HomeMy WebLinkAbout2508 EL CAMINO REAL; F | MULTI-PERMIT FILE; CB004298; PermitCity·of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
11/17/2000 Sign Permit Permit No:CB004298
· Building inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
Project Title:
-0i
25W EL CAMINO REAL CBAD St: F
SIG~
Lot#:
$2,100.00 Construction Type:
COFFEE BEAN & TEA
(2) WALL MOUNTED SIGNS W/ELEC
0
NEW
Applicant: Owner:
SAN PEDRO ELECTRIC
701 LAKME AVENUE
WILMINGTON CA 90744
310-549-4661
Total Fees: $106.34
Building Permit
Add'I Building Permit Fee
Plan Check
Add'I .Plan Check Fee
Electrical Fee
Renewal Fee
Add'I Renewal Fee
Other Building Fee
TOTAL PERMIT FEES
.. Total PaymentsTo Date:
i!
Status:
Applied:
Entered By:
Plan Approved:
ISSUED
11/17/2000
JM
11/17/2000
11/17/2000
$0.00
Issued:
Inspect Area:
4688 ii/17/00 0002 01 02
Balance Due:
$52.33
$0.00
$34.01
$0.00
$0.00
$0.00
$0.00
$20.00
$106.34
C:GFu 106 ~3·4
$106.34
FINAL APPROVAL
Inspector: /IL pate: 41/17)
J l Clearance:
NOTICE:. Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition.
You are hereby FURTHER·NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy
changes, nor planning, zoning, grading or other similar application processing-or service fees in connection with this project. NOR DOES IT APPLY to any
fees/exactions.of which you have oreviously been aiven a NOTICE similar to this, or as to which the statute of limitations has oreviouslv otherwise exoired.
eERMl1 APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
.. -~!-~
.H -,<~ :,~ ',,• :,
FOR OFFICE USE ONLY
PLAN CHECK NO. c./31.rzc;t3
EST.VAL. hloo
Plan Ck. Dep~-------,---
Validated By_·_J_...__ __ -,-rr-~~--,--:,
Date _________ .:;....,~;......,"-r--c:,''i!
/t39:£,
Address (include Bldg/Suite #) Business Name (at this address)
Legal Description Lot No. · Subdivision Name/Number·
Assessor's Parcel # o /I -e l-c.114 ti /
#of Stories
Name Address Ci y
T§?~iA~~,1~~Nr:._,>~Qnfrailt<1r,. · .. ·o\~ge'nttciFcon'iJa~or. ·::o·qwiier;j"1J: As~nt·toc ow~er
Name Address City
}}-drjo~~tut::~},:~~~~'i . ' !j i·.' c~ .. , •;-,'
C,
Nam Address
'.,s; '.<i;:'c:o.NfjtAqtjjR;.~:c9ij'p,ANY0NAME.:::Z:'.?·-,::.,•, ,·.: .:.: ...
Unit No. Phase No. Total (I of units
Proposed Use
# of Bedrooms
State/Zip
State/Zip
State/Zip
# of Ba.throoms
Telephone # Fax #
Telephone#
:· .. ·
~rotY-/~ ~ Sol(
Telephone#
n • n •-:-., • -::-• "• •~n• •, s • : ... , r . , --::, "" , .
(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, commending 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 applic nt to a civil pe11alty·of not more th ~m:IF liars [$5001) . .S. d M 7o. t-'4J::'YV1e (,4v--e t,J; .J.e, e.(J.. w,f ?, 66/
Name Address City · Stat ip
State Li<:ense # 3 -5"' for '7 License Class c '-Is
Designer Name Address . City
State License # _________ _
;6: ·;:WO,RKJ;RS.',CON!PE~SATION . :::\t;:~::~:. , .. -~ ::·, ~'.' '":';' ::-· .:: ... _··. ;-·: .. · . : ',.,
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
0 I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
,.,g--1 have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My worker's compensation insurance carrier and po icy number are:
lnsurance·-Company '(?y,,1c!) 1-. _ PolicyNo. yyr,/c;x:::>8co[s6F5qfi Expiration Date 1-/-/-c>I
{THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$'100] OR LESS)
0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which tt,is permit is issued, I shall not employ any·person in any manner so as
to become·subject to the Workers' Compensation Laws of California.
WARNING: Failure to secure, workers' compensation coverage is unlawful, and .shall subject an employer to criminal penalties and civil fines up to one hundred
thousand _doll...,.-Hrl'l'!:!),OOO) • addition to the cost of compensation, damages.as provided for in Section 3706 of the Labor ode, int rest and attorney's fees.
SIGNATURE_---t.b.,:z,z:...i~--i~-=-=-----------------''----DATE _-+-+--1-+--'-'c;__;;=-_...,_-';j'.', .. owijti'l,su .. ., _:~-'.-.. ,.: " -.. ·:_=-:· -~ .. -=.: ..
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
0 I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intend,ed 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).
0 I am exempt under Section ______ Business ·and Professions Code for this reason:
1. I personally plan to pr_ovide the major labor and materials for construction. of the proposed property .improvement. 0 YES ONO
2. I (have / have not) signed an application for a building permit for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number):
4. I plan ·to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone
number/ contractors license number): __ ~-------------------------------------------
5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number·/ type of work): ________________________________________________________ _
DATE _________ _
·-......... ·:, -' -:_;: ~-'-,' ;' .. ·.
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? 0 YES O NO
Is the applicant or future building occupant required to obtain a permit'from the air pollution control district or air quality management district? 0 YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? o· YES O NO
IF ANY OF THE ANSWERS ARE YES, A Fl~AL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE
REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
;s-:;·0
·;'
0~:0:N~'fltlicf1c5JfLEiji:5tNif ~~~Nev·;::::··-:;·,~····:,: -~ -:::-__ ::. _: ;.~ . : _:',':-_:, .; .. :: .··:=.-0••• ". ,
I hereby affirm that there is a-construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code).
LENDER'S NAME __ ~-----------
!J3/ :::~e.e!!J.~.(\~T-CERT!,FICATION·., .. : : ,:·;
LENDER'S ADDRESS_· --'------------------------:v 'f'"'f~,M¥ ,•-,•-: ,,/._ ~
., .-,, ::.:., ·-:'
i certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all
City ordinances and State laws relating ~o building construction. I hereby authorize representatives of the Citt of Carlsbad to enter upon the above mentioned
property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP -HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES,
JUDGMENTS, COSTS 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 n commenced within 180 days•from the date of such permit or if the building or work authorized by uch perm· is suspended or abandoned
at any time after t~ m ed a period of 180 days (Section 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATU ~;...-rdcq.-f.~====--'------------_:_-'----
WHITE: File YELLOW: Applicant PINK: Finance
City of Carlsbad Bldg Inspection Request
For: 04/16/2001
Permit# ·CB004298
Title: COFFEE BEAN & TEA
Description: (2) WALL MOUNTED SIGNS W/ELEC
Type:SIGN Sub Type:
Job Address: 2510 EL CAMINO REAL
Suite: F Lot 0
Location:
APPLICANT SAN PE;bRO ELECTRIC
Inspector Assignment: AR ---
Phone: 8005494661
Inspector: L
owner: At:1
Reniarkli. AM PL.EASE-• t p.Q..)~ X\'{f tJoorJ
Total Time: _____ Requested By: .ROSA
CD Description
38 Signs
Date Description
' 04/13/2001 38 Signs
Entered By: CHRISTINE
Act Comments
Associated PcRs !-----~~--~--~------
Inspection History
Act lnsp Comments
CA AR
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
03-30-2012 Patio/Deck Perm it Permit No: CB004530
Building Inspection Request Line (760) 602-2725
Job Address: 2508 EL CAMINO REAL CBAD St: F
Permit Type: PATIO .
Parcel-No: Lot#: 0
Valuation: $1,305.00 Construction type: NEW
Re~erence #:
Project Title: GOFFE BEAN & TEA LEAF-180 SF
OUTSIDE. DINING TRELLIS
Applicant:
MAUREEN BURKETT
4635 CASS ST
SAN DIEGO CA 92109
858 581-2812
Building Permit
Add'I Building Permit Fee
Plan Check
Add'I Plan Check Fee
Strong Motion Fee
Gre~n Bldg Standards (SB1473) Fee
Renewal Fee
Add'I Renewal Fee
Other Building Fee
Additional Fees
TOTAL PERMIT FEES
Owner:
Total Fees: $53.92 Total Payments To Date:
Inspector:
FINAL APPROVAL
Date: --------
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
Plan Checl<#:
ABANDOND
12/01/2000
RMA
$32.07
$0.00
$20.85
$0.00
$1.00
??
$0.00
$0.00
$0.00
$0.00
$53.92
$20.82 Balance Due:
Clearance: ------
$33.10
NOTICE: Please take NOTICE that app~oval of your project includes the "Imposition" offees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/e_xactions." You have 90-days from the date this permit was issued.to.protest !mposition of these fees/exactions, If you protest them, you must
fol)ow the protest proce9ures set forth in Government Code Section·66020(a), and file the protest and any other required information with the City Manager for
processing in accordance.with Cartsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED thatyour right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes, nor planning, .zoning, grading or otl]er similar application processing or service fees in connection.with this project. NOR DOES IT APPLY to any
fe /exa i n of whi h h v r · I I imil r hi r whi h h e f:limi ti n h r vi usl oth rwise ex ired.
\
FOR OFFICE USE ONLY ' -~ ' PERMIT APPLICATION PLAN CHECK NO.-l-'.::,~"-=--f:-_ JD
CITY OP eARt..SBAP BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
EST, VAL. -+--:::J.....,.=r----~-::,.,, r-f;:.
Legal Description Lot No. Subdivision.Name/Number Unit No. Phase No. Total # of units
Assessor's Parcel # Existing Use Proposed Use
!61:.~Jj~11fA'1;.~~l6~.PD~~~fil'!lm~~IB.±!14l~~~et~~ltl~ID~g~~~~4~~~l.~~JL~t~~~~~
(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, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt ~herefrom, 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)).
Name Address City State/Zip Telephone#
State License # ________ _ License Class ________ _ City Business License # _______ _
Designer Name
State License #
Address City
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
State/Zip Telephone
0 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.
0 I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance ·of the work for which this permit is
Issued. My worker's compensation insurance carrier and policy number are:
Insurance Company ________________ ~--Policy No.____________ Expiration Date _______ _
(THIS Sl;CTiON NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS)
0 CERTIFICATE OF EXEMPTION: 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 Workers' Compensation Laws of California.
WARNING: Failure to secure workers'. compensation coverage la unlawful, and shall aubject an emplonr to criminal penalties 1md civil fines up to one hundred
thousand dollars ($100,000), In addition to the coat of compensation, damages aa provided for·fn Section 3706 of the Labor code, Interest and attorn!ly's fees.
