The URL can be used to link to this page

Home My WebLink About2261 COSMOS CT; ; CB971903; PermitD U ; L D I N G P ;? R M Page 1 of i Job Aod-ess 2261 roi,-'OS CT c.ul t Permit ". yj. ^ MISCET ^AM^OUS Parcel No 213-0" 0- 4 n -00 T o^-tf Vet In at i <>n i] L'ccj-p^ncy Group Referenced Lkicription CREATE TWO OFFICES OUT OF CUBICLES Pe> n it ML- '":>''•< '"I 5"? Project No A97..-.I4 ;. ' Developnsetit No 07/14/97 0001 01 J2 Appl/Ownr GLYNN, CHUCK 1090 JOSH"A WA1 VISTA, CA * •* * Fees Required Fees Adjustments Total Fees 760 ctit>:- lyp.e VN Statue ISSl'Fl Applied 07/1 4' 37 Apr / 1 s 'sue r 7 / : •- .. •• '? Entered By MDP Collected & Credits Fee description Miscellaneous Fee Miscellaneous Fe« Miscellaneous Fee A MISCELLANEOUS * A 00 OC ,t 84 00 Ext fee Data 40 00 PERM7"" 20 00 ELE'-mRIC 24 oo WEC- 84 00 HWOVAL *. CITY OF CARLSBAD 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1461 'FRMIT APPLICATION * CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr, Carlsbad CA 92009 (760)438-1161 1 PROJECT INFORMATION " •"" ~- FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date 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 Parcel #Existing Use Proposed Use Description of Work 2 CONTACT PERSON (If different from applicant) SQ FT #of Stones # of Bedrooms = »r~1T.: r~V •* tt of Bathrooms Name r Address 3 APPLICANT J^Contraotoir TU Agenff orSoltra«oT^ * City nB"r"™"n Agent Tor Owner State/Zip Telephone tt Fax tt ^••^v-'pVTyrf-"**"^-.;: t ;; Name 4 PROPERTY OWNER '" '> C '"* Name E ' CONTRACTOR . COMPANY N&I Address Address m^**y£XflK *xr~asn* ••,-,-«•»• -.---•• s* -i-rr .,f)-' City City State/Zip State/Zip Telephone tt Telephone tt .. vs .:--.;• — •• -s :, ' -, (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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)1 Name State License tt Address License Class City ' State/Zip City Business License tt //J Telephone » Designer Name Address City State/Zip Telephone State License # 6 WORKERS'COMPENSATION "~'r '"" """""* r" Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations O 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 Of 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 J/frT^? f-YjfJC^ Policy No __J-?J ' j(*3 Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) 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 eny 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 addition tojh* <»st otpompensation damages a* provided for In Section 3706 of the Labor code Interest and attorney a fees SIGNATURE (^l^^L^f^,^^! DATE 3 "Sf ~^\J 7 OWNER BUILDER DECLARATION ^ ~- " ' 1 - •" ""'•- < K 1 hereby affirm that I am exempt from the Contractor s License Law for the following reason O 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) C] I am 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 L~H YES QNO 2 I (have / have not) signed an application for a building permit for the proposed work 3 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 and provide the major work (include name / address / phone number / contractors license number) __^^_^__^____________________^_^_______^___^____^______^^_________^__ 5 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. •••^ffif.