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Home My WebLink About2359 CARLSBAD BLVD; PUMP STA; CB911431; PermitBUILDING PERMIT 10/24/91 13:58 Page 1 of 1 Job Address: 2359 CARLSBAD BL Str: Permit Type: ELECTRICAL Parcel No: 155-200-03-00 Valuation: . 0 Construction Type: NEW - Occupancy Group: Class Code: Description: SEWAGE PUMP STATION CITY JOB : NO FEE Permit No: CB911431 Project No: A9000564 Development No: Fl: Ste: Status: ISSUED Applied: 10/24/91 Apr/Issue: 10/24/91 Validated By: JPY Appl/Ownr ! KEN QUON/CITY OF CARLSBAD 2075 LAS PALMAS DR CARLSBAD,CA 92009 *** Fees Required *** 438-1161 Fees : Adjustments: Total Fees: Fee description Other cted & Credits *** . 00 .00 .00 Ext fee Data NO FEE P. J- ^ DATE CITY OF CARLSBAD 2075 Las Pabnas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Palms Dr., Carlsbad, CA 92009 (619) 438-1161 I. PERMIT TYPfc A - U Commercial U New Building LJ Tenant Improvement B - D Industrial O New Building D Tenant Improvement C - D Residential D Apartment DCondo O Single Family Dwelling D Addition/Alteration D Duplex D Demolition D Relocation D Mobile Home ^Electrical D Plumbing D Mechanical D Pool D Spa D Retaining Wall D Solar TO 2. PROJECT INFOF UTON ~ " Building or Suite S o**X- f)/v4\/ Subdivision Name/Number PLAN CHECK NO. EST.VAL PLAN CK DEPOSIT^ VALID. BY DATE /£> "^. OFFICE USE ONLY Address Nearest Cross Street LEGAL DESCRIPTION Lot No.Unit NoT Phase No. CHLCK BtLUW lr SUBM11 D 2 Energy Gales D 2 Structural Calcs D 2 Soils Report D 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK SQ.FT.# OF STORIES UUM1AL.1 NAME CITY \\\ a i ire rent irom applicant) STATE ADDRESS ZIP CODE DAY TELEPHONE 4. APPLICANT U UJN I KAC IXJK &rtGENI I-OR CONTRAC1UK ADDRESS UUWNhH U AGLN I FOR OWNER CITY STATE ZIPCODE DAY TELEPHONE%/ b. I'KUFKH'l'Y UWNKK NAME f- ( CITY ' C/ 6. CUN/'kAUIuU NAME />, ,-«£> /y)& fl >^*, i L0A^, ADDRESS STATE ZIP CODE DAY TELEPHONE <J^frJ ^ADDRESS P.&. &>*- *°V( CITY STATE STATE UC. # ZIPCODE /^-^fT DAY TELEPHONE i LICENSE CLASS /f CITY BUSINESS LIC. # DESIGNER NAMh CITY STATE ZIP CODE DAY TELEPHONE STATE UC. # 7. WORKEKS^CUMPLNSATION WorKers Compensation Declaration: I hereby affirm that I have a certificate ot consent to self-insure issued by the Director or Industrial 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 POLICY NO 7*f TO'IRATION DATE Certificate of Exemption: so as to^oecortie SUbJeTI I ertity that m the performance ot the work lor which this permit is issued, I shall not employ any person in any manner Will lu 11' rinmrrmntinn Laws of California. SIGNATURE 8. OWNEK-BUIUJtK Ownp*DUilder Declaration: I hereby affirm that I am exempt irom the Contractors License 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 offeretrfer^sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improvestheeeon, and who does such work himseljj3i-tl«ouj$li lilSi uwiTemployees, provided that such improvements are not intended or offered for saleT*tf;-4iQwever, the buildingjiP+mpfoveiTient is sold within one year of completion, the owner-builder will have the burden of proving that he did notbuikl orJmpro've for the purpose of sale.)- D I, as owner of the property,a»rexcRlsi«ely contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor>tlcense Law doesnet^pply to an owner of property who builds or improves thereon, and contracts for such projects with contractorisHTcensed pursuant to the Contfactor's License Law). D I am exg»p1under Section Business-and Professions Code for this reason: :. 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 COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY: Is the ap^jUcant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention prografRJinder Sections 25505, 25533 or 25534 of the Presley-TannerHazardous Substance Account Act? D YE3^----^^^ D NO ^— -~"~ Is the applicant or future building~^cTiipaoLxe5^redto^obtam~a^ermit from the air pollution control district or air quality management district?D YES D NO^^*-*^^__^^^ Is the facility to be constructed witijin^OOOfeet of the outer^oiltidefjtofaschool site? D YES_^-~-~""^ D NO -— IF AN>J2F-Hffi*NSW£RS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS KtET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 9. CONSmUQilON LENDING AGENCY i hereby attirm that therels tion lending agency lor the performance ot the work lor which this permit is issued (.sec Joy/uJ code). APPLICANT CERTIFICATION I certify that I have read the application and state that the above information is correct, 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 AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SATO OTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSIIA: 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 &nCt) 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 tlje work js commenced for a period of 180 days (Section 303(d) Uniform Building Code). APPLICANTS SIGNATURE WHITE: File YELLOW: Applicant PINK: Finance DATE UNSCHEDULED fNffP^CTJQN INSPECTOR ,PERMIT * JOB ADDRESS PLANCK #- TIME ARRIVE:TIME LEAVE: CD LVL DESCRIPTION "7^—79 T& jOejt-t^t, "f^ rvyVs J ACT COMMENTS