SIGNATURE ______ ~--------------------DATE ________ _
,ni.QW'.t'ttRIJ/llt~1miit~'il"trFjJ;~:1:::~mI~I::,1'tfi::3~Z1I:ru~~J;,'k"..1&fr~i,1~~i1ji~~~11t~i~tti:1.fai!ttr¾'lt~1~?~~~~
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
0 I, as owner of the property or my employees with wages as their sole compensation, will do the work arid 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 qr 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).
0 I am exempt under Section ______ Business and Professions Code for this reason:
1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO
2. I (have / have not) signed an application for a building permit for the proposed work.
3. I have contracted _with the following person (firm) to provide the proposed construction (include name_/ address / phone number / contractors license number):
4. I plan tq provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone number/ contractors license number):, ___________________________________________ _
5. I will provide some of the work, but I have contracted (hired) the following persons-to provide the work indicated (include name / address / phone number / type
of workl: _______________________ '--------------------------------
PROPERTY OWNER SIGNATURE_____________________ DATE ________ _
1:~.e--~1~~tf!'Bi~':tm{R[J1:"~..-.m~H-~~~trs~1g~r;~ti'l,Jt'tl:&it~1f~1tt¥i!'li~W
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? CJ 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? 0 YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O NO
IFANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE
REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
11Wi~[~~ire1,,JSJR1mrt§~lr~&;t.,~1;1~«I.r~"BMtm£~:1~a1~J,F.~1~.~1Jft~~tt~;:i.r~%Jlt~ft~i::t1:.~~{i'.:lr;rwr1~1-~:1;\t~-
1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(1). Civil Code).
LENDER'S NAME_____________ LENDER'SADDRESS ____________________ -'-----
~~~lPD6tl;'f~a,'.~jf,(-~~(rm;\~~~~"'ft;f~;;"E~ff-:fm{~~~1~~~-~~~~jgf&~'Rc~~~~S~~~~
I certify that I have read the application .and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all
City ordinances and State ·1aws relating to building construction. I hereby authorize representatives of the Citt of ,;::arlsbad to enter upon the above mentioned
property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY QF CARLSBAD AGAINST ALL LIABILITIES,
JUDGMENTS, COSTS 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 be.come null and void if the building or work
authorized by such permit is not commenced within 180 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 thEl work is commenc d I a period of 1 , day action 106.4.4 Uniform Building Code). ~~ A ·
APPLICANT'S SIGNA'TURE1/-~~¥i",4Al!CCIL.tC_~~-.C.""'4~~L---------DATE -4-l"=l.....,_+~--""''""=--------
PINK: Finance
"ii • ,f
10/01/2001
MAUREEN BURKETT
4635 CASS ST
SAN DIEGO CA92109
Re:
Application Date: 12/01/2000
Plan Check #: CB004530
Address: 2508 EL CAMINO REAL #F
Expiration bate: 12/01/2001
Permit Type: PATIO
Description: GOFFE BEAN & TEA LEAF-180 SF
OUTSIDE DINING TRELLIS
You applied to have your plans checked on the date noted above. To date, the related building
permit has not been obtained. The original plan review application will expire as no building permit
has been issued.
Plans submitted and not retrieved from the building department prior to the plan check expiration.
date noted above will be destroyed.
The provisions of sections 304 (d) of the Uniform Building Code. state:
"Section 304 9d) Expiration of Plan Review
Applications for which no permit is issued within one year following the date of
application shall expire by limitation, and plans and other data submitted for review
may thereafter be returned to the applicant or destroyed by the Building Official.
In order to renew action on an application after expiration, the applicant shall
resubmit plans and pay a new plan review .fee."
In order to provide better service, please indicate your handling choice for the plans originally
submitted and return this letter to the Building Department.
__ Project Abpndoned - I will pick up plans within 10 days
·' __ Project Abandoned -Plans may .be destroyed.
If you have any questions, please contact the Building Department at (760) 602-2718.
Raenette Abbey
Building Department
r' "·' City of Carlsbad
osto21too1"'
1635 Faraday Av Carlsbad, CA 92008
Sign Permit Permit No:CB010876
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
2508 EL CAMINO REAL CBAD St: F
SIGN
Parcel No: Lot#: 0
Valuation: $1,800.00 Construction Type: NEW
Reference #:
Project Title: COFFEE BEAN-WALL MOUNTED-ILLUM
Applicant:
SAN PEDRO SIGN CO
701 LAKMEAV
WILLMINGTON CA 90744
310 549-4661
Owner:
Status: ISSUED
Applied: 03/02/2001
Entered By: RMA
Plan Approved: 03/02/2001
inspe~f~f o£l({H.?6i0ioo2 01 02
CGF• 77=37
Total Fees: $77:37 Total PaymentsTo Date: $0.00 Balance Due: $77.37
Building Permit
Add'I Building Permit Fe.e
Plan Check
Add'I Plan Check Fee
Electrical Fee
Renewal Fee
Add'I Renewal Fee
Other Building Fee
TOTAL PERMIT FEES
Inspector: ....... e.. .... 'tl::-....... .---__
"lu)
FINAL APPROVAL
Date: I..\ IQ\ Clearance:
$34.77
$0;00
$22.60
$0.00
$0.00
$0.00
$0.00
$20.00
$77.37
NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in.Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any
fees/exactions of which you have previously been aiven a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired.
PERMIT APPLICATION
FOR OFFICE USE ON~~
PLAN CHEJ,~ NO. Coot t2Y7 {;
CITY,OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 920oa·
EST. VAL. ---lr-tf.+--l-,0'--1-,D<-------
Plan Ck. Dep sit " !E=
Validated By .... -=--=~-.,_.-fJ-..,~=------
Date 3/A.(o,1·
Address (include Bldg/Suite #)
~,S;Q f2 J3 j_ Cr-itn[(IO
Legal Description .
Assessor's Parcel #
/67 c:730 t/f;8t:Pc>
¥ {2.e-.4 / p Business Name (at this address)
C-c>FP/S.e i3GPN
Lot No. Subdivision Name/Number Unit No. Phase No.
Existing Use Proposed l,Jse
Total # of units
Name . Address City State/Zip Telephone# Fax#
~~~1~~)9!i~~~~e~,~~ir~~[~ef~2r~f~~~r~~~~i~~~7~Ic~~§~~
Name Address City State/Zip Telephone#
ii':'m.½':",..,..PR'"o· "'p'E~/j;..vro·"w" N, 'l="R .. ..,. ~»:rt,"".·_..,. ~-v~~-..:::-;,:s>; :<' ~-J~;·:, ~.v:: -~· ·~-~--~ .. ,:!: ·, ~.,_y,>-.. ·~-::?'if-'J"''~~. ·-~-,-.::-.. ,,·:,<-»-rr,;--,~~:;.";,!;'-"'-· ·-..:}»~r:~.~~.--~ :~·.-\;;i-~'-"c...:' -r ,, :.:,:e :'i.,.r, ~,,, , ..... :;:;,·:./--:-¼~i~bf.-~"~<.,.;~~-t4'. ')f/[-f .;:")!._~-~-::,~<1"':~--°1'~J :.&~~,.;:::.t/i::-·1,~~Wr-~ _,1r [jtlr1s. "o:d -~-~,t:)f t;Pt'"'"::,:..l?i'J~~~.:,;..i;";i;;t::s;,,· "-·~;t:;t;;; .. :,~(ll,,.,~-,,_~1t·..:c~~tt'::,_-~~~~;/:·· .. ·., .. ~~..tlf~ "'~'~s~·.-·"";}'~3}'· ·:
Name Addr ss City S.tate/Zip Telephone #
tq~-Z:~~~P:NJ"~9,%Qhili~iii~~4Mt;11~~~~~~~:\i-l&~1:~-~~~:~~~:~~~f~il~lcif~§:~~~~1:;~,it;,i1;~1
(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, commendif'1g with Section 7000 of Division 3 of the Business and Professions Code) or th11t 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 ($5001). srn J)e.J.rcJ SIM Cc:) 2<;,9/ l4--R,-.,,-e,_ ~,'/1,vtrnsl-oa 707lfC/ 3/0s<-/fctGGI
Name ~ Address City · State/Zip T[ephone #
State Licen~e # 3 S. / 0 I / l!icense Class C (/ S City Business License # l). } j } d--
Designer Jl!ame
State License #
Address City State/Zip · Telephone
f~-:~WQR~iF.t~tiPJ!MPiN"'~AitP~t::~f.:::ii«:;:~~:~1~::~«&t:J;&~~T,-3~7~&;:~?;;:i~;'i,;:~y~~~~25~:~:~~~~~r:zE~~~~i7~%~~t~~;~~{'.~\~:!C~
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one. of the following declarations:
0 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.
'-JZL)1 have and will maintain workers' compensation, as· required by Section 3700 of the Labor ·code, for the performance of the work for which this permit is
fssued. My worker's compensation insurance carrier and policy number are: o. C) J !
Insurance Companv'{c'C',m.c:,r4 ~ k".) /yr p Policy No./-, /r/!OcJJVc]{l6u 1/--Expiration Date l/-Ji,.O /
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS)
0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as
to become subject to the Workers' Compensation Laws of California.
WARNING: Failur secure workers' compensation coverage is unlawful, and shall subject an· ljlmployer to criminal penalties and civil fines up to one hundred
thousan ars ($ ,0 0), 1 addition to the cost of compensation, damages ea provided for-in Section 3706 of the Lab r co e, interest and attorney's fees.
SIGNATURE._-'1:.==--.....,_..,..,,,__/_'--'""'__:-_-__ --,----------,--------,---D.ATE ')__ 0
~~~&YYNE1tr11tr. :~D~fi1trePJ~::-tr&tlQiJ:ltf~Jt~:A(11: ~::r::t~1::.riif7-~:J£lii£~;~~-:;-2J-~~tJi}5~~;-~f~i·\r~i:::~~:ft:)~1~:!.ti~j1~~·~L~i:~Jl~J~tt~t~jI~i1Ltt;l'it:~te~t~\tJ
I hereby affirm t at I am exempt from the Contractor's License Law for the following reason: ·
0 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).·
0 I am exempt uncler Section ______ Business and Professions Code for this reason:
1. I personally plan to provide.the major labor and materials for construction of the proposed property improvement. 0 YES ONO
2. I (hav!I / have not) signed an application for a-building permit for the proposed work.
3. I have contracted. with the following. person (firm) to provide the proposed construction (include name / address / phone number / contractors license number):
4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone
number/ contractors license number>=-----------,----------~---'----'-----------------------
5. I will provide some of the work, -but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type
of work): _______ ---------~-------------,--'-,--------,-----------------------
PROPERTY OWNER SIGNATURE_______________________ DATE ___ ..,... ___ ,__ __
~qf.;icElAl;IDs~s'~t:T'1~lJE®l~lP.~lt(JlAtiJj:[IT!;[~ijM1:r~~l~~~7-z:~.'l:i~~W:it~~t~~:r~i~;Mrt~z~'.fj.,~'}l+~gJ4
Is the applicant or future building occupant required to submit a bu!iiness plan, acutely hazardous m'aterials· registration form or risk management and prevention
program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? ·o YES O NO
Is the applicant or future building occupant required to obtain a permit from the air polluti~n control district or air quality management district? 0 YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school ·site 7 0 YES O NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE
Rl:QUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. .
!§f..fjiQ~6iiRf911~.NPI~~~A9~~~;-xr.;·I!:;Q:E;I]~~~-~3;~I0~&?jR~¾~~:~~-~~~£::J;~;~~~~~~=m1.~~~~~.;~~~--~-!:'::o/i~~i;1;<~.:.jJ~~:~;~~~~~{j
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097 (i) Civil Code).
Ii.ENDER'S NAME LENDER'S ADDRESS _______________________ _
tt~;l\_~e~1Q#N.l!i;:;R-;;;~:;;;B:;;n:;;•e;;:lc:;;:-_A;;:;_ :m;:;.t....;;::10;;:;J;;:1_ :,:;:;~::¥~:/;;::;~;;;:::;:;--:;;;tt::~;;:\~::-~:::1~=0.::-~l.:;::->l::~1.=~:;F-~==~\::;:::~*~-t;'b.~~~~~~~~f.%2.7~:~~i~~~~~~~]~~!KS:~~~rM~l~~i~~~gu
I certify that I ,have read the application-and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all
City ordinances and State laws relating to building construction. I hereby authorize representatives of tl')e Citt of Carlsbad: to enter upon the above mentioned
property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES,
JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE.AGAINST SAID CITY IN CONSEOL!ENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA permit is required for excavations over 5'0w deep and demolition or construction-of structures over 3 stories in height.
EXPIRATION: Every per · · 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 s~13 mil is n9t c m ed within 180-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 co need fo a perio~ of 180 days (Section 106.4.4 Uniform Building Code). J !
APPLICANT·ss,GNATURE :::{::.~e::}....-/-~-====----------------DATE 3 Id.La r
WHITE: File YELLOW: Applicant PINK: Finance
'' I
lnspe,ction List
,..,~ t )'
Permit#: CB010876
Date Inspection Item
04/16/2001 38 Signs
03/09/2001 38 Signs
03/07/2001 38 Signs
Monday, July 09, 2001
Type: SIGN
Inspector Act
PY NR
PY NR
PY NR
COFFEE BEAN-WALL MOUNTED-ILLUM
Comments
NP PLANS
NO PLANS, AGAIN!
NO PLANS
Page 1 of 1
.LICl;:NSED CONTRACTOfl'S DECLARATiON '
I hereby affirm that' I am licensed un<ler provi-· 1 · sions. of-Chapter .9 (commencing with Sectioi:i
·7\l_l)O) of_ Division 3 oHhe·Business an)l Profes-
·sions Code, -and·my,llcense is Ir\ full force and ef-·
.feet.
' ' OWNER-BU!LDER DEC::l.l\RATiO'N
·Pl.hereby affirm that I am exellip\ ,from,th'3 co·n-
-tractor's-L!cense Law for th.a following reason,
·.(Sec. 7031.5 .B.usine.ss "!hd·Professlons Code),.Any·
city ·or·county which requires a permit to con-
struct, 'alter,: 'improve, ·demolish, or repair any.,
structure, prior to its isslianc'I ai~o requires tJle.
-;1~11licant fo.r s·uch .perr:ni,t to file a signed stat~
ment that he' is licensed pursuant ·to the prolll-
sioris.oMhe Coiltragtor'i; Licen~e Law (C~apter, 9
coMmen<;lng · with -~e<;tlon 7!)00 of !)!vision ~ .of
the-Business and Professfo,ns Code) 6r;that Is ex-
·empt' therefrom and ,the basis fqr the allegeq ex-
·emptlon, ·Any·vJolation.of Section 7031.5 by an,ap,
· piica_nt for a -permit subjecis the applicant _io a
clvil,penaity_of not ll)ore.than five hundred doll;i.rl? (~500), . . • ·
DI, as owner <if _the .i>roP.erty,, g_r m-i empioY,ees
with wages as tt,eir sole compensation, wlli· do
the-work, ·and the structure ls·not Intended or.:of-
f11red for-~;tie (Sec;:. 7044, Buslnes_s, and_ Profes:
sions Code: The Contrac_tor's L,icense· L,a'I( Mei;
r\Qt apply to, ;in owner of property who, bl!llds or
improves !hereon. and who does such yvork
himself or through his own employees, provided
that such lmproveinerits, are not Intended o~ of.-
-fered·for sale.·li, however,.the bliilding,or.lmprove-
ment Is sold within one year of completion, the
owner-buiider, will have the !Jurden of proving'ihat ·
he· did r:iot ·build or ·Improve for the purpose .of
s;ile). ·
0 I, as owner of the prope,rty; arri exclusively con-
tracting With llcenseil contractors to construct
tt,e project (Sec. 7044, Busine~s and Prof~ssions
Code: The 'Contractor's License Law does.not ap-
ply to aIJ, own.er of property \•ho builds or Im-
proves thereon, and who contracts for such pro-
jects with ii-contra,ctor(s) license pursuant to the
contractor"s l:.lcense Law).
I am exempt under Sec ,•. B. & P.G,
for this reaso,,._ _____ ~--1---.---,,.~
Datii --~~--Owner ', 'I'
-WORKERS' COMPENSATIO
.I hereby.affirm that I tiave.t c
·, sent-to self-Insure, or. a C!lr1
Compensation· lnsllrl1,nce, o
thereof (Sec. ~. Labor Cod
POLICY NO~·--------~--"-
COMPANY ___ ~----~---
OyOP,Y Is filed W!th the city. 0 Cerylfled copy ,ls tie re by furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE . (Th:!I section need not be complete(;l·if the per,
rrilt 1s"1br on.a huri<;tred dollars·(S109) or less). _
· I ce:<tlfy that-ln·the.pe.rformance:of th!! work for
y,h_ich,"tf\ls.permlt:15 lssuec!, L.s!li!.II not employ ~ny
person i'n-any 11)an11er so as to· tiecome subject to
t:he ~rkers' Cojnpensa'tlon Laws-of. California .. ·
NOTICE TO APPLICANT: If, after m;iklng.thls·c'er-
tlficate of-Exerr\pt)o~, you s.!1ould becorne-suqject
to ·tl\e Workers' Compensation· p·mvlslons of the
Labor Coile, you must forthwith ccir{iply-wlih. such
provisions orthls per[11It shall J)_e i:le'!med tevo~ed.
"CONSTRUCTION-LENDING AGENCY
I ,her!!bY aff)r.m, that ,there Is a 9ons\rilctlon .. I11n,
,ding ag(litcy for. the performance .of ·th!! work for.
which \his permit Is l5s_ued (Sec. 3097, Civil 'Code).
I •. . CITY~# _CARLSE!A~,,-B~!I-DJ~(; ~~P~l\R:r"MENT-,'
--. , APP\...ICAT,ION ~ P,ERMIT
USE BAl,..L POINT PEN ONLY .. · 1'200 -E.LM AVgNUE-(714) 438"'.;'-5525
_--. ··-· -7, 0'7"5...,-,'
. '
_ ..
. ~~i6~A~iT~?:.~i~ 't1~~~~~:-
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! --NO. ._ ' -~ • --' JOB ·ADDRESS AV.ST." DATE OF APPLIC-A'l"I0N ' . ._,~ ;,· ,....,._,,,, ;,,-,II ,: < • • •• • ' ' RO ' BUS. LICEN'sE· P,ER"!,.!T "NUMBER ... :-: : •. t_'""IIIIII ·, ~-'5:i'lf'i '.··-¼ri,}:/;;~: C /J·lfit MO . R.i€i -~ i), A3s-~~ ?l~/3c> .. :\\
l)WNER -~u-·
owN_E_R',s MAit.iNG A'?DREss · _ ,_. ;-_'_------.. ____ --.. _ -__ :_ · -----~~_-. -~ · .' -:. 11-c_o NT1f_A __ ~To·R·.sAi>oii'Es-s---~----c,--• __ ._~ • I ;~N~-~-·A __ ci:oli•s ••
~5Z:>8 .&L.-:.:~/Y//~Zt-~~ .: . ~ ://2~ ;tJ,;~n /41/&_·iu,,_~76·--:3~g{i
: Lo:r-, Bl,,OCK :suso1v-1s1o_N -----oi.:;s1G"Ni;!!. S:f-AT;_ LIC!\NSE-_, -4ll~l61~·775,·· ... ·. ·_ : .'/{~;~ . BP -· -~-··.··· ··-· r !J~';,~. IJ:P ~ ." . . ..·. ·foEsfaNER'S:_ADDRESS ~i:DE'SlGNER!,S 'PH.ONE
-· ·;-·· . -..·-;,·, . ' .. ,. ;
i .Q~~.l.~~~~S''':-~tlJl ~1--t _ ~~~-~.!
, • • • ~ -• • -~ • '': ~ ~. ·<; ' ·, ;:..'
. rrc . ~;f_"",
c'ENS_u~ T-RACT'-GP GANO USE'·, ZONING
~LllG SQ~ FT. BL(?«; 'usE occ. GP LARD PLA_N, ii° no y -. · .. ·_ l·TYPE--CONST.
. · · . ··.· '/-1·..,0 . · -· ·. ---· -"-------_::::>_,__.__' ' ., :·--
l RES. UNITS ---r PARKING ·SPAC~-
OT~ ,, · Pt::UMBll\!G PERMIT
,-_
AMT ... 'JI QTY: :M~QHANICAl:..-PERMIT--
lNUM.B~:oF STOR~~~-[_ -
· ·-1·oc:d: _La';\o_.-_ ~ _
. . . . . :]'
'
'
AMT.
~lf§I.YQ9?8~ _4J~~~~Al~
. Not r·~ttP..f "F!. '!fachi'l'b-C.rtilied ·.·' :.; ,; ' ,d,:;
:: •. i.f·1i:.r.;;1u·1-· 1~-•. ... c,QeOl =o:oiFf--!'if. :1,i.z22/sf-·. ,; :· sd~t:ip.
•" , •• ~ I-, -•, '.,. I 1' I '. t , ,
/'
_, ai:i :re.:
:1 • .11 'EAC.H'FIX:fUlfE_TR_AP' J-o.·-: ,INSTA\L FURN. QUCTS ·up T0,100,000 BTU (
~ACH BUICDING .. S~ER
. J I EACHWATER H~ATER AND/OR VENT : P:: ~1--, ~ -/ I EACH GAS SYSTEM 1 TO 4 OUTJH~ "---------' . -' EAC~ GAS SYST~r., 5-0.R MORE.
l:_ACH !NSTAL., AlT~R. REPAIRWATEtPIP~
EACH LAWN SPRINj<L:ER-SYSTEM ·,
QV~ R lO_Q.~00 BTl,J .