-'.COMPLETE THIS SECTION FOR WOWJteSMJfi^TMi BUILBINQ PERMrTSONUf ^ T 'T1 '> ' ^'^ 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 25S05 25533 or 25534 of the Presley Tanner Hazardous Substance Account Act? Q YES Q NO Is the applicant or future bulding occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES Q NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? Q YES Q 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 '""" """r""' T 7"-^^'T -r-r^- > »' ,---,-. _.. ..,- - ,,... , ,., , , I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(0 Civil Code) LENDER S NAME _ LENDER S ADDRESS _ 9 APPLICANT CERTIFICATION * ~ ~'^* " •"TT— '^'T-^-—"--!^^^-™-^? ~~? ~;,-.-'^;^tr^^.S^-m~u°'*-^- ., "-—•— 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 authonze 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 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 work is commenced forj^period of 1 80 days (Section 106 4 4 Uniform Building Code) APPLICANT S SIGNATURE DATE ~} - FINAL BUILDING INSPECTION DEPT: BUILDING ENGINEERING FIRE PLANNING U/M PLAN CHECK#: CB971903 PERMIT*: CB971903 WATER DATE: 09/03/97 PERMIT TYPE: MISC CUBICLES !^). [p (f^ iTL f| M K pi ADDRESS: 2261 COSMOS CT ^ ^ca Q 4 1097 • 'S CONTACT PERSON/PHONE* : C/ROD/520-4928 LL U\ SEWER DIST: CA WATER DIST: CA 3v I INSPECTED ^~ RV __ ^=Ji \) J___£»_ INSPECTED BY: INSPECTED BY: ™ , ., _.™-.,r.— -.— «.,„,„ ^. .. DATE i | INSPECTED: Z^pfc* APPROVED X DISAPPROVED DATE INSPECTED: APPROVED DISAPPROVED DATE INSPECTED: APPROVED DISAPPROVED COMMENTS: Z-lU-ft^' O_jSjkCc^_^ O-po-«-os/^-dl ^"<x_V_« 7 cJLN-O!.^ — ft_»-iC*i ^ r Jto^_-x. CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB971903 FOR 09/33/97 DESCRIPTION: CREATE TWO OFFICES OUT OF CUBICLES TYPE: MISC JOB ADDRESS:2261 COSMOS CT APPLICANT: CONTRACTOR: OWNER: GLYNN, CHUCK STE: INSPECTOR AREA TP PLANCK# CB971903 OCC GRP CONSTR. TYPE VN LOT: PHONE: PHONE: PHONE: 760 598-7614-) REMARKS: C/ROD/520-4928 SPECIAL INSTRUCT: INSPECTOR TOTAL TIME: CD LVL DESCRIPTION 19 29 39 49 ACT COMMENTS ST Final Structural PL Final Plumbing EL Final Electrical ME Final Mechanical / ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP 073197 Final Structural CO TP 072397 Interior Lath/Drywall AP TP 072297 Frame/Steel/Bolting/Welding AP PK 072297 Rough Electric AP PK COMMENTS T-24, FIRE APR WALLS SD COMPENSATION INSURANCE FUND PO BOX 807 SAN FRANCISCO CA 94101-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE 10-01-96 POLICY NUMBER 333-96 UNIT 0000018 CERTIFICATE EXPIRES 10-01-97 CITY OF CARLSBAD JOB ALL OPERATIONS ATTN PURCHASING DEPARTMENT FRANK MANNEN 2075 LAS PALMAS DRIVE CARLSBAD CA 92009-^859 This is to certify that we have issued a valid Workers Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration This certificate of insurance is not an insurance policy and does not amend extend or alter the coverage afforded by the policies listed herein Notwithstanding any requirement term or condition of any contract or other document with respect to which this certificate of insurance may be issued or may pertain the insurance afforded by the policies described herein is subject to all the terms exclusions and conditions of such policies PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS $1 000,000 00 PER OCCURRENCE ENDORSEMENT #0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 10/01/96 IS ATTACHED TO AND FORMS A PART OF THIS POLICY NAME OF ADDITIONAL INSURED CITY OF CARLSBAD ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10/01/96 IS ATTACHED TO AND FORMS A PART OF THIS POLICY EMPLOYER LEGAL NAME GOOD & ROBERTS, INC 1090 JOSHUA WAY VISTA CA 92083 GOOD & ROBERTS, GENERAL CONTRACTOR INC THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND PRINTED 09-18-96 pQ4 • . SCIF 10285 (REV. 2-95)