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Home My WebLink About2131 PALOMAR AIRPORT RD; EXPIRED | MULTI-PERMIT FILE; CB010169; Permit4, 'City of Cadsbad .' . 1635 Faraday Av Carlsbad, CA 92008 .02/05/2001 . Commercial/Industrial Permit Permit No: 0B010169 Building Inspection Request Line (760) 602-2725 Job Address: 2131 PALOMAR AIRPORT RD CBAD Permit Type: TI Sub Type: COMM Parcel No: 2130702700 Lot #: 0 Valuation: $40,000.00 Construction Type: NEW Occupancy Group: ' . Reference #: Project Title: TELIGENT INSTALL (14) ROOF MOUNT ANTENNAS 212IPALOMAR AIRPORT RD #100 dARLSBAI5 CA 92009 0729 02/05/01 0002 01 02 \ W C OF 456-27 Total Fees: $521.07 ( TotI'Pymêhts.To Date: $64:80 k -BIance Dub: $456.27 Building Permit / /Iz~$298.59 Meter Size \ Add'I Building Permit Fee / so:oo Add'IRéI.Wter.Cbn. Fee $0.00 Plan Check f ,. . $194.08 Mète(Fee ,\ $0.00 Add'I Plan Check Fee $0.00 . •SDCWA Fee ' $0.00 Plan Check Discount . $0.00 CFDPayoff Fee /. I $0.00 Strong Motion Fee $84P ' /\c j j$0.00 Park Fee \ \"-$0.00 PFE (CFD Fund'), I $0.00 LFM Fee \ $000 ' Liense Tax (51 / / $0.00 Bridge Fee \ \ \$0.0O in'e Tax (CFDund) / $0.00' 'BTD #2 Fee -\ \ $0.00 \rraff1c Impact Fee / / $0.00 BTD #3 Fee' \ ' $0.00 rraffié Impact (CFD Fund) / $0.00 Renewal Fee - \ / \$0.00 JNC01LFMZTraportation Fee / $0.00 Add'I Renewal Fee . \ $0.00 LUMBINft .00 Other Building Fee \ \, $0.00-., ELECTRIr PER IT Pot. Water Con. Fee , to $0.00 MECANIC1..TT '.. Meter Size \ J 1) MaseTy ee'!jRED NACCORDA ccm U.B.C. Add'I Pot. Water Con. Fee i/$10.00f rl~f Sew& IJN 106.4.4 ,,/ ' $0.00 Red. Water Con. Fee . "— $0.00 RdevPrkin M. .-' $0.00 PE RW-!Ek-EbS!GNAThRE . FINAL APPROVAL Inspetor: •Date: ______________ : Clearance: NOTICE: Please take NOTICE that approval of your project includes the 'Imposition" of fees, dedications, reservations, or other exactions hereafter ôollectively 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 tees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. Applicant: WICKLUND STEVEN 13210 FLORENCE AVENUE SANTA FE SPRINGS CA 90670 .562-777-0983 ' - nco I ISSUED 01/12/200f JM 01/25/2001 02/05/2001• Owner:—...., - C B GRAHAM INTERNATIONAL INC C/O RREEF.MANAGEMENT Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: FOR OFFICE USE ONLY 'PERMIT APPLICATION -•- PLAN CHECK NO.c o" EST. VAL. rrY OF CARLSBAD BUILDING DEPARTMENT 1635 -Faeaday Ave,.,, Carlsbad, CA 92008 Va an Ck. Deposit hdatedBv3 _ P _______ Date__________________ 1 PROJECTJNORMAJJON . -':_ ,. 2.if3FJlt14Q ,1r'/)Ok/ -fl''cinI) - .. 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' Parcel # - xistin Use Pro osed Use . Rôp '1—or worK re.#c¼ -- '- ° (1k1/k7 rf- y - Descnptuorof VI/ork S . FT. #0 t ties •- # of Bedrooms # of Bathrooms -- y-j292 3,-i-A,'v/ I?1 Name •Address City State/Zip ?8oteleone # ax # 3 UQT Uactr AnfCon Qwner nio tfl 3 ?i Name - -Address - - City - State/Zip Telephone # 0 557- Name Address - City DftState/Zip j.c? Telephone # r-5- eEOLNTRAC - - - ,.,(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 fora permit subjects the applicant to a civil penalty of not more than five hundred dollars [$50011. - - b,'/-14I C ,'e,'4M N~ I 8/UL 3y/i ,+ qii ? /6 Name - Address - City, State/Zip Telephone # - State License # - - License Class ________________________ - City Business License /2 9-? - Designer Name - - - Address - City State/Zip Telephone State License # NPE tSATL 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'compénsation as provided by Section 3700 of the Labor Code, for the performance - of the work for which this permit is issued. 0 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 /119,'LAI,(12,c" I 4J5(j.jPj9/t1C C Policy No. 31 - Expiration Date . /o//oo 1 '(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS) C] 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 dollars ($100,000), in 9ddition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE / DATE " /1- - LOWNE Mr-RA DELAKfl )— 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 contraàtorls) licensed - pursuant to the Contractor's License Law). . •. . . - - o I am exempt undr Section -, Business and Professions Code for this 'reason: I personally'plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES DNO - I (have / have not) signed an application for a building permit for the proposed work. - - -- -. I have contracted with the following person (firm( to provide the proposed. construction (include name / address / phone number / contractors license number(: ---, 4.