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Home My WebLink About2188 PALOMAR AIRPORT RD; ; 82-287; PermitC] i her•Irm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division -3 of the Business and Professions Code, and,my license is in full force and effect. Lic. No. --Class _________-Claso I hereby affirm that I am exempt from the. Con-tractors License Law for the following reason (Sec. 7031 1 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 Con- tractor's License Law (Chapter 9 commencing with Section 7000 of Division 3 of the Business and Pro- fessions Code) or that is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by an applicant for a permit subjects me applicant to a Civil penalty of not more than five hundred dollars ($500). . I, as owner of the property, or my employees h wag es as their sole compensation, will do the 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. It, 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 saId. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 704.4, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for each projects with a contractors) license pursuant to the Contractor's I License Law). - -- - C] t am exempt under Sec. - ' 8. & P.C. for this reason - Ix w a -I Ui Z 0 2~rprRrptM5ONLL& PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA ANQCLARATIONS. CARLSBAD BUILDING DEPARTMENT . APPLICATION & PERMIT' 1200 Elm, Carlsbad, California 92008 (114) 438-5525 . . AV, ST. 1 , OATEOFAPPLIC~AT1 o NI BUSINESS LICENSE # " - . 53o tE ocA -- . AD, '1,— okrw- A'trpoc-4- OWNER'S NAME OWNER'S PHONE PRIME CONTRACT R ' . CONTRACTORS PHONE 4 (ed . k'3oo Owrc (u'der VALUATION PERMIT NUMBER ZONE / - OWNER'S MAILING ADDRESS a Cl a cbo Ai cc-4- R 60d Car ts CONTRACTOR'S ADDRESS LICENSE NO. PLAN I.D. # BLDG USE CODE LOT BLOCK - SUBDIVISION , 7tSSESSOR PARCEL NO. DESIGNER ' . €fl STATE LICENSE # STANDARD PLAN # BUILDING SO. FOOTAGE DESC RI P,T ION OF WORK . - r p fl DESIGNER'S ADDRESS N3 DESIGNER'S PHONE 141-Iso3 - 0 Q Rdt flIeES!MWhitf?111ed 94OO - F/P FLRELEV. vD ND ----- I NO STORIES OCC GP' ECU CENSUS TRACT - GP LAND USE PARKING SPACE RES UNITS GRADING PERMIT ISSUED 'I ' Y N n REDEVELOPMENT I AREA - yD NO- - I O5 94'600• f TYPE CONST I 0CC LOAD , FIRE SPA-, - YO NO 'QTY. E' MECHANICAL PERMIT - ISSUE - - '- .300 SUMMARY/ACCOUNT NUMBER EACH-FIXTURE TRAP, INSTALL FURN. DUCTS UP-TO 100,000 BTU . BUILDING PERMIT ' - 01-000-4220 EACH BUILDING SEWER' - - OVER 100,000 BTU _ SIGN PERMIT 01- 000-4221 - EACH WATER HEATER AND/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK EACH GAS SYSTEM 1.TO 4 OUTL BOILER/COMPRESSOR 3.15 HP TOTAL PLUMBING 01-000-4222 EACH GAS SYSTEMS OR M - METAL FIREPLACE ELECTRICAL 01-000-4223 - - cz - EACH INSTAL.. , PAIR WATERPI VENT FAN SINGLE D MECHANICAL 01-000-4224 EACH VACU~WIREAKER - MECHEXHAU -H000/DUCTS MOBILEHOME 01-000-4225 - WAT_OFTNER - RELOCA_NOFEAFURNACE/HEATE MOBILEHOMEPARKINSP -. EACH ROOF DRAIN (INSIDE) . -TOTAL ' SOLAR 01-000:4226 MECHAN(CAL . ' -_-_I - STRONG MOTION 65-640-0519 - TOTAL PLUMBING__I_- . . FIRE SPRINKLERS '01-000-4227 QTY. ,ELECTRICAL PERMIT - ISSUE'-. -' - -2 .00' QTY. SOLAR - ISSUE . - - PUBLIC FACILITIES FEE 25-000-4933 BRIDGE FEE NEW.CONST_EAAMP/S)NT/BKR ' -_ COLLECTORS SCHOOL FEE - DISTRICT - 1PH ___-3PH , .' - STORAGETANKS _- - Carlsbad 65-623-0519 ..