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Home My WebLink About2290 COSMOS CT; ; CB972506; PermitBIJILDING PERMIT 09/05/97 11 03 job6 Address ^290 COSMOS CT Permit Tvpe MISCELLANEOUS Parcel No. 213-050-44-00 Valuation ° Suite Lot# Reference^ Anol/Ownr HAR-BROAppl/uwn SIGANL PRKWY * ** SIGNAL HILL, CA 90806 Fees Required *** *** Fees Adjustments Total Fees Fee description 50-00 '' ' Miscellaneous Fee #1 * MISCELLANEOUS TOTAL ".- Permit No CB972506 Project No A9703188 Development No / a /Appl iea 09/0 Apr/Issue 09/05/97 Entered By JM 562-986-4165 Fees Collected & Credits * * n n.Total Credits ^ Total Payments ,uS!ir$^___?«!!!;!__^ ---'--.. "v ~ \ 50 00 PERMIT FE > : . 5:°,<(D^' x ''7 '•. so oo PPCOVAL DATE CITY OF CARLSBAD 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-H61 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr, Carlsbad CA 92009 (760)438-1161 1 PROJECT INFORMATION ,Kt-': 7 I FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposits Validated By i 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 Description of WorK^ s 2 CONTACT PERSON (if different from applicant) #of Stories J # of Bedrooms tt of Bathrooms Name &APPLiCANT j Contractor .. Address | Agent for Contractor City State/Zip Telephone Fax # Q;pwner ;L~] Agent for ;0wner Name Address^"City State/Zip Telephone # PROPERTY OWNER ..... *: Name Address City State/Zip Telephone ff i CONTRACIPR - COMPANY NAME (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]) Name State License # Address ^ License Class State/Zip City Business License # Telephone # Designer Name Address City State/Zip Telephone State License # '6 WORKERS' COMPENSATIONTM lift. /J- . li ~':-- ; W ' ' """. '^''^f- Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations Cf. | 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 0 I nave ar>d wl11 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 57s9/£ ^t^f /ZsA;& Policy No */£" ~7/£. 7 ~ ^ 7 Expiration Date 7/t (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) n 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 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)^ addrtiw to the cost of compensation damages as provided for in Section 3706 of the Labor code, interest and attorney's fees SIGNATURE ^^gg^y ^\^^Cf^^-^ DATE ^/^'/?~f 7 OWNER-BUILDER DECLARATION ' ••'i?" • "i:: .... lih 1 ' •' It ., T* '- T«il% 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason l~l 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) l~l 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~| YES l~lNO 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 COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS OJMLY '-t llj: .ff.i 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? Q YES O 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 Q Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? 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 •8v::ii*CONSjR.yCTIONLENDING:'AGENCY ;. J'^'T S3:. .;ij;.;.; ;'", "fv ^ ^ ; ,.;. ;": ...... • I 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) NO LENDER'S NAME LENDER'S ADDRESS_ :*APPliCANT CERTIFICATION 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 authorize representatives of the CitV 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 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 thewofk is commenced for a ipenod of 1 80 days (Section 1 06 4 4 Uniform Building Code) APPLICANT'S SIGNATURE DATE WHITE File YELLOW Applicant PINK Finance 06/11/98 INSPECTION HISTORY LISTING FOR PERMIT# CB972506 DATE INSPECTION TYPE INSP ACT COMMENTS 10/29/97 Final Structural RI RI C/BOB/909/676-4257 10/29/97 Final Structural TP AP 09/08/97 Insulation RI RI C/BOB/909/676-4257 09/08/97 Insulation TP AP SOUND WALLS RE-PLACE 09/08/97 Interior Lath/Drywall TP AP BTM 2' OF WALLS WHERE REMOVED HIT <RETURN> TO CONTINUE... BASE ** ACTIVITY PROCESSING ** 06/11/98 Permit No: CB972506 12:18 Type: MISC MISCELLANEOUS Dates: Job Title: WATER DAMAGE REPIR-INSULATIONValuation: Status Applied Completed EXPIRED 090597 Apr/Issue : Expired : 090597 042798 Descr; AND DRYWALL. CONCRETE STEPS Type Const; NEW Altkey; Address: 2290 Street: COSMOS CT Lot#; Suite; Parcel; 2130504400 Owner; FUJITA INVESTORS OF CALIFORNIA Occupancy; Reference^; No district keyword Appl/Ownr ; HAR-BRO Telephone; 562-986-4165 Address; 2750 SIGANL PRKWY SIGNAL HILL, CA 90806 Insp Area; TP Entered By; JM INSP; YES APPR: NO COMM; NO MULTP; NO MULTA; NO $ BAL; NO Project; A9703188 WATER DAMAGE REPIR-INSULATION Entered: 09/05/97 By: COUNTER COSMOS CT PERMITfl CB972506 DESCRIPTION: WATER DAMAGE AND DRYWALL. TYPE: MISC JOB ADDRESS: 2290 APPLICANT: HAR-BRO CONTRACTOR: OWNER: REMARKS: C/BOB/909/676-4257 SPECIAL INSTRUCT: CITY OF CARLSBAD INSPECTION REQUEST FOR 10/29/97 REPIR-INSULATION CONCRETE STEPS PHONE: PHONE: PHONE: INSPECTOR AREA TP PLANCKtf CB972506 OCC GRP CONSTR. TYPE NEW STE: LOT: 562-986-4165 INSPECTOR TOTAL TIME: CD LVL DESCRIPTION 19 ST Final Structural ACT COMMENTS ***** INSPECTION HISTORY ***** DATE DESCRIPTION 090897 Insulation 090897 Interior Lath/Drywall ACT INSP AP TP AP TP COMMENTS SOUND WALLS RE-PLACE BTM 2' OF WALLS WHERE REMOVED JUL-15-1997 08 03 HAR-BRO, INC (VP DEPT 310 986 5925 P 02 AC?O/?/7 ££ftTfi PRODUCER Alexander & Alexander o 801 S Figueroa Street Suite 700 Los Angeles CA 900 17 INSURED - - --- '< x -' —-•"- - * ,r.r:^7/"*^?* C -..- 07/O7/1997 • 213-S99-4OOO f California, Inc Har-Bro. hie Mr James Franklin 2380 Mira Mar Avenue Long Beach CA 90B1 5 I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW COMPANIES COMPANY A FIREMANS FUND AFFORDING COVERA INS CO GE COMPANY • EVANSTON INSURANCE CO COMPANY c AIU INSURANCE CO COMPANY D STATE INS FUND THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OH OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS COLTR B A C O TYPE OF INSURANCE OENERAi WMHITTY X_COMMERCIAL GENERAL LIABILITY _] CLAIMS MADE | X | OCCUR OWNER S & CONTRACTOR'S PHOT AUTOMOBILE LIABIUTY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABIUTY ANY AUTO EXCESS LIABILITY X UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS LIABILITY THt PATon PROPRIETOR/ INCL TNFRS/EXECUTIVE ICERS ARE X SXCL POLICY NUMBER GLP1 002776 DXA80171665 BE932-90-33 46-7127-97 POLICY EFFECTIVE DATE (MM/DO/YY) 07/01/1997 07/01/1997 07/01/1997 07/01/1997 POLICY EXPUMTION DATE IMM/DO/YY) 07/01/1998 07/01/1998 07/01/1998 07/01/1998 LIMITS GENERAL AGGREGATE PRODUCTS COMP/OPAGG PERSONAL * ADV INJURY EACH OCCURRENCE FIRE DAMAGE (Any ant tun MEB EX* (Any en* p*r»on) COMBINED SINGLE LIMIT BODILY INJUftr (Pttf person] BODILY INJURYiff KOOtnO PROPERTY DAMAGE AUTO ONLY IA ACCIDENT OTHER THAN AUTO ONLY EACH ACCIDENT AGGREGATE EACH OCCURRENCE AGGREGATE X I WC ST ATU- | 1 OTH-1 TORY LIMITS 1 1 EH EL EACH ACCIDENT EL DISEASE POLICY LIMIT EL DISEASE EA EMPLOYEE t 2,000,000 * 1,000,000 * 1,000,000 » 1,000,000 • 50,000 » NO Coveraqe » 1,000 000 t « » » « t 1 10,000,000 « 10,000,000 t « 1,000,000 t 1,000,000 9 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIOWS/veHICUfirtPECIAL ITEMS RE LtCOTOe * 268441 ny-ni^. ^ij. j^_- ••-—<•• '' — - ' -'-fAHftrttltf CONTRACTORS STATE LICENSING BOARD Ann Workers' Comp Unrt P 0 60X26000 SACRAMENTO, CA 9S826 I tfttf »• '• " „ ;>xi'< SHOULD ANY OF THE ABOVE DtSCRWEO POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING COMPANY W1U. BNCUWKXB MAIL 30 CAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFTEXCEPT 10 DAYS NOTICE FOR NON-PAYMENT BUT FAILURE TO MAO. SUCH NOTICE SHALL IMPOSE NO OBUOATION OR UABHJTY OF ANY KIND UPON THE COMPANY ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENT ATIVE 1 ^ Greg Martin ^.-^-d \_C_-< j v\i<«-TA/--*~ <9d»*3065599 JUL-15-1997 07 42 310 9S6 5925 P 02 H XVR—BF1O HAR-BRO INC., GENERAL CONTRACTORS & CONSULTANTS 2750 SIGNAL PARKWAY SIGNAL HILL CA 90806 • (562)528-8000 . (714)821-1081 • FAX (562) 528-6050 September 5, 1997 City of Carlsbad To Whom It May Concern: RE- AUTHORIZATION TO SIGN PERMITS FOR CONTRACTOR I hereby authorize the following person to act on my behalf in obtaining permits from the Building department of the City of Carlsbad and to sign permit application for me. I am properly licensed as required by the State of California. I assume full responsibility under the law for permits taken by persons authorized to act on my behalf. This authorization shall continue until the Department of Building and Safety of the city of Carlsbad is notified in writing that such authorization is canceled by it contractor Person authorized to sign permit: Signature Name: Bob Andrews Jajfties JJ trafflclin Executive Vice President Company Name: Har-Bro, Inc Contractors State License Number: #61-258441 1 IB E AIRPORT DR *206 SAN BERNARDINO CA 92408 (909)890-1727 . FAX (909)890-1735 4? 136 SARAH WAY TEMECULA CA 92590 (909) 676-4257 - FAX (909)695-9106 20746PLUMMERST CHATSWORTH CA91311 (818)718-9555 . FAX (818)718-9559 SEP-05-1997 08 26 1-800-266-5677 (266-LOSS) Contrvr t&'s Uceruos CoWomio B7SB44! B72SS2V B736W2 Nevada 62-003167182-0047160 Antona S3114556 B3-114557 Hawaii BC 19782 310 986 5925 1775 OLD COUNTY ROAD #7 BELMONT CA 94002 (415)693-4500 . FAX (415)593-4530 5525S VALLEY VIEW BLVD « LASVEGAS NV89118 (702)691-8900 • FAX. (702) 891-9100 http //www haitxa com 97%P 01