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Home My WebLink About2516 LA COSTA AVE; ; CB901710; Permitt j .•. 10/25/90 10:13 Page 1 of 1 B U I L D I N G Job Address: 2516 LA COSTA AV Permit Type: ELECTRICAL Parcel No: Valuation: 0 P E R M I T Str: Permit Project Development Fl: Ste: 0 3 1 No: CB901710 No: A8900922 No: O? Construction Type: NEW Occupancy Group: Class Code: ~/3/'-f t":l· .L : I.:iSUED Description: TEMPORARY POWER Appl/Ownr : NAKHSHAB. SASAN 2516 LA COSTA AV CARLSBAD, CA 92009 *** Fees Required *** *** Applied: 10/25/90 Apr/Issue: 10/25/90 Validated By: CD 619-943-0481 Fees Collected & Credits *** -------~------~-----------------------------Fees: Adjustments: Total Fees: Fee description 15.00 .00 1'5 .00 Enter "Y" for Electric Issue Fee > Enter "Y" for Temforary Service > * ELECTRICAL TOTAL ($10 Minimum) Total 9.·edi t.s: Total Payments: Balance Due: Units Fee/~nit CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 .00 .00 15.00 Ext fee Data 5.00 Y 10.00 Y 15.00 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las J>al mas Dr., Carlsbad, CA 92009 (619) 438-1161 1. PERMIT TYPE A • COHHERCIAL 0 INDUSTRIAL TENANT IHPROVEHENT 0TENANT IMPROVEMENT C 0RESIDENTIAL 0APARTMENT 0CONDO 0SINGLE FAMILY DI/ELLING 0ADDITION/ALTERATION 0DUPLEX 0DEHOLITION 0RELOCATIOII 0HOBILE HOME 0ELECTRICAL 0PLUMBING 0MECHANICAL 0POOL 0SPA 0RETAINING I/ALL 0SOLAR 00THER _____ _ ECT INFORMATION PLAN CHECK No. 2 !$ / '-,4 {Z)f T/1 /1-r,£.uild,ng or Nearest Cross Streets LEGAL DESCRIPTION Lot No. Subdivision Name/NU!ber CHECX BELOII IF SUBIIITTED: EST. VAL--------------~ PLAN CK DEPOSIT ___________ _ VALID. BY _____________ _ DATE---------------- un, t No. Phase No. D 2 Energy Cales Oz Structural Cales 0 2 So,t s Report 0 1 Addressed Enveloee ASSESSOR'S PARCEL z;~D BLDG. SO. FTG . 3. CONTACT PERSON NAME CITY SIGNATURE 4. APPLICANT 0 CONTRACTOR NAME CITY EXISTING USE # Of STORIES ADDRESS STATE ZIP CODE 0 AGENT FOR CONTRACTOR ADDRESS STAlE ZIP CODE OIINER PROPOSED USE s.,=.J';? DAY TELEPHOIIE 0 AGENT FOR OIINER DAY TELEPHONE 0LESSEE 0TENANI ADDRESS STAIE C4 ZIP CODE 2-/J~ ~t., Y/ /£.J,c/ -:n-Jo t_ 12.t?t:.2"7 DAY TELEPHONE *f£l-£ S'"'sto 6. CONTRACTOR ' NAME ADDRESS Cl TY STATE ZIP CODE DAY TELEPHONE STATE LIC. # ____ _ LICENSE CLASS------CITY BUSINESS LIC. # SIGNATURE TI !LE DATE DES I GNER NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHOIIE STATE LIC. # 7. WORKERS' COMPENSATION 1/orkers• C~nsat1on Declaration: hereby affirm that have a cert1f1cate of consent to self·,nsure issued by the Director of Industrial Relations, or a certificate of \Jorlters I Coq:>ensat 1 on Insurance by an adni t ted insurer, or an exact copy or duplicate thereof cert If i ed by the Di rector of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C). INSURANCE COMPANY POLICY NO. EXPIRAT ION DATE Certificate of E•en"f)tion: I certify that ,n the performance of the work for which th1s permit 1s issued, I shall not en"f)loy any person ,n any manner so as to become subject to the llorkers• C~nsation Laws of Cal1forn1a. SIGNATURE DATE 8. OWNER-BUILDER DECLARATION Owner-Builder Declaration: I hereby affirm that I am e.keffl)t from the Contractor's License Law for the followu,g reason: 0 l as owner of the property or my employees w1th wages ns the,r sole compcnsat1on, will do the work and the structure 1s not rntended 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 ,.-proves thereon,. and who does such work h1ms•lf or through h1s own employees, provided that such 1.-provements are not intended or offered for sale. If, however, the building or 1.-prove,nent is sold w1th1n one year of CO<ll)let1on, the owner·bu1lder w1ll have the burden of prov,ng that he d1d not build or 1.