- EXIST BLDG EA AMP/SWT/BKR ' . AOKSTORAGE _. - Encinitas 65-624-0519 - 1PH ' - 3 P PUMP ' , San Djeguilo 65-625-0519 REMODEL/ALTER' PER CIRCUIT - PLANCHECKFEE - - San Marcos , 65-626-0519 TEMPPOLE20OAMPS' OVER200AMPS - TEMP OCCUPANCY 130 DAYS) TOTALELECTRICAL.TJ. TOTAL SOLAR . - , - TOTALFEESPAYABLE £ ' I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY J Expiration. Every permit issued by the Building Official under the provisions ofthis * AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER CERTIFY UNDER PENALTY OF-PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shalt expire by limitation and become null and void. It the building or work -5' 0" DEEP AND OEMOU'TION OR CONSTRUCTION OF DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS authorized by such permit is not commenced within 180 days from the dale DI suchpermit, or if the building or work authorized by such permit is suspended or STRUCTURES OVER 3 STORIES IN HEIGHT ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON abandoned at any time after the workiscommencedfora _eriod01180days. -. STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND APPLICANT'S SIGNATURE __OWNER CONTRACTOR 0 APPROVED BY KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEOLIENCE OF THE BY PHONE 0 - -- _ - GRANTING OF THIS PERMIT, El thereby affirm that I have a certificate of consent to selt.inSure, or a certificate of Workers' Compensation Insurance, or a cerlif red copy thereof (Sec. 3500, Labor Code). Z POLICY NO. 2 COMPANY ' in 0 Copy is filed with the City. 2 Lu - 0 Certified copy is hereby furnish , - CERTIFICATE OF EXEMPTION OM d WORKERS' COMPENSATION INS' ANCE - - (This section need not be completed i the permit is for one hundred dollars ($100) o less) if 0 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. NOTICE TO APPLICANT: If, after making this Certi. - ficate of Exemption, you should become subject to the Workers' Compensation provisions of the Labor - Code, you must forthwith comply with such ' provisions or this permit shalt be deemed revoked r 0 I hereby affirm that there is a construction I ..,lending agency for the performance of the work to, al ',,which this perirlit is issued Sec 3097. Ciuit Code). 2) Lit t LendersName - -Il L Lender's Address ' -. FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS - INSPECTION REQ. IF CHECKED INSPECTOR'S APPROVAL DATE SOILS COMPLIANCE PRIOR TO FOUNDATION INSP STRUCTURAL CONCRETE OVER 2000 PSI PRESTRESSED . CONCRETE POST TENSIONED CONCRETE FIELD WELDING HIGH STRENGTH BOLTS SPECIAL MASONRY PILES/CAISSONS INSPECTORS 'T:-.-. INcPFcTIoN TYPE I DATE INSPECTOR BUILDING FOUNDATION REINFORCED STEEL MASONRY GUNITE OR GROUT FLOOR & CEILING SUB FRAME SHEATHING FRAME EXTERIOR LATH INSULATION INTERIOR LATH & DRYWALL, -- PLUMBING.' SEWER AND BL/CO PLUMBING UNDERGROUND. PLUMBING TOP OUT TUB AND SHOWER PAN GAS TEST ELECTRICAL TEMPORARY POWER . . -. ELECTRIC UNDERGROUND ROUGH ELECTRIC ELECTRIC SERVICE BONDING G. F. I. - SMOKE DETECTOR - MECHANICAL DUCT & PLEM., REF. PIPING HEAT- AIR COND. - SOLAR SYSTEMS VENTILATING SYSTEMS - 'f:- - CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE - - c ITEMS ABOVE HAVE BEEN APPROVED. . - - - JOBSITEFINAL PLUMBING ELECTRICAL - -. ' : _________ ) . •. MECHANICAL GAS BUILDING SPECIAL CONDITIONS (I T CERT OF OC•NCY ISSUED VALIDATION City of Carlsbad APPLICATION FOR CERTIFICATE OF OCCUPANCY BUILDING DEPARTMENT 1200 ELM 438.5525 Address where Business will be conducted 2188 B Palomar Airport Rd. Buildin a Permit''1o. 82 -287 Name of Occupant c cM- j)#1p..ft9f.s Business Phone L Address of Home Office of Occupant if different from above Sa.€ n Home Office Phone Owner of Building 1.oaote.. L. Vc,s Address PLtjII-ç- 'Rj )14Phone 4-6O Type of Business ccvvoyiks syycp Car 'Shad CIA, Describe exact use of all portions of each building and lot Repcuc o- accrc4- radio* Previous use use of Building O.N 'tc.4-i c (" PQ r"7 Type of flammable or explosive liquids to be used, if any 'sj ON I certify that I have read the statements dontained in this application; that they are true and correct, and that I make this statement under penalty of perjury. Dated this day of FIrz, 19 in the City of Carlsbad, State of California Signature of Signature of 9 77U Official Applicant Use Zone jii1. FOR DEPARTMENTAL USE ONLY Occupancy Group Type of Construction Planning Department Date n,.- / Approved hill"Disapproved By Engineering Department Date (I, / J 3 Approved Disapproved By Fire Prevention Dat Approved Disapproved By Health Department ' Date1—B3 111A LjAa.&. Disapproved By Building Department Date Approved Disapproved By V White - Building Dept. Yellow - Applicant Pink Finance Gold - Fire Dept. tT 0 rJob AddressZJ& 'PMjMA_ _si21- MISCELLANEOUS FEE RECEIPT iI PLANCHECKFEE 01-000-4806 Owner - Mailing Address VALUATION - El DEMOLITION - ElHOUSE MOVING PARKS AND RECREATION FEE City Zip Tel. Contractor \Jj,,j Address El PUBLIC FACILITIES FEE City - Zip . Tel. - 1-1 SCHOOL FEE - DISTRICT____________________ - State Lic. City - S. Ciassif. Lic. No. El Carlsbad COMPLETE FOR PLAN CHECK ONLY . LI. Encinitas * 1 DESCRIPTION LEGAL . San Diego El San Marcos .. - - . - ASSESSORS PARCEL NO. , I. .' . . DESCRIPTION OF WORK •5 - - - .. - - - •- - - . LI - - LI' PLAN ID NO. DESIGNER ADDRESS , - -. j fl . . 1•Jw - PHONE ... ip~O) - - , - -.1 - TOTAL FEE $ '- - CONTACT PERSON 4 -14 hL 0 - WARNlNG:PLAF'iCHECK FEES. WHERE NO ACTION IS :APPLICANT IN 180 DAYS AND NO BUILDING PERMIT IS ISSUED, TAKEN BY THE FEE ARE - ' - -1-4? kDIP6,tif IFORFEITED TO THE CITY. - - - , . •1 COMMENTS - -: * - // 1c 7-:drt-7 6 LreotApplicat / I ate4 City of Carlsbad - MISCELLANEOUS 1200 ELM, CARLSBAD, CA 92008 • TEL. (714) 438-5525 RECEIPT White - Applicant Yellow - File Pink - (1) Finance (2) Data Process Gold - Assessor -- - . ,- - 1 • .' -- . -------. -- I.. - ..' - - ---..- - * IF THIS ITEM-IS NOT CHECKED,, FINAL INSPECTION. ( INTERDEPARTMENTAL INFORMATION SHEET lit AUG 4.1982 ;1JJtIPI.IUViIJIi BUILDING ADDRESS:. YZI -APE. 21;Oullding Department III. PLANNING DEPARTMENT ZONE: SCHOOL FEES: ENCINITAS CARLSBAD UNITS REQ'D: % COVERAGE-ALLOWED - PARKING SPACES REQ'D: BUILDING HEIGHT REQ'D:._______ SAN DIEGUITO PROVIDED: —.PROVIDED: PROVIDED: PROVIDED:. SAN MARCOS FRONT SETBACK : SIDE SETBACK REAR SETBACK ALLOWED: PROVIDED-* INTRUSIONS: RE-DEVELOPMENT'APPROVAL REQ'D: LANDSCAPE & IRRIGATION PLAN COMMENTS: I ENVIRONMENTAL PROTECTION REQ: ADD ITONAL COMMENTS: OK TO ISSUE: DATE: cLVIk\n .0K TO FINAL: DATE: S \ ENGINEERING DEPARTMENT' R.O.W: IMPROVEMENTS: PUBLIC FACILITIES FEE:' . . . SEWER 'CONNECTION: DRIVEWAY LOCATION(S): GRADING PERMIT: EASEMENTS: LEGAL DESCRIPTION: ADDITIONAL COMMENTS: DRAINAGE: *CHECK IF ENGINEERING INSPECTION REQ'.D. ON FINAL: OK TO ISSUE&I DATE:&SdL-PWI: ' OK TO FINAL: DATE: ' . CARLSBAD FIRE DEPARTMENT (9(APPROVED DISAPPROVED PLAN -CHECK #__________ OTHER REF. II PAGE 1 OF_I_ 1275 ELM AVENUE, CARLSBAD, CA 92008 (7114) 438-5521 PLAN CHECK REPORT PROJECT / V/,V/5. 