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Home My WebLink About2105 CAMINO VIDA ROBLE; ; CB910886; PermitBUILDING PERMIT06/10/91 14:56 Page 1 of 1 Job Address: 2105 CAMINO VIDA ROBLE Str: Permit Type: ELECTRICAL Parcel No: Valuation: 0 Construction Type: VN Occupancy Group: Class Code: Description: TEMPORARY POWER CB91-513 Permit No: CB910886Project No: A9100603 Development No: Appl/Ownr : BRIGGE AND BERGE 16672 MILLIKEN AVENUE IRVINE, CA 92714 Status: ISSUED Applied: 06/10/91 Apr/Issue: 06/10/91 Validated By: DC 714 863-1064 *** Plan Check Numbe Fees Required Fees : Adjustments: Total Fees: Fee description Enter "Y" for Ele Enter "Y" for Tern * ELECTRICAL TOTAL ted & Credits * * * .00 .00 15.00 Ext fee Data 5. 00 Y 10.00 Y 15.00 CFTY OF CARLSBAD 2075 Las Palmas Dr., Carisbad CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las PaI was Dr., Carlsbad, CA 92009 (619) 438-1161 A ^>C6mmercial Brlew Building D Tenant Improvement B - D Industrial D New Building D Tenant Improvement C - D Residential D Apartment D Condo D Single Family Dwelling O Addition/Alteration D Duplex D Demolition D Relocation D Mobile Home jyElectrical D Plumbing D Mechanical D Pool P Spa D Retaining Wall D Solar D Other 2. PROJECT INFORMATION Address PLAN CHECK NO. ^ EST. VAL PLAN CK DEPOSIT, VALID. BY DATE FOR OFFICE USE ONLY or Suite No. Nearest Cross Street DESCRIPTION Lot No.Subdivision Name/Number Unit No.Phase No. CHECK BELOW IF SUBMH IhU: D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PRQPOSED USF. DESCRIPTION OF WORK SQ.FT. 7 / # OF STORIES 3. UJNTAUT FtKSun Of ainerent trom applicant; NAME ADDRESS CITY SJATE ZIP CODE DAY TELEPHONE 4. APPLICANT LJUONTKAUiyS ,., /J _/_ciTYMtf^5t,y 6&*7/«'L CITY /X. ^tf^^ 0. UUHIKALIUK NAME -SV^''*'? ^*""" /&£ CITY STATE LIC jgAUENT FOR CON 1 RAUTOR U OWNER U AGENT FOR OWNtiK ADDRESS t2&7gf /Stf^&tjie^J "Dtf-., STATE C?/^ ZIP CODE %2&£ 2 DAY TELEPHONE "^ ^ ^ (^f 3-3 // / *7 «2, /^7/ "/// /rvrxJ y^t^ ^<ADDRESS /«*«• ' STATE <^X ZIPCODE ;?i27/^- DAY TELEPHONE C^7 ^ ) $&'3"^ &<5 / /?&<!> t't, ADDRESS STATE ZIP CODE DAY TELEPHONE .#J$b2/f~} LICENSE CLASS & ~/ CITY BUSINESS UC. # DESIGNfcH NAME CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. # 7. WORKERS'COMPhNSAnuN Workers' Compensation Declaralion: I hereby aflirm that I have a certilicate ot consent to sell-insure issued by the Director oMndustnai 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 ^jJcJ'&zfiz/ f\ I POLICY WZ./tff tf$&/flfafa&PKV3R DATE /& ~ / "*? f Certificate ot Exemption:! certify that in the performance of the work for which tnis 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 DECLARArlON Owner-Builder Declaration: I hereby affirm that 1 am exempt trom the Contractors 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). I am exempt under Section Business and Professions Code for this reason:D (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^ejcempt therefrom, and the basis for the alleged exemption. Any violation of Section ,7031 -5 by any applicant for a permit subjects the applicant^foja civiU>enalty of not more than five hundred dollars [S500]). SIGNATURE f#L? i J s// ,- """ DATE // COMPLETE Is the applicant prevention ECTI0X.FOR NON-RESIDENTIAL BUILDING PERMITS ONLY: <• future/ouilding occupant required to submit a business plan, acutely hazardous/materials registration form or risk management and :ram upder Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? YES D NO azifrdous/rna 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. V. UUMSTKUC71 ION LENDING AGKNC.T I hereby alhrm LENDER'S nstruction ending agency lor the perlormance ot the work tor which ths permit Is issued (Sec 3097UCvodeJ. LENDER'S ADDRESS O. APPLICANT I certify that 1 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 AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SATO CITY IN CONSEQUENCE OF THE GRANTING OF TIDS 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 abandoned at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform- Building Code). A^PLICAN DATE: WHITE: File YELLOW: Applicant PINK: Finance DATE PERMIT # JOB ADDRESS UNSCHEDULED INSPECTION INSPECTOR PLANCK # TIME ARRIVE:TIME LEAVE: CD LVL DESCRIPTION ACT COMMENTS