Loading...
HomeMy WebLinkAbout2525 EL CAMINO REAL; 111; STE 111 PRE 2016; PermitCITY OF CARLSBAD BUILDING DEPARTMENT 729-1181 -Ext. 36 For Applicant to Fill In 4' Owners Name Mode 0' Dag Mail Address Plaza Camino Real Contractor Millie & Seversrn Contr. Address r.p. 13- 1269, Long- Deac To Const. JJ To Add 0 To Alter 0 Convert 0 To Move From Type of Const. Frame and Masonrg Frame, Masonry, etc. To Be Used For Kind of Foundation_______________ No. of Stories_______________ Floor Space (Sq. Ft.) 3 ,165 Garage Floor Space (Sq. Ft.) Attached___________________ Detached__________________________ Legal Description Lot Block Subdivision Or Section Township Range No. of Existing Building Will this construction include any plumbing installation or alter- ation? Yes 0 No 0 Signature of Applicant 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 DESCRIBED(RES)DENTIAL ROPERTY SIGNATURE OFPERMITTEE '- ----- Application föBUiLDING Permit Building Permit Fee OEC26-68 5 AID*******00 Buildinq DeDf. Use only Building Address .77 j 1m 711 St. Near El Camino Real Set Back Bldg. Valuation Front P.L. Main Bldg. Side P.L. Garage Rear P.L. Other Group Zone Approved by Contractor City Bus. Lic. No. Water Meter Sewage Disposal System Inspection Record 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 CARD PERMIT NO. TOTAL FEE t o______ BUILDING DEPAR'ENT 729-1181 - Ext. 36 Application for MECHANICAL Permii For Applicant to Fill In - HO. ITEM INSTALLATION AND/OR RELOCATION EACH AMT. uu )V-101J . 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 grani- 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 ,1,p1:: a For the installation or relocation of each boiler or compres- sor to and including three horsepower, or each absorption L:z.Ie,l,lt,Ic_f;t9_- STREET NAME je~" system to and including 100,000 B.t.n.'s. $ 4.00 For the installation or relocation of each boiler or compres- sor over three horsepower to and including 15 horsepower, or each absorption system, over 100,000 8.t.u.'s to and inclu- 1. CONTRACTOR Southland }Itg . & A/C Inc ____________________________________________________________________________________ Plaza Camino Real, A Limited OWNER P a.xtfl,ersh ip ding 500,000 B.t.n.'s $ 7.50 - 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.u.'s. $10.00 ADDRESS 2800 Temple Avenue - 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.I.o.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.t.u.'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 0, CITY BUSINESS LICENSE NO. For each air handling unit over 10,000 cubic feet per minute. $ 5.00 For each evaporative cooler oil,er than portable type. $ 3.00 0'3 GROUP For each vent fan connected to a single duct. $2.00 2.-s---- 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 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 CALIFORNIA 0 THAT I AM THE LEGAL OWNER OF T OVE DESCRIBED PRO E TY DATE JOB FINALED SIGNED BY PERMITTEE SPAID ** 15 SO CFY OF CARtSBAD BUILDING DEPARTMENT OWNER Mode O'Day MAIL ADDRESS P1 aza Camino Real Center CITY Carlsbad TEL. NO. PLuMBERproffitt & Durnell Plbg.,In ADDRESs12630 So. Hawthorne Blvd. CITY Hawthorne 24NO 772-276 STATE CARLSBAD BUSINESS LICENSE NO. 165580 LICENSE NO. 24 NO. ITEM L_FEE 1 TOILET @ $1.25 1 25 BATH TUB @ 1.25 - SHOWER @ 1.25 1 WASH BASIN @ 1.25 1 25 KITCHEN SINK @ 1.25 DISHWASHER @ 1.25 LAUNDRY TUB OR TRAY @ 1.25 AUTOMATIC WASHER © 1.25 1 WATER HEATER & VENT © 1.50 1 50 GAS SYSTEM 1 TO 15 .30 EA. ADO. © 1.50 FLOOR DRAIN OR SINK @ 1.25 LAWN SPRINKLER © 2.00 1 MISC. WATER PIPING © 1.50 1 50_ GARBAGE DISPOSAL © 1.00 VACUUM BREAKER OR BACK FLOW DEVICES I TO 5 © 2.00 5_0__ GRADING PLAN YESD NOfl PERMIT $ - 00 TOTAL FEE $ ~~7 50 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 DESCRIBED RESIDENTIAL PROPERTY. SIGNATURE OF PERM[' &UMBIN PERMIT - APPLICATION A SPA ID2332****** .30 -f BUILDING . 