'j7ec: _____ ADDRESS ARCHITECT __________________ ADDRESS - OWNER S ADDRESS OCCUPANCY __________ CONST. _____ TOTAL SQ. n- 0, SPRINKLERED X'TENANT IMP. PHONE PHONE STORIES / APPROVAL OF PLANS IS PREDICATED ON CONFORMING TO THE FOLLOWING CONDITIONS AND/OR MAKING THE FOLLOWING CORRECTIONS: Provide one copy of the floor plan(s), site plan, and sheets Storage, dispensing or use of any flammable or combustible liquids, flammable liquids, flammable gases and •hazardous chemicals shall comply with Uniform Fire Code and Building(s) not approved for high piled combustible stock. Storage in closely packed piles shall not exceed 15 feet in height, 12 feet on pallets or i.n racks and 6 feet for tires, plastics and some flammable liquids. If high stock piling is to be done, comply with Uniform Fire Code, Article 81. 14. Medical gas system() shall comply with N.F.P.A. Standard 56F. X" 5. Fire extinguishers shall be provided basedupon the following .criteria: __2 La) 1-2A rated ABC extinguisher for each 3c'Ocsq. ft. or portion thereof. x b) maximum travel distance to an extinguisher of 75 feet other: Fire sprinkler system(s) per N.F.P.A. Standard shall be provided to protect Dry chemical extinguishing system(s) shall be installed per N.F.P.A. Standard 96 to protect cooking equipment and exhaust system. Plans of system(s) shall be approved by the Fire Department prior to installation of system(s). S Show on site plan locations of all nearby proposed or existing hydrants within 200 feet. Hydrant(s) shall be provided and located - Show location(s) on site plan. Fire Flow: gpm for hours from. hydrants. S Access for fire apparatus is not.adequate. Provide S . 12. 5 shall be of hour construction with openings protected with hour assemblies. S • (TJ 13. Comply with regulations on attached sheet(s). S_ an Examiner bat e ____ Report mailed to architect ,A? Met with ,'1iat, Attach to Plans A .. CARLSBAD FIRE DEPARTMENT PAGE 2 OF I PLAN CHECK REPORT PROJECT ZZv/&w/(-5 ó'6 PLAN CHECK 1 11+. Drapes and other decorative materials shall be flame retardant. Certification thereof shall be provided. Exits, exit lights, fire alarm stations, hose cabinets and extinguisher locations shall not be concealed by decorative material. Interior finish shall conform with Title California Administrative Code regulations. Fireplaces and other appliances employing open flames shall 'have metallic guards. Loose chairs exceeding 299 shall be bonded together in groups of 3 or more. Storage and janitor closets shall be of one-hour construction with all openings protected with 3/1+ hour self closing and latching assemblies. An approved fire alarm or two-way communication system shall be provided per Title 21+, California Administrative Code. An occupant capacity 'sign, with minimum one inch letters and numbers, shall be posted near main exit.( square feet per person). Exit doors shall be openable from the inside without the use of a key or any special knowledge or effort. A "THIS DOOR MUST REMAIN UNLOCKED WHENEVER THE PUBLIC IS PRESENT" sign, with minimum one inch letters, shall be provided adjacent to main exit door_______ "EXIT" signs shall be in block letters minimum 6 inches high. Luminance on face of sign shall be 50 lux. "EXIT" signs shall be electrically illuminated and energized from separate circuits. Show on electrical plan(s). One of the above circuits shall be part of the emergency lighting system. An "EXIT" sign shall be posted over exit door and directional signs located Show locations on floor plan(s). Approved panic hardware shall be provided on exit doors - -Show on door schedule. Corridor shall be of one-hour construction with door open- ings 'protected with 20 minute self closing and latching assemblies. An additional exit door shall be provided in erUniform Building Code, Chapter 33. . _Z 30 1) 7Z va 7/s e t- ,4 Aa ih c —e o --- OCC-i /l a -' I - 5// COI I 5 33 03 c- '7. P "E,(ami ncr / ate 21+. - clVf5? 