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Home My WebLink About2344 HOSP WAY; 128; CB970622; PermitlK ff-0!0 .. r r r • , t A I l I . r +--. 4 .. • I t . y t .. . r. t • r,. f . A :,. h l:) [ • J l .t,, ) • & r T ,., ,.._ . • ~•s A.' I • f A •• • . .... .. i 'A A ~ I< A, , . . A . " .. r • . . r r ,, UR ., • ..... ' .. ... ., t t ~ ~ ~ ~ c,U > . r • • r 'l~ ' r • { nf .. f • t' N ' t 'y .·1A ·H. ·1,c, ' j, .I ; * • 1 t f l. l ff n ' . ' " • t . . . . ) • .. .. FINAL APPROVAL INSP.~-1.-S. D/\TE.:! ~!~ CLEARANCE_,____ _ _ _ CITY OF CARLSBAD (619) 438-1161 Palmas Dr Carlsbad, CA 920Cfi 2075 Las ., . .. 1 · ' . ,f + ) . PERMIT APPLICATION FOR OFFICE USE ONLY PLAN CHECK NO. °!lo ' ,;2_g CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 EST. VAL. _________ _ address) ~ Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total I of units Proposed Use Name Address City State/Zip Telephone I lm!"--:.'M~v--.i,· ~ ..... Name Address City State/Zip Telephone I lr:~rir.Bi.milb~PMF¢:tMiff 'Sil'WtiGNfS151SHitiiWEH ~- csec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, altar, Improve, demolish or repair any structure, prior to Its issuance, elso requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provieions of the Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that ha la exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any epplicant for a permit subjects the applicent to a civil penalty of not more than five hundred dollars ($50011. Name Address City Stata/Zip Telephone I State License I _________ _ License Class _________ _ City Business Ucansa I _______ _ Designer Name Address City Stat■ Ucansa I _________ _ [L,;..wQJIKEBS.:.,COMPENM, noN..,,.;.,.,;".'' ;: •. .ll'"~.L.~~~· -·~-..e....u, . _,,,:,_,_;:.,.,: ~:::..~ --., Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: State/Zip Telephone 0 I have and will maintain a certificate of consent to Hit-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of tha work for which this permit la issued. 0 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 worker's compensation insurance carrier and policy number ara: Insurance Company_____________________ Policy No._____________ Expiration Data _______ _ (THIS SECTION NEED NOT BE COMPLETED IF '!°HE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS! 0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which tl)ia permit is iasued, I shall not employ any parson in any manner 10 as to become subject to tha Workers' Companaation Laws of California. WARNING: Failure to aecure•worllan' compensation coverage is unlawful, and shall subject en employer to c:rimklal panaltlu end dvll finn up to one hundred thouaend dollars ($100,000), In addition to the coat of compensation, dama911 es provided for in Section 3706 of tha LabQ, code, int-t and attorney'■ f.-a. SIGNAT .RE_______________________________ DATE _________ _ '7. -NER-BUILDER DECLARATION ·,., I h eby affirm that I am exempt from tha Contractor's License Law for the following reason: I, as owner of tha property or my amployaes with wagas as their sole compensation, will do the work and the structure is not intended or offered for sala (Sec. 7044, Business and Professions Code: Tha Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who does such work himsalf or through his own employaas, provided that such improvements are not Intended or offered for aale. If, however, the building or improvement ia sold within one year of completion, the owner-builder will hllve the burden of proving thllt he did not build or improve for the purpose of aale). 0 I, as owner of the property, am excluaively contracting with licensed contractors to construct the project (Sec. 7044, Buaineaa and ProfHalons Code: The Contractor'• LicenH Law does not apply to an owner of property who builds or improves thereon, and contracu for auch project• with contractorlal licensed pursuant to the Contractor's License Law). 0 I am exempt under Section ______ Buainess and Professions Code for this reason: / 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement . .efvES ONO ~/ have not) signed an application for • building permit for the proposad work. 3:"'4i;.;,; contracted with the following person lfirml to provide the proposed construction (include name / address / phone number/ contractors licenH number): 4. I plan to provide portions of the work, but I have hired the following parson to coordinate, supervise and provide the major work (include name / address / phone number / contractors license numberl: _________ _,.,,.:.+------------------------------------ 5. &0¥amJHIS 'SECTION I:, th'J u;,plic==>t or future buildir,w ccupant requira.:I to> •ubmit • bua;inea;~ 1>ian, acutely nazardoua material• reg11tretion form or riak management and prevention program under Sections 26505 6633 or 26634 of the Presley-Tanner Huardoua Substance Account Act7 0 YES O NO Is the applicant or future building occupant required to obtain • permit from the air pollution control district or air quality management district? O YES O NO Is tha facility to be constructed within 1,000 fNt of the outer boundary of a achool aite 7 0 YES O 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 ANO THE AIR POLLUTION CONTROL DISTRICT. r.;-}&O.NSTRUCTION LEN0ING"AGENCY •" ·.s~JJ:~i'~,1i::-.,•-• .".':.:"'ff,f-; .. : ': ~:';·:;,~m-.c,~im;~ •. ·~i;\ ... . .i:. I hereby affirm that there is a construction lending agency for the performance of the work for which thia permit la iasued (Sec. 3097111 Civil Code). LENDER'S NAME ______________ _ LENDER'S ADDRESS _________________________ _ ft; APPLICANT CERTIFICATION I certify that I have reed 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 City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. APPLICANT'S SIGNATU DATE CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB970622 FOR 04/15/97 DESCRIPTION: INSTALL DRAIN&LINES-WASHER & ELECT FIXTURES UNIT# 128 TYPE: MISC STE: INSPECTOR AREA DC PLANCK# CB970622 OCC GRP CONSTR. TYPE NEW LOT: JOB ADDRESS: 2344 HOSP WY APPLICANT: ELKOR PROPERTIES CONTRACTOR: PHONE: 312 669-1200 PHONE: OWNER: REMARKS: RS/TRISHA SPECIAL INSTRUCT: TOTAL TIME: CD 29 39 LVL DESCRIPTION PL Final Plumbing EL Final Electrical PHONE: INSPECTOR I)~~---------- ACT COMMENTS 1-£µAc/ ***** INSPECTION HISTORY***** DATE 040497 040297 DESCRIPTION Underground/Under Floor Rough Electric ACT INSP AP DC AP DC COMMENTS