5_2 S ADDRESS _ NEAREST El Camino Real & Vista Way 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 VA ImATItj 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 BUILDING DEPARTMENT 729-1181 -Ext. 36 For Applicant to Fill In PERMIT NO. TOTAL FEE $ Application for Building Dept. Use Only PERMIT FEES: Each Fee BUILDING ADDRESS: \(iQ(g ~2ntj:~L4A C RQ Item Recpt. Sw. Lighting fixtures w/ballast for each 10 $ 1.00 CJ St. Near I/I Elec. Ranges, Clothes Dryers, Water Heaters .50 10 .S OwNE O, lec. Space Heaters Dishwashers, Garbage Disposers, Auto. Washers, Sta. Cooking Units .50 ADD 55: Ca 1MOTORS: Per each motor H.P. CITQ 0 to 1 $ .25 1 to 2 $ .50 ç11 S ( TELEPHONE NO 2 to 5 $ 1.00 5 to 15 $ 1.50 State City Busines57D License j L..... License 0 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 I7: 0 to 150 AMPS For each additional 100 Amps. $ 10.00 $ 2.00 Temp. Power Pole, 100 AMPS or LESS $ 3.00 For Each add 'I Meter, over one per service $ 3.00 ISC: Approvals Date By: SUPPLEMENTARY PERMIT FEE: $ 2.00 Conduit at 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 OFCARLSBAD ANDTHE STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESI .DENTIAL PROPERTY. SIGNATURE OF PERMITTEE: S.D.G.&E. FINAL: CITY OF CAR.LBA • SEWER. BUI LDING DEPARTMENT PERMIT- APPLICATION FOR APPLICANT TO FILL IN LEGAL BUILDING DESCRIPTION LOT NO. ADDRESS . 14 - NEAREST - BLOCK TRACT CROSS ST. USE OF BUILDINGS OWNER MAIL I . CONTRACTOR ADDRESS ADDRESS CITY • TEL. NO. 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 ITS © $5.00 OVERFLOW SEEPAGE PIT, ORAINFIELD 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 OWNERS AUTHORIZATION PERMIT $ 2 00 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 OWNERS AGENT ADDRESS 1 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 PERM ITTEE CONNECTION DATA Lateral Charge Computation 30 H., 10, V. @ 4" = ______ 6" = Add. Horiz. @ 4" = _____ 6" = Add. Vert. @ 4" = _____ 6" = Total Construction Cost 10% Service Charge Total Lateral Charge Lot. No.: Logged in Plat: LINE COST DATA A. D. & Assmf. No. LINE COST: C. C. @_" / dwelling P. S. @ / dwelling OTHER TOTAL 5 Grand Total, Lateral, etc. FOR SEWER LOCATION St. NORTH ENGINEERING SEWER DEPT. Signed Signed This is a Sewer Permit When Properly Filled Out, Signed and Validated Issued By PERMIT VALIDATION CITY OF CARLSqft& CONSTRUCTION LENDER INFORMATION 'OVER) BUILDING DEPARTMW AppIica1...3r BUILDING Permit 729-1181 - Ext. 36 Building Permit Fee OCP For Applicant to Fill In /Q NAB 12-69 619*******9.00 cc Owner's Name t'4 cpC / Mail Address 2 /3o Contracfo A4 Contr. Add 2.2-f-.,' //04 i ress '-" Building Dept. Use Only Building Address ,, yC_ St. Near To Const. 0 To Add 0 To Alter 0 Convert 0 To Move From Type of Const. Frame, Masonry, etc. To Be Used For6 /c ,.4./ Kind of Foundation_______________ No. of Stories_______________ Floor Space (Sq. Ft.) 3 Garage Floor Space (Sq. Ft.) Attached Detached________________________ etl Legal Description '' Lot Block ..')1 ubdivi or :r SectJ Township Range No. of Existing Building Will this construction include any plumbing installation or. alter. ation? Yes 0 No El Set Back Bldg. Valuation s..x7 c1 cO. Front P.L. Main Bldg. Side P.L. Garage Rear P.L. Other Group Zone Approved by Contractor City Bus: Lic. No. Water Meter Sewage Disposal System Inspection Record -S.. Sign ____TTT:: 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. Utility Company Notified - Date By - I CERTIFY THAT I AM PROPERLY REGISTERED AND/OR Final LICENSED AS REQUIRED BY CITY OF CARLSBAD AND STATE OF CALIFORNIA DESCR. ,@R THAT I AM THE LEGAL OW IF a check is tendered for payment for the above fee and the check is not honrd when presented for payment, your OF THE ABOVE BED RESIDE I Y. SIGNATURE building permit will be immediately revoked. - OF PERMITTEE City of Carlsbad Building Dept. Permit void if work oTcommenced within 60 days of issuance. CONSTRUCTION LENDER IDENTIFICAflOU • • .•• CALIFORNIA STATE CODE OF CIVIL PROCEDURE -. • SECTION 1193 (J) • • name of ender branch PLAN CHECK PLANNING: SCHOOL FEES: SAN DIEGUITO________________ CARLSBAD_____________________ % COVERAGE___________________________ BUILDING HEIGHT FENCES/WALLS_________________________________ TWO CAR GARAGE/I( ENCINITk1R4LSAD irtmefl SAN MARCOS_____________________ REQUIRED SETBACKS FRONT SIDE REAR LU LU COMMENTS- LU REDEVELOPMENT APPROVAL) LIJ LLJ LL 7PAN U LANDSCAPE coMMNrs: IRED: ENV IRONMN-—RE-'cJtRtD: ADDITIONAL COMME OK TO ISSUE:_.