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HomeMy WebLinkAbout2280 FARADAY AVE; MULTI-PERMIT FILE; CB141819; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 07-28-2014 Sign Permit Permit No: CB141819 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 2280 FARADAY AV CBAD SIGN Status: Lot#: 0 Applied: Valuation: 2120614500 $2,400.00 Construction Type: NEW Entered By: ISSUED 07/28/2014 LSM 07/28/2014 07/28/2014 Reference #: PC#: Project Title: Applicant: ISIS= INSTALL ONE NON ILLUM WALL SIGN CHARLAINE ARCHITECTURAL SIGNS 8817 PRODUCTION AVE SAN DIEGO, CA 92121-2219 858-566-8868 Building Permit Add'I Building Permit Fee Plan Check Add'I Plan Check Fee Electrical Fee Renewal Fee Add'I Renewal Fee Other Building Fee Additional Fees TOTAL PERMIT FEES Owner: Plan Approved: · Issued: Inspect Area: KIRSHNER/LEONARD REAL ESTATE II LL C C/0 PACIFICA CAPITAL INVESTMENTS 5119 EL MIRLO RANCHO SANTA FE CA 92067 $58.27 $0.00 $40.79 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $99.06 Total Fees: $99.06 Total Payments To Date: $99.06 Balance Due: Clearance: $0.00 NOTICE: Please take approval of your project includes the "lmpo 1tion" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exact' s." Y u have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest proced r. s set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordanc ith Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, o annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which ou have reviousl been iven a NOTICE similar to this or as to which the statute of limitations has reviousl otherwise ex ired. THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: 0PLANNING 0ENGINEERING ~" «~~» ¥ CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov SUITE#/SPACE#/UNIT# OBUILDING 0FIRE Est. Value Plan Ck. Deposit Date? APN PHASE# # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME DESCRIPTION OF WORK: Include Square F(!et of Affected Area(s) EXISTING USE APPLICANT NAME Primary Contact ADDRESS CITY PHONE EMAIL DESIGN PROFESSIONAL ADDRESS CITY PHONE EMAIL PROPOSED USE GARAGE (SF} PATIOS (SF} STATE ZIP · FAA STATE ZIP FAX STATE LIC.# \6\ .s 0HEALTH 0HAZMAT/APCD SWPPP CONSTR. TYPE OCC. GROUP FIRE SPRINKLERS YESONoD (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair an~ structure, prior to its issuance, also requires the applicant for such permit to file a signed statement tnat 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 applicantfor a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500]). Workers' Compensation Declaration: I hereby affirm under penalty of peljury one of the following declarations: bd l 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. f) ~ 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' compensat' n insurance carrier aM policy number are: Insurance Co.~tU'<... eo~ LlM: Policy No. OA-ODSX5b.54W01)4 Expiration Date ~-1-1----~"-'1!;;;:W 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 permitis issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage ls unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, a ag as provid for in Section 3706 of the Labor code, interest and attorney's fees. RS CONTRACTOR SIGNATURE OAGENT l( I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: D D 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). 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). 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. OYes 0No 2. I (have I 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 I 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 I address I phone/ 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/ type of work): RS PROPERTY OWNER SIGNATURE OAGENT DATE Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention progratn under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Yes No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Yes No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Yes 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. I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address 1J ,', I certifythatl have read the application and state that the above infonmation is correct and that the infonmation on the plans is accurate. I agree to complywith all City ordinances and State laws relating to buildingconsbuction. I hereby authorize representative 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. 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 ~ the building or work authorized by such permitis not commenced within 180 days from the date of such penmit or' e bu· di g or mrk auth rized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). Ji5 APPLICANT'S SIGNATURE DATE STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. CERTIFICATE OF OCCUPANCY /Commercial Projects o nlyl Fax (760) 602-8560, Email building@carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. I CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE I FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICKUP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. i) ASSOCIATED CB# MAIL TO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. i) NO CHANGE IN USE/ NO CONSTRUCTION MAIL/ FAX TO OTHER: CHANGE OF USE/ NO CONSTRUCTION ~ APPLICANT'S SIGNATURE DATE Inspection List Permit#: CB141819 Type: SIGN _!)at_e __ Inspection Item ____ _ 05/27/2015 19 Final Structural 05/21/2015 38 Signs 05/21/2015 38 Signs 05/21/2015 39 Final Electrical Wednesday, May 27, 2015 Inspector _ !-ct PY AP PY RI NR RI ISIS= INSTALL ONE NON ILLUM WALL SIGN Comments PLEASE SIGN INSPECTION CARD IN FILE CUSTOMER WILL PICK UP SIGNED CARD Page 1 of 1 ' .,. ,.,_ B U I L D I N G P E R M I T 11/14/89 12:24 Permit No: CB891783 Project No: A8903145 Development No: Page 1 of 1 Job Address: 2280 FARADAY AV Str: Fl• Ste: i357 11/14/BS' 0001 01 02 Permit Type: SIGN Parcel No: 212-061~32-00 Valuation: 1,000 Construction Type: NEW C-PRMT 41°<\) Occupancy Group: Class Code: Status: ISSUED Description: MONUMENT RESEARCH COURT CONTRACTOR MOTIVATIONAL SYSTEMS 823 WE$T 23RD STREET NATIONAL CITY CA 92050 . *** Fees Required *** *** Applied 11/14/89 Apr/Issue Validated By: DC Lie. C 482116 Feep Collected & Credits *** ________ .-_,_ --. --~---------------------- Fees: Adjustments: Total Fees: Fee description Building Permit p1·an Check * BUILDING TOTAL 41.00 .oo 41 ;,00 Total. credits:· Total Paym~p.ts: Balance ·;Dµ·e_: Qnits. · Fee/Oni t ~._ ' ,-_, ', ' .00 .00 41.00 Ext fee Data • • --• ~ • ' -,.,, ',, I: -', - _, I ; .j 1 ', ,, ' ' . CITY OF CARLSBAD '• / I 25.00 16.00 41.00 FINAL APfE::~ -- 1----T---~.-:::,.@':'.3~ E ~____:._~';;.::,. ,e ==e:..~ 2075 Las-Palmas Dr., Carlsbad CA 92009 (619) 438-1161 PERMIT APPLICATION -• City of Carlsbad Building Department 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 EST. VAL. _____ ... /:__ ________ _ 1. A B C 2. TENANT IMPROVEMENT ONEIi D TENANT IMPROVEMENT ORESIDENTIAL OAPARTMENT OCONDO OSINGLE FAMILY DIIELLING OADDITION/ALTERATION ODUPLEX ODEMOLITION ORELOCATION OMOBILE HOME OELECTRICAL OPLUMBING OMECHANICAL OPOOL OSPA ORETAJNING IIALL OSOLAR PLAN CHECK No. Subd1 vision Name/NUTiber PLAN CIC DEPOSIT ____________ _ VALID. BY _____________ _ DATE ______________ _ Unit No. Phase No. CHECK BELOW I F SUBMITTED: 3. 4. 5. 02 Energy Cales 02 Structural Cales D 2 Soi ls Report D 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED use BLDG. SQ. FTG.Mo11{J/lfl~ ).~OF STORIES Fzs uJ.,;;3,1 sl. CO~A~T PERSO.!i- NAMel:SO /:) /3 t.., A ("7/ cmN(;;./,' ttr;./_ SIGNATURE APPLICANT NAME CITY PROPERTY OWNER NAME CITY , D CONTRACTOR STATt c;_ ADDRESS ZIP CODE 0 AGENT FOR CONTRACTOR ADDRESS STATE OIINER STATE ZIP CODE ADDRESS ZIP CODE 7~(}S(J DAY TELEPHONE Oo11NER 0 AGENT FOR OIINER DAY TELEPHONE OLESSEE OTENANT DAY TELEPHONE 6. CON.TRACTOR LJ ; r/,. . NAME ~()f1'f0f,~c-( 'r~c; Oz w. 2J~.J J-1' ADDRESS~ J 7. CI TY /:J G-f, 1ett t-(2 SIGNATURE~,,.,- DESIGNER NAME CITY STATE LIC. -~ WORKERS' COMPENSATION STATE STATE ZIP CODE ') ,,l OW C-41 LICENSE CLASS _____ _ TI TL0'r<1< l\! a ADDRESS ZIP CODE DAY TELEPHONE CITY BUSINESS LIC. # DATE rr/lYI JT', DAY TELEPHONE STATE LIC. # llorkers• Compensation Declaration: hereby affirm that have a certificate of consent to self-insure issued by the Director of Industrial Relations, or a certificate of llorkers' Compensation Insurance by an aanitted 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 shall not employ any person in any manner so as to become subject to the llorkers' Compensation Laws of California. SIGNATURE DATE 8. OWNER-BUILDER DECLARATION Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractor's License Law for the following reason: DJ as owner of the property or my employees with wages es their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Prof.essions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon., and "10 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). 0 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, cOlllllencing 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]). 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 risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley· Tanner Hazardous Substance Account Act? DYES ONO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? OYes ONo Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Ores IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCllJPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS IIET OR IS IIEETIIIG THE REQUIREIIENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 9. CONSTRUCTION LENDING AGENCY hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(i) Civil Code). LENDER'S NAME LENDER'S ADDRESS 10. APPLICANT'S SIGNATURE I certify that I 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. I ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JlllGMENTS, COSTS AND EXPENSES IIHICH MAY IN ANY IIAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. Expiration. Every permit issuea 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 180 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 for a period of 180 days (Section 303(d) Uniform Building Code). D OIINER ~NTRACTOR D BY PHONE APPROVED IIY: DATE: WHITE: File YELLOW: Applicant PINK: Finance -- UNSCHEDULED INSPECTION DATE -..3/; bo 7 INSPECTOR /v1 t t:--- PERMIT # C/3 ~9 / 7$-3 PLANCK# ---------- JOB ADDRESS 2 28:0 J=A.R,AD.A Y A; TIME ARRIVE: TIME LEAVE: ----------- CD LVL DESCRIPTION ACT COMMENTS ,,. I ""' ... B U I L D I N G P E R M I T 11/02/89 10:10 Permit No: CB891726 Project No: A8902919 Development No: Page 1 of 1 Job Address: 2280 FARADAY AV Str: F 1 :r:102 11/02?aii,e 6001 01. 02 . Permit Type: SIGN Parcel No: 212-061-32-00 Valuation: 1,200 Construction Type: NEW C-·PRMT 48n00 Occupancy Group: Class Code: Status: ISSUED Description: BEI MOTION SYSTEMS CONTRACTOR ADVANCE PRINTING 1275 SIMPSON WAY . ESCONDIDO, CA 92025 *** Fees Required *** *** Applied 11/02/89 Apr/Issue Valida·ted By: DC Lie. C NO 619 746-5069 F~e·s Collected & Credi ts *** --------------------------___________ :_:'-;------~-------------------- Fees: · Adjustments: Total Fees: Fee description '48. 00 .00 4$'.00 Total_ Cr~dits :' Total Pc!-ym13n-ts: . Balande· PUe: · Units p·ee/Uni t .00 .00 48.00 Ext fee Data --------------------~-------~-------------~~---------:-----------------Building Permit Plan Check * BUILDING TOTAL >-> -1 CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 ... 29.00 19.00 48.00 ,I.-···· • -- PERMIT APPLICATION City oi"'Carlsbad Building Department EST. VAL / '2.C) z:!;, ,:,· 0 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PLAN CK :DE=POS~l::T:====================== VALID-BY JO C- 1. PERMIT TYPE OATE ///2.../1<' 7 A -COMMERCIAL B -D INDUSTRIAL C -D RESIDENTIAL NEW ONEW OAPARTMENT D DUPLEX D DEMOLITION OMECHANICAL OPOOL 0 TENANT IMPROVEMENT 0 TENANT IMPROVEMENT D CONDO .Os INGLE FAM! LY DWELLING ORELOCAT!ON OMOBILE HOME OELECTR!CAL OsPA ORETAINING WALL OsoLAR OoTHER_~---~- 2. PROJECT INFORMATION PLAN CHECK No. FO LEGAL DES CR I PT! ON Lot No. Subdivision Name/Number Unit No. Phase No. CHECK BELOII IF SUSHI TTED: D 2 Energy Cal cs O 2 Structural Cal cs D 2 Soi ls Report D 1 Addressed Envelope EXISTING USE PROPOSED USE BLDG. SC. FTG. # OF STORIES 3. ADDRESS iz.-zs '$ t.Mp~~ STATE CA ZIP CODE -~ Z, t) 2:-_5 DAY TELEPHONE SIGNATURE 4. APPLICANT Ql CONTRACTOR ":'.:J1~s ~GENT FOR CONTRACTOR O OWNER O AGEN~ ~qR. Oj'NER NAME A., D'1A.l\lC-l CITY ~SC... ADDRESS l,2. "Z? '"e:, ( Jl,(_f>f::.OA/ (.)I.I '1' STATeCA, -ZIP coDE <::/ LO '25 DAY TELEPHONE 5. PROPERTY OWNER OIINER OLESSEE OTENANT NAME CITY STATE ADDRESS ZIP CODE , DAY TELEPHONE 6. CONTRACTOR 1 NAME Al;,'1.~ -:b c._a.A-9 /2.?5 -~ t"'l,p.so......r W<1 CITY c;_ SC..· STATC::/l CITY STATE ADDRESS ZIP CODE 1 ze, Z.5 DAY TELEPHONE '14l.o-S6 '-' If' LICENSE CLASS C.. 4S TITLE ADDRESS ZIP CODE CITY BUSINESS L!C. # DATE DAY TELEPHONE STATE LlC. # 7. WORKERS' COMPENSATION 8. Workers• Compensation Declaration: hereby affirm that l have a certificate of consent to self:insure issued by the Director of Industrial Relations, or a certificate of Workers• Compensation Insurance by an admi-tted 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). . l r INSURANCE COMPANY "!) tk-l"°lL ~ 1\.1. 'O POLICY NO. (Q ,2 \ (\,t9,f ... ~er EXPIRATION DATE \,\_ '\,0 q,6 Certificate of Exemption: 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. SIGNATURE DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D l 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 <me-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 !, 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 fi.le a signed statement that he is licensed pursuant to the provisions of the Contractor• s License Law (Chapter 9, corrrnenci ng with Section 7000 of Division 3 of the Business and Profess ions 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]). SIGNATURE DATE COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY: ls 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 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? DYES ONO ls the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? DYES ONO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? DYES IF ANY OF THE ANS\IERS 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 DISTRICL 9. CONSTRUCTION LENDING AGENCY hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097( i) Civil Code). LENDER'S NAME LENDER'S ADDRESS 10. APPLICANT'S SIGNATURE I certify that I 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. I ALSO AGREE TO SAVE INDEMN! FY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JOOGMENTS, COSTS AND EXPENSES IIHICH MAY IN ANY IIAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT- 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 corrrnenced within 180 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 corrrnenced for a period of 180 days (Section 303(d) Uniform Building Code). D OIINER ll!.coNTRACTOR D BY PHONE APPROVED BY., ______ _,_ DArE: WHITE: File YELLOW: Applicant PINK: Finance , \ PERMIT APPLICATION City oi"'Carlsbad Building Department EST. VAL / '2.C) z:!;, ,:,· 0 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PLAN CK :DE=POS~l::T:====================== VALID-BY JO C- 1. PERMIT TYPE OATE ///2.../1<' 7 A -COMMERCIAL B -D INDUSTRIAL C -D RESIDENTIAL NEW ONEW OAPARTMENT D DUPLEX D DEMOLITION OMECHANICAL OPOOL 0 TENANT IMPROVEMENT 0 TENANT IMPROVEMENT D CONDO .Os INGLE FAM! LY DWELLING ORELOCAT!ON OMOBILE HOME OELECTR!CAL OsPA ORETAINING WALL OsoLAR OoTHER_~---~- 2. PROJECT INFORMATION PLAN CHECK No. FO LEGAL DES CR I PT! ON Lot No. Subdivision Name/Number Unit No. Phase No. CHECK BELOII IF SUSHI TTED: D 2 Energy Cal cs O 2 Structural Cal cs D 2 Soi ls Report D 1 Addressed Envelope EXISTING USE PROPOSED USE BLDG. SC. FTG. # OF STORIES 3. ADDRESS iz.-zs '$ t.Mp~~ STATE CA ZIP CODE -~ Z, t) 2:-_5 DAY TELEPHONE SIGNATURE 4. APPLICANT Ql CONTRACTOR ":'.:J1~s ~GENT FOR CONTRACTOR O OWNER O AGEN~ ~qR. Oj'NER NAME A., D'1A.l\lC-l CITY ~SC... ADDRESS l,2. "Z? '"e:, ( Jl,(_f>f::.OA/ (.)I.I '1' STATeCA, -ZIP coDE <::/ LO '25 DAY TELEPHONE 5. PROPERTY OWNER OIINER OLESSEE OTENANT NAME CITY STATE ADDRESS ZIP CODE , DAY TELEPHONE 6. CONTRACTOR 1 NAME Al;,'1.~ -:b c._a.A-9 /2.?5 -~ t"'l,p.so......r W<1 CITY c;_ SC..· STATC::/l CITY STATE ADDRESS ZIP CODE 1 ze, Z.5 DAY TELEPHONE '14l.o-S6 '-' If' LICENSE CLASS C.. 4S TITLE ADDRESS ZIP CODE CITY BUSINESS L!C. # DATE DAY TELEPHONE STATE LlC. # 7. WORKERS' COMPENSATION 8. Workers• Compensation Declaration: hereby affirm that l have a certificate of consent to self:insure issued by the Director of Industrial Relations, or a certificate of Workers• Compensation Insurance by an admi-tted 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). . l r INSURANCE COMPANY "!) tk-l"°lL ~ 1\.1. 'O POLICY NO. (Q ,2 \ (\,t9,f ... ~er EXPIRATION DATE \,\_ '\,0 q,6 Certificate of Exemption: 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. SIGNATURE DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D l 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 <me-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 !, 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 fi.le a signed statement that he is licensed pursuant to the provisions of the Contractor• s License Law (Chapter 9, corrrnenci ng with Section 7000 of Division 3 of the Business and Profess ions 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]). SIGNATURE DATE COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY: ls 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 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? DYES ONO ls the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? DYES ONO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? DYES IF ANY OF THE ANS\IERS 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 DISTRICL 9. CONSTRUCTION LENDING AGENCY hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097( i) Civil Code). LENDER'S NAME LENDER'S ADDRESS 10. APPLICANT'S SIGNATURE I certify that I 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. I ALSO AGREE TO SAVE INDEMN! FY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JOOGMENTS, COSTS AND EXPENSES IIHICH MAY IN ANY IIAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT- 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 corrrnenced within 180 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 corrrnenced for a period of 180 days (Section 303(d) Uniform Building Code). D OIINER ll!.coNTRACTOR D BY PHONE APPROVED BY., ______ _,_ DArE: WHITE: File YELLOW: Applicant PINK: Finance , \ .. . UNSCHEDULED-INSPECTION PERMIT # C/3 17 2--~ l\f',19{/ INSPECTOR. __ -1/~ v---+--------pu1C: # _____ _ JOB ADDRESS ________________________ _ TIME ARRIVE: _____ TIME LEAVE: _____ _ CD LVL DESCRIPTION ACT COMMENTS