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CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92()()() (619) 438-1161
PERMIT APPLICATION ~ V
PLAN CHECK NO.
City of Carlsbad Building Departaent
I
EST. VAL 2075 Las Pal..,,. Or., Carlsbad, CA 92009 (619) 438-1161
PIAN CK DEPOSIT _______ _
VALID. BY _________ _
I. PERMII hPE DATE
A -D COmmerc1al U New Bu1ldmg LI I enant Improvement
B -□ Industrial □ New Building D Tenant Improvement
C -□ Residential □ Apartment □ Condo □ Single Family Dwelling □Addition/Alteration
□ Duplex D Demolition □ Relocation U Mobile Home LI Electrical □ Plumbing
□ Mechanical □ Pool □ Spa □ Retaining Wall □ Solar □ Other
2. PROJECI" INFORMATION FOR OFFICE USE ONLY
Address
2310 Hosp Way
Nearest Cross Street El ~j no
LEGAL DESCRIP I ION 1vts10n Name/Number 0mt No. Phase No.
CHECK BEWW IF SOBMll 1£0:
□ 2 Energy Cales O 2 Structural Cales □ 2 Soils Report O 1 Addressed Envelope
ASSESSOR'S PABCEl EXISTING 1JSE PROPOSED USE
DESCRIPTION OF WORK
Plumbing and Electrical for Kitchens.
SQ. IT. # OF STORIES
3. WN IACI PERSON (II dll[ereni from appJJcanf) • 200 NAMERichard Whitney ADDREss5928 Pascal Court, SU1.te
CI1Y Carlsbad STATE Ca ZIP CODE 92008 DAY TELEPHONE( 619 l 431-2800
4. APPIJCANI UWNIRACIUR □AGENI FORwNIRACIOR uuvvNut □AGENI FOR OWNER
NAME • ADDRESS 1 0 t S • t 200 New Design Remodeling & Const. 5928 Pasca Cur, ui e
CITYMilnl~d STATE CA ZIP CODE 92008 DAY TELEPHONE (619)431-2800
Limited
Los Angeles STATE CA
ADDRESS
ZIP CODE
1990 Westwood Blvd., Suite 300
90025 DAY TELEPHONE (310)474-1720
NAME • New Design • ADDRESS Remodeling & Const. 5928
92008
Pascal Court, Suite 200
DAYTELEPHONE (619)431-2800 CITY Carlsbad STATE CA ZIP CODE
STATE UC. # 545075 LICENSE CLASS B CI1Y BUSINESS UC. #437954
CITY STATE ZIP CODE DAY TELEPHONE STATE UC.# 7. WuitkkkS5 WUPENSA'IIUN
Workers' Compensation Declaration: I hereby affirm that I have a cert1hcate of consent to self-msure issued by the O1rectorof lndustnal
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 Truckers Exchange POLICY NON20077301 EXPIRATION DATE 4-20-92
Certihcate oi Exempuon: I certify that m the performance of the work ior which this penmt 1s issued, I shall not employ any person m any manner
so as to become subject to the Workers' Compensation Laws of California.
SIGNATURE DATE
8. OWNkk-B0llDkk DP.i!CAkA:liuN
Owner-Butlder Deciarat1on: I hereby affirm that I am exempt from the Contracto?s Lcense Law for the foilowmg reason:
□ 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:
(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 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars [$500]).
SIGNATURE DATE
COMPLEIE IHIS SECIION FOR NON-RESIDENIIAL BUILDING PERMll'S 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?
□YES □NO
ls the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
CYES □NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
□YES □NO
IF ANY OF TIIE ANSWERS ARE YES, A FINAL CERTIFICATE OF OOCUPANCY MAY NOT BE lS.Wl!D AITERJULY 1, 1989 UNLESS TIIE APPLICANT
HAS M.IIT OR JS MElmNG TIIE REQUIREMENTS OF 11-IE OFFICE OF EMERGENCY SERVICES AND TIIE AIR POillITION CDNTROL DISI1UCT.
9. WNSIROCIIUN IENDING XGENCY
I hereby affmn that there 1s a construction lendmg agency for the performance of the work for which this pernut 1s issued (Sec 3097(1) Civtl Ccxie).
LENDER'S NAME LENDER'S ADDRESS
10. APPllCXN I Ciltlll'ICAIKJN
I certify that I have read lie apphcat1on and state that the aOOve mfonnauon 1s correct. I agree to comply with all City ordmances 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 ID SAVE INDEMNIFY AND KEEP IIARMIJ!SS TIIE QTY OF CARlSBAD AGAINST ALL IJABIIJl1ES, JUDGMENTS, CXJSrS
AND EXPENSES WIDCH MAY IN ANY WAY N:X:RUE AGAINST SAID QTY IN CDNSEQ\JENCE OF TIIE GRANTING OF TIIlS PERMIT.
OSHA: An OSHA permit is required for excavations over 5'011 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 for a period of 180 days (Section 303(d) Uniform Building Code).
APPLICANT'S SIGNATURE DATE: _____ _
WHITE: File YELLOW: Applicant PINK: Fmance
PERMIT# CB920341
DESCRIPTION: PLUMB/ELEC FOR
TYPE: MISC
CITY OF CARLSBAD
INSPECTION REQUEST
FOR 04/23/92
LAUNDRY/KITCHEN
INSPECTOR AREA PK
PLANCK# CB920341
OCC GRP
CONSTR. TYPE NEW
JOB ADDRESS: 2310 HOSP WY
APPLICANT: NEW DESIGN REMODELING
CONTRACTOR:
STR: FL: STE:
PHONE: 619 431-2800
PHONE: f2 PHONE: OWNER:
REMARKS: MH/GENE/434-1494
SPECIAL INSTRUCT: SUITE 160
TOTAL TIME:
CD
29
39
LVL DESCRIPTION
PL Final Plumbing
EL Final Electrical
INSPECTOR-~•~--""'=--------
ACT COMMENTS
-At----
***** INSPECTION HISTORY*****
DATE
041092
041092
DESCRIPTION
Rough/Topout
Rough Electric
ACT INSP
AP PK
AP PK
COMMENTS