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Home My WebLink About2271 COSMOS CT; ; CB951775; PermitPermit No. Project No Development No BUILDING PERMIT12/04/95 16-04 Page 1 of 1 Job Address- 2271 COSMOS CT Suite Permit Type MISCELLANEOUS Parcel No 213-050-41-00 Lot#. Valuation 20,000 ' Construction Type Occupancy Group Reference* Status Description 40 SKYLIGHTS-ICBO APPR # 4063 Applied Apr/Issue Entered By Appl/Ownr ACTIVE DAYLIGHT INSTALLATIONS 310-952-8990 444 QUAY AV #6 LOS ANGELES, CA 90744 CB951775 A9502577 NEW ISSUED 12/04/95 12/04/95 RMA *** Fees Required ****•*Fees Collected & Credits * * * Fees 350.00 Adjustments ' op",' Total Fees ,350. OO'- Fee description ./' .: ~;..'\ |': 'r To.ta:l/Gredits. (Total (Payments •i B a 1 ah c e ,.Due .'^ sjjhitsv ""?Feei/Unit 00 00 350 00 Ext fee Data Miscellaneous Fee ,#!-'' -,; * MISCELLANEOUS TOTAL7:-O \ '^. ' i ;... •--> -.-• - 350.00/ \ '^.-' ' \ \. •-- ::*-<•>** ' ./' \ 6-'' \350 00 PERMIT FE 350 , 00 -; -.. '•• ,:..' ;• .j.•• i.,- i>,>rs'-:- ty'':/ :'' \' >' i 4949 12/04/95 0001 01 02 C-PRMT 350.00 INSP. CLEARANCE. APPROVAL DATE. CITY OF CARLSBAD 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161 APPLICATION City of Carlsbad Building Department 2075 Las Palraas 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. 2. PROJECT INFORMATION FOR OFFICE USE ONLY Address Nearest Cross" Building or Suite No (-0* LEGAL DESCRIPTION Lot No Subdivision Name/Number Unit No Phase No CHhCK BtUJW IF SUBMITTED D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK SQ FT app # OF STORIES # OF BEDROOMS f)# OF BATHROOMS 3CONTACT NAME (last name first) tijUN tit different trom applicant) Koixj^TADDRESS /Oo5" X U OWNER D AGLN I F f O *> S~ yV , l/V £ C APPLICANT ^CONTRACTOR D AGENT FOR CON I RAC I OH NAME (last name first) *;,,-£• fc /V> $ i ^ v flf'-T ADDRESS ZIP CODE*? )- fl- *j DAY TELEPHONE fl<CITY STATE 5 PROPERTY OWNER , y NAME (last name first) TJT-| *^ STATE ZIP CODE DAY TELEPHONE CITY first) L/|IU>-v^ f -STATE ZIP CODE STATE LIC # &7/) / S" LICENSE CLASS DAY TELEPHONE 3)6 Ti BUSINESS LIC # UES1GNEK NAME (last name first) CITY STATE ZIP CODE DAY TELEPHONE STATE LIC # 7 WORKERS' COMPENSATION Workers' Compensation Declaration Inereoy 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 [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 SIGNATURE DATE 8 OWNER-BUILDER DECLARATION Uwner-iiuilcler Declaration 1 hereby affirm that I am exempt trom Uie Contractor's License Law 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, pnor 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 5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [SSOO]) 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 nsk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES D 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 D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OC3CUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HASi METX)R IS MEETING THE^EQUTREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT 9 CUNSTKUUTION LENDING AGENCY I hereby affirm that there is a construction lending agency tor the performance ot the work tor which this permit is issued (Sec 3097(0 Civil Code) LENDER'S NAME LENDER'S ADDRESS IO AFFLKJAN I UiKTll'KJVTKJN I certify that 1 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 IAISO AGREE "ID SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST All UABIUTIES, JUDGMF.NTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SATO 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 stones in height Expiration Every permit issued by I building or work authorized bv^tiCn permit i such permit is suspended or aroandoned aj, APPLICANTS SIGNATURE ; Official under the provisions of this Code shall expire by limitation and become null and void if the ommenced within 365 days from the date of such permit or if the building or work authonzed by ! after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code) DATE /^ WHITE- File YELLOW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB951775 FOR 01/11/96 DESCRIPTION: 40 SKYLIGHTS-ICBO APPR # 4063 STE: PHONE PHONE PHONE 310-952-899,0 / TYPE: MISC JOB ADDRESS: 2271 COSMOS CT APPLICANT: ACTIVE DAYLIGHT INSTALLATIONS CONTRACTOR: OWNER: REMARKS: MW/PAT/8.9.9j^9221 SPECIAL INSTRUCT1;—REQUESTED PETE DREIBELBIS-BE-HIS-INSPECTOR. INSPECTOR AREA TP PLANCK# CB951775 OCC GRP CONSTR. TYPE NEW /- LOT: INSPECTOR TOTAL TIME: —RELATED PERMITS—PERMIT* CB880631 SE940025 AS940018 CB940416 CB950455 FS950011 AS950041 FAD95009 CD LVL DESCRIPTION STATUS EXPIRED ISSUED ISSUED EXPIRED ISSUED ISSUED ISSUED ISSUED ACT COMMENTS 14 ST Frame/Steel/Bolting/Welding ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP COMMENTS \ City of Carlsbad Building Department 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 the 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 workers' compensation insurance carrier and policy number are. 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 empJayLany^person in any manner so as to become subject to the C worke^s-i^Jmpensationf&ws of California. DateSignature 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 92009-1576 • (619) 438-1161 • FAX (619) 438-0894 " 6 Sf ¥ DEC 04 '95 05 38PM STftTE COMP INS FUND POLICY SER P 1/1 COMPENSATION INSURANCE P O BOX 420807, SAN FRANCISCO. CA 94142-0807 FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE DtCEMBEB 4, r CT.1Y OF C4 BDjLU'iNG OS PI. ATJM: RAi 202075 LA,5 WJ-FAS CARLSBAD CA 9£009 POLICY NUMBER 1356(»55-95 CERTIFICATE EXPIRES Hi- 1 -t}Q JOE: 3-4 LJ4PLO L 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 foi the policy period indicated This policy 13 not subject to cancellation by the Fund except upon ten days' advance written notice to the employer We will also give you TEN 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 EhPLOYkR'fe LlABiVlTY I,!«JT JlJCUKDSG DEJ?E\'!J.e, COSTS: .'M ,000,000 Fr-R OCCURSfcHCE. EMPLOYER Si Wlr^'S. ncuslifd. U I)J?A. 'ACnVl, DA2C WU 4«14 OSJAY ?,'6 UTGtf Js 9U7H «.t'3TALi.ATIOMS L