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Home My WebLink About2239 CAMINO ROBLEDO; ; CB972464; PermitBUILDING PERMIT 09/03/97 11:16 Page 1 of 1 Job Address: 2239 CAMINO ROBLEDO Suite: Permit Type: ELECTRICAL Parcel No: Lot# : Valuation: 0 Occupancy Group: Reference*: Description: ELEC METER PEDISTAL 100AMP : SINGLE PHASE-ARROYO LA COSTA Permit No: CB972464 Project No: A9703124 Development No: Appl/Ownr : VILLAGES OF LA COSTA 2300 ALGA ROAD CARLSBAD, CA 92009 *** Fees Required *** flBPft SlfirfUff: ISSUE&OO Applied: 09/03/97 Apr/Issue: 09/03/97 Entered By : JM 760 929-2705 Collected & Credits Fees : Adjustments: Total Fees: Fee description Enter "Y" for Ele Single Phase Per * ELECTRICAL TOTA 35 *** .00 .00 35.00 Ext fee Data 10.00 Y 25.00 35.00 SPIRED IN ACCORDANCE wiwuafi. \ r CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 'ERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Patmas Dr., Carlsbad CA 92009 (760)438-1161 1. PROJECT INFORMATION 2239 Camino Robledo FOR OFFICE USE O PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated BvDate Address (include BJdg/Suit* *) Tract 13386 474 Arrovo La Business Name (at this address) Costa/88-Q3 2_357 Legal Descriptiongal Description255-271-58 Lot No.Open Space Subdivision Mime/Number Unit No.Phase No.Total f of units Assessor's Parcel * Electric meter pedestal Existing Use •for" Proposad Use Description of Work SO. FT. ;2. CONTACT PERSON Of drffenint from applcarril ^^ Tim O'Gradv 2300 Alaa Rd. *of Stories * of Bedrooms * of Bathrooms PA Name Address Sfll!-APP£lCArJf "W D'^SnlrlitSrlftlT^IAgolffo^lolSfiK.£). Development 2300 Alga Rd. City State/Zip Telephone t Carlsbad CA 92018-9000 929-2701 Fax* 929-2705 Name Address City State/Zip Telephone f 450 "B" St. #620 S.D. 92101 515-5653 City State/Zip Telephone * Villages of La Costa sout-.hwgat-., T._ r.. p Name Address jft^rttdhtft*^ (Sec. 7031.5 Business end Professions Cods: 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 auch permit to file a signed statement that he Is Hcensed 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 7031.6 by any applicant for a permit subjects the applicant to a dvH penalty of not more than five hundred dollars UBOO)). Schilling Corporation P.O. Box 71 9002 Santea PA 97073 448-5392 Name State License 9 4881 Address License Class City State/Zip Telephone * CHvBusiness License 0 770300 EXP. 5/31 /98 Designer Name Address City State/Zip Telephone State License f ..._.e. • WORKERS- COMPENSATION .rf, •., •-;..;-' -:;; r • •. \::::^-'•>:•'•• r;^;c.:-::::m3^^^ ••• :••. •• ••• •'"•-:-. Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: P 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. Q I have and will maintain workers' compensation, as required by Section 3700 of the Labor Coda, for the performance of the work for which this permit is issued. My worker's compensation Insurance carrier and policy number are: Insurance Company . PoHcy No. Expiration Date • (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*100) OR LESS) Q CERTIFICATE OF EXEMPTION: I certify that In the performance of the work for which this permit is issued, I shall not employ eny parson in any manner so as to become subject to the Workers' Compensation Lews of California. WARNING: Failure to secure workers' compensation coverage Is unlawful, and anal subject an employer to criminal penalties end dvH tine* up to one hundred thousand dollars (9100,000). 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, owi*i»*uiijjtt ofecUiiATib^^ I hereby affirm that I am exempt from the Contractor's License Law for the following reason: Q I, as owner of the property or my employees with wages es their sole compensation, wiN 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 en owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements sre 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). £V I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec. 7044, Business end 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 contractors) licensed pursuant to the Contractor's License Law). Q I em exempt under Section Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. Q YES QNO 2. I (have / have not) signed en application for a building permit for the proposed work. 3. I have contracjed with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number):Schilling Corporation (see above) 4. 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 licenss number): 6. I will provide some of tNe work, but I have c of work): __ . ad (hired) the following persons to provide the work Indicated (include name / address / phone number / type DATEPROPERTY OWNER SIGNATURE COMPLETE THIS SECTION FDR I / \_^"Is the applicant or future buHding occypf nt required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 26505, 25633 or 25634 of the Presley-Tanner Hezardoua Substance Account Act? Q YES Q NO Is the applicant or future bUUIng occupant required to obtain a permit from the air pollution control district or air quality management district? D YES Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school she? Q YES D 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. i8i::;;vco'rti1iiu^ ~ ^71"?MH'WB'iMw*'"'' **-*r^w*>* *+ "-i' *** "«•»• «g^ ^^w;- I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued ISec. 3097(1) Civil Code). LENDER'S ADDRESSLENDER'S NAME 9. I certify that I have read the application and state thet the above information is correct and that the information on the plena is accurate. I agree to comply with aN City ordinances and State lawa relating to buttling 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, OSHA: An OSHA permit is required for excavations over 6'0* deep and demolition or construction of structures over 3 stories tn height. EXPIRATION: Every permit Issued by the Building Official under the provisions of this Code sheH expire by limitation and become nuH and void if the building or work authorized by such permit Is not commenced within 365 days from the dste of such permit or If the building or work authorized by auch permit Is. suspended or abandoned et any time after the work is commenced for a period of 1BO deys (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE