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Home My WebLink About2478 IMPALA DR; ; CB920890; PermitB U I L D I N G P E R M I T Permit No: CB920890 ProJect No: A92011J6 Deve.:!.opment No: 08/28/92 14:35 Page 1 of 1 ,T0b Address: 24/6 IMPALA DR Suite: ~ermit Type: SIGN Parcel No: ~ot#: Vuluation: 0 ConLtruction Type: NEW Jccupancy Group: Reference#: ~escription: LA POSADA DE GUADALUPE Appl/Ownr : PALOMAR INVESTMENT ASSOC PO BX 577 ENCINITAS, CA *** Fees Required Fees: Adjustments: Total Fees: Status: ISS,..IED Applied: Apr/Issue: 08/28/92 Validated By: CD FINAL APPROVAL .00 .00 ,00 INSP.p DATE~ 1, ~ Z). 9~ CLEARANCE _____ , CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92()()() (619) 438-1161 PERMIT APPLICATION A V PLAN CHECK NO. City of Carlsbad Building Depart91eflt 207S Las Pal.as Dr •• Carlsbad, CA 92009 (619) 438·1161 EST. VAL ------------~ PLAN CK DEPOSIT ________ _ VAUD.BY __________ ~ 1. P£ltMI I IYPE DATE ____________ _ A -LI Commercial O New Bu1ldmg LI Tenant Improvement B -0 Industrial LI New Building O Tenant Improvement C -LI Residential O Apartment O Condo D Single Family Dwelling D Addition/ Alteration D Duplex D Demolition D Relocation D Mobile Home D Electrical O Plumbing D Mechanical O Pool O Spa O Retaining Wall D Solar D Other ____ _ FOR OFFICE USE ONLY mt o. CHECK BEWW IF s0BMl1 I£0: 0 2 Energy Cales D 2 Structural Cales D 2 Soils Report O I Addressed Envelope EXISJJNG USE PROPOSED USE ASSESSOR'S PAHC~ -::: DESCRIPTION OF W SQ. FT. ~ ~ ;2 7 (,, # OF STORIES e,}\..Q. 3. WN IACI PERSON (if dulerent from applicant) NAME ADDRESS CI1Y STATE ZIP CODE DAY TELEPHONE 4. APPUCAN I NAME UcdNIRACluk DAGEN I Fok cON IRAC!uk ADDRESS o OWN Ek o ACEN I Fok OWN Ek STATE ZIP CODE DAY TELEPHONE vJf;/ ~ /mer,d-AADDRESS /J t /1{)X Tr 7- CllY ~ Gft, ru.i c,f r;())/fATE crA-z1p CODE 0Q)..v DAY TELEPHONE 7 tµ.1-o ficf'O 6. CDN"l t NAME ADDRESS ZIP CODE CilY STATE DAY TELEPHONE STATE UC.# LICENSE ClASS CllY BUSINESS UC. # DESIGNER NAME ADDRESS CllY STATE ZIP CODE DAY TELEPHONE STATE UC.# 1. WOitkERS' OOMPENSXnON Workers' Compensation Declaration: I hereby affirm that I have a certificate of consent to sell-msure issued by the Director 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 cerubcate of Exemption: I cernfy that m lhe performance of lhe work for which this permit 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 A. bWNER-B0llDER DFfiA1tA1IDN Owner-Builder Declaration: I hereby alhnn that I am exempt from the Contractor's Llcense I.aw 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.). 0 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). D 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 ruls 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? DYES 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? DYES ONO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? DYES D NO IF ANYOFll-lEANSWERS ARE YF..5, A FINALCERTIFICATEOFocx:tJPANCYMAYNaf BE~UEDAFTER.JULY 1, 1989 ~ 11-IEAPPIJCANT HAS MET OR IS MEETING 11-IE REQUillEMENTS OF nm OFFICE OF EMERGENCY SERVICES AND 11-IE AIR POll.UllON CDNTROL DISl1UCT. 9. OONS'I kOCnON LENOCNC ACENCV I hereby alllrm that there 1s a construction lending agency lor the performance of the work for which this permit 1s issued (Sec 3097(1) Civil Code). LENDER'S NAME LENDER'S ADDRESS to. APPUcAN'I" cEltl1FlcA'l1oR I cemfy that I have read the apphcauon and state that the above mlormauon 1s 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 purposes. I AISO AGREE TO SAVE INDEMNIFY AND KEEP 1-1.ARMLFSS TIIE CTIY OF CARLSBAD AGAINSf AU. UABIIIIlES, JUDGMENTS, CDSTS AND EXPENSES WIDCH MAY IN ANY WAY Aa:RUE AGAINSf SAID CTIY IN CDNSF.QUENCE OF nm GRANTING OF nos 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 abandoned at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code). DATE:,A,r4 72. PINK: Finance