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HomeMy WebLinkAbout2141 PALOMAR AIRPORT RD; MULTI-PERMIT FILE; CB973287; PermitBUILDING PERMIT Permit No: CB973287 102'30797 '09:19 . ,. Project No: A9704239, Paqe 1 of 1 . Development. No: JobAddress: 2141 PALOMAR AIRPORT RD . Suite:100 Permit Type: SIGN . •. . . Parcel No: 213-070-16-00 * . Lot#: ValiIation: 800 Constructibn:Type: NEW Occipancy Grbup: .. . Reference#: . Status:,ISSLJED Description: WALL MOUNTED SIGN NON-ILUM. -. Applied: 10/30/97 Apr/Issue: 10/30/97 Enteied By:JM - Appl/Ownr 3870E EAGLE DRIVE 714 000101 02 00 ANAHEIM, CA 92807 • Fees Required - Eëesol1ected & Credits 0 Fees: . 35.O - (9~TdAAdjustments: . oo tal edits: .00 / Total Fees:. •5.00 Tota1P'ments\: . .00 -00 al~~Di e 35. Fee description U \ ji Ext fee Data ------------------------- --------------------- Building Permit 21.0 Plan Check. 14.00 '4 SIGN TOTAL 35. 00 1952 IN $ ft [ FIAAPPOVAL $P.A" DA1E "LE ..~Z AAI!CE___________ • .,,. .. - - - •-. . CITY OF CARLSBAD * 2075 Las Palmas Dr., Carlsbad, CA 92009. (619) 438-1161 . -- PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 FOR OFFICE USE ONLY PLAN CHECK NO.75 7 EST.VAL. co Plan Ck. Deposit Validated By .JItI" Date Z4 4Z r o. . Address (include Bldg/Suite 6) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total 6 of units Assessor's Parcel S Existing Use sod Use '2t- 164.irLL.. Si. . 1Z0. SQ. FT tot Stones I of 2. .CONTACT PERSON (if en.ran..* i'l&iM) Name /" / Address City State/Zip Telephone S Fax S 3, APPLICANT tontractor 06gent for Contécr Oö 0 A iöör Name Address City State/Zip Telephone S 4. .:pROpER1YOWpdER ... .. . . . . Name Address City State/Zip Telephone I 5 CONTRACTOR COMPANY NAME - - 77 .-. 7 (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, commanding with Section 7000 of Division 3 of the Business and Professions Codel 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 1$5001). rnc. 0 3 )e' 1-c.. A0, oa I.4', Cr') 9o) Name Address J City State/Zip Telephones State LicenseS S,O9I L/ License Class '-'/Ci() City Business licenseS ___________ Designer Name Address City State/Zip Telephone State License S 6 WORKERS COMPENSATION Tr 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' compensation as provided'by Section 3700 of the Labor Code, for the performance of)he 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: J Insurance Company Fu i'.0 Policy No. _/:7c 3') odd Z11C Expiration Date_____________ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 161001 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 California. WARNING: Failure to cure a thousand dollars 16100 01, In SIGNATURE TK 7. OWNER-BUILDER I I hereby affirm that I am rk 'compensation coverage Is unlawful, and shall subject an employsr to criminal penalties and civil fine, up to one hundred to the cost of compensation, damages as provided for In Section 3706 of the Labor cqde. kfl.r.st and attorney's fees. DATE /6 / & TION 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, 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 provingthat 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 em 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 I address / phone number / type of work): PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOR NON-RES!DaVTL4L 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? 