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HomeMy WebLinkAbout2525 EL CAMINO REAL; 107; STE 107 PRE 2016; PermitfITLOF CARLSBAD BUILDING DEPARTMENT 729-1181 -Ext. 36 For Applicant to Fill In Owners Name Hickory Farms Mail Address Contractor Millie and Severson Contr. Address P.O. Box .1269, Long RPaC To Const. 0 To Add 0 To Alter 0 Convert 0 To Move From Type ofConst. Frame and Masonry Frame, Masonry, etc. To Be Used For Dept. Store Kind of Foundation_______________ No. of Stories Floor Space (Sq. Ft.) 3 , 231 Garage Floor Space (Sq. Ft.) Attached_______________________ Detached__________________________ Legal Description Lot Block Application fBUiLDiNO Permit Building Permit Fee DEC 26-68 5! 022O5******* 00 Building Dept. Use Only Building Address S ii i t P 1 0 7 St. Near El Camino Real Set Beck - Bldg. Valuation Front P.L. Main Bldg. Side P.L. Garage Rear P.L. Other Group Zone Approved by Contractor City Bus. Lie. No. Water Meter Sewage Disposal System Inspection Record Subdivision or Section Township Range No. of Existing Building Will this construction include any plumbing installation or alter- ation? Yes No D Signature of Applicant I ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY AND STATE LAWS REGULATING BUILDING. I CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY CITY OF CARLSBAD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE SIGNATURE OF PERM ITTEE Utility Company Notified - Date By Final If a check is tendered for payment for the above fee and the check is not honored when presented for payment, your building permit will be immediately revoked. City of Carlsbad Building Dept. Permit void if work is not commenced within 60 days of issuance. CITY OF CAR PERMIT NO. TOTAL FEE $ BUILDING DEPAR ENT 729-1181 -Ext. 36 Application for MECHANICAL Permit For Applicant to Fill In PA tfl L3O68 Ee2384* *** * * 1 1 ao. ITEM INSTALLATION AND/OR RELOCATION EACH I AMT. For the installation or relocation of each forced-air or gravi- ty type furnace or burner, including ducts and vents attached to such appliance, up to and including 100,000 B.t.u.'s $ 4.00 For the installation or relocation of each forced-air or gravi- tytype furnace or burner, including ducts and vents attached - to such appliance over 100,000 B.t.u.'s $ 5.00 For the installation or relocation of each floor furnace, in- cluding vent. $ 4.00 For the installation or relocation of each suspended heater, recessed wall heater or floor mounted unit heater. $ 4.00 Building Dept. Use Only For the installation, relocation or replacement of each ap- pliance vent installed and not included in an application. $ 2.00 For the repair of, alteration of, or addition to each heating appliance, refrigeration unit, comfort cooling unit, absorption unit, or evaporative cooling system, including installation of controls regulated by this Code. $ 4.00 BUILDING ADDRESS For the installation or relocation of each boiler or compres- sor to and including three horsepower, or each absorption system to and including 100,000 B.t.u.'s. $ 4.00 STREET NAME For the installation or relocation of each boiler or compres- sor over three horsepower to and including 15 horsepower, or '' CONTRACTOR So.'h1 arid Htg . & A/C ______________________ each absorption system, over 100,000 B.t.u.'s to and inclu- 7 Plaza Camcbno Real, A Limited OWNER 2,4A P a3tner ship ding 500,000 B.t.u.'s 57.50 For the installation or relocation of each boiler or compees- sur over 15 horsepower to and including 30 horsepower, or each absorption system over 500,000 B.t.u.'s and including 1,000,000 B.t.u.'s. $10.00 ADDRESS N 2800 Temple Avenue For the installation or relocation of each boiler or conlpres- Sor over 30 horsepower to and including 50 horsepower, or for each absorption system over 1,000,000 B.t.u.'s to and in- cluding 1,750,000 B.t.u.'s. $15.00 CITY Long Beach For the installation or relocation of each boiler or refrigera- tion compressor over 50 horsepower, or each absorption system over 1,750,000 B.Lu.'s. $25.00 CITY BUSINESS LICENSE NO. For each air handling unit to and including 10,000 cubic feet per minute, including ducts attached thereto. $ 3.00 CITY BUSINESS LICENSE NO. For each air bundling unit over 10,000 cubic feet per minute. $5.00 For each evaporative cooler otl,er than portable type. $ 3.00 GROUP For each vent fan connected to a single duct. $ 2.00 For each ventilation system which is not a portion of any heating or air conditioning system authorized by a permit. $ 3.00 INSPECTION RECORD For the installation of each hood which is served by