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Home My WebLink About2100 COSTA DEL MAR RD; ; CB940578; PermitBUILDING PERMIT 05/17/94 10 03 Page 1 of 1 Job Address- 2100 COSTA DEL MAR RD Suite- Permit Type ELECTRICAL Parcel No Lot# Valuation: 0 Construction Type NEW Occupancy Group Reference# Description 6 20 AMP CIR + BACKFLOW PREVNT SPORTS SHINKO PARKING LOT Permit No Project No Development No. CB940578 A9400810 Status- Applied Apr/Issue- Entered By ISSUED 05/17/94 05/17/94 DC Appl/Ownr SPORTS SHINKO LTD 2100 COSTA DEL MAR ROAD - CARLSBAD, CA 9200.8 ' *** Fees Required ***** 619 438-9111 Fees Collected & Credits *** Fees : Adjustments Total Fees Fee description 6.0 00 , •_ •••'''.00•'eqcoo.-, / Total? 'Cre'dits;; \ Total "Payments' '.- 1 '••• -'Balance Due'..: -.-; Units •,••:; • Fee/Unit 00 00 60 00 Ext fee Data Enter "Y" for Electric,;'(Issue Fee } Single Phase Per AMP V.I. ' : ,s';>" Other I • \ , !/>. * ELECTRICAL TOTAL \ ,"^ "'.'it-.- \ \ ;-S. 'N-^ w £0 00-: x ;';;, <; T il ('. 'Hi? ^f'A •': ,< '. t .:' .'>'.' 'I ; ''• •';/ 10 00 Y 30.00 6 X 20 20 00 BACKFLOW 60.00 CITY OF 2075 Las Palmas Dr , Carlsbad, PERMIT APPLICATION City of Carlsbad Building Department 2075 Las PaImas Dr., Carlsbad, CA 92009 (619) 438-1161 1 PERMIT TYPE From List 1 (see back) give code of Permit-Type For Residential Proiects Only From List 2 (see back) give Code of Structure-Type Net Loss/Gain of Dwelling Units PLAN CHECK NO./ 'j — EST VAL PLAN CK DEPOSIT_ VALID BY I DATE 2. PROJECT'INFORMATION FOR OFFICE USE ONLY Address Buildmg.or Suite No LEGAL DESCRIPTION Lot No Subdivision Name/Number Unit No Phase No CHECK BELOW IF SUBMITTED D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK SQ FT # OF STORIES # OT BEDROOMS # OF BATHROOMS UJN i AJJT PEKSUN (.ir auierent rrom applicant; NAME (last name first) CITY STATE ZIP CODE DAY TELEPHONE A APPLICANT U CONTRACTOR U AGENT FOR CONTRACTOR D OWNER .BvAGENT FOR OWNER NAME (last name first) ADDRESS CITY STATE ZIP CODE DAY TELEPHONE 5 PROPERTY OWNER NAME (last,name first) 'SO ~' CITYX STATE ADDRESS ZIP CODE DAY TELEPHONE 6 CONTRACTOR NAME (last name first) CITY STATE ADDRESS ZIP CODE DAY TELEPHONE STATE LIC #LICENSE CLASS CITY BUSINESS LIC # DESIGNER NAME (last name nrstj /UJDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE UC # WORKERS^ COMPENSATION workers' Compensation Declaration I hereby atrirm that I have a certificate ol consent to sell-insure issued by the Director ol 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 POLICY NO EXPIRATION DATE Certificate ot Exemption I certily that in the performance oT the work lor 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 SIGNATURE DATE 8 OWNER-BUILDER DECLARATION Owner-builder Declaration 1 hereby atrirm that 1 am exempt from tne contractors License Law lor me loiiowing reason H 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) D I am exempt under Section Business and Professions Code for this reason (Sec 7031 5 Business and Professions Code Any City or County which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption Any violation of Section 7031 5 by any applicant for a permit subjects the arjplicanmo a civil penalty of not more than five hundred dollars [$500]) SIGNATURE S^in "V 1 ^ j.. . J^ ^ DATE COMPLETE THIS SECTIOMTOR NON-RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future beilding occupant required to submit a business plan, acutely hazardous matenals registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1,1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT 9 CONSTRUCTION LENDING AGENCY I hereby attirm that there is a construction lending agency tor the performance ot the work tor which this permit is issued (Sec 3097(1) Civil Code) LENDER'S NAME LENDER'S ADDRESS 10 APPLICANT CERTIFTCAnOr* 1 certify that 1 have read the application and state that the above information is correct 1 agree to comply witn 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, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID OTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA. An OSHA permit is required for excavations over S'O" deep and demolition or construction of structures over 3 stones 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 permitys not commenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or abandopJE&atXfny time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code) APPLICANTS SIGNATURE <^ j( jts^JL^ ___ DATE ^/S TE: File YELLOW: Applicant PINK: Finance City of Carlsbad Building Department OWNER-BUILDER INFORMATION Dear Property Owner An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified For your protection you should be aware that as 'owner-builder' you are the responsible party of record on such a permit Building permits are not required to be signed by property owners unless they are personally performing their own work If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city They are also required by law to put their license number on all permits for which they apply If you plan to do your own work, wit the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers'compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U. S Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents 2O75 Las Palmas Drive • Carlsbad, California 92OO9-1 576 • (619)438-1161 Page Two If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions A frequent practice of unlicensed persons professing to be contractors is to secure an 'owner-builder' building permit, erroneously implying that the property owner is providing his or her own labor and material personally Building permits are not required to be signed by property owners unless they are performing their own work personally Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814 Please complete and return the attached owner-builder verification form so that we can confirm that you are aware of these matters The building permit will not be issued until the verification is returned Sincerely, CITY OF CARLSBAD Attachment bjn OWNERINFO MST 14 i i M A City of Carlsbad Building Department OWNER-BUILDER VERIFICATION Attention Property Owner An 'owner-builder' building permit has been applied for in your name and bearing your signature Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit No building permit will be issued until this verification is received (j ) I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) txl & :*>/7 ft oAs~€^' signed an application for a building permit for thenot) proposed work I have contracted with the following person (firm) to provide the proposed construction Name Address Phone City Contractors License No I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work Name Address Phone City Contractors License No I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated Name Address Phone Type of Work Signed Property Owner 2O75 Las Palmas Drive • Carlsbad, California 92OO9-1576 • (619) 438-1161