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 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 Code). LENDER'S NAME LENDER'S ADDRESS_____________________________________________________ 19 `-'APPLICANT 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 Cltp of Carlsbad to enter upon the above mentioned properly 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 th 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 mence hin 385 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 w is com enc for a period of 180 days (Section 108.4.4 Uniform Building Code). APPLICANT'S SIGNATURE . DATE WHITE: File YELLOW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB973287 FOR 11/17/97 INSPECTOR AREA DESCRIPTION: WALL MOUNTED SIGN NON-ILUM. PLANCK# CB973287 0CC GRP CONSTR. TYPE NEW STE: 100 LOT: PHONE: 714 632-1100 PHONE: PHONE: INSPECTOR TYPE: SIGN JOB ADDRESS: 2141 PALOMAR AIRPORT RD APPLICANT: SIMCO CONTRACTOR: OWNER: REMARKS: C/GARY/714-632-1100 SPECIAL INSTRUCT: TOTAL TIME: CD LVL DESCRIPTION 38 EL •Signs ACT COMMENTS 2. INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP COMMENTS L + B U I' L D. I N G P1. E'R N I T Permit No: CB970472 03/06/97 15 Project No A9700637 Page 1 of I Development No Job Address: 2141 PALOMAR AIRPORT RD' ,. : Suite: * Permit Type SIGN 311 03/O8,7 0001oi. o Parcel-No: 213-Q70-16-00 ' Lot#: '9400. Valuation: 1,950 Construction'-Type: NEW 'Occupancy Group: :' -- , Refez'ence#: Status: ISSUED Description: PLASTIC ILLUMINATD-OV.ER ENTR Applied: 03/06/97 GOSSMONTBANK' ' .''Apr/Issue: 0$/O6197,, — 'Entered BY: RMA Appl/Ownr : SIGN TECH , 619 527*1589 . ., - . * 4444 FEDERAL BLVD . ... '---• - SAN DIEGO CA 92102 •.-,; ,. S ** Fees Required -*** — ' Collected'& Credits------------- Adjustments: 0 "00 BaZz 94 Fee. description J ,\Eni' Ext f,e' Data Building Permit.' 7 45.00 Plan Check , . . 29,00 c\ 20 00 ELECT TOTAL NCORPORATED 1q52 4 k' INSR. . * CLEARANCE - As -. . 'S - ••_S • - .- CITY OF CARLSBAD 2075 Las Palmas. Dr, Carlsbad, CA 92009 (619) 4384161 • qiLf7 C1 EST. VAL ( 5t9 PLAN CX DEPOSIT_______________________________ VALID. BY DATE 3/Li TJ PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 A0W& PERMIT TYPE A - COMMERCIAL FNEW qTENANT IMPROVEMENT 1. I B - 0 INDUSTRIAL [-]NEW DTENANT IMPROVEMENT C - DRESIDENTIAL DAPARTMENT DCONDO OSINGLE FAMILY DWELLING DADDITION/ALTERATION [)DUPLEX DDEKoIITIoN DREIOCATION []MOBILE HOME []ELECTRICAL D PLUMB ING []MECHANICAL EJPOOL DSPA DRETAINING WAIL (—]SOLAR DOTHER Add 141 Building or Suite No. PROJECT INFORMATION PLAN CHECK No. I FOR OFFICE USE ONLY s Nearest Cross Streets LEGAL DESCRIPTION Lot No. Subdivision Name/Number Unit No. Phase No. CHECK 02 En BELCRA IF SUBMITTED: ergy Cat cs 02 Structural Calcs 02 Soils Report Di Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK / (fiPj4 3/,IU *c& Cfj77Uila, - £9/SS BLDG. 50. FIG. /...,f*(_)f # OF STORIES CONTACT PERSON NAME ,)fl/f) Cy&),!,J? ADDRESS 4I44 CL24J 6/v~L CITY SCL.P1 ZLaCI'Q STATECft—ZIP CODE DAY TELEPHONE l.121t) L7-(olfto SIGNATURE APPLICANT 'C0NTRACTOR 0 AGENT FOR CONTRACTOR DOWNER []AGENT FOR OWNER NAME ADDRESS DAY TELEPHONE STATE ZIP CODE - CITY ESSEE TENANT PROPERTY OWNER OWNER ADDRESS 2/ // thJona-rA CITY (Xv1, ba_.' STATE& ZIP CODE '?260'7 DAY TELEPHONE CONTRACTOR wAME ,77.t..j ADDRESS 1q/J44 i_.vD CITY.5'..7 DIE47 STATE C/ ZIP CODE DAY TELEPHONE(7J) S-7-I5 STATE LIC. _____________ LICENSE CLASS "IS CITY BUSINESS LIC. 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 77'77 t//'7 7 POLICY NO. '4/s L-'/lR'lPIRATION DATE 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. In SIGNATU A it B. OWNER-BUILDER DECLARATION Owner-Builder Declaration: 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, will 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 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 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 ($500)). SIGNATURE fl fi.. 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 DNo Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? DYES DNO 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 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 Code). 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, JIEOMENTS, COSTS AND EXPENSES WHICH KAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. Expiration. Every permit issued by the Building Official under the provisions of this Cede 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 time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Cede). APPLICANT'S OWNER CONTRACTOR 0 BY PHONE WHITE: File YELLOW: Applicant PINK: Finance B U I L D I N PER MI T Permit No: C.B911622 64/67/93 .11:49 . Project No: A9102044 'Page 1 of I , Development No: 'Job Address: 2141 PALOMAR AIRPORT RD - .Suite: 300 - (4/r7'Q (yv\i. (1 A') Permit-Type:" SIGN - - L•VI I.. i.. a! 'Jv.L. Parel No: 213--070-16-00 Lot#: - C-PRMT 1400 Valuation: 860 Construction Type: NEW Occupancy Group: Reference#: Status: ISSUED Description: GRAHAM INTERNATIONAL SIGN Applied: 12/02/91. STE 300. Apr/Issue: 04/07/93 - -•- - . . Entered By: SBB -' Appl/Ownr : ARCHITECTURAL SIGN SOURCE 619 528-1890 - P.0.' BOX 900381.. - - 9528922 6326 RIVERD LE, 'SAN DIEGO, CA - *** Fees 'r -* .-* F!J)e. 'e & Credits * -------------------------. • -; Fe s 5-3 Adjustments: -. C eçIt: - .00 — Total Fees: —Or \f Building Permit Plan Check ,JJJ 15.00 Strong Motion Fee 1-00 - :Othér • > \ 14.00 a - 14.00 RENEW * BUILDING TOTAL INCORPORATED 1952 53 00 H _.•0 . " 'H -, .- a — I N$A1' I'. - •- -- - - '.- .' . - -• TE ANCE -.. -- - -.- ,_ a ,,••• ,, •1 CITY..OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 .. B U I L D I N G P E R M I T, Permit No: CB911622 12/05/91 09:27 •. Project No: A9102044 Page 1 of 1 - - Development No: Job Address: 2141 PALOMAR AIRPORT RD Str:, Fl: Ste: errnit Type: SIGN 4 , 5494 12/05/91 0001 01 02 Parcel No: 213-070-16-00 C-PRMT 39.00 Valuation: 860 Construction Type: NEW . * Occupancy ,Group: . Class Code: Status: ISSUED Description: GRAHAMINTERNATIONAL SIGN Applied:12/02/91 SITE. .300 . Apr/Issue: 12/05/91 Validated By: SBB * Appl/Ownr :.ARCHITECTURAL SIGN SOURCE 619 528-1890 P.O. BOX 900381 SAN DIEGO CA 92L9-0 CONTRACTOR : 619-528-1022 SAN DIEGO,/CA 9200 - *** Fees Required ./*r* '.' Fst\l.ecte & Credits --------------------- Fees: •- : Ad j us tme n ts: f i et: \ . 00 Total Fees: • ayminit : - .00 39. nc 00 Fee description e Ext fee Data - ---- ----- ------------- BUILDING TOTAL 5.00 4 ) . • - -L.:_ • 39.00 INCORPORATED 1952 Al 4 1 - CITY OF CARLSBAD 2075 Las Palmas Dr.-,''Carlsbad, CA 92009 (619) 438-1161 - .•. All;I::I PERMIT APPLICATION p City of Carlsbad Building Department 2075 Las Patmes Dr., Carlsbad, CA92009 (619) 438-1161 PLAN CHECK NO. ,,WAI ffilop I. PERMIT TYPE A - Li Commercial LI New Building Li Tenant Improvement B - 0 Industrial 0 New Building 0 Tenant Improvement C - 0 Residential 0 Apartment 0 Condo 0 Single Family Dwelling 0 Addition/Alteration Duplex , 0 Demolition 0 Relocation 0 Mobile Home 0 Electrical 0 Plumbing O Mechanical 0 Pool 0 Spa 0 Retaining Wall 0 Solar 0 Other__________ 2. PROJECT INFORMATION I FOR OFFICE USE ONLY A5 1ess Building or Suite No. Nearest Cross Street Yarrow LEGAL DESCRIPTION Lot No. Subdivision Name/Number Unit No. Phase No. MAP 10738 . 