me- chanical exhaust, including the ducts for each hood. $ 3.00 For the installation or relocation of each domestic type incinerator. $ 5.00 For the installation or relocation of each commercial or industrial type incinerator. $20.00 For each appliance or piece of equipment regulated by this Code but not classed in other appliance categories, or for which no other fee is listed in this Code. $ 3.00 :i For the issuance of this permit. $ 3.00 I ACKNOWLEDGE THAT I HAVE READ THE APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL STATE AND CITY LAWS REGULATING THE MECHANICAL CODE OF THE UNIFORM BUILDING CODE. I CERTIFY THAT I AM PROPERLY REGISTERED AND OR LICENSED AS RE- QUIRED BY THE CITY OF CARLSOA AND STATE OF CALIFOR IA OR T V DESCRIBE AM THE LEGAL OWNER OF THE D DATE JOB PINALED SIGNED BY PERMITTEEI _____________________________________________ 50 CITY OF CAR BUILDING DEPA ENT 729-1181 -Ext. 36 PERMIT 4268 I******1O.50 Application for MECHANICAL Permit For Applicant to Fill In NO. ITEM INSTALLATION AND/OR RELOCATION EACH AMT. For the installation or relocation of each forced-air or gravi- ty type furnace or burner, including ducts and vents attached to such appliance, up to and including 100,000 B.t.u.'s $ 4.00 For the installation or relocation of each forced-air or gravi- ttype furnace or burner, including ducts and nests attached to such appliance over 100,000 B.t.u.'s $ 5.00 For the installation or relocation of each floor furnace, in- cluding vent. 4.00 For the installation or relocation of each suspended heater, recessed wall heater or floor mounted Unit heater. 4.00 Building Dept. Use Only For the installation, relocation or replacement of each ap- pliance Vent installed and not included in an application. $ 2.00 For the repair of, alteration of, or addition to each heating appliance, refrigeration unit, comfort cooling unit, absorption unit, or evaporative cooling system, including installation of controls regulated regulated by this Code. $ 4.00 BUILDING ADDRESS For the installation or relocation of each boiler or compres- sor to and including three horsepower, or each absorption system to and including 100,000 B.t.u.'s. 4.00 STREET NAME For the installation or relocation of each boiler or compres- sor over three horsepower to and including 15 horsepower, or j each absorption system, over 100,000 6.t.u.'s to and i nciLl- ding 500,000 B.t.u.'s 7.50 7..5" CONTRACTOR ____________________________________________________________________________________ OWNER For the installation or relocation of each boiler or compres- sor over 15 horsepower to and including 30 horsepower, or each absorption system over 500,000 B.t.u.'s and including 1,000,000 B.t.o.'s. $10.00 ADDRESS /4 For the installation or relocation of each boiler or compres- sor over 30 horsepower to and including 50 horsepower, or for each absorption system over 1,000,000 B.t.u.'s to and in- cluding 1,750,000 B.t.u.'s. $15.00 CITY For the installation or relocation of each boiler or refrigera- tion compressor over 50 horsepower, or each absorption system over 1,750,000 B.t.u.'s. $25.00 CITY BUSINESS LICENSE ND. s7.37 For each air handling unit to and including 10,000 cubic feet per minute, including ducts attached thereto. $ 3.00 CITY BUSINESS LICENSE NO. For each air handling unit over 10,000 cubic feet per minute $ 5.00 For each evaporative cooler Ottrr than portable type. $ 3.00 GROUP For each vent fan connected to a single duct. $2.00 For each ventilation system which is not a portion of any heating or air conditioning system authorized by a permit. $ 3.00 INSPECTION RECORD For the installation of each hood which is served by me- chanical eohaust, including the ducts for each hood. $ 3.00 For the installation or relocation of each domestic type incinerator. $ 5.00 For the installation or relocation of each commercial or industrial type incinerator. $20.00 For each appliance or piece of equipment regulated by this Code but not classed in other appliance categories, or for which no other fee is listed in this Code. $ 3.00 :j For the issuance of this permit. $3.00 I ACKNOWLEDGE THAT I HAVE READ THE APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL STATE AND CITY LAWS REGULATING THE MECHANICAL CODE OF THE UNIFORM BUILDING CODE. I CERTIFY THAT I AM PROPERLY REGISTERED AND OR LICENSED AS RE- QUIRED BY THE CITY OF CARLSBAD AND STATE OF C NIA OR I AM THE LEGAL OWNER OF ABOVE OE PRPT __,•, DATE JOB FINALED SIGNED BY PERMITTEE CITY Of (ARLSBADO BUILDING DEPARTMENT OWNER Hickory Farms MAIL ADDRESS Plaza Camino Real Center CITY Carlsbad TEL. NO. PLUMBER Proffitt & Durnell Plbg.,In ADDRESS 12630 So. Hawthorne Blvd. ClTYHawthorne, CalifI-EL NI772=2768 STATE CARLSBAD BUSINESS LICENSE NO. 165581 LICENSE NO. 8733 NO. ITEM FEE 2 TOILET © $1.25 2. 50 BATH TUB © 1.25 SHOWER © 1.25 2 WASH BASIN © 1.25 2. 5 0 2 KITCHEN SINK @ 1.25 2. 50 DISHWASHER © 1.25 LAUNDRY TUB OR TRAY © 1.25 AUTOMATIC WASHER @ 1.25 1 WATER HEATER & VENT © 1.50 1. 0 GAS SYSTEM I TO 15 .30 EA. ADD. © 1.50 4 FLOOR DRAIN OR SINK @ 1.2$ 5. 0 LAWN SPRINKLER @ 2.00 1 MISC. WATER PIPING @ 1.50 1. 0 GARBAGE DISPOSAL @ 1.00 VACUUM BREAKER OR BACK FLOW DEVICES 1 TO 5 @ 2.00 15. 50 GRADING PLAN YES fl NOV PERMIT $ 2 00 TOTAL FEE $ 17. 0 I ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I AM PROPERLY REGISTERED AND LI- CENSED AS REQUIRED BY THE CITY OF CARLSBAD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE D$$..CRIBED RESIDENTIAL PROPERTY. SIGNATURE OF PERMITTEE dJiJiMBIN6 a1 PERMIT - APPLICATION /75 - 75 / W-6-619 581**** ** 1 1.50 BUILDING ADDRESS 5f / £I (AM NEAREST CROSS ST. El Camino Real & Vista Way GROUP I ZONE Inspection Record APPROVALS DATE INSPECTORS SIGNATURE UNDER _FLOOR _WORK ROUGH PLUMBING GAS PIPING GAS VENTS PLUMBING FIXTURES MISC. GAS TEST UTILITY CO. NOTIFIED FINAL V VALIDATION This is a Plumbing Permit When Properly Filled Out, Signed and Validated. Permit void if work is not commenced within 60 days of date of issuance. PERMIT NO. 4 Q TOTAL FEE $ c2O. 59 Application for ELECTRICAL Permit SPAIP ******20-50 CITY OF CARL AD BUILDING DEPARTMENT 729-1181 - Ext. 36 For Applicant to Fill In PERMIT FEES: Each Fee BUILDING ADDRESS: Item Recpt. Sw. Lighting fixtures w/ballast for each 10 $ 1.00 5'(OO 1 St. Near Elec. Ranges, Clothes Dryers, Water Floaters .50 ,,.5 OWNER( ( lec. Space Heaters Dishwashers, Garbage Disposers, Auto. Washers, Sta. Cooking Units .50 ' ADOR ,tOTORS: Per each motor H. P. CITY 1 0 to 1 $ .25 £"O 1 to 2 $ .50 5'b ool ' TELEPHONE NO.").-.._ - - 2 to 5 $ 1.00 5 to 15 $ 1.50 ______ State r City Business I. License 'S 0 c\_____ _License 1 111 15 to 50 $ 2.50 50 to 200 $ 5.00 Group Zone ' By SIGNS: No. trans. Ea. $ 1.00 Inspection Record: No. lamps over 50 ea. $ .50 SERVICE: 0 to 150 AMPS For each additional 100 Amps. $ 10.00 $ ' 2.00 Temp. Power Pole, 100 AMPS or LESS ' S 3.00 For Each addl Meter, over one per service . $ 3.00 tISC: Approvals Date By: SUPPLEMENTARY PERMIT FEE: $ 2.00 Conduit TOTAL: Temp. Power R. Wiring Fixtures - ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY AND STATE LAWS REGULATING ELECTRICAL WIRING. I CERTIFY THAT I AM PROPERLY LICENSED BY THE CITY OFCARLSBAD ANDTHE STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESI- DENTIAL PROPERTY. SIGNATURE OF PER MITT E E: S.D.G.&E. FINAL: - CITY OF CARLSBAD AdMU JMBIN6 BUILDING DEPARTMENT PERMIT - APPLICATION OWNER 4lC_k&r'f tUV'. 7 MAIL ADDRESS.S\L1'T 1_ CITY (aL.4hAç TEL. NO. PLUMBER~f~_C-,-t=j gns cçcc - ADDRESS . TEL. NO.',?J STATE CARLSBAD BUSINESS - LICENSE NO. A I LICENSE NO. A - C 4e Fe NO. ITEM FEE TOILET @ $1.25 BATH TUB © 1.25 -- SHOWER © 1.25 WASH BASIN @ 1.25 KITCHEN SINK © 1.25 DISHWASHER © 1.25 LAUNDRY TUB OR TRAY © 1.25 AUTOMATIC WASHER © 1.25 WATER HEATER & VENT © 1.50 GAS SYSTEM I TO IS .30 CA. ADO. @ 1.50 FLOOR DRAIN OR SINK @ 1.25 LAWN SPRINKLER © 2.00 MISC. WATER PIPING @ 1.50 GARBAGE DISPOSAL @ 1.00 VACUUM BREAKER OR BACK FLOW DEVICES 1 TO 5 © 2.00 GRADING PLAN YES E] NO PERMIT $ 2 00 TOTAL FEE $ I ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I AM PROPERLY REGISTERED AND LI- CENSED AS REQUIRED BY THE CITY OF CARLSBAD AND STATE OF CALIFORNIA OR THAT I AM OF THE ABOVE DESGRIBED..RESIBESTIALI PROPERTY. SIGNATURE OF PERMITTEE M-6-69 184*******IlOO BUILDING )( /c2'7 ADDRESS NEAREST CROSS ST, GROUP I ZONE Inspection Record APPROVALS DATE INSPECTORS SIGNATURE UNDER FLOOR WORK ROUGH PLUMBING GAS PIPING GAS VENTS PLUMBING FIXTURES MISC. GAS TEST UTILITY CO. NOTIFIED FINAL VALIDATION This is a Plumbing Permit When Properly Filled Out, Signed and Validated. Permit void if work is not commenced within 60 days of date of issuance. CITY OF CA•SBAD PERMIT NO. TOTAL i FEE $ BUILDING DEPARTMENT 691 729-1181 -Ext. 36 Application for ELECTRICAL Permit SPAID For Applicant to Fill In Builg"? PERMIT FEES: Each Fee BUILDING ADDRESS: Item Recpt. Sw. Lighting fixtures w/ballast for each 10 $ 1.00 LS'o\- W il Elec. Ranges, Clothes Dryers, Water Heaters .50 OW*6 $-0 lec. Space Heaters Dishwashers, Garbage Disposers, Auto. Washers, Sta. Cooking Units .50 ADDR . L( 2'...\—.Q-----cL_.----_. MOTORS: Per each motor H. P. CIT , 0 to 1 ' $ .25 1 to 2 $ .50 TELEPHONE NO. 2 to 5 $ 1.00 5 to 15 $ 1.50 State City Business License Q 1.__-. License ' 1 15 to 50 $ 2.50 50 to 200 $ 5.00 Group Zone By - SIGNS: No. trans. Ea. $ 1.00 Inspection Record: No. lamps over 50 ea. $ .50 SERVICE: to 150 AMPS . For each additional 100 Amps. $ 10.00 $ 2.00. Temp. Power Pole, 100 AMPS or LESS $ 3.00 For Each addI Meter, over one per service $ 3.00 4 MISC Approvals Date By: SUPPLEMENTARY PERMIT FEE: $2.00 Conduit TOTAL: Temp. Power R. Wiring F ixtures I ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY AND STATE LAWS REGULATING ELECTRICAL WIRING. I CERTIFY THAT I AM PROPERLY LICENSED BY THE CITY OF CARLSBAD AND THE STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESI- DENTIAL PROPERTY. SIGNATURE OF PER MITT E E: (L..Mi3z S.D.G.&E. FINAL: WY OF CARLSBA• S SEWER BUILDI NG DEPARTMENT PERMT, APPLICATION FOR APPLICANT TO FILL IN LEGAL DESCRIPTION LOT NO. BLOCK - TRACT USE OF BUILDINGS CONTRACTOR - ADDRESS - CITY . TEL. NO. CONTRACTORS STATE. CARLSBAD BUSINESS LICENSE NO. LICENSE NO. NO. DESCRIPTION OF.WORK FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $3.00 SEPTIC TANK, SEEPAGE PIT OR PITS @. $5.00 OVERFLOW SEEPAGE PIT, ORAINFLELD EXTN.. CESSPOOL, DRYWELL. MANHOLE @ $5.00 HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1.50 CONNECT ADDITIONAL BLDG. OR WORK TO HOUSE SEWER @ $1.50 ALTER. REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM @ $2.00 OWNER'S . PERMIT $ 2 00 AUTHORIZATION . TOTAL FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD. ING TO THE PUBLIC SEWER. SIGNED THIS DAY OF OWNER OR OWNER'S AGENT . ADDRESS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY THE CITY OF CARLS- BAD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP- ERTY. . .. - SIGNATURE OF PERMITT.EE - - - - BUILDING . .. ADDRESS. .4 NEAREST CROSS ST. OWNER MAIL . ADDRESS CITY - TEL. NO. CONNECTION DATA Lateral Charge Computation 30' H., 10' V. 4" = _____ 6" Add. Horiz. I@ 4" = _____ 6" Add. Vert. @ 4" = _____ 6" Total Construction Cost 0% Service Charge Total Lateral Charge Let. No.: Logged in Plat:- - LINE COST DATA A. D. & Assmt. No. LINE COST: -C. C. @_ / dwelling . P. S. 1P / dwelling OTHER - TOTAL Grand Total, Lateral, etc. FOR SEWER LOCATION LO f) - St. NORTH ENGINEERING SEWER DEPT. Signed Signed This is a Sewer Permit When Properly Filled Out, Signed and Validated - Issued By PERMIT -VALIDATION - - -w.-v ,z; .2r'- 0 i hereby affirm that lam licensed under ;UI ')proviaiona of Chapter 9 (commencing with I. Section .7000) of Division 3 of the Business ' - and Professions Code, and my license is in 7. ZL - full force and effect. -.j' •.. " r I hereby affirm that i am exempt from the Contrac- - - tot's License Law for the following reason Sec. 7031.5 a' - Business and Professions Code: Any city or County whicr. re - quires a permit to construct, alter, improve, demolish. or k' repair any structure, prior to its issuance also requires the up plicant for such permit to tile a signed statement that he is licensed pursuant to',rhe provisions at the Contractor's License Law Chapter 9 commencing with Section 7000 of -. - Division 3 nithe Business and Professions Code) or that is en- '-----i empt therefrom and the basis for the alleged exemption: Any z 7 violation of Section 7031,5 by an applicant br a permit sub- jet ts the applicant to a civil penally of not more than live hun- dred dollars ($500). ' I, as owner of the property, or my employees with wages ' i I as their sole compensation., will do the work, and the struc- ture is not intended nr'otlered or said (Sec. 7044, Business "and Professions Code: The Contractor's License Law does t.J vat apply- to an owner 0? yroperty:wtru builds or, improves -.0 thereon and who does such work himself or through his own-- -. m employees, provided that such improvements are not intend' Mi ¶,,ed or,oftered for sale,,, It, however, the building or improve- Z merit is sold within one year of compleliOn, the owner-builder- it will have the burden of proving that he did not build or im' '-"''0 -"prone for the purpose of sale). -, I I I. as owner of the property, am exclusively contracting - " • with, licensed contractors to construct the project (Sec. 7044. - 1'Basivess and Professions Code:"Thn Contractor's License - :Law does not apply to an owner of property who builds or im- -- proven, thereon, and who contracts for each projects with a -' rA contractor(s) license pursuant 'to-the Contractor's License 2. JF LaW),i.1(;i 1,1 As a homeowner lam improving my home. and the follow"' tic4 7 log conditions extol 1: The work is being performed ' prior Innate, 2. I' have., lived., in, my, home for twelve months print to completion 01 this work. Mi - - ' -' -, 3,-I- have ' not -claimed, this exemption during the 1'• Iasi three years. 'O.lumeeiii'pt under Sec. ' '" , B&P.C. ' ;"f.for this reason C,'- ' ', S. - - 0 - I hereby affirm that I have a certificate of consent to - ( self.insxre, era certificate of Workers' compensation fn./ — - surance. or a certified copy thereof Sec. 3800, Labor Code) ' x.p6Licv N. o,'.) 'ir' ' -COMPANY ' " - "Copy is tiled with the city 4 0 Certified copy is hereby furnished Mi 11 ' ' 14 U 'CERTICATEOF,EXEMPTION FROM —. U WORKERS' COMPENSATION INSURANCE. , I t' 'rw This section need not be completed if the permit .is for one hundred dollars ISfOOl or less) - Ui -- -39 M°,I certify that in the performance Of the work for which IX this permil,is issued. I shall not employ any person in any, 'manner seas to become subject to the Workers' Compen. 'sation Laws of California., NOTICE TO APPLICANT: If, after making this Certiticare, of Exemption, you Should become subject to the Workers' ,"- Compensation provisions. of the Labor Code, you must '-forlhwittr comply with such provisions or this permit shall deemed revoked.' . it .'t.E[" Dl heeb"aItirrn rkol there is a construction lending 7'U, -. agency for the 'perfor0½"nce of the work for which this per. 4a ' mit is issued (Sec. 3097. Civil Code) - -' - " "*-'• - '' '------- - Ui I Lender's Name - I Lender's Address' L,. USE RAIl Pflhldl Pfld ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. 4 CARLSBAD-BUILDING DEPARTMENT ' ' '''' "APPLICATION -& PERMIT 1 2075 Las Palmas Dr., Carlsfld, CA 92009-1915 (619) 438-1161 .106 ADDRESS AV. ST,R . THOMAS BROS NO. ' ~~N 8USINESS LICENSE d* VALUATiON PERMIT NUMBER 5z7c —. ZONE LOT BLOCK, SUB DIVISION ASSESSOR PARCEL NO. ' CONTRACTOR , CONTRACTORS PHONE ' OWN B P'S NAME OWN E R'S PHONE p / CONTRACTOR'S ADDRESS STATE LICENSE NO. ._ ,. BUILDING SO. FOOTAGE ADDRESS ' DESIGNER DESIGNER'S PHONE OWNER'S MAILI 27366 ,tz*j_ooi, a DESCRIPTION OF WORK 06/0/89 0001 01 02 DESIGNER'S ADDRESS STATE LICENSE NO. B1dF'rnt - -2619.O( no i-t) ' ' '' F/P FLR ELEV. - NO - , STORIES Diy-r'o d- &J-8-1 %J k"-€ ' 52_- 9" p '' EDU -A.4 D NO CENSUS TRACT- PARKING SPACE RES UNITS GRADING PERMIT ISSUED REDEVELOPMENT J TYPE 0CC LOAD FIRE SPR - ' YD ND AREA oD ND L*IVST % [flfrPf - ND Not Valid Un/ecs Machine Cent lmi& - QTY PLUMBING PERMIT ISSUE -7,,çô QTY MECHANICAL PERMIT ISSUE SUMMARY/ACCOUNT NUMBER * EACH FIXTURE TRAP , . INSTALL FURN. DUCTS UP TO 100,000 BTU '' - ' €UILDINGPERM)T' -" - 001-810'00-00'8220 - EACH BUILDING SEWER , , . . - - - OVER 100,000 BTU , SIGN PERMIT 001-810-00-00-8221 J 'EACH WATER'HEATER AND/OR VENT . - BOILER/COMPRESSOR UP TO 3 HP . - PLAN CHECK 001'810-00-00'8891 Zq 'EACH GAS SYSTEM 'I 104 'OUTLETS " '. BOILER/COMPRESSOR 3.15 HP'' - ' " -''-, - "'TOTAL--PLUMBING '- '001-810-00'00-8222 - -'- - - - --" -EACH GAS SYSTEM 5 OR MORE , ' , — METAL-FIREPLACE ' , , ELECTRICAL . 001-810-00-00-8223 , - ,EACH INSTAL,, ALTER, REPAIR WATER PIPE - VENT FAN SINGLE DUCT ' ' ' ' MECHANICAL -. 001-810-00-00-8224 - EACH VACUUM BREAKER '- - '. - .L MECH EXHAUST HOOD/DUCTS -' . -'- ' ' MOBILEHOME - 001-810-00-00-8225 - - ' - -- - WATER SOFTNER . .. - . RELOCATION OF EA FURNACE/HEATER . SOLAR 001-810-00-00-8226 EACH ROOF DRAIN (INSIDE) . DRYER VENT I ' - - STRONG MOTION - 880-519-92-33 -. i) — TOTAL MECHANICAL $ ' I ' — - '7"e' _FIRE SPRIN'r(LERS 001-810-00-00-8227 ' - TOIAL PLuMBING ' i ' ,,_ PUBLIC FACILITIES FEE 320-810-00-00-8740 BRIDGE 'FEE ' - '360'810-00'00-8740 OTY. ELECTRICAL PERMIT ISSUE OTY. , MOBILE HOME SETUP PARK-IN-LIEU (AREA ONSI' EA AMP'SWI I/KR r ' CAR PORT . TIF 312-810-00-00-8835 i P 3 PH' - - .i85) . AWNING ' - -' , .''' LACOSTA hF - - - 311-810-00-00-8835" , ,EIIST SLOG EA AMP/SWT 1BKR - - - . .' • _ GARAGE * . , , ... -- ' - FMF - - - 1 PH 3 PH ' . ' - LICENSE TAX 001-810-00-00-8162 47 -- . REMODEL ALT E R 'PER CIRCUIT , -, . , ' - ' ' -' '' - '- -' ' -'/FF - -' - - - 880-519'92-57-' — TEMP POLE 200 AMPS OVER 200 AMPS TEMP OCCUPANCY 30 DAYS) , x • . CREDIT DEPOSIT I TOTAL ELECTRICAL . . - .r - ' ' ' TOTAL , ' . - TOTAL FEES PAYABLE I k'_-__-e?7"" ,• I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY Expiration Every permit issued by the Building Official under the provisions of ff115 * AN OSHA PET IS REQUIRED FOR EXCAVATIONS OVER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE e 0 expire by lion and become null and void If the building or work 50" DEEP AND DEMOLITION OR CONSTRUCTION OF hin 180 days from uch DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS permit. or if the buInofor work authorized by such permit :uo:n:dr STRUCTURES OVER 3 STORIES IN HEIGHT ISSUED: TO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS GOVERNING BUILDING CON- abandoned at any t'id)s aj'er the work is commenced for a period 01180 days. STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND , I It, APPLICANT'S - OWNER 0 APP CONTRACTOR 0 - ED BY -"n 'DAT 7 / 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 /II1K.." - 'T / t7. GRANTING OF THIS PERMIT. _,_4' BY PHONE 0 - L (_'c._ TYPE DATE. . INSPECTOR BUILDING FOUNDATION REINFORCED STEEL MASONRY GUNITE OR GROUT SUB FRAME 0FLOOR 0 CEILING - - - SHEATHING 0 ROOF 0 SHEAR. FRAME EXTERIOR LATH. -. - -- - INSULATION. INTERIOR LATH & DRYWALL r I , PLUMBING 0:SEWER AND BL/CO 0 PL/cp. . - UNDERGROUND 0 WASTE 0 WATER 7 TOP OUT 0 WASTE 0WA1ER TUB AND SHOWER PAN -. - GAS TEST O WATER HEATER :o SOLAR WATR. ELECTRICAL -- . - - ---. - -- 0 ELECTRIC UNDERGROUND 0 U4FER- -. - --- - .ROUGHELECTRIC O ELECTRIC SERVICE 0 TEMPORARY. O BONDING D4POOL . MECHANICAL 0 DUCT & PLEM., 0 REF. PIPING HEAT — AIRCOND.SYSTEMS VENTILATING SYSTEMS SYSTEMS CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ITpM.q APO%/P I4Avc RFFN APPROVED. FINAL PLUMBING ELECTRICAL MECHANICAL GAS :.- . :•..-j\'. .-- BUILDINGS. - I SPECIAL CONDITIONS FIELD INSPECTION RECORD - - -. REQUIRED SPECIAL INSPECTIONS . J INSPECTORS NOTES INSPECTION REO. IF INSPECTOR'S DATEAPPROVAL 4 \ CHECKED -- -. - .. .. - .- _____ SOILS COMPLIANCE,- -• - - PRIOR TO FOUNDATIO - N INSP . * STRUCTURAL CONCRETE OVER 2000 PSI PRESTRESSED .CONCRETE POST TENSIONED, CONCRETE FIELD WELDING - - -- - .44 -. - - - •'_•S••- ..- - - HIGH STRENGTH'J BOLTS._4 - .-/ SPECIA[MpOR 4 ----------------. --. ._. -' - PILES CAISSONS. . - - -. - :-• -. . - -- - - -. - - - - . - - - - - - -.4--.. ----.4 ------ ----- ... -. - - _'I__- . -. - - -. .• -- - -- .--- -- -- - --- -...' '------4--' - •-:'' -- __________________ ___________ - I j- ..i ' . • .. - ,n/vl r. ~'q 0~\Q\86 KOEOT 05 I 'S r -'- - - .4......4 i;--- .--•-- • •-:.' • •.'. City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 '11-30-2001 Electrical Permit Permit No:CB013297 Building Inspection Request Line (760) 602-2725 Job Address: 2525 EL CAMINO REAL CBAD St: 107 Permit Type: ELEC Status: ISSUED Parcel No: 1563020900 Lot #: 0 Applied: 10/17/2001 Entered By: JM Reference #: Plan Approved: 11/27/2001 Issued: 11/30/2001 Project Title: PLAZA CAMINO REAL Inspect Areal: REPLACE 200 AMP CIRCUIT - ALUM TO COPPER Applicant: Owner: NEAL ELECTRIC PLAZA CAMINO REAL- C/O WESTFIELD CORP INC5661 :11,30/01 0002 01 02 .1325 KIRKHAM WY / c 11601 WILSHIRE BLVD N. cop 12000 P0 WAY CA 92064 / LOS ANGELES CA 90025 S -858-513-2525 I Total Fees: $120.00 -- \. Total Payments To Date: $0.00 BalanceDue:. $120.00 I •-'." / .• " •.. .-, 5, Electric Issue Feet ( 7 - - $10.00 Single Phase per AMP 0 // $0.00 Three Phase per AMP '\O $0.00 Three Phase 480 Per AMP') i.... ,-' S I-• J ; $0.00 Remodel/Alteration per AMP .. , ,c •.. _ $0.00 Remodel Fee ' I ii;. '- / ç' "'s1 / / $0.00 Temporary ServiceFee , '• - I \ .-•!/ / $0.00 I Test Meter Fee , .•;_' 'J / $0.00 I Other Electrical Fees ... S - • / $110.00 I Additional Fees \ N ' /' $0.00 / I. \.._ iCCHP)fATFD / TOTAL PERMIT FEES \\ / 1952 CORDANC EA17H U.B.C. SIG FINAL APPROVAL Inspector: Date: ______________ 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 capachy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 -,'- (760)438-1161 1. .PROJECTINFORMATION 5'. FOR OFFICE USE ONLY PLAN CHECK NO15'V3Z'17 EST. VAL. Address (include ldg/Suite #) Business Name (at this address) r r 41 Ce&iô Rca! 1ar 94e /pi Legs) Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use . . Proposed Use flpfrze.i 2&'o ,4ii,1 C..rrc.'t ffepfQCi pnj 7'o-? A/c'j, Description of 'Work or SQ. FT. I #of Stories # of Bedrooms # of BatI{rooms 2 CONTACT PERSON (If dlffereiit from applicant) I f/jt,,,e, C -/ynii 12C 13 7( :Yz D,, ,Sf 7. Name I Address City V State/Zip Telephone # Fax # 3 APPUCAJIT 0 Contractor ' Agent for Cntrator 0 Owner DAgent for Owner Name I Address City State/Zip Telephone # 4 PROPERTY OWNER Name - Address City State/Zip Telephone # 5 CONTRACTOR COMPANY NAME (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 applicant to a civi15,penalty of not more than five hundred dollars I$5001). — ,A4i /,,.. /"32ç0 /(,r/('h4,r, Lay /gveify 9toi,c' Name Address tity I State/Zip Telephone # State License # License Class City Business License # Designer Name Address City I State/Zip Telephone State License # 6. WORKERS' COMPENSATION . ...' . . . . : .. ..: : . :. . .... 