last name first)Cinena Air ADDRESS Palarnar Airport Rd. CITY STATE ('A ZIP CODE DAY TELEPHONE 3J_0R77 NAME (last name firstY\ & J Foster, Inc. ADDRSS2819 Central Ave. CITY Spring Valley STATE CA ZIP CODE 91977 DAY TELEPHONE 697-4151 STATE LIC. # çy LICENSE CLASS CITY BUSINESS LIC. #lpp3j DESIGNER NAME (last name tirst) - ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE UC. # WORKERS' CDMPENSATION Workers' Compensation Declaration: I hereby affirm that I have a certificate of consent to self-insure issued by the Director of Industrial Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C). INSURANCE COMPANY ui* T R POLICY NOQAQc EXPIRATION DATE ' 1 Oc Certificate of Exemption: ceri hat l'töftnance of the work tor iWth1 permit is issued, I shall norenilony person in any manner so as to become subject to the Workers' Compensation Laws of California. SIGNATURE DATE DATE L4 L4 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.). O 1, 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). 0 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 [$5001). SIGNATURE DATE COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY: Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? DYES ONO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? DYES ONO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? DYES ONO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCXUPANCY MAY NCYF BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS MEF OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION WN11IOL DISTlucr. 9. WNSH{UCI1UN LENDING AGENCY 1 hereby atfirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(1) Civil Code). LENDER'S NAME Nnt LENDER'S ADDRESS W. AI'PUCANI cEwL1Pit.AnoN I certify that I have read the application and state that the above information is correct. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABilITIES, JUDGMENTS 00S1S 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 within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or aband ned at antim th e after e work is commenced for a period of 180 days (Section 303(d) Uniform Bui!1lnBd APPLICANTS SIGNATURE fl f 4 . DATE: UNSCHEDULED INSPECTION DATE INSPECTOR___'/ _____________________ PERI(IT $ - PZIANCX 0 JOB ADDRESS 2 5 /i-t--'' -ir,r , TIM! ARRIVE: ThU LEAVE: co LVL DESCRIPTION AC? CO)OUNTS • p To 6/15/69 -----... .,— ,-'--- ----'--1" 2 r 0 'I hereby ffirrn that I am licensed under UI #provIaione of Chapter 9 (commencing with I I Section 7000) of Division 3 of the Business s—I - and Professions Code, and my license is in L- full force and effect. U - hereby affirm that i am exempt from- the Centrac- I tot's, License Law for the following reason ISec: 7031.5 Business and Professions Code: Any City or County wtlicr, re-quires a permit to construct.