112 I nom I, R. J. Sommerville County of San Diego Air Pollution Control Officer June 14, 1983 JUN 81983 Theodore L. 'Vallas, President Flight Trails, inc. CITY OF CARLSBAD 2192 Palomar Airport Road Building Department Carlsbad, California 92008-4896 Dear Mr. Vallas: After examination of your Application No. 20296 for an Air Pollution Control District Authority to Construct and Permit to Operate a gasoline dispensing facility for intermediate refuelers located at 2188 Palomar Airport Road, Carlsbad, California, the District has decided on the following action pursuant to California Health and Safety Code 41960, and Rule 20 of the Air Pollution Control District Rules and Regulations: Authority to Construct is granted to install an intermediate refueler facility with the gasoline vapor returned through the associated underground storage tank Phase I vapor control system. The intermediate refueler shall he adapted to accept bottom loading. The intermediate refueler facility will have an estimated maximum throughput of 18,000 gallons per month and consists of: Two (2) 10,000 gallon storage tanks for Aviation gasoline, One (1) 11-2-inch diameter dispensing hose fifteen (15) feet in length with an Emco Wheaton-1401 coupling on the intermediate refueler end of the hose and an Emco Wheaton J-1302 dry break on the pump end of the hose. The intermediate refueler connector consists of an Emco Wheaton J-1302 dry break. The dispensing pump consists of a submerged turbine for each i--.,,L ,..,-.,- One (1) 2-inch diameter vapor return hose seventeen (17) feet in length with an Andrews' 200-C female coupler on the intermediate refuler end of the hose and the storage tank end (dry break) of the hose. Each Phase I vapor control adapter (dry break) consists of an. Emco. Wheaton Coaxial Adapter with an Emco Wheaton coaxial elbow installed to connect to the vapor return hose. This Authority to Construct is issued subject to the following, conditions: 1. A copy of this Authority to Construct letter shall be posted or kept readily available at the above specified facility until the District issues the Permit to Operate. AIR POLLUTION CONTROL DISTRICT 9150 Chesapeake Drive. San Diego, California 92123 (619) 565-5901 I FLIGHT TRAILS, INC. Application No. .20296 June 14, 1983 Page 2 2, The permit applicant shall notify the District (Walt Geudtner, 565-5419) within ten working days following the vapor recovery installation that construction has been completed. Failure to notify the District auto- matically cancels the temporary authorization to operate that is incor- porated into this Authority to Construct letter.. Continued operation after cancellation is a violation of District Rule 10(b) and can result in civil and criminal penalties. The Phase I system shall be operated in accordance with the requirements of District Rule 61.3. ..Upon request of the District the permit applicant shall provide access, facilities, utilities, and anynecessary safety equipment, forvapor control system testing and inspection. S. The intermediate gasoline refueler facility described above shall be certified by the Air-Resources Board (ARB). In the event that the refueler facility is not certified by ARB or it is determined that the refueler facility will .not meet District Rule 61.2, the applicant shall within 10 days so notify the Air Pollution Control Officer and shall, within 60 days, amend its application to include a system that can be certified by ARB and meet Rule 61,2. The intermediate refueler (mobile transport truck) shall alsc.be certified by ARB. The permit applicant, must Iè prepared to implement changes to the pro- posed, vapor recovery system if the ARB or District source test results deem such changes necessary to comply with APCD Rule 61.2. The coupler and hose assembly attached to the underground storage tank dry break shall be disconnected and stored after use. If left connected at the underground storage tank and disconnected at the truck connector assembly, vapors can escape to the atmosphere at ground 'level. To preclude gasoline spillage,provisions shall be made for adequate shutdown of product flow when the intermediate refueler tank is full. This Authority to Construct does not relieve the holder from obtaining permits or authorizations which may be required by other 'governmental agencies. Contact the appropriate building inspection department (city or county) and fire district prior to installation of the vapor control equipment, for permit and/or inspection requirements. Within ten days after receipt of this Authority to Construct, the applicant may petition the Hearing Board, in accordance with Rule 25, for a hearing on any conditions imposed herein. FLIGHT TRAILS, INC. Application No. 20296 June 14, 1983 Page 3 This is not a Permit to Operate. Operation of this equipment without written authority (District Permit to Operate, Startup AuthOrization or Hearing Board Variance, etc.) will be in violation of Rule 10(b) and will be subject to civil and criminal penalties. This Authority to Construct authorizes temporary operation of the above facility, to commence upon receipt by the District of written -notification of completion of construction. This authorization will :be in effect, unless cancelled, until the above facility is inspected by the District.. If, during a Permit to Operate inspection, there are deficiencies, the District may deny your Permit to Operate or, depending on the extent of the deficiencies, require you to make repairs within a specified period of time. In the latter case, you W.j1 be charged a fee to pay for the reinspection If the repairs are not-made-by the date of the reinspection, your Permit to Operate may be denied. This temporary authorization may be cancelled if documentation of successful completion of all required installation tests is not received within thirty (30) days after the completion of construction. This Authority to Construct is nontransferable and will expire one -year from date of issuance. If you have any questions regarding this action, please contact me at (619) 565-5181. Sincerely, 6 .4 (L • • ROBERT L. BATTEN • S Associate Air Pollution ControlEngineer . RLB:krf S S • Enclosures: APCD Rules 61.2 and 61.3 cc: Building Department S • • • Fire District S S i hereby affirm that I have a certificate of consent to sell-insure, or a certificate of .Workers Compensation Insurance, or a certified copy thereof (Sec. 3800. Labor Code). POLICY NO. COMPANY ' 44 z 0 Copy is filed with the city. 0 Certified Copy is hereby furnished. • . 0 . CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE • (This section need not be completed if the permit is for one hundred dollars 151001 or less)LIJ I certify that in Ihe performance of the work (or' o which fhis perr'nif is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. • NOTICE TO APPLICANT: It. after making this Certi- ficate of Exemption, you should become subject to Code, you must forlhwrnplyith such visi?this nsdr be the Workers' Compensation~rovsons of the Labor 1 be ked. r • I hereby affirm that there is a construction I lending agency for the performance of the work for uJ which this permit is issued (Sec .'3097CivilCode) ' - I. Lenders Name .•c_ ' • Lender's Address ____________________________ II hereby affirm that I am licensed under. rOvlsions of Chapter 9 (commencing with• Section 7000) of Division -3 of the Business and Professions Code, and my license Is in ,full force and effect. - Lic. No. Class I hereby affirm that I am exempt from the, Con-.tractor * s License Law for the following reason (Sec. 7031 SBusiness 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 Con. tractor's License Law (Chapter 9 Commencing with Section 7030 of Division 3 of the Business and Pro. fessions Code) or that is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by an applicant for a permit subjects roe applicant to a civil penalty of not more than live hundred dollars ($500). I, as owner of the property, or my employees eith 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 safe. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden 01 proving that he did not build or improve for the purpose of safe). t, as owner - of the properly, am exclusively cool roCling with licensed contractors to construct - the projecl (Sec. 7044. Business and Professions Code: The Contractor's License Law does not apply 10 an owner of property who builds or improves thereon, and who contracts for each projects with a contractor(s) license pursuant to the Contractor's License Law), tam exempt under Sec. _-_'_. B. & P.C. for this reason 0 a 0 0 ID a- CI, C ID 'C USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN'SHADED AREA AND DECLARATIONS . ' ': —. APPLICATION & PERMIT1200 Elm, Carlsbad, California 92008 (714) 438-5525 .106 ADDRESS AV, ST. OAT OF APP CATION . BUSINESS LICENSE # - / ? RD. P. / - — , OWNER'S NAME OWNER'S PHONE PRIME CONTRACTOR J CONTRACTORS PHONE if 77 is , 7J 1L/uJ VALUATION PERMIT NUMBER r:" L_j ZONE • ' ' . OWNER'S MAILING ADDRESS . CONTRACTOR'S ADDRESS ,3v /Jo3 ' LICENSE NO. PLAN I.D. # ' BLDG USE CODE . at LOT I BLOCK SUBDIVISION ASSESSOR PARCEL NO. r. DESIGNER DESCRIPTION OF WORK 'STATE LICENSE # STANDARD PLAN # BUILDING SO. FOOTAGE DESIGNER'S ADDRESS DESIGNER'S PHONE - 7/ ILtQ9Q coi o 7'I4' a eoo "5•._' ' . Not Valid Unless Machine Certified — ,Pt7 't,i2v4U1r A\ 'P/P FLR ELEV. yD ND ' NO STORIES OCCGP EDU CENSUS TRACT., ' GP LANI USE . PARKING SPACE RES UNITS GRADING PERMIT ISSUED . Y O N 0 REDEVELOPMENT AREA ' .- Y O NO ' TYPE CONST 0CC LOAD ' FIRE SPA . 'V 0 NO QTY, PLUMBING PERMIT - ISSUE SO QTY. MECHANICAL PERMIT - ISSUE 010 '' - SUMMARY/ACCOUNT NUMBER EACH FIXTURE TRAP , . / . INSTALL FURN. DUCTS UP TO 100,000 BTU ' . BUILDING PERMIT 01'600-4220 EACH!LDlNG SEWER ' -- 5 . • OVER 100,000 BTU SIGN PERMIT ' 01'000'4221 EACH WA HEATER AND/OR VENT ' . BOILER/ MPRESSOR UP TO 3 HP . ' PLAN CHECK 01-000-4806 — EACH GASSY M 1 TO 4 OUTLETS , ' ' BOILER/COM SSOR 315 HP ' - TOTAL PLUMBING - ' 01-000'4222 EACH GAS SYSTEM R MORE , FIREPLACE . . _METAL ELECTRICAL .