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. 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 compens tio insura ce carrier and policy number are: - Insurance Company .S' / I'QI I Policy NO.WY/53OO Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS) o 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' compensatiorl. coverage is unlawful, and shall subject an employer to criminal penalties and civil fines .up to one hundred thousand dollars ($10 in addition SIGNATURE t compensation, damages as provided for in Section 3706 of the Labor code, Interest and attorney's tees. DATE /0 -17'o, 7. OWNER-BUILDERDECLARATION..............S 7/.................. I hereby affirm that I am exempt from the Conti4'tor'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 under Section _______________ Business and Professions Code for this reason: I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO ((have I have not) signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number): 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): 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 COMPLETE ThIS.SECTION FOR NON-RESIDENTIAL.BUILDING PERMITS ONLY ......... -- ... ... ,.:...: .........: .. .5 5 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 0 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 0 NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 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 REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 8... :CONS'TRUCTION LENDINGAGENCY 5: •:'5"' :•O ...........S 5 5 S S I hereby affirm that there is a construction (ending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME LENDER'S ADDRESS__________________________________________________________ 9 APPLICANT CERTIFiCATION 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 the Cit' 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 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 t k commencedAor yeriod of 180 days (Section 106.4.4 Uniform Building Code). he APPLICANT'S SIGNATURE Yn141 '1_.'45'14Zfv DATE an: File YELLOW: Applicant PINK: Finance City ofCarlsba,d Bldg inspection Request Lr For: 07116/2002 Permit# CB013297 Inspector Assignment: PY Title: PLAZA CAMINO REAL Description: REPLACE 200 AMP CIRCUIT - ALUM TO COPPER Type: ELEC Sub Type: Phone: 7604382633 JOb Address: 2525 EL CAMINO REAL Suite: 107 Lot 0 Location: Inspector: APPLICANT NEAL ELECTRIC Owner: PLAZA CAMINO. REAL Remarks: FINAL., Total Time: Requested By: CONTRACTOR Entered By: CHRISTINE CD Description Act Comments 39 Final Electrical 4V 3y Associated PCRs/CVs Inspection History Date Description Act .lnsp Comments 07/10/2002 14 Frame/Steel/Bolting/Welding NR PY NO ONE THERE - NO ACCESS 07/10/2002 24 Rough/Topout NR PY 07/10/2002 34 Rough Electric NR PY 07/09/2002 14 Frame/Steel/Bolting/Welding NS PY 07/09/2002 24 Rough/Topout NS PY 07/09/2002 34 Rough Electric NS PY 06/05/2002 34 Rough Electric NR PY NO ONE THERE - NO ACCESS City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008' .',. 1.: 05-28-2002 Miscellaneous Permit Permit No: CB021604 Building Inspection Request Line (760) 602-2725 :...:. , Job Address: 2525 EL CAMINO REAL CBAD St: 1.0. Permit Type: MISC , Subtype: OTHER ' ' Status: ISSUED Parcel No: 1563020900 Lot #: 0 Applied: 05/28/2002 . Valuation: , $0.00 ' Entered By: MDP Reference #:'. Plan Approved: 05/28/2002 Issued:. 05/28/2002' '. Project Title: SHIEKH SHOES Inspect Area: DEMO NON BEARING PARTIONS SOFFITS _• ;ppIicant _Owner -.-.... .J R LENNEN CONSTRUCTION PLAZA CAMINO REAL, ' '. :; I C/OWESTFIELD CORPINC 8022 05/28/02 0002"01 02 •' • 11601-WILSHIRE BLVD N • ' COP - • 6000 ' .47O8ST ANDREWS. DRIVE 95219 / LOS ANGELES CA90b25 09 476-8205 ,' -''? \"-::Pz\\ / L)9 \ Total Fees: $60.00 / Total Payments To Date: $0.00J Balance Due: $60.00 :- :•'• Miscelaneous Fee #1 / ' •• '.•' Miscelaneous Fee #2 \j$0.00 \ Additional Fees / • \' " - ..,.....$0.00 \ - TOTAL PERMIT FEES ______ $60.00 \ \\ INCORPORATED, ID / ', , - '.:- , • -1 ,. -•'- 711 - FOR OFFICE USE ONLY 'PERMIT APPLICATION PLAN.-CHECK NO.__________ CITY OF CARLSBAD BUILDING DEPARTMENT EST VAL. 1635 Faraday Ave., Carlsbad,' CA 92008 ., Plan Ck. Deposit -. . Validated By. Date___________________ E1 1ECT INFORMATIOfi& 9r LC7'IWO O thTk# ~11VL'S .. Address '(jnclude Bldg/Suite #) ' r Business Name (at this address) i&1)91 L. . . ' . . •-• •.. 