HomeMy WebLinkAbout2350 HOSP WAY; 151-B; CB920343; Permitl'f/1//'32. Jl~:2.h
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CARLSBAD,CA ~tllOtl
Fees Requ:i.red *** ----------------------
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PROVAL
10. 00 f'LlME 1L
3U, (
i ·3p, ______ DATE r-#
vL~RANCE ____ _
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 920()<) (619) 438-1161
PERMIT APPLICATION ~ ~
PLAN CHECK NO.
City of Carlsbad Building Departaent
2075 Las Pal•• Dr., Carlsbad, CA 92009 (619) 438-1161
PI.AN CK DEPOSIT, _______ _
I
EST. VAL
VALID. BY, __________ _
I. P£ilMI I hPR DATE
A -0 Commercial U New Building U Tenant Improvement
B -□ Industrial C New Building □ Tenant Improvement
C -□ Residential □ Apartment □ Condo □ Single Family Dwelling □ Addition/ A1teration
□ Duplex □ Demolition C Relocation □ Mobile Home □ Electrical □ Plumbing
□ Mechanical □ Pool □ Spa □ Retaining Wall □ Solar □ Other
2. PRWECI' JNIDRMATION FOR OFFICE USE ONLY
Address 2350 Hosp Way Bu1ldmg or Suue No.151 _8
Nearest Cross Street El camino Real
LEGAL DESCRIF'I loN Lot No. Subd1vis1on Name/Number Unit No. Phase No.
CHECK BEWW tF S0BMI 11 ED:
□ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope
ASSESSOR'S PABCBL EXISTING USE PBOPOSED USE
DESCRJPTION OF WORK
Plumbing and Electrical for Laundry and Kitchens.
SQ. IT. # OF STORIES
3. WNl'.AC'I PFJlSON (I[ ditterent from app\lcariO NAME Richard Whitney ADDRESS 5928 Pascal court, Suite 200
C I b d CA 92008 (619)431-2800 Cl1Y ar s a STATE ZIP CODE DAY TELEPHONE
4. APPuCANi ULUNJHALJUK UXGENI FORCONIRACIOR UUWN.t::K UAUtNJ 1'UKUVVNLK
NAME New Design Remodeling & Con4DDRESS 5928 Pascal Court, Suite 200
CI1Y Carlsbad STATE CA ZIP CODE 92008 DAYTELEPHONE (619)431-2800
NAME Hosp Way Limited ADDRESS1990 Westwood Blvd., Suite 300
CI1Y ~ J\ngeles STATE
6. CDNJ 17t CA ZIP CODE90025 DAYTELEPHONE (310) 474-1720
NAME New Design Remodeling & con1DDRESS 5928 Pascal Court, Suite 200
CI1Y carlsbad STATE CA ZIP CODE 92008 DAYTELEPHONE (619)431-2800
CI1Y BUSINESS UC. # 437954 STATE IJC. #545075 IJCENSE CIASS B
CI1Y STATE ZIP CODE DAY TELEPHONE STATE IJC. #
7. WOkRRllS WMPRNSXIIUN
Workers' COmpensatton Declarauon: 1 hereby afhrm that I have a cert1hcate of consent to self -msure issued by the VI rector of industnal
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 COMPANYTruck Insurance Exchangeuey Ncfll20077301 EXPIRATION DATE 4-20-92
Ceriibcate of Exempuon: [ cerufy that m the performance of the work for which this permit ts 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. UWNEK-BUliDER DHCLARXhuN
Owner-Builder Oeclarauon: [ hereby affmn that I am exempt from the Contracto?s Llcense Law for the following reason:
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.).
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 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 pennit 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 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 pennit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500]).
SIGNATIJRJ! DATE
GOMPLE'IE nns SECIION FOR NON-RESIDEN i lAL BUILbiNG PERMll'S ONLY:
Is the applicant or future building occupant required co 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 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 FINAi.CERTIFiCATE OF oa:uPANCY MAY Nor Bl! ISSUED AITER JULY 1, 1989 UNIJlSS THE APPUCANT
HAS MET OR IS MEETING THE REQUIREMENTS OF nm OFFICI! OF EMERGENCY SERVICI!S AND THE AIR POLLUTION CDNTROL DISllUCT.
9. WNSJRUCliON LP..NUMG AGENCY
I hereby afhnn that there 1s a construction lending agency for the performance of the work for wfuch this penrut ts issued (Sec 309)(1) CiVII C&ie).
LENDER'S NAME LENDER'S ADDRESS
10. XPPLICAN'I cmttmt!AliuN
I certify that I have read lhe apphcat1on and state that the above mformauon 1s correct. I agree to comply with ail 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 AISO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CTIY OF CARISIIAD AGAINST ALL UABIU111!S, JUDGMl!Nr.i, CXlSTS
AND l!XPl!NSES WIIlCH MAY IN ANY WAY AO'.JUJE AGAINST SAID CTlY IN OONSEQIIENCI! OF TIIE GRANTING OF TIIlS PEIIMIT.
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 the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code).
APPIJCANTS SIGNATURE DATE: _____ _
WHITE: File YEIJ.OW: Applicant PINK: Fmance
•
PLANCK # _____ _ PERMIT #-,-------~ / _
JOB ADDRESS ___ ....::d).::;..'3,c..;;.S?)-"""---"'~--"-'!f--'--"'4<----"-/.-=,S-.~/-------
TIME ARRIVE: _____ TIME LEAVE: _____ _
CD LVL DESCRIPTION
PERMITS
6/15/89
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ACT COMMENTS
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