1706 (3R11J-1M INTERNATIONAL PLAZA CHECK BELOW IF SUBMITTED: 02 Energy Calcs 02 Structural Calcs 02 Soils Report 0 1 Addressed Envelope ASSESSOR'S PARCEL i 213-00•— i EXISTING USE PROPOSED USE DESCRIPTION OF WORK SQ. FT. 24/4/l1. # OF STORIES 3 - 3— CM 13111-PPLR014 (It different from applicant) NAME ADDRESS CITY - STATE ZIP CODE DAY TELEPHONE - APPLICANT CkONTRACTOR LI AGENT FOR CON RA(JIUR Li OWNER Li AGENI FOR OWNER NAME ARCHITECTURAL SIG' SOURCE ADDRESS P.O. BOX 900381 CITY STATE CA ZIP CODE 92190 DAY TELEPHONE (619) 528-1890 . PROPLRI'YUWNtR NAME WM INTERMTIOML ADDRESS 2141 Palanar Airport Road, Suite,300 CITY Carlsbad STATE CA ZIP CODE 92009 DAY TELEPHONE (619) 438-1545 NAME A.R. tiYLIE CCtv1P1NY ADDRESS 6326 Riverdale Street CITY San Diego STATE CA ZIP CODE 92120 DAY TELEPHONE (619) 528-1022 STATE UC. # 417 LICENSE CLASS (1/fl47 CITY BUSINESS LIC. # DESIGNER NAME ADDRESS CITY N/A - STATE ZIP CODE DAY TELEPHONE STATE UC. # WORKERS' WMPENSATION Workers' Compensation Declaration: I hereby affirm that I have a certificate of consent to sell-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. Q. INSURANCE COMPANY ALLIED . POLICY NO. ACPWC781O07372CPIRATION DATE 12-21-91 Certificate of Exemption: I certify that an 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 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 r -offFiëd for sale . 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves the n, and who does such work himself or through his own employees, provided that such improvements are not intended. or offered for sal If, however, t I he building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that did not build or improve for the purpose of sale.). 1, as owner of the operty, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contrac r's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) lic pursuant to the Contractor's License Law). I am exempt under Section and Professions Code for this reason: - (Sec. 7031.5 Business and Professions Code: Any City or County which r rmit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a si tatemént that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commencing with Section 7000 of Division Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 y plicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]). 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 2S S, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? DYEs DNO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? DYES 13 NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? DYES. 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 TILE OFFICE OF EMERGENCY SERVICES AND THE AIR POU.13110N CONTROL DISTRICT. WNSThUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency [or the performance of the work for which this permit is issued (Sec 3097(i) Civil Code). LENDER'S NAME LENDER'S ADDRESS APPLICANT CERTIFICATION I certiiy 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 CIY OF CARlSBAD AGAINST ALL UABIIIFIES, JUDGMENTS CX)STS AND EXPENSES WI-UGH 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'O" 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 ly 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). APPLICANTS SIGNATURE -. DATE: WI-IITE: File YELLOW: Applicant PINK:. Finance .. -. . .