- I plan to provide portions of the work, but I have hired the following person to coordinate, supervise 'arid provide the major work (include name / address / phone.. - number / contractors license number): 5. I will provide some of the work, but I havecontracted (hired) the following persons to provide the work indicated (include name /'address / phone number / type' of work): PROPERTY OWNER SIGNATURE DATE ED NUILDING31,01E 1.0 Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials, registrationform 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 quIity management district? 0 YES 0 NO - Is the facility to be constructed within 1,000 feet of the out 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. ' -- - -- - CY ii I hereby affirm that there is a construction lending agency, for the perfoimenc,. of the work for which this permit is issued (Sec. 3097(i( Civil Code(. LENDER'S NAME - . - - ' -- ' LENDER'S ADDRESS T 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 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 in height. EXPIRATION: Every permit issued by the building Official under the provisions of this Code shall expire by limitation arid becoii-ie 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 time after the work is commenced for a ,,, yriod (180 days (Section 10644 Uniform Building Code) .. :APPLICANT'S SIGNATURE ___ £!17IdQ1ij _v__________- _. - 'DATE - - - - - - - -----------------., - WHIT : File YELLOW: ApplicantPINK: Finance Cit July 6, 2001 DIGITAL COMMUNICATIONS GROUP 12823 FOOTHILL BLVD., UNIT B SYLMAR CA 91342 RE: BUILDING PERMIT EXPIRATION PERMIT TYPE:. TI of Carlsbad :1111 r ii .i - .11.1:1g a 2 itialU Permit Number: CB010169 Issue Date: 2/5/2001 ADDRESS: 2131 PALOMAR AIRPORT RD PLEASE CALL FOR AN INSPECTION IF WORK IS COMPLETE Our records indicate that your building permit will expire by limitation of time on 8/4/2001. The provisions of UBC, Section 106.4.4 as amended by the Carlsbad Municipal Code state: "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 (unless issued prior to 7/1/99 which is one year from date of permit), or if the building or work authorized by such permit is stopped at any time after the work is commenced for a period of 180 days or if the building or. work authorized by such permit exceeds three calendar years from the issuance date of permit. Work shall be presumed to have commenced if the permittee has obtained a required inspection approval of work authorized by the permit by the Building Official within 180 days of the date of permit issuance. ' Work shall be presumed to be stopped if the permittee has not obtained a required inspection approval of work by the Building Official within each 180 day period upon the initial commencement of work authorized by such permit. Before such work can be recommenced, a new permit shall be obtained to do so, and the fee, therefore, shall be one-half the amount required for a new permit for such work, and provided that no changes have been made Or will be made in the original plans and specifications for such work, and provided further that such suspension or abandonment has not exceeded one year. • In order to renew action on a permit after expiration, the permittee shall pay a new permit fee.. Any person holding an unexpired permit may apply for an extension of the time within which work may commence under that permit when the permittee is unable to commence work within the time period required by this section for good' and satisfactory reasons. The Building Official may extend the time for action by the permittee for a period not exceeding 180 days on written request by the permittee showing that circumstances beyond the control of the permittee have prevented action from being taken. No permit shall be extended more than once. Please check below indicating your intentions and return this letter to us. Project abandoned. A new permit will be obtained prior to commencing work. No fee extension requested for 180 days. (attach a letter of explanation) Renewal permit requested. If the project has been completed and only a final inspection is needed, please call the inspection request line at (760) 602-2725. ' If you have any questions, please contact the Building Inspection Department at (760) 602-2700. PAT KELLEY Principal Building Inspector 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-2700 • FAX (760) 602-8560 Building Counter • (760) 602-2719 • FAX (760) 602-8558 BtI L D'I N G P ER,M I T Permit, No: CB981723 .06/04/98 10:31 . Project No: A9801360 Page 1 of :. Development No: ,Job Addres: 2131 PALOMAR AIRPORT RD. - Suit: 100 Permit Type MISCELLANEOUS 77120iO4/98 02 Parcel No 213-070-27-00 Lot# Valuation: 0 - Construction Type: NEW Occupancy Group: Referene#: . Status: ISSUED Description DEMO NON-BEARING WALLS Applied 06/04/98 Apr/Issue: 06/04/98 Entered By: JM Appl/Ownr : PETERBUILT CONST . . 619 26028524 4026 HAWK STREET - SAN DIEGO CA 92103 ' - Fees. Required *** • Fee Collected & Credits Fees: 30. Adjustments: di 00 Total Fees 0;'-'0.6 rotal . 00 Fee description Ext fee Data Miscellaneous Fee# 30 00 PERMIT 952 IT -. V PERMIT nsw. $ECTLON10G4.4 . .• -. SIGNATURE DATE FINAL APPROVAL , INSP DATE_ V.. - CLEARANCE_I J CITY OF CARLSBAD - V 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 4381161 ' PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 0 4'IFoc FOR OFFICE USE ONLY PLAN CHECK NO. 7rt1? EST. VAL. Plan Ck. Deposit Validated By_ Date .1. LOkti4 " Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's P cel # Existing Use Use r 1 W6 4—J L5 _ Description of Work SQ. FT. . #of Stories # of Bedrooms # of Bathrooms :2TCONTACT PERSON . Name - Address City State/Zip Telephone # Fax # 3 APPLICANT 1ntr'ctor, 0 A fcCdta&r. Name Address City State/Zip Telephone # 4 .,PROPERTY OWNER Name . Address City State/Zip Telephone # S CONTRACTORThOMPANY NAME T (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 exemptigg. Any violation of Section 7031.5 by any applic nt for a permit subjects the applicant to a civil penalty of not more than five h nØed, dollars I$5001). f-&ei'r CL4 Name Address City State/Zip ' Telephone # State License # License Class City Business License # -71- Le Designer Name Address City State/Zip Telephone State License # 6 WORKERS 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. - El I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company Policy No. Expiration Date__________________ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) 0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. - WARNING: Failure to secure workers' compensation coverage is unhiwful, 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. SIGNATURE . DATE 7 OWNER BUILDER DECLARATION ' i ' Z . '2" ' - 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 I (have / have not) signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number): I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone number / contractors license number): I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work): PROPERTY OWNER SIGNATURE ' DATE COMPLETE THIS SECTION FOR NONRESIDENTIAL BUILDING PERMITS ONLYL. i-,- 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. 8CONSTRUCTION LENDING AGENCY " J " I hereby affirm that there is a Construction lending agency for the performance of the work for which this permit is issued (Sec. 30970) Civil Code). LENDER'S NAME LENDER'S ADDRESS__________________________________________________________ 9 tAPPLICANT CERTIFICATION L a 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 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 rk i Co egced for a perId of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE fr\ DATE WHITE: File YELLOW: Applicant PINK: Finance ON of Carlsbad INDUSTRIAL TENANT IMPROV Permit No: CB900399 Job Address: 2131 PALOMAR AIRPORT RD Status: EXPIRED Permit Type: ITI Applied: 03/09/1990 Parcel No: 2130701500 Lot #: Approved: Reference No: 0 1 Issued: PC, #: Inspect Area Project-Title: REMODEL LOBBY OF OFFICE BLDG Applicant Owner PETERBUILT CONSTRUCTION GRAHAM INTERNATIONAL 0 8380.MIRAMAR MALL 3125 - SAN DIEGO CA 619 455-6500 00136104885 I Plan Check $5900 - 0013610488J an Check $59.00 00 OS I * - 0 * C Fees $59 00 Additional Fees $0 00 Total Fees $59.00 I Balance L $0 00 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 1. PERMIT TYPE I A - 0 COMMERCIAL DNEW DTENANT IMPROVEMENT B - 0 INDUSTRIAl DNEW DTENANT IMPROVEMENT C - DRESIDENTIAL DAPARTMENT DCONDO DS!NGLE FAMILY DWELLING D ADD ITION/ALTERATION DDUPLEX DDEMOLITION DRELOCATION DMOBILE HOME DELECTRICAL DPLUMBING DMECHANICAL DPOOL DSPA DRETAINING WAIL DSOLAR DOTHER________________ EST. VAL PLAN Cit DEPOSIT ".