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Home My WebLink About2140 JEFFERSON ST; ; CB940937; Permit^"To" I8 B " ' L ° > » ' ? E R „ ; T Permt No CB940937 T?K aJ^ Project No A9401324Job Address 2140 JEFFERSON ST e Development No Permit Type ELECTRICAL Suite Parcel No Valuation 0 Lot# Construction Type NEW 7991 08/01/94 «w» AOccupancy Group wto/V* 0001 01 02 Description TEMP POWER POLE FOR^RAILER6* Statfrs^sSUED 20-00 Applied 08/01/94 Ar^i/^ Apr/Issue 08/01/94Appl/Ownr POWER PLUS Entered By MDP 1167 LAW STREET 619 471~5495 SAN MARCOS, CA 91761 """ " "" .... *** Fees Required ***x' •."... ' .' ._, ,. X __ _-:.;***_-_;u.-; -Fees.;.eo.lldcted & Credits Fees 20 00 '• '\ '•''"' :~~~~ : Adjustments < -.00 •--'••"....,, ''\'- .'.V. \ Total Fees /2.0~po ,' ''""'-•'• -.Tc?.t?1'sCredits.. \ Fee description / 6~";: / ... ' ;/'; '"' "Balance Due \ 20 00 •• r. ' ^ ^ ^. *....'. - • - ~ • ' ^ee/unit \ Rvt- fa d r\^i.p,-.!.-^ nv„ ,- • - ; ;— r^'i^i.- '" . . i-iAu j.ee Datatnter Y for Elerhr-i « TC.^,,_ r,_ ... , •- ,>- —T :-'- *•Enter "Y"10 00 Y 10 00 Y 20 00 FINAL APPROVAL INoP DATE_ CLEARANCE f CITY OF CARLSBAD Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Pa I mas Dr , Carlsbad, CA 92009 (619) 438-1161 T 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/Gam of Dwelling Units . PLAN CHECK NO. EST VAL PLAN CK DEPOSIT_ VALID BY ~ DATE 2. PROJECT INFORMA'IION FOR OFFICE USE ONLY Address^, Nearest Cross Street Building or Suite No LEGAL DESCRIPTION ot No Subdivision Name/Number ~ p v/^-ov/vje^v i s> T^. r o r1^ n Unit No Phase No en — LHLLK BtLUW If SUBMIITLD I 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 WORi SQ FT K—, J__ \ j —-)— 4^v^S> TtMV &~ \JL/v^£) TDHIFS (T# OF STORIES # OF BEDROOMS # OF BATHROOMS 3 UJJMTALJ1* FEKbUN lit different irom applicant) NAME (last name first) CITY STATE ADDRESS ZIP CODE DAY TELEPHONE 4 APPUCANT pCONTRACTOR NAME (last name first)* CITY U AGhNT FOR CONTRACTOR ADDRESS U OWNER U AGENT FORTOWNEH STATE C0L.' ZIP CODE ^ Z-O fe 7 DAY TELEPHONE */ 7 ( £ 5 PROPERTY OWNER •*•> <- NAME (last name first) V«L S i ,LA. CITY CX lf\ \a r , O STATE ^ ' ^ADDRESS 2- C? If ^ B. . ZIP CODE ^ / 7 & / DAY TELEPHONED 7 IS V7-V63/ 6 CONTRACTOR ^N. jO I NAME (last name first) |—'c?>O-C_ /" f" | CITY 5d/t<—- i/l^^Ht-C^ STATE (-&- ZIP CODE STATE LIC # &l35lb LICENSE CLASS ADDRESS // CITY BUSINESS LIC # DESIGNER NAME (last name lirst) CITY STATE ^ADDRESS ZIP CODE DAY TELEPHONE STATE LIC # WORKERS^ COMPLNSAI1ON Workers' Compensation Declaration I hereby altirm that I have a certiticate otconsent to self insure issued by the Director ot 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 C\JU\~ UCxvxW tify that in the perfor POLICY 35~2S''EXPIRAT1ON DATE // ~ / " " 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 to the Workers' Compensation Laws of California SIGNATURE DATE 8 OWNFJl-BUILDER DECLARATION Owner Builder Declaration 1 hereby atlirm that 1 am exempt from tne Contractors License Law tor tne tollowing reason D 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 ) D 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 applicant to a civil penalty of not more than five hundred dollars [$500]) SIGNATURE DATE COMPLETE IhilS SECTION FOR NUN RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or nsk management and prevention program under Sections 25505, 25533 or 25534 of the Presley Tanner Hazardous Substance Account Act? D YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 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 TIIE 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 ATR POLLUTION CONTROL DISTRICT 9 CONSTRUCTION LENDING AGENCY I hereby atlirm 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 CERlirlCAnON I certity that 1 have read the application and state that the above intormation 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. UABIIJTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SATO 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 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 authonzed by such permit is not commenced within 365 days from the date of such permit or if the building or work authonzed 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 BuildjngjCo^e),. APPLICANTS SIGNATURE I/}/I .A //// ^O £/ DATE or a j?erio &C.cr-f.WHITE File YELLOW Applicant PINK. Finance