% .DATE:4 ,OK TO FINAL: DATE:_______________ ENGINEERING LEGAL DESCRIPTION VERIFIED? A.P.N. CHECKED?2 P.F.F. PARK IN LIEU R.O.W:______________ IMPROVEMENTS: E.D.U: SEWER: S LATERAL: DRIVEWAY: GRADING PERMIT: DRAINAGE: EASEMENTS: A/o/s/ ADDITIONAL COMMENTS: A-7i - ,11, 7- / C..4 7y £,V\/. OK TO ISSUE: * ENGINEERING INSPTI'ON REQUIRED: PUBLIC WORKS INSPECTOR: FINAL OK: DATE: * IF THIS ITEM IS NOT CHECKED, BUILDING DEPARTMENT WILL MAKE ALL INSPECTIONS (DRIVEWAYS, CURB CUT, DRAINAGE, ETC.) DATE: rij ter J USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHAflFfl ARFA ANfl DEClARATIONS hereby affirm that lam licensed under, kf vialona of Chapter 9 (commencing with . tlon 7000) of Division 3 of the Business L Lc end,Profeaalona Code, and my license is (h' full for No Class - C I hereby allirm that I am exempt from the Contrac' - tar's License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or County which re-quires a permit to construct, alter, improve, demolish, or repair any slructure prior to its issuance also requires the ap' pticant br such permit to tile a signed statement that he is .licensed, pursuant to the provisions -of ilhe Contractor's License Law (Chapter 9 commencing with Section 7000 01 - -- ' Division 3 of the Business and Professions Code) or that is en-, empt therefrom and the basis for the alleged exemption. Any .' violation of Section 7031.5 byav applicant for a permit sub-jects the applicant to a Civil penally qt.00t more than live hun- dred dollars (SSOO)..,",, .:.. ,.12 •_ -'C . 0 I, as owner of tlru-property, or my employees with wages 116611 as their solo compensation,' will do the'work, and the struc- ture is not intended or offered for sale (Sec. 7044. Business ,J and Professions Code:,.Thu Contractor's License Law does 5 . 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 intend' W ed 0) offered for sale. .11. however, the building or improve Z menl is sold within one year 01 completion, the owner-builder 39 will have the burden of proving that he did not build or I'm o , prove for .the purpose of sale). - 0 I, as owner of the property, am exclusively contracting - ',- with licensed contractors to construct the project (Sec. 7044, • I Business and'P(ofessions Cede: The Contractor's License Law does not apply to an owner 01 property who builds or im-proves thereon, and who contracts for each projects with a contractor(s) license pursuant to the Contractor's License Z ' Law). . 0 As a homeowner -I am improving my home, and the 10110w' Cr.• • isp conditioos exist: . • 5. Thu work is being performed prior to sate. 2. .1 have lived in my home for twelve months prior to completion 01 this work. w 3. I have not claimed this exemption during the O • last three years.' 0 lam exempt under Sec. ___________________ , B & P.C.. - .ufor this reason - ' • . - .:. - - . -' ' - .- . • herebyaIIrrm that I have -a cenificale 01 consent set -insure. or a certificate 01 Workers' -,,, Compensation Insarance, or -a certified copy tvereof .....' (Sec.. 3800. Labor Code). • . Z '- POLICY NO. c.;1 (,oL 2 '.COMPANY 4er - •..••0..- -. .- (I) S 'Copy s trIed with " the cay z ' - Ut - - D'Cer1tid cop s'hereby burnished - a-'-..-• , ..• 0 CERTIFICATE OF EXEMPTION FROM ' WORKERS' COMPENSATION INSURANCE (This section need not be Completed it the permit LLI • Y is lot one hundred dollars 18109) or 1esN Ic cc 0 I certify that in the performance of the work tom 0 . whiCh this permit is issued. I shalt not employ any person in any manner so as to become subject to the Workers' Compensation Laws 01 California - -NOTICE TO APPLICANT It. alter making this Cern ticate 01 Exemption, you should become sublect to - - the Workers Compensation provisions 01 the Labor - 'Code, you must forthwith comply wiltS' such provisions or thiS permit Shall be deemed revoked F ( 'DI hereby affirm that' there is a Construction e. Ix ) lending agency 'or the performance of the worm, to, which In,! permit is isSued (Sec 3097, Civil Code) wi' - Lender's Name' ