HomeMy WebLinkAbout2332 HOSP WAY; 207; CB920742; Permit( 7/29/cu ..... 4: J ...
R I I L D I N G P E' R ,'1 T T
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2075 Las Palmas Dr., Carlsbad, CA 920()() (619) 438-1161
PERMIT APPLICATION PLAN CHECK NO. f c:7' tJ 1 !f )_
City of Carlsbad Building Departaent
2075 Las Pal1118S Dr •• carlsbad, CA 92009 (619) 438-1161
PIAN CK DEPOSIT. _______ _
I
ESf. VAL
VAIID. BY. __________ _
I. P£RMII hPE
A -LI Commercial U New Bmldmg LI Tenant Improvement
B -0 Industrial □ New Building D Tenant Improvement
C -□ Residential □ Apartment □ Condo □ Single Family Dwelling □ Addition/ Alteration
LI Duplex □ Demolition LI Relocation □ Mobile Home □ Electrical □ Plumbing
□ Mechanical □ Pool □ Spa □ Retaining Wall D Solar □ Other
DATE
2. PROJECT INFORMATION FOR OFFICE USE ONLY
Address Butidmg or Smte No.
2332 Hosp
Nearest Cross Street
Way 207
El Camino Real
LEGAL D£ScRIPI ION Lot No. Subd1V1s1on Name/Number Onn No. Phase No.
CHECK BEWW IF SOBMI 11 ED:
□ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope
ASSESSOB'S PARCEL EXISTING USE PROPOSED USE
DESCRIPTION OF WORK Plumbing and Electrical for Laundry and Kitchen
SQ. Ff. # OF STORIES
3. WN [ACI PDlSON (I( dllierenf from apphcant)
NAME Richard Whitney ADDRESS5929 Pascal court, Suite 200
CI1Y Car 1 sbad STATE CA ZIPCODE92008 DAYTELEPHONE (619)431-2800
1-. XPPUCANI □WNIRACIOR □AGENI FORWNIRACIOR uuvvNtK □AGENI FOR OWNER
NAME New Design Remodeling ADDRESS5928 Pascal Court, Suite 200
CllY Carlsbad STATE CA ZIPCODE92008 DAYTELEPHONE (619)431-2800
NAME Hosp Way Limited
ADDRESS . 1990 Westwood Blvd., Suite 300
CllY kAt'~ Angeles STATE CA 6. CDNI
NAME
ZIPCODE90025 DAY TELEPHONE ( 310) 474-1720
ADDRESS
New Design Remodeling & Const. 5928 Pascal court, Suite 200
CI1Y Carlsbad STATE CA ZIP CODE 92008 DAY TELEPHONE ( 619) 431-2800
STATE UC.# 545075 UCENSE CLASS B CI1Y BUSINESS UC.# 437954
CI1Y STATE ZIP CODE DAY TELEPHONE STATE UC.#
7. woruams WMPENSXIIUN
Workers' Compensation Oeclarat10n: I hereby affirm that I have a cert1hcate of consent to self-msure issued by the Director of 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).
Truck Insurance Exchange N2007-85-50 9-21-92 INSURANCE COMPANY POUCY NO. EXPIRATION DATE
Cert1hcate of Exemption: I cerufy that m the performance of the work for which this penm[ 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-B0ilDER Dfi!OOiXliON
Owner-Butlder Oeclarat1on: I hereby affmn 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 Llcense 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 Llcense 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 Llcense 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 pennit to file a signed statement that he is licensed pursuant to the
provisions of the Contractor's Llcense 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 IRIS 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 fonn or risk management and
prevention program 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 pennit from the air pollution control district or air quality management district?
CYES CNO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
□YES □NO IF ANY OF TIIEANSWERS ARE YES, A FINAi.CERTIFICATE OFOCx:IJPANCYMAYNar BE ISSUED AYl'Ell.JIJLY 1, 1989UNU!SS TIIEAPPIJCANT
HAS MET OR IS MEETING TIIE RF.QIJIREMENTS OF nm OFFICE OF EMERGENCY SERVICl!S AND TIIE AIR FOillITION CDNTIIOL DISllllCT.
9. WNSIROCIION IENDING AGF.NCY
I hereby afhrm that there 1s a constructmn lending agency for the performance of the work for which this penntf 1s issued (Sec 3097 (t) Llvtl Code).
LENDER'S NAME LENDER'S ADDRESS
10. AW□CXN I CEkiiFICXliON
I cerufy that I have read the apphcatmn and state that the above mformatlon 1s correct. I agree to comply with ail 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 Al.'iO AGREE ID SAVE INDEMNIFY AND KEEP HARMLESS TIIE CfIY OF CARISBAD AGAINST AIL IJAIIIIJ11ES, JUDGMENTS, <DSTS
AND EXPENSES WlUCH MAY IN ANY WAY ACDUJE AGAINST SAID CfIY IN CDNSF.QIJENCI! OF TIIE GRANTING OF TIIlS PERMIT.
OSHA: An OSHA pennit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height.
Expiration. Every pennit issued by the Building Official under the provisions of chis 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 pennit or if the building or work authorized by
such pennit is suspended or abandoned at any time after the work is commenced for a pericxl of 180 days (Section 303(d) Unifonn Building Code).
DATE: 7-2-1-fz_ APPUCANTS SIGNATURE /
0
PINK: Fmance
PERMIT# CB920742
DESCRIPTION: PLBG&ELEC
KITCHEN
TYPE: MISC
FOR
CITY OF CARLSBAD
INSPECTION REQUEST
FOR 08/03/92
LAUNDRY AND
PHONE:
STR:**
431-2800
INSPECTOR AREA PK
PLANCK# CB920742
OCC GRP R-1
CONSTR. TYPE NEW
: **** STE: 207 JOB ADDRESS: 2332 HOSP WY
APPLICANT: NEW DESIGN REMODELING
CONTRACTOR:
OWNER:
PHONE: I J
PHONE: /__,..,
REMARKS: MH/
SPECIAL INSTRUCT:
TOTAL TIME:
CD
29
39
LVL DESCRIPTION
PL Final Plumbing
EL Final Electrical
INSPECTOR_,__~---------
ACT COMMENTS
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***** INSPECTION HISTORY*****
DATE DESCRIPTION ACT INSP COMMENTS