- alter. improve, demolish, or 'I repair any structure, prior to its issuance also requires the ap- plicant for such permit to tile a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 commencinq with Section 7000 ot Division 301 the Business and Professions Codol or that is eo empt therefrom and the basis Or Ihe alleged exemption. Any ''1 violation of Section 7031:5 by an applicant for a permit sob'-jects the applicant to a civil penalty of not more than live hun- dred dollars ISSOOI 19 I I I, as owner of the property, or my employees with wages as their Sole compensation, will do 150 work, and the struc' " tore is not intended or uttered for sate (Sec. 7044, Business I ..,a , and Professions Code: Jho Contractor's License Law does not apply to an owner ul..ptoperty who'buitds Or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intend" 101 ed or offered for sale. It, however, the building or improve- Z meot is sold within one year of completion, the owner-builder i will have the burden of proving that he did not build or im- ' prone for the purpose 01 sale).' - ' - '' " 'I 0 I, as owner of the propurty, am exclusively contracting with licensed contractors to construct the project (Sec. 7044. Business and Professions Code: The Contractor's License I Law does not apply to an owner 01 property who builds or im- proves thereon, and who contracts for each projects with a contractor(s) license pursuant to the Contractor's License Law). .. .. - 0 As a homeowner I am improving my home, and the follow- ing conditions exist: - ' _ ; . The work is being perturmed prior to sale.. i have lived-in my 'home for twelve 'months prior to completion 01 this work. 3.' I have 'not claimed 'this exemption 'during the last three years. 0 lam exempt under Sec. ' ' •, B& P.C. I for this reason .0' - / - 0 hereby attirm that t have'acertiticjte 01 consent to I sett-irrsure. era certificate of Workers' ompensation in. serance, era certified copy thereof (Se 3800. Labor Cudel - POLICY NO, • '.1 . COMPANY nEJ COPY is tiled With the City Dcerritiecepy is hereb - in e CL ''CERTIFICATE OFEXEM t N FROM - O ... .WORKERS', COMPENSATIO SURANCE (I) _ (This section need not be comp t d it the permit - ' - 'is for one hundred dollars 1 01 or tesslLIJ $ 0 ,t certify the' ha fln the performance u he work for which I cc this permit is issued. t shalt not,empboy any person in any 0 , manner, so as to become subject to the Workers' Compen. sation Laws Or California. - NOTICE TO APPLICANT: If. alter making this Certificate, 01 Exemption. you should become subject to the Workers' I Compensation provisions 01 the Labor Code, you must p forthwith comply with ouch provisions or this permit shalt -- be deemed revoked. fi' - Pr vs .i t I hereby affirm that there is a Construction tending L CC agency iorthe performance 01 the work br which (his per. IJ O I ' mit is issued Sec. 3097, Civil Code) zI Mi Lender's Name - L_'Lender's Address' - - ------5--- .--• 0) C) C-(0 C LL' C 0). 0) 0 01 a) CIL 'en C USE BALL POINT PEN ONLY &.PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. CARLSBAD BUILDING DEPARTMENT - APPLICATION --PERMIT - - 2075 Las Palmas Dr., Carlsbad, CA 92009-4859 (619) 438-1161 2075 7 JOB ADDRESS AV. ST.RO, NEAREST CROSS ST. DATE OF APPLICATION - 8USINES,AI'CENSE at - VALUATION PERMIT NUMBER 20 5 ' f ' ZONE - - LOT BLOCK SUBDIVISION ASSESSOR PARCEL NO. ' CONTRACTOR CONT ACTORS PHONE If CRG3 OtE-i 7253 OWNER'S NAME OWNER'S PHONE BUILDING