• 01-000-4223 — EACH INSTAL., ALTER, B NR WATER PIPE . VENT FAN SINGLE DUC . MECHANICAL 01-000-4224 EACH VACUUM BREAKER MECH EXHAUST - H000IDU - MOBILEHOME 01-000-4225 WATER SOFTNER .' , - . RELOCATION OF EA FURNACE/HEANFR MOBILEHOME PARK iNSP . EACH ROOF DRAIN (INSIDE) . ' ' s...,. , SOLAR 01-000-4226 1'OTL MECHANICAL r - STRONG MOTION - - '65-640-0519 * ,TOTAL PLUMBING ' . FIRE SPRINKLERS 01-000-4227 QTY. ELECTRICAL PERMIT - ISSUE - . r. A 6'U QTY. - . SOLAkISSUE • . - PUBLIC FACILITIES FEE - ' 25-OOÔ-4933 BRIDGE FEE - NEW.CONST EAAMP/SWT/BKR ' ' COLLECTORS - - — . SCHOOL FEE - DISTRICT 1 PH - ' 3 PH - : -• STORAGE TANKS . . Carlsbad - 65-623'0519 EX1ST.B LOG EA AMP/SWT/BKR ROCK STORAGE ' . ' Encinitas ' 65-624-0519 * . 1-PH ' ' • 3 PH •_ - . PUMP , - , - San Oieuito 65-625-0519 REMODEL/ALTER PER CIRCUIT ' • / PLAN CHECK FEE. . ' 'N, ' -. San Marcos 65-626-0519 TEMP POLE 200 AMPS'' .. ' -' • . . '. • i . - "N 'OVER 200 AMPS - ';' . , ,,'- ' - . ' , - 'TEMP OCCUPANCY 130 DAYS) , ' . • -- _________- . . . - TOTAL ELECTRICAL -1 11,,Ovl~ .1 TOTAL SOLAR TOTAL FEES PAYABLE / .•c' I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY Expiration. Every permit issued by the Building Official underthe provisions olthis AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by limitation and become null and void. If the building or work aU horized by such permit is not commenced within 180 days from the dateof such -5'0'* DEEP AND DEMOLITION OR CONSTRUCTION OF DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS permit, or it the building or work authorized by such i'rnit is suspended Or STRUCTURES OVER 3 STORIES IN HEIGHT ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON- aba oned at any time after Ihe work is commenced for a period of 180 days. - STRUCTION, WHETHER SPECIFIED HEREIN OR NOT, I ALSO AGREE TO SAVE INDEMNIFY AND , APP VED BY ' - DATE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS CANT S SIGNATU 11"I"I'le4 OWNER 0 CONTRACTOR . - E GRANTING OF THIS PERMIT. EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE v' BY PHONE ' ' - - . . . - - i ,7-1404 INSPFCTIflN TYPE DATE INSPECTOR BUILDING FOUNDATION 1 REINFbRCEDSTEEL.. MASONRY GUNITE OR GROUT FLOOR & CEILING SUB FRAME SHEATHING f FRAME EXTERIOR LATH INSULATION INTERIOR LATH & DRYWALL PLUMBING SEWER AND BL/CO PLUMBING UNDERGROUND PLUMBING TOP OUT TUB AND SHOWER PAN GAS TEST ELECTRICAL TEMPORARY POWER ELECTRIC UNDERGROUND ROUGH ELECTRIC ELECTRIC SERVICE BONDING A G. F. I. - SMOKE DETECTOR MECHANICAL DUCT & PLEM., REF. PIPING -) HEAT - AIR COND. - SOLAR SYSTEMS 7t r VENTILATING SYSTEMS SYSTEMS . V' I U N CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ITEMS ABOVE HA VE! BEEN APPROVED. JOB SIT IFINAL- - .1uuJI:1IIL I1IIll[sL MECHANICAL fIIAWiVIE. I:Iu1IIi]Ii[c III SPECIAL CONDITIONS CERT'OF OCCUPANCY ISSUED FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS V V INSPECTORS NOTES - INSPECTIdFi REQ. IF CHECKED INSPECTOR'S APPROVAL DATE R. - SOILS COMPLIANCE PRIOR TO FOUNDATION INSP . V V STRUCTURAL CONCRETE OVER 2000 PSI PRESTRESSED V CONCRETE . V V POST TENSIONED CONCRETE . V V V FIELD WELDING V BOLTS V HIGH STRENGTH V SPECIAL MASONRY V LPILES .CAISSONS L' V ¼ - JV -