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Home My WebLink About2512 LA COSTA AVE; ; CB900673; Permit... B U I L D I N G P E R M I T 05/01/90 11:58 Page 1 of 1 Job Address: 2512 LA COSTA AV Permit Type: ELECTRICAL Parcel No: 216-160-21-00 Valuation: O Construction Type: NEW Occupancy Group: Description: TEMPORARY POWER OWNER ELIHU, SHAWN Class Code: 7940 EASTRIDGE DRIVE LA MESA, CA 92041' *** Fees Required *** *A* Fees: Adjustments: Total Fees: Fee description 15.00 .00 1'5. OU Enter "Y" for Electric Issue Fee Enter "Y" for Temporary Service * ELECTRICAL TOTAL ($10 Minimum) Str: Lie. CITY OF CARLSBAD Permit No: CB900673 Project No: A8901465 Development No: Fl: Ste: 5136 05/01/90 0001 01 02 C-PRHT 15-00 Ct# &qu Status: ISSUED Applied 05/01/90 Apr/Issue Validated By: JPY 619 297-8411 ,00 .00 15.00 *** Ext fee Data 5.00 Y 10.00 Y 15.00 L APPROVAL INSP. DATE r/zr(o..11 CLEARANCE ____ _ 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 PERMIT APPLICATION 11\ V City of Carlsbad Building Department EST. VAL _________ -,_,,£~::....._ 2075 Las Palmas Dr., Carlsbad, CA 92009 (619)438-1161 PLAN CK DEPOSIT _____ 7 "~:;_ ___ _ VALID. BY ____ -,.,,,.,:./::_ _____ _ 1. PERMIT TYPE DATE---~_,,<::...../ _______ _ A COMMERCIAL 0 I NOUS TR I AL 0 RESIDENTIAL O APARTMENT 0 DUPLEX O OE MOL IT I ON OMECKANICAL □POOL '1. 5/2-Nearest Cross Streets LEGAL DESCRIPTION Lot No. CHECK BELOW IF SUBMITTED: TENANT IMPROVEMENT 0 TENANT IMPROVEMENT □CONDO □SINGLE FAMILY DWELLING OADDITI0N/ALTERATI0N □RELOCATION OM081LE HOME □ELECTRICAL □PLUMBING OSPA QRETAINING WALL □SOLAR □OTHER No. Subdiv1 s 1 on Name/NlM!lber Q2 Energy Cales 02 Structural Cales 02 Soils Report D 1 Addressed Envelope EXISTING USE ASSESSOR'S PARCEL BLDG. SQ. FTG, # OF STORIES - Unit No. Phase No. PROPOSED USE 3. CONTACT PERSON NAME ADDRESS ZIP COOE 4. 7. 8. CITY STATE DAY TELEPHONE SIGNATURE APPLICANT 0 CONTRACTOR D AGE!fl FOR CONTRACTOR □OWNER D AGENT FOR OWNER NAME ADDRESS STATE ZIP COOE DAY TELEPHONE £;__11-k--OWNER 7140 EA-':,[/t./f)b,c-□,esm OmANr P/2.. STATE CITY STATE STATE LIC. # ____ _ SIGNATURE DESIGNER NAME Cl TY STATE WORKERS' COMPENSATION ADDRESS ZIP COOE Z.~ DAY TELEPMONE ADDRESS ZIP COOE LICENSE CLASS _____ _ TITLE ADDRESS ZIP COOE DAY TELEPHONE CITY BUSINESS LJC, # DATE DAY TELEPHONE STATE LIC. # Workers• COl'll)ensat1on Declaration: hereby affirm that have a cert1f1cate of consent to self•insure issued by the Director of Industrial Relations, or a certificate of Workers• C~nsation Insurance by an adnitted insurer, or an exact copy or 6.Jplicate thereof certified by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C). INSURANCE COMPANY POLICY NO. E)(PJRATION DATE 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• Coq>ensation Laws of California, SIGNATURE DATE OWNER-BUILDER OECLARATION owner-Builder Declaration: I hereby affirm that I am exempt from the Contractor's 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 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 irrproves thereon,. and who does such work himself or through his own employees, provided that such irrprovements are not intended or offered for sale. If, however, the building or irrprovement is sold within one year of c~letion, the owner·bui lder will have the burden of proving that he did not build or irrprove for the purpose of sale.). 0 I, as owner of the property, am ex.elusively 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 irrproves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). 0 I am ex.empt 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, irrprove, demolish, or repair any structure, prior to its issuance, al so requires the applicant for such permit to file a signed statement that he is I i censed pursuant to the provisions of the Contractor's License Law (Chapter 9, coomencing 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 Accol¥!t Act? OYES ONO Is the applicant or future building OCC"4)Bnt required to obtain a permit from the air pollution control district or air quality management district? □YES ONO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? OYES o,o IF ANT Of THE ANSWERS ARE YES, A FINAL CERTIFICATE Of OCDJ'ANCY MAT NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS tl:T OR IS tl:ETING THE RECIJIREMEIITS Of THE OFFICE Of EMERGENCY SERVICES AND TME AIR POLLUTIC. CONTROi. DISTRICT. 9. CONSTRUCTION LENOING AGENCY hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(il Civil Code). LENDER'S NAME LENDER'S ADDRESS 10. APPLICANT'S SIGNATURE 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 purposes. I ALSO AGREE TO SAVE INDEJIINIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JlOQIJENTS, COSTS AND EXPENSES WHICH MAT IN ANY WAT ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING Of THIS PERMIT. Expiration. Every permit issue([ 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 su permit is not coomenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned a ny t· after the work is coomenced for a period of 180 days (Section 303(d) Uniform Building Code). 0 OWNER □ CONTRACTOR 0BY PHONE APPROVED BY; _______ _ DA.TE: WHITE: File YELLOW: Applicant PINK: Finance