HomeMy WebLinkAbout2380 HOSP WAY; 238; CB920521; PermitPERMIT APPLICATION PLAN CHECK NO.
City of Carlsbad Building Department
2075 Las Pal-Dr., Carlsbad, CA 92009 (619) 438-1161
I. PEkMI I hPE
A -0 COmmerctal D New Bu1ldmg LI I enant Improvement
B -D Industrial O New Building D Tenant Improvement
C -0 Residential D Apartment D Condo □ Single Family Dwelling □ Addition/ A1teration
□ Duplex □ Demolition
□ Mechanical □ Pool
LI Relocation □ Mobile Home □ Electrical □ Plumbing
□ Spa □ Retaining Wall □ Solar O Other
2. PR~ INFORMATION FOR OFFICE USE ONLY
Bu1@mg or Suite No.
a:?. io
LEGAL DESCklPI ION lot No. Sufxl.1V1s1on Name]Number Omt No. Phase No.
CHECK BEWW IF SOBMI I I ill:
□ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope
DE PTION OF WORK I I 11'\rt....U ,·I'\, J.,r~ et" o""-" <--t\ °"""'
SQ. FT. # OF STORIES
3. WN IACI PFltSON (II dlHerent from appJlcant)
NAME ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
4. APPIJCAN I
NAME
UWNiRACIOR DAGEN I FORWNIRACIOR DOWNER □AGENI FOR OWNER
ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
s. ::UOP£RB ~.;"n,,.~
CITY cc.,...,(~ b~
(Zu(2J
STATE 6,,----
ADDRESS ?. 'I g O H!,._s f> l,v "'""1 ~ ;l. ~ °t'
ZIP CODE ~ ~ DAY TELEPHONE 41' U -6 2. ( ?
NAME
CITY STATE
STATE UC.#
ADDRESS
ZIP CODE
LICENSE CLASS
DAY TELEPHONE
CITY BUSINESS UC. #
CITY STATE ZIP CODE DAY TELEPHONE STATE UC.#
7. WOitkERS' WMPkNSXliON
Workers' Compensation Oeclarat1on: I hereby affirm that I have a cert.1hcate of consent to self-insure issued by the D1rector 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).
INSURANCE COMPANY POLICY NO. EXPIRATION DATE
Ceruhcate of Exemption: I certify that m the performance of the work for which this penmf 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. oWNffi-BODDmt Dfi!LARAIION
Owner-Bmlder beclarat1on: I hereby afhnn that I am exempt from the Contracto?s Lcense Law for the following 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 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 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 permit 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 S£CIION FOR NON-RESIDEN IIAL B0IIDING PERMI I'S 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?
□YES □NO
Is the applicant or future building occupant required to obtain a permit from the air ix>llution control district or air quality management district?
CYES □NO
ls the facility to be constructed within 1,000 feet of the outer boundary of a school site?
□YES □NO
IF ANY OF TIIBANSWERS ARI! YES, A FINALCERTIFICATEOFOCDJPANCY MAY NOT Ill! ISSUl!D AFTER JULY I, 1989IJNIJ!SS TIIBAPPI.ICANT
HAS M1IT OR IS MEETING Tiffi REQUIREMENTS OF TIIE OFFICE OF EMERGENCY SERVICES AND Tiffi AIR POillITION CDNTROL DISfRICT.
9. WNSIROCIION IENDING AGF.NCY
I hereby afhrm that there 1s a construcnon lendmg agency for the performance of the work for which this permit ts issued (Sec 3097(1) C1vU Code).
LENDER'S NAME LENDER'S ADDRESS
10. AWLicANI CEklfiJICAIIUN
I certify that I have read the apphcatton and state that the above mformauon ts correct. I agree to comply wnh all 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 ID SAVE INDEMNIFY AND KEEP HARMLllSS Tiffi CTIY OF CARLSBAD AGAINST AU. IJABIIJTIF.S, JUDGMENTS, CXJSTS
AND EXPENSES WIIlCH MAY IN ANY WAY ACDIUE AGAINST SAID CITY IN CDNSEQIIENCE OF Tiffi GRANTING OF TIDS 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 axle 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
su 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).
DATE: _____ _
YELLOW: Applicant PINK: Finance
City of Carlsbad
■ ~1 111& 11,i•I •JA•RI 4 I, ,14 ,; I
DATE: 11/25/92
TO: REIFEL, DEBORAH
2380 HOSP WY #238
CARLSBAD CA 92008
RE: BUILDING PERMIT EXPIRATION
PERMIT NUMBER: CB920521
ISSUE DATE: 05/27/92
LAST INSPECTION:
PLEASE CALL FOR AN INSPECTION
IF WORK IS COMPLETE
ADDRESS: 2380 HOSP WY #238
Our records indicate that your building permit will expire by limitation
of time on 12/09/92.
The provisions of UBC, Section 303(d) state: "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 one calendar year from the date of such permit,
or if the building or work authorized by such permit is stopped at any time
after the work is commenced for a period of six consecutive calendar months or
if the building or work authorized by such permit exceeds three calendar years
from the issuance date of permit. Work shali be presumed to have commenced if
the permittee has obtained a required inspection approval of work authorized
by the permit by the building official within one year of the date of permit
issuance. Work shall be presumed to be stopped if the permittee has not ob-
tained a required inspection approval of work by the building official within
each six month period upon the initial commencement of work authorized by such
permit.
Before such work can be recommenced, a. new permit, or a renewal permit as
specified below, shall be obtained.
1. PERMITS WHERE WORK HAS NOT COMMENCED.
not commenced in the first calendar year from the
permit may be obtained provided:
For permits where work has
date of issuance, a renewal
(A) No changes have been mada or will be made in the original plans and
specifications for such work.
(B) That the expiration has not exceeded three years from the original
issuance date.
(C) That the same edition of the model codes is in effect as used in
the initial plan check.
(D) That a fee equal to one-half the amount required for a new permit
be paid.
The renewal permit shall expire three calendar years from the date of initial
permit issuance.
2075 Las Palmas Drive • Carlsbad, California 92009-1576 • (619) 438-1161
11/23/92 INSPECTION HISTORY LISTING
FOR PERMIT# CB920521
DATE INSPECTION TYPE INSP ACT COMMENTS
06/12/92 Rough/Topout RI RI MH/RAY/434-7723
06/12/92 Rough/Topout PK AP
06/12/92 Rough Electric RI RI MH/RAY/434-7723
06/12/92 Rough Electric PK AP
06/10/92 Final Plumbing RI RI MH/DEBRA/431-7723
06/10/92 Final Electrical RI RI MH/DEBRA/431-7723
06/09/92 Final Plumbing RI RI MH/DEBRA/431-7723
06/09/92 Final Plumbing PK CA
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