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Home My WebLink About2270 CAMINO VIDA ROBLE; S; CB951713; Permit0 BUILDING PERMI 11/22/95 10:06 Page 1 of 1 Job Address: 2270 CAMINO VIDA ROBLE Suite Permit Type: PLUMBING Parcel No: 213-050-47-00 Lot*: Valuation: 0 Occupancy Group: Reference*: Description: PARAPET MOUNTED GAS PIPE-OK : PER MIKE P. Appl/Ownr : PLOTKE PLUMBING P.O. BOX 231186 ENCINITAS, CA 92024 *** Fees Required *** Fees : Adjustments: Total Fees: Fee description 619- T Permit No: CB951713 Project No: A9502495 Development No: S 4792 11/22/95 0001 01 02 Construction Tfyp&fcT NEW 27-00 Status: ISSUED Applied: 11/22/95 Apr/Issue: 11/22/95 Entered By: RMA -632-0461 llected & Credits Enter "Y" for Plu: Gas Piping System * PLUMBING TOTAL *** .00 .00 27.00 Ext fee Data 20.00 Y 7.00 27.00 FINAL APPROVAL INSP. Td CLEARANCE CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las PaI BBS Dr., Carlsbad, CA 92009 (619) 438-1161 1. PERMIT TYPE From List 1 (see back) give code of Permit-Type: For Residential Projects Only: From List 2 (see back) give Code of Structure-Type: Net Loss/Gain of Dwelling Units PLAN CHECK NO.~f / J ESr.VAL_ PLANCKD: VALID. BY DATE 2. PROJECT INFORMATION FOR OFFICE USE ONLY Address Building or Suite No. 2270 Camino Vida Roble Suite S Carlsbad, CA 92009 El Camino RealNearest Cross Street LEGAL DESCRIPTION Lot No. Subdivision Name/Number 7 APN #213-050-07 Unit No.Phase No. CHECK BELOW IF SUBMITTED: D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D 1 Addressed Envelope ASSESSORS PARCEL.EXISTING USE PROPOSKD USE DESCRIPTION OF WORK SQ.FT. Install 2" gas line # OF STORIES # OF BEDROOMS # OF BATHROOMS 3. cuNTAur HiKSUW (.a ditierent rrom applicant; NAME (last name first)Rosingana/ John ADDRESS 2 2 3 3 _ R Faraday Aye . Carlsbad CA 92008 CITYSTATEZIP CODEDAY TELEPHONE APPLICANT D CONTRACTOR NAME (last name first) CITY EESGENT FOR CONTRACTOR ADDRESS STATE ZIP CODE TJOWNERD AGENT FOR OWNER DAY TELEPHONE 5. PROPER rY OWNERNAME (last name first) Carlsbad Industrial ASSAEOSESS 2270 Camino Vida Roble-K CITY Carlsbad STATE ZIP CODE 92009 DAY TELEPHONE (619) 431-3525 ADDRESS C1TY STATE LIC. *LICENSE CLASS d ADDRESS DAY TELEPHONE \J JC| 0 CITY BUSINESS LIC. # IZTj^V 5\ DESIGNER NAME (last name first) CITY N/A STATE ZIP CODE DAY TELEPHONE STATE LIC. # TTWORKERy 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'POLICY NO.EXPIRATION DATE Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I snail not employ any person in any manner so as to become subjSft to tt^e Workers' Compensation Laws of California. SIGNATURED ] 8. OWN^R-Blfl (Jwner-BuiKKjr Declaration " I hereby aTTTrm that I am exempt trom the Contractor's Licerise~Eaw lor the following 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.S by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]). SIGNATURE DATE COMPLETE THIS SECTJ'OTj FOR N_ON-R'£SlDENTIAL BUILDtNG 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 255QS, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES Bf 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 ffl NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES 04, 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 THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 9. CONS'IKUCIION LENDING AGENCY I hereby affirm that there is a construction lending agency or the performance of the work lor which this permit is issued (.Sec 3097UJ Code). LENDER'S NAME LENDER'S ADDRESS 10. APPLICANT 1 certify that 1 nave 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, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSIIA: 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 suah 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 abafid/ned^t any rifle after the work is commenced fora period of 180 days (Section 303(d) Uniform Building Code). APPLICANTS SIGNATURE/^feAVr - * DATE: 1 1/22/95 WHITE:YELLOW: Applicant PINK: Finance infSCHZDCLfD TMSPtCTTOM DAT! / ^Z*?~?<^INSPECTOR PERMIT * JOS PIAHCX » TIM AJLRIVt;TIM CO LVL DC3CHIPTIOM <!^> -- ^Sft ACT COHKEOTS QATg !<->'!' /^ INSFICTOJK A/ PCJWXT » . PtAMCX *. J0» ADDM3J ^q "? O fayUM (JjJ* /£0h 0? TI« AMIVf: TIKI LXAVt: CO LVL 014 CHI PTI OH ACT COMKEKTS •/is/it November 15, 1995 To: City of Carlsbad, Building Department From:'John C. Rosingana, A Cut Above Foods, Inc. Re: Permit for installing 2" gas line to 2270 Camino Vida Roble, Suite 'S', Carlsbad Materials: Approved 2" black iron gas pipe, fittings, 2 hole pipe supports. Location: Starting at back of meter location, core thru wall at street end of building, 90 up on interior wall thru roof. Starting there, attach to parapet around building to Suite S with approved anchors to code at 12 inches or more above roof level. At Suite S, 90 down and penetrate roof, terminating inside Tenant area. Other: Gas piping inside tenant space will be covered under separate Tenant Improvement permit All penetrations in roof to be sealed to code and best industry practices. All anchors to be of approved type and suitable for application. Attachments: 1). Roof Plan with location of pipe run. 2). Cross Section "South" 3). Parapet-Roof Connection Detail *v4 s 8 *-•: I u I-J 5ti!* \S5. Ir*- IA P •*• s 1=1 s w CD 5 0z. '"•"" ni; 11 City of Carlsbad Building Department WORKERS' COMPENSATION DECLARATION hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self-insure for A. workers' compensation as provided by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. have and will maintain workers' compensation, as required by section 3700 tf the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: B. INSURANCE COMPANY POLICY NO.EXPIRATION DATE: (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) 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 m C. workers compensation laws of California. Signature ate Warning: Failure to secure workers' compensation coverage is unlawful, and shall be subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, Interest and attorney's fees. March 3, 1995 2O75 Las Palmas Dr. * Carlsbad, CA 92OO9-1576 • (619) 438-1161 • FAX (619) 438-O894