BOILER/COMPRESS~R UP T'o 3 _HP
·BQll.£R/COMPRES~D!l·3-15_HP
!OILERfcOMPRESSQR 16-30 H.P
~
·' VENT FAN'SINGLE DUCT . -
MEc~~sT ~ ttooD10.u~Ts · _ · ± _.__ II v rrL:.. l,t ~ T-i " ~/_/; ~-: ... ~ ~-
,-
,., . . ~ w
,:-·I-~ ~ >
WATER SClFTNER -----_: llELOCA-TfONOFEA-FURNA..CE/HEATER.-' .--~ . ~, -,
S<t...'€... ~?o . /~Su<: ?).d'<l ...!.
T.CIT.AL PLUMBING TOTAL MECHANiCAL PLAN CHE ,
~ CONTRACTOR' I/. ·coNTRACTOR Ii-'-'---'---'--,-~ 4~.,,.~ CY.~..,..'!::.-~~'==~=--= --::::.-='""'~5='-=---1~ 1
QTY . . ELECTRICAL PERMIT AMT. QTY. MOBILE HOME PERMIT I Ar.~-:-. 11 :~·-· .--------~-~,-.,_ ... ,-,-..~~-, -
' . . . ' . ' • ' 1:1.cl:ld --
-·-------Tt:iT!'.!.. !'!..UMBIN'G __ .. n I
. -'"' :"~RICAL
1 . '.NEW_ CONST EA ~MP/SWT/BKR . ' . • AWNING , , • . MECHI ----,. --,NICAL
.., __ ::_:: HOME 1 PH -j~--=-_ _ . -~ ~if -. . · PORCH . -. ' -· --•. · .. · · unR .. ,
EXISHLDG EAAMP/SWJ/BKR l 11-l ,SET-UP I IL !:·n, ·-. , -~, ,_ :---AH
l PA .25 . 3 PH . 0 I, . . _ II I RAMADA, C"BANA I !! ,. _ , , ., .
REMODEL/ALi:ER' PERCiRCUIT . FENOEOVER6' -R011JG'. 1n.o'i-h.ru " .. ,
< --TEMPPOLE 200AMPS --TOTALMOBIL~l:IOME MIC,O·FILM ,
OIJER200AM~ --~--~ -·~ I.; .-1 ·1 ·: I
TEMl'bccui?ANc:r1300Avs1 1 11 ·-1 -....... __ . __ .. ~: ~--11-r 1 , , 1 ·-. ~,-
TOTAL'ElECTRJc.ii.-L
C:ON.TRACTOR
L ~.su.e...,. ;}.. ... 'Q
7 -' " -. ~ _,
. -'. TOTfl FE~.S~AYABLE
. ' .. -_ ' ~-~ --~-:-· . ~· . . ;s c.J; 0 () J_, ·--rf>e e;.-
1 HAVE CA REF ULL_Y EXAMINED THE COMPLE.TED "APPLICAT,i6N AND,P!,RII/IIT, AND-DO· -"AN 9SHA _PERMl.:f IS ·REq"UiRE9 FOR f!:XCA V_AJl<;?NS OVER •-.. -. -
HEREBY CERJ'!FY1•T-HAT ALl.c INFORM/l-T_ION,,HEREON' IS TR"-1"' AND CORRECT AND I 5':0" DE_EP A!IJD DE,M(?LITION OR .CONSTRUCTION Of
FURTHER C1iRTIFY ANQ AGREE; IF A PERMIT IS,ISSUED;TO COMPLY WITH ALL CITY, S,TRUCTURES OVEf! 3 ST IES IN HEIGHT'
. CQUNTY ANp STATE ~AWS GOVERNING BYILDING ·CONST·RUCTION,,WHETHER· • . . .
·SPECIF'IED HEREIN OR NOT. 1,ALSO ·AGRE!, TO SAVE INDEMNl~Y AND KEEP·HARM-: ,,...__...,,-r ~ -
l:
.,.; :.1., . I ·1 ---~~I_ .. ---------;;;
, I -~ 1· :, G{,n. ~
~
LESS'THE c:1:r·y OF.CARLSBAD ,AGAl~ST ALL,LIABILIT!ES, JUDGMENTS, COSTS AND •
. !=XPENSES \(VHICH MAY !N ANY -WAY ACCR U.E AGAINST SAID,Cl:rY ,IN CONSEQUEN<;E 1~~~6~;:;;;i~';';::4~~;:1~~~::;;,.-..... _=.;;::::::;:=:-:;;r,:;r;;~;;ef_-'-~:::-;:;::::7::::;:;:-i:c;:::;:-,-~~t:;';'.;;:c;:;--;;-;;-'-_J_'..'.".._E.__J::.=µJ4_ft./;:;;;./-. OF'TH!='GRANTING QF'1"HIS PERMIT. CONTRACJ:ORO'
AGE_l'!:T_.Q_ __Ef,'_l':_,HONE (:] -,
I\
" • ~. • ,,
-..., sft'E ,.. .. J~ ADDRESS: t, ... •;,-, .. ..,, OWNER: ~ .:.\ R.f;~, ~o;~CJ5~gA~O t:2,tj
('•, -~ -FIELD.INSPECTION RECORD.,-··"'""· •..
INSPECTION ,· . DATE INSPECT0R:.-' -,>\ ~ -;,. _ .... ,
I WOOD FLOOR -_ _ . ·1 " I·;:::-.. :, ,, .. ~.. . 1·-1 .~--· . . . .
FQU!-,10ATIO~• f:"ORMS•Sl;:T BACK •TOIL~T • -" . 'H' "'" ·, ...
UNDER FLOOR P.L~M!3ING'_ · _'''
UNDER FLOOR: 1-tEATJNG.---
OK TO INST ALL SUB FLOOR
~LAB ··FhOOR
UNDER SLAB PLUMBING I
FOOTING. FORM$. SETBACK. TOILET. --' -. , ·-, . ).