'S Legal Description ' LotNo. Subdivision Name/Number , it,No. Phase No, Total # of units Assessor's Parcel '# I Existing Use Proposed Use S. •,S , - , scription of Work . . ' SQ. FT.' .' •#of Stories # of Bedrooms . # of Bathrooms 1.10tWVun,oA) or QNW 210 TPERSON(Ifdifferentrom applicant) , , Name Address - '. , Address - . - •. City, " State/Zipi Telephone # Fax # .97 PCAN S •" Name ,. Address . - . . . . City ' State/Zip , , Telephone# T S tTIF 5 € EN i?' City '----State/Zip , Telephone #' - - iow ! I rLi3 I (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 statenent that he is licensed pursuant to the provisions of the ContractSr'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 b'asis for the alleed - exempti - ny violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of not more thanfiv hundred dollars l$5001). £ oJ '11OK ,17)bLe1J5 M. itvA), C4. Qi-vq ft41 Name ', - . * . - Address - " , ; City State/Zip' Telephone # - S State License #3"'5''/O License Class ' " City Business Licese # Designer Namb . , " Address ' - City State/Zip.',Telephone State License # JU Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: .. - 0 I have andwill maintain a certificate of consent to self-insure for workers'l compensation as provided by Section 3700 of the Labor Code, fr the performance - of the work for which this permit is issued, I have arid 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: -, S Insurance Company - ' . - .' - ..' Policy No. ' ,' Expiration Date '. (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$1001 OR LESS) - - - . 0 CERTIFICATE OF EXEMPTION: 1, 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. 1 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 dollars ($100,000). in addition to the cost of compensation damages as provided for in Section 3706 of the Labor code interest and attorney's fees SIGNATURE - , ' -' S " ' DATE UE KID - ' _57 221MM I hereby affirm that I am exempt from the Contractor's License Law for the following reason:,,. I, as- owner of the property or my employees with wages as their sole compensation, will do thg wo'rk 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 doei 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; amexclusively 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) licensid - - - pursuant to the Contractor's License Law). 0 lam exempt under Seition - - - - • Business and Professions Code for this reason'... I pdrsonally plan to provide the major labor and materials for construction of the proposed property improv(iment. 0,YES ONO 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. l plan to provide portidis of the work; but I have hired the following person to coordinate, supervise and provide the major work (include name I address / phone number /contractors license numb'r): _ 5.' 'will provide some of the'work, but I have contracted (hired) the following persons to provide the work indicated (include name I-address / phone number/ type of work): ' - ' ' . - S ' ' ' -J. PROPERTY OWNER SIGNATURE - . - -. -, r - DATE gg 57m, fn ____ Is the applicant or future building occupant required to subrnit'a business plan, acutely hazardous' materials registration form or risk mariagement and prevention p'ogram under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES 0 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 0 NO Is the facility to be constructed within 1,000 feet of the outer boundary of a 5cho1 site? 0 YES - 0 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 - REQUIREMENTS OF,THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL. DISTRICT. M 7s ER ' 5 " I hereby affirm that there is a co ' nstruction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). - - '. -' LENDER'S NAME - - .. .LENDER'S ADDRESS - - - I certify that I have read the application and state that the abov'e information is correct and tat 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'representativesof the Cit, of Carlsbad to enterupon the above mentionOd property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS-THE CITY OF CARLSAD'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. - S -. • - . - , . p-s., - - •5 - - 5-. EXPIRATION: Every permit issued e 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 mmen ed ithin 18 ays from the date of such permit or if the building or work authorized by suc peri)tit is suspended or abandoned - .,at any time after the work is co mence fo p r 180 days (Section 106.4,4 Uniform Building Code), - -'S - APPLICANT'S SIGNATURE - _ DATE° WHITE. File . YELLOW. Applicant • PINK. Finance . - 5 5 5 . - . , '• - ' 55 - 5 , - - -, S I S,•i ,S S S 4 • .' S - 'S -