• , I VALID. BY DATE /9/97 3923 03/09/90 0001 01 02 Q //$3 C--PRMT 59.00 Address BuilDing or suite NO. 2131 PALU4AR AIRPORT RD CROSS ST. YARROW DR Nearest Cross Streets LEGAL DESCRIPTION Lot NO. Subdivision Name/Number Unit No. Phase No. #3 CAPIS PCT 83-10 MAP # 10738 CHECK 0BEL 2 IF SUBMITTED: Energy Calcs 02 Structural Calcs 02 Soils Report Di Adessed Envelope ASSESSOR'S PARCEL 213 070 1500 ExISTId r NG Si office PROPOSED USE DESCRIPTION OF WORK -r1 ôR c BLDG. SO. FTG.307°°°' /1 A H OF STORIES 3 3. CONTACT PERSON NAME PETER LASE ADDRESS 8380 I'1IRAMAR MAIL #125 CITY SAN DIEGO z, STATE CA ZIP CODE 92121 DAY TELEPHONE (61) 455-6500 SIGNATURE NS 4. APPLICANT ACTOR 0 AGENT FOR CONTRACTOR DOWNER DAGENT FOR OWNER ADDRESS 8380 MIRPTMAR MAIL #125 CITY SAN DIEGO NAME PETERBUILT STATCA ZIP CODE 92121 DAY TELEPHONE (619) 455-6500 5. PR LESSEE ri TENANT NAME NJ OWNER ffj CA ADDRESS 2141 PlIii1ARhIRPORL' RD STATE ZIP CODE 92008 DAY TELEPHONE (619) 438-1545 CARLSBAD - CITY CORP ADDRESS 8380 MIRAMAR MALL #125 CITY SAN DIEGO STATE CA ZIP CODE 92121 DAY TELEPHONE (619) 455-6500 STATE LIC. H 477592 LICENSE CLASS Bi CITY BUSINESS LIC. # SD 86010497 SIGNATURE TITLE DATE DESIGNER NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. WORKERS' COMPENSATION 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 GOLDEN EAGLE INSURANCE POLICY NO.PWC 049300 EXPIRATION DATE 03/90 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. SIGNATURE DATE OWNER-BUILDER DECLARATION Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractors License Law for the following reason: D I as owner of the property or my employees with wages as their sole compensation, wilt do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Cede: 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 Cede: 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 Cede for this reason: (Sec. 7031.5 Business and Professions Cede: 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 Cede) 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 0 N 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 30970) Civil Cede). LENDER'S NAME LENDER'S ADDRESS APPLICANT'S SIGNATURE 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, JW4ENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. Expiration. Every permit issuedZ loie/enced Official under the provisions of this Code shall expire by limitation arid become null and void if the building or work authorized by such permi d 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 time after e for a period of 180 days (Section 303(d) Uniform Building Code). APPLICANT'S SIGNATURE if DOWNER , CONTRACTOR DBY PHONE APPROVED-BY'. DATE: WHITE: File YELLOW: Applicant PINK: Finance 6. C NAME DATE: 03/07/91 PLAN CHECK EXPIRATION PC# CB900399 DATE: 03/09/91 TO: PETERBUILT CONSTRUCTION ADDRESS: 2131 PALOMAR AIRPORT RD 8380 MIRAMAR MALL 3125 SAN DIEGO, CA 92121 You have applied to have your plans checked on the date shown above, and you have not obtained your building permit. The provisions of Section 304(d) of the Uniform Building Code state: "Section 304(d) Expiration of Plan Review Applications for which no permit is issued within one year following the date of application shall expire by limitation, and plans and other data submitted for review may thereafter be returned to the applicant or destroyed by the Building Official. In order to renew action on an application after expiration, the applicant shall resubmit plans and pay a new plan review fee." Please check the appropriate box indicating your choice and return this letter to the BUILDING DEPARTMENT. PROJECT ABANDONED. I WILL PICK UP PLANS WITHIN 10 DAYS. PROJECT ABANDONED. PLANS MAY BE DESTROYED. If you have any questions, please contact the Building Department at (619) 438-1161. DORIS COSMAN Building Department