OK ;-'6 POUR.CON(;RETE · ' ' ·.,
•I.FRAME
ROUGH ELECT~ICAL
ROUGH PLUMBING
ROUGH HEATING/VENTILATING
FRAME.OK. PLACE INSULATION
INSULATION OK • PLACE WALLBOARD.
WAL!-,EIOARD _ QK • PL.ACE TAPE . .
EXTERIOR .J.,.!\TH QK • PLA<:;E. STL!~CO
i,.$
-FIR.EPLJ;-CE.
DAMPER-& STEEL
"PLATE_TIE:~HEIGF.IT OF.CHIMNE;Y
OTHE;::R·-.
TEMP POWER ,fPOLEl
SEWER
<:;AS TEST.
swJM 'pooL • · SITEEL.BONDlNG
• PREDECK
~·--
• FENCE .PRf¥PLASTER
SHQWN • F~AM~.
•·PAN
.. ·,,.
t",·'
/I I .I .. ~ .. ,
Fl!'tAL IN~P BY BLDG DEPT . j.(j/f/J,11 J /4 JJ.JI-.
~TH~~.DEP:r:~:R~QCOMPLETED ~~-fZ71'f [Wt: I
ELEC METE~"':pERM-TEMP · · f
GAS-MEfER-PERM~TEMP -". ~ .... ,.
... --
\'
\
I CERT p~_ocduPANCY 1ssuED _ I j ~-~Jj=: ~~ ~ ' .. ~ i-_ --~
\ ·: f.
' ' • .,_ -~ ,,.-i ·" .... '·· •• ·-r '._:
:-• . '\ ~ ~~ .~
"' J . -'-.. _,,. --:;::-·-~~f.
l N°SPEci-o~·s ~OT Es·""~-:
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f<_---e~ wd /3~ hv--~a~-'~
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. RE,OUEiST F~~SPECTION Tl~F,0_,~C/
INSPECTOR ~ PERMIT NO _______ DATE, ~ '
owN{R __ .·____,Q_ .. .....,u~,t.f<.__,____/-L,.___,,,"'--~'""""-------------------
ADDREss ;l SO Z--c!:: c;R ·, Sw.~u C-
BUILDING
D FOUNDATION
D REINFORCING STEEL
D MASONRY
0 GROUT· GUNITE
D FLOOR AND CEILING FRAME
D SHEATHING
D FRAME
D EXTERIOR LATH
D INSULATION
c:;J l~ERIOR LATH OR DRYWALL
~ FINAL
PLUMBING
D UNDERGROUND PLUMBING
D UNDERGROUND WATER
D ROUGH PLUMBING
D TOP OUT PLUMBING
D SEWER AND PL/CO
D TUB OR SHOWER PAN
D GAS TEST
~ WfoER HEATER
(;;a/ FINAL
READY FOR INSPECTION: DMONDAY
ELECTRICAL
D TEMPORARY SERVICE
D ELECTRIC UNDERGROUND
D ROUGH ELECTRIC
D POOL BONDING
D ELECTRIC SERVICE
D CEILING HEAT
D· G.F.1.
D SMOKE DETECTOR
~NAL
MISCELLANEOUS
D PLENUM AND DUCTS
D COMBUSTION AIR
D PATIO
D SIGN
D GRADING
D DRIVEWAY
D CONDITIONED AIR SYSTEMS
Q ijji-FER PIPING
if FINAL
DTUESDAY DWEDNESDAY DTHURSDAY ~y
SPECIAL INSTRUCTIONS-.....----------------------------
REQUESTED BY __________ ---_________ PHONE NO·--------
PERSON TAKING REPORT _______ _
• • INTERDEPARTMENTAL
BUILDING DEPARTMENT
BUILDING ADDRESS:
PLANNING DEPARTMENT
'
SHEET
DATE:
~E
---------
APR O 1 1
CITY OF CARLSBAD
Building Department
ZONE LOT SIZE LOT WIDTH -----------------'------------
UNITS ALLOWED UNITS PROVIDED ------------------------
PARKING SPACES REQUIRED PROVIDED ----------------------
% COVERAGE ALLOWED PROVIDED -------------
BU IL DING HEIGHT ALLOWED PROVIDED
FRONT SETBACK:
ALLOWED
PROVIDED -------
INTRUSIONS
----------
SIDE SETBACK: REAR SETBACK:
LANDSCAPE & IRRIGATION PLAN COMMENTS:
ENVIRONMENTAL PROTECTION REQ:
ADDITIONAL
OK TO OK TO FINAL DATE _ _,_,,_ ___ ~ -------------
ENGINEERING DEPARTMENT {/~:
R.O.W. INDUSTRIAL WASTE IMPROVEMENTS -----------------~---
SEWER CONNECTION DRIVEWAY LOCATIONS ---------------------
GRADING PERMIT E/JVJ EASEMENTS _________ DRAINAGE ____ _
LEGAL DESCRIPTION~ H(l) P~s ~ ~jJ1.&-±-,,y
ADDITIONAL COMMENTS ------.-----'----,-"--------------------
OK TO FINAL DATE ------------
FIRE DEPARTMENT
SPRINKLING SYSTEM ___________ FIRE PROTECTION EQUIP. _______ _
FIRE ALARMS EXITS _______________ _
FIRE HYDRANTS LOCATION ____________ ~--'----
ADDITIONAL COMMENTS
OK TO ISSUE: DATE OK TO FINAL DATE -----------------------
WATER DEPARTMENT
-REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE ________ _