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Home My WebLink About2375 CAMINO VIDA ROBLE; BLDG 6; CB962311; PermitUf-it» • 12/05/96 11:35 BUILDING PERMI CAMINO VIDA ROBLE Permit Type: SIGN Parcel No: 213-050-27-00 Valuation: 1,197 Reference*: • Occupancy Group: ^T,«« crr^ir C-MTR! Description: LETTERS ON WALL OVER SIDE ENTR : AT&T APDl/Ownr : JIM'S SIGN SHOPAPPi/uwnr ^^ INDUSTRIAL WY STE D ; FALLBROOK CA 92028 Suite: T Permit No: CB962311 Project No: A9603299 Development No: 619 1356 12/05/96 0001 01 02C-PRMT 48-00 Construction Type: NEW Status: ISSUED Applied: 12/05/96 Apr/Issue: 12/05/96 Entered By: RMA 728-8761 *** Fees Required *** Fees: *8 Adjustments: Total Fees: Fee description Building Permit Plan Check * SIGN TOTAL ected & Credits *** .00 .00 48. 00 Ext fee Data 29.00 19.00 48.00 FINAL Af*PROVAL PATE CLEARAIiOE 2075 LasPalmas CITY OF CARLSBAD Dr., Carlsbad, CA 92009 (619) 438-1161 PERAfflT APPLICATION H^T/B City of Carlsbad Building Department vm^^KV 2075 Las Palnas Dr., Carlsbad, CA 92009 (619) 438-1161 Xjj£p^ 1. FfcKMTl TYFE <, For Residential Projects Only: From list 2 (see back) give Code of Structure-Type: Net Loss/Gain of Dwelling Units 2. PROJECT INFORMATION Auoress £* ^?~~7 £™~ ^""vxt_^ it i/*^ * 1 1 r*v\ ^VTP*^v^^^ ^^ ouite NO. Nearest Cross Street £^<L- C3^M||^JO E-fc^S L- LEGAL DESCRIPTION Lot No. Subdivision Name/Number PLAN CHECK NO. \! ^L~^* ] EST.VAL (( ^7 PLAN CK DEPOSIT . VALID. BY Uiir DATE \'\ \L, Hf '1 — ' r \T) 1 u.,.-i 11L/ FOR OFFICE USE ONLY AT>TUnit No. Phase No. CHECK BELOW IF SUBMITTED: D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED. 1!SE SQ.FT.BATHROOMS 3. UONTACT FEKXJN (.it ditterent from applicant) NAME (last name first) CITY STATE ADDRESS ZIP CODE DAY TELEPHONE 4. APPLICANT D CONTRACTOR NAME (last name first) CITY UAGENT frOR CON IRACTOR ADDRESS STATE ZIP CODE U OWNER U AGENT FOR OWNER DAY TELEPHONE 5. PROPERTY OWNER NAME (last name fir CITY Y\ZBO CODE ADDRESS •? \r>\ (=/^— I *^r \ V—•*—- DAY TELEPHONE 10 | 74) - 6. CONTRACTOR NAME (last name first) CITY -3"! M STATE IP CODE ADDRESS 4'2-<:J ^\ DAY TELEPHONE STATE LIC.LICENSE CLASS CITY BUSIN DESIGNER NAMt (last name first) CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. # 7. WORKERS' COMPLNhAllON Workers'Compensation Declaration: I hereby affirm that I have a certificate of consent to self-insure issued by the Director ot 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 S|^TE'C^tLlP. I M$. Wffi)POLICY NO. Y2.Q7*2?\^> '^EXPIRATION DATC ^. , tCertificate ot Exemption: I c^ertifythat in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become siibjfi*f(p the Workejsf-Qompensation Laws of California. SIGNATURE 8. OWNER-B ION/ Uwn>oer Declaration: 1 Hereby ariirm that 1 am exempt from the Contractors License Law tor the lollowmg 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). O 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 COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS 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? a YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1,1989 UNLESS THE APPLICANT ^JUNSTKUl'llUN UJJJ1J1NG AGENCY I hereby attirm that there is a construction lending agency tor the performance ot the work tor which this permit is issued (Sec 3097U) Civil Code). LENDER'S NAME LENDER'S ADDRESS 10. AWUCANT ChRIlHCAUUN I certify that Tnave read the application and state that the above intormation 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 SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. 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 abandonedlaj anytime after thejwertcjs commenced for a period of 180 days (Section 303(d) Uniform Building Code). APPLICANTS SIGNATURE WHITE: JPfle ,OW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB962311 FOR 12/11/96 INSPECTOR AREA DESCRIPTION: LETTERS ON WALL OVER SIDE ENTR PLANCK# CB962311 AT&T OCC GRP TYPE: SIGN CONSTR. TYPE NEW JOB ADDRESS: 2375 CAMINO VIDA ROBLE STE: LOT: APPLICANT: JIM'S SIGN SHOP PHONE: 619 728-8761 CONTRACTOR: PHONE: OWNER: PHONE: REMARKS: MW/SUZANNE/431-4685X409 SPECIAL INSTRUCT: INSPECTOR TOTAL TIME: —RELATED PERMITS-- CD LVL DESCRIPTION 38 EL Signs PERMIT! FAD93008 CB961826 TYPE FADD ITI STATUS ISSUED ISSUED ACT COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS City of Carlsbad Building Department WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. have and will maintain workers' compensation, as required by section 3700 f the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: INSURANCE COMPANY POLICY NO.EXPIRATION DATE: (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the • C. workers compensation laws of California. Signatur Warning: Failure to secure workers' compensation coverage is unlawful, and shall be subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, Interest and attorney's fees. March 3, 1995 2O75 Las Palmas Dr. - Carlsbad, CA 92OO9-1576 - (619) 438-1161 - FAX (619) 438-0894 COMPENSATION INSURANCE P.O. BOX 420807, SAN FRANCISCO. CA 94142-0807 PU INI D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE DECEMBER 5. 1996 ' POLICY NUMBER -1207293-96 CERTIFICATE EXPIRES: r CITY Of* CARLSBAD ATTN: BUILDING DEPARTMENT 2075 LAS PALMAS DR|VE CARLSBAD, CA 92009.'JOB; ALL OPERATIONS L This is to certify that we have issued a valid Workers' Compensation insurance policy In a form approved by the California Insurance Commissioner to the employer named below for the policy period Indicated, This policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer. We will also give you TEN days' advance notice should this policy be cancelled prior to Its normal expiration. This certificate of insurance Is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with respect to which, this-.certificate of Insurance may berlssued, or may pertain, trie insurance'afforded by the policies described herein is subject to all the.t^pjfar exclusion's an.d cbhdttlon6:Qf suchpqijcjes. '' ;•• •*':'. , AUTHORIZED REPRESENTATIVE".. ,'..•-!•' , : *: • " " PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COST: $1,000,000 PER OCCURRENCE. EMPLOYER r JIM'S SIGN SHOP . 420 D INDUSTRIAL WAY FALLBROOK CA 92Q29 NR L THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND SCIF 10262 (REV. 3-35}