SO. FOOTAGE CONTRACTOR'S ADDRESS STATE LICENSE NO. O3 rc LWOB ' - OWNERSMANG ADDRESS - DESIGNER DESIGNER'S PHONE ArA C_ DESCRIPTION OF WORK DESIGNER'S ADDRESS , STATE LICENSE NO. - -- - -' ' F/P FLR ELEV. NO TpRIS 0CC GP EDU YO ND FIRE SPR - PARKING SPACE RES UNITS GRADING PERMIT ISSUED REDEVELOPMENT TYPE 0CC LOAD - 'AREA CONST - P 0 N 0 Y 0 NO ' Y O ND - Not Valid Unless Machine Certified OTY , PLUMBING PERMIT- ISSUE ' 7 QTY. MECHANICAL PERMIT- ISSUE ' L)v -- SUMMARY/ACCOUNT NUMBER , EACH FIXTURE TRAP . INSTALL FURN, DUCTS UP TO 100,000 BTU BUILDING PERMIT . ooi 0101 02B1dPmt 30 EACH BUILDING SEWER - -' - ' - OVER 100,000 BTU - 'SIGN PERMIT - - -' 001-810-00'00-8221 " -P EACH WATER HEATER AND/OR VENT ' 'BOILER/COMPRESSOR UP TO 3 HP - , PLAN CHECK - 001-810-00-00-8821 EACH GAS SYSTEM I 104 OUTLETS ' BOILER/COMPRESSOR 3.15 HP - , - TOTAL PLUMBING 001-810'00'00-8222 ' - 'EACH GAS SYSTEM 5 OR MORE - - , METAL FIREPLACE - - ' -, ELECTRICAL -- '- - 001-8 0-00-8223 -EACH INSTAL.. ALTER, REPAIR WATER PIPE , , VENT FAN SINGLE DUCT - . ' MECHANICAL Wt-kV O-00-8224 :EACH VACUUM BREAKER - , MECH EXHAUST - HOOD/DUCTS - ' MOBILEHOME ' 0'(10-00-0O-8225 WATER SOFTNER ' RELOCATION OF EA FURNACE/HEATER ' , - SOLAR - 001-81ç-00-8226 EACH ROOF DRAIN (INSIDE) • . - DRYER VENT • - ' 'STRONG MOTIlN47) - '519-9 . a ' TOTAL MECHANICAL ' . - , . - , FIRE SPRIN '6810-00-07 - - TOTAL PLUMBING ' , ' ' PUBLIC FA$ES FEEt 320-81 • . - O"2 QTY. , - BRIDGE FEE '<s" 3T-'08740 - c- - OTY. ELECTRICAL PERMIT -'ISSUE . - -- - - * . - -•- -. MOBILE HOME SETUP - - " - ' PARK-IN-LIEU (AREA NEW CONSTEA AMP/SWT!BKR - • -' CARPORT - . . TIF p10-00-00-8835 — 1 PH- - ' - 3 PH - . ' AWNING ' , LA COSTA TIP 133.810,00:00,8835 EXIST BLDG EA AMP/SWT/BKR - -' ' ' - • I GARAGE " • . -• - -' - FMF • - ' ' • 1 PH 3 PH , . - ' ' , - LICENSE TAX - 001-810-00-00-8162 REMOOEL.'ALTER PER CIRCUIT - - -- ' - MFF ° 880-519-92-57 • TEMPPOLE 200 AMPS ' • - . . ' - ' — ' -: - ' - ' - - ' cv' - -OVER 200 AMPS • '' - ' - . • ' ' - . . IEMP OCCUPANCY I30DAYS) -• . ' — . - - ' . - - - • ,r - . CREDIT DEPOSIT TOTAL ELECTRICAL - - TOTAL TOTAL FEES PAYABLE c:-2 I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY Expiration. Every permit issued by the Building Official under the provisions otthis * AN 061-IA P€T IS REQUIRED FOR EXCAVATIONS OVER Code shall expire by limitalion and become null and void If the building or work THE CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING authorized such permit is not commenced within 180days from 5'0" DEEP AND DEMOLITOON OR CONSTRUCTIIDN OF the clateof such DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS permit, or i7the building or work authorized by such p:rrnd is suspended or STRUCTURES OVER 3 STORIES IN HEIGHT ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON- abandoned SI any lime after the work is commenced for a period 01180 days. STRUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COS S AND APPLICANT IGNATURE * OWNER 0 CONTRACTOR g APPROVED BY • , ' CA EXPENSES / WHICH MAY IN ANY WAY GRANTING OF THIS PERMIT---- ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE ax TYPE