-prove for the purpose of sale.). 0 I, as owner of the property, am exclusively contract1n9 with l 1censed contractors to cons truct the project (Sec. 70l.4, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or ilfl)roves thereon, and contracts for such proJects w1th contractor(s) licensed pursuant to the Contractor's license Law). 0 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 perm1t to construct, alter, 1~rove, dCfflOlish, or repair any structure, prior to 1ts issuance, also requires the applicant for such pcrn11t to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, cc••.,,,.,nc1ng with Section 7000 of D1v1s1on 3 of the Business and Professions Code) or that he is exen"f)t therefrom, and the bas1s for the alleged e•en"f)tion. Any v1olat1on of Section 7031.5 by any applicant for a permit subJects the applicant to a c1vil penalty of not more than five hundred dollars [$500) ). SIGNATURE DATE COMPLETE THIS SECTIOII FOR NON·RESIOENTIAL BUILDING PERMITS ONLY: ts the applicant or future building occupant required to submit a business plan, ecutely hazardous materials reg1Stration form or risk managemC?nt and prevention program undor S•ct ions 25505, 25533 or 25534 of the Pr .. ley-Tanner Hezardous Substance Account Act' Ons ONo ls the applicant or future butld1ng occupant requ1red to obtain a ~rmit from the air pollution control district or air quality mana9C1T1ent district? 0Yes 0No Is the facility to be constructed within 1,000 feet of the outer boundary of a school sire> OYEs If ANT Of THE AIIS\IERS ARE YES, A FINAL CERTIFICATE Of QC(l.ll'ANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS NET OR IS NEETIIIG THE REQUIRENENTS Of THE OFFICE OF EMERGENCY SERVICES ANO THE AIR POLLUTION CONTROL DISTRICT. 9. CONSTRUCTION LENuING AGENCY hereby affirm that there ,s a construction lending agency for the performance of the work for wh1ch th1s permit 1s issued (Sec 3097(1) C1v1l Code). LENDER'S NAME LENDER 'S ADDRESS 10. APPLICANT'S SIGNATURE I certify that I have read the appl1catlon and state that the above 1nformat1on 1s correct. I agree to COOl)ly with all City ordinances and State laws relating to bu1ld;ng construct1on. I hereby authorize representatives of the C1ty of Carlsbad to enter upon the nbovc mentioned property for 1nspcctlon purposes. I ALSO AGREE TO SAYE INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSCS llfflCH MAY IN ANT I/AT ACCRUE AGAINST SAID CITT IN CONSEQUENCE Of THE GRANTING OF THIS PERMIT. Expiration. Every permit issued by the Building Off1c1al under the provisions of this Code shall e•pire by l1m1tot1on and become null and vo,d 1f the building or work author12ed by such permit 1s not conmenced w,th,n 180 days from the date of such p,,rm1t or 1f the building or work author,zed by such p,,rm1t 1s suspended or abandoned at any t1me after the work 1s c°"""'nc.,lffor_yr•od of 180 days (Section 303(d) Uniform Bu1ld1ng Code). ~ATURE ,<_ / / /J ~ER OcOIITRACTOR OsY PHOIIE ~':r~~VE_D_s_Y_, _______ _ WHITE: File YELLOW: Applicant PINK: Finance PERMIT# CB901710 DESCRIPTION: TEMPORARY POWER TYPE: ELEC CITY OF CARLSBAD INSPECTION REQUEST FOR 10/26/90 LA COSTA AV STR: INSPECTOR AREA TP PLANCK# CB901710 OCC GRP CONSTR. TYPE NEW FL: STE: JOB ADDRESS: 2516 APPLICANT: OWNER CONTRACTOR: OWNER: PHQNE: 9430481 PH0NE: PH0NE: ~ INSPECTOR I ~ REMARKS: Tl/MH/943-0481 SPECIAL INSTRUCT: TOTAL TIME: --RELATED PERMITS-- CD LVL DESCRIPTION PERMIT# CB890524 RW900048 TYPE SFD ROW 32 EL Const. Service/Agricultural S'fATUS !~SUED !~SUED I I ACT COMMENTS I Af!_ 777~'3 ~~_,_--'-'-"'-"----"",-\~~~~~- ***** INSPECTION HISTORY***** DATE DESCRIPTION ACT INSP COMMENTS