DATE INSPECTOR BUILDING FOUNDATION REINFORCED STEEL MASONRY GUN ITE OR GROUT SUB FRAME Li FLOOR LI CEIJNG' -• SHEATHING 0 ROOF LI SI1EAR FRAME EXTERIOR LATH INSULATION I INTERIOR LATH & DRYWALL PLUMBING LI SEWER AND BL/CO EThPLICO UNDERGROUND 0 WASTE d WATER TOP OUT 0 WASTE LI ,NATER TUB AND SHOWER PAN GAS TEST O WATER HEATER 0 SOLftR \'ATER ELECTRICAL o ELECTRIC UNDERGROUND EI UFFER ROUGH ELECTRIC O ELECTRIC SERVICE 0 TEMPRARY O BONDING 0 POOL MECHANICAL O DUCT & PLEM., 0 REF. PIPING HEAT — AIRCOND.SYSTEMS VENTILATING SYSTEMS CALL FOR FINAL INSPECtION WHEN ALL APPROPRIATE ITEMS ABOVE HAVE BEEN-AIkPROVED FINAL PLUMBING ELECTRICAL MECHANICAL 1 GAS BUILDING SPECIAL CONDITIONS FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS INSPECTORS NOTES INSPECTION REQ. IF CHECKED INSPECTOR'S APPROVAL DATE SOILS COMPLIANCE PRIOR TO FOUNDATION INSP OVER 2000 PSI STRUCTURAL CONCRETE PRESTRESSED CONCRETE POST TENSIONED CONCRETE FIELD WELDING BOLTS HIGH STRENGTH SPECIAL MASONRY L PILES CAISSONS GOQS 04\36 OTOT 03B1b OQO -. -. *.,,..'t_I... ' ' :,. I - - - . 'S 0) 0 0) >-; USE BALL POINT PEN.ONLV.& PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. gr'. , I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with - Section 7000) olDivision 3 of the Business .,,and Professions Code, and my license is in L full force and effect -1 I thereby affirm . that I am exempt. from. the. Cootrac' ... tots license Law for the following reason (Sec. 7031.5 - Business and Professions Code: Any city or County whicl', re- I quires a permit 10 construct, alter, improve, demolish. or fIt jepaie any Structure, prior to its issuance also requires the ap' 'plicant lot Such permit to file a signed Statement that he is I lte'nsed pursuant to the provisions-of the Contractor's License Law (Chapter 9 commencing with Section 7000 of - - Division 3 of [he Business and Professions Code) or that sen empt therefrom and the basis for the alleged exemption ,, Any' violation of Section 7031.5 by an applicant for a permit sub' . jecfs the applicant to a civil penalty of not more than live -huo' - dred dollars ($500), LI I, as owner ol.lhe property. Or my employees with wages IZ I aslheir sole cnmy'eosalion. will do the work, and the slruc' lure is not intended or offered for sale (Sec 7044. Business 'and' Professions Code: The Cool ractor's license Law does I not apply to an Owner,ol property who builds or improves I - thereon and who does Such work himself or through his own employees, provided that such improvements are not intend-. lot - 'e($ or oflered for sale, If, however, the building or improve:' I — Z ment is Sold within one year of completion. the owner-builder - will have the burden of proving that he did not build or im' prove for the purpose of sale) I_I, ns,owner of the property, am exclusively contracting with licensed contractors 10 construct the project (Sec. 7044, I Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who builds or im' r proves -thereon. and who contracts or each projects with a,. I U) contractor(s) license pursuant In the .Cuntractor's License - -,,Law) I— Il -AS a'homeowner lam improving my home, and the lollow. 4 ing conditions exist:, 4 t' ... ' "a , f - f . The work is being performed prior In siie,,__ _, - 2. 1 have lined in my home to Iwelve monfhS prior to completion Of this work,.. 3. 'I—have not claimed this' exemption during' the - last three years. 0 lam exempt under Sec ' B & P.C.. : for this son -:' "l rrerebjatlirnt that I,have a certificate 01 consent to )r-uell.insure. or a certificate-of WorkersCempenSali0n In. - - surance, eta certified copy thereof (Sec. 3800. Labor Codel I - .'x POLICY ,aOi ( ' COMPANY - - Copy is liled with the city DLCei,tifie5 copy is fur ,hed - Lu J CERTIFICATE OF EXEMPTION FROM" -* ,., , WORKERS' COMPENSATION INSURANCE (I) .' IThis section' need not be completed if ISO permit ix • " is ioi'one hundred dollars _($,100) or 10551 Y. I D-.-l.cenify that in the performance 01 the work for which this permit is issced;I shall not employ any person in any - 0 , manner so as to become subject to the Workers' Compen. I - satioo Laws 01 California. - - rNOTICE TO APPLICANT: If. alter making this Certificate.. j, - 01 Eoemptión, you should become subject 10 the Workers' F Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall .1 he deemed resdkedT',,, .:• ' - ' - -n - - -0 I hereby-aflirm heat there is a construction lending I agencjfor'Ihe performance 6f the JorIr br which this per. 0) rrtiI is issued ISec, 3097, Civil Code) - - - - WI Lender's Name, -' ' '! - ---------------Lender's AddrTs •" - I' CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT - -. 2075 Las Palmas Dr., Carlsbad, CA 92009-1915 (619) 438-1161 JOB ADDRESS AV, ST. RD, THOMAS BROS NO. DATE OF APPLICATIONJ BUSINESS LICENSE A VA TiON PERMIT NUMBER 205 LOT BLOCK SUBDIVISION ASSESSOR PARCEL NO. CONTRACTOR, CONTRACTORS PHONE a .a'T7 h&t...125.o ZONE -.--- NAME CR ONEOWNER'S OWNE R'S PH CONTRACTOR'S ADDRESS OWNER'SMAINGAOORESS Co STATE LICENSE NO. O&)OB (JIi.'_p10. BUILDING SO. FOOTAGE _ •.- 5 - DESIGNER DESIGNER'S PHONE DESCRIPTION OF WORK . DESIGNER'S ADDRESS - STATE LICENSE NO. .- . F/P FLRELEV, NO OCCGP EDU 0 , - STORIES YO NO - - CENSUS TRACT PARKING SPACE RES UNITS GRADING PERMIT ISSUED REDEVELOPMENT TYPE 0CC LOAD, FIRE SPR - - AREA ' - CONST - - - - b 0 N 0 - Y O NO YO No Not Valid Unless Machine Certified - QTY. PLUMBING PERMIT ISSUE OT Y MECHANICAL PERMIT ISSUE SUMMARY/ACCOUNT NUMBER - EACH FIXTURETRAP '_ INSTALL FURN, DUCTS UPTO100,000BTU -, BUILDING PERMIT 001'810'00'00'8220 EACH BUILDING SEWER , - . g. - OVER 100.000 BTU ' ' - " , ' ' SIGN PERMIT ' 001-810-00-00'8221--''•''' EACH WATER HEATER AND _DRVENT — BOILER/COMPRESSORUPTO3HIP PLAN CHECK 001-810-00-00-8891 - 'EACH GAS S'YSTEM'I'TO4 OUT LETS ' -.' BOILER/COMPRESSOR 3.15 HIP , , TOTAL PLUMBING 001'810'00'00'8222 'EACH GAS SYSTEM 5 O MORE " 'T ' . , METAL FIREPLACE _--. .'. -'-ELECTRICAL-''_"'001810'00'00'8223 EACH INSTAL.. ALTER: REPAIR WATER PIPE: . — VENT FAN SINGLE DUCT . ' -MECHANICAL _001'810-00-00.8224 EACHVACUUMBREAKER -', . — - MECHEXHAUSTHOOD/DUCTS , MOBILEHOME -001'810-00'0O-8225 — WATERSOFTNER1 ,. _- . -. _. .,,. RELOCATION OF,EA FURNACE/HEATER .,-.-- -SOLAR _--'00'1'810'00'00'8226 - - - EACH ROOF DRAIN (INSIDE) - • . . DRYER VENT '. STRONG MOTION 880-519'92'33 - TOTAL MECHANICAL ' '' -- - TOI At. _PLUMBING '_'-_-- . - - - FIRE SPRINKLERS ,-0O1:81O.0o.0O8227 . -PUBLICFACILITIESFEE, _320-810'00-00-8740 OTY. ELECTRICAL PERMIT- ISSUE'' - 2..- OTY. MOBILE HOME SETUP BRIDGE FEE 360-810-00-00-8740 ' . _'___.-- PARK-IN-LIEU (AREA - - ----.--•---- ' - -. -' NEW CONSI EA AMP SW1 IIKR CAR PORT TIE 31281000008835 I'PH 4 3PH AWNING ' : . LA COSTA TIE 311-810-00-00-8835. - - EXISTBLDGEAAMPISWT'BKR GARAG------- -- - ' - - - FMF " ' - f;PH _3 PH -. -. -' , LICENSE TAX 001 -810'00'00-8162 . — REMODELALTIR PER CIRCUIT - ' - ' . MFF 880-519-92-57 TEMP POLE 200AMPS - -o' OVER 200 AMPS 'j --- _'•.''-C , _-. .' - TEMP. OCCUPANCY (30 DAYS) -''.T .. ,.•-•-•A I • . fli_- r,'C) _ —. --------k-_- __'-- --- .--•---- 'CREDIT-DEPOSIT - TOTAL ELECTRICAL - r TOTAl TOTAL FEES PAYABLE I - - - HAVE CAREFULLY EXAMINE D T HE COMPLET~D "APPLICATION AND PER MIT" AND DO HEREBY Expiration. Every permit issued by the Building Official under the provisions ofth,s AN OSHA PERM:T IS REQUIRED FOR EXCAVAT$ONS OVER Code shall expire by limitation and become null and nod If the building o work CERTIFY' UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE authorized by such permit is not commenced within 180 days from the date of such SO" DEEP AND DEMOLITION OR COP4STRUCTN OF 'AND DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AGREE IF A PERMIT IS permit, or if the building or work authorized by such permit is suspended or STRUCTURES CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON OVER 3 STORIES IN HEIGHT ISSUED: TO COMPLY WITH ALL abandoned SI any time after the work is commenced for a period -KEEP H COSTS AN OWNER . of190 days .-_- CONTRACTOR je APPROVEkB~ DATE "Ll CTARMILESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS D STFUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AN u APPLICANT IGNAT~U~RE/p EN WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITYjN CONSEQUENCEOF THE •,-:i_:_--, ____OFSPT- EXPENSES GR__ E By PHONE For / TYPE I DATE INSPECTOR BUILDING FOUNDATION REINFORCED STEEL MASONRY I - GUN lIE OR GROUT SUB FRAME LI FLOOR Li CEILING . . SHEATHING Li ROOF Li SHEAR FRAME EXTERIOR LATH - INSULATION INTERIOR LATH & DRYWALL PLUMBING El SEWER AND BL/CO [i PJCO UNDERGROUND DWASTE D!WATER TOP OUT 0 WASTE '0 WATER TUB AND SHOWER PAN GAS TEST Li WATER HEATER Li SOLAR WITER ELECTRICAL O ELECTRIC UNDERGROUND 0 UFFER ROUGH ELECTRIC O ELECTRIC SERVICE Li TEMPORARY Li BONDING Li POOL MECHANICAL Li DUCT & PLEM., Li REF. PIPI)'IG HEAT - AIRCOND. SYSTEMS VENTILATING SYSTEMS CALL FOR-FINAL INSPECTYON WHEN ALL APPROPRIATE ITEMS ABOVE HA 'E BEEN APPROVED FINAL.. PLUMBING ELECTRICAL . MECHANICAL GAS . -. . BUILDING SPECIAL CONDITIONS FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS. . INSPECTORS NOTES INSPECTION - REQ. IF CHECKED INSPECTORS APPROVAL D ATE S PRIOR TO FOUNDATION INSP . SOILSCOMPLIANCE - . - - STRUCTURAL CONCRETE OVER 2000 PSI -- PRESTRESSED CONCRETE - - POST TENSIONED CONCRETE FIELD WELDING HIGH STRENGTH BOLtS SPECIAL MASONRY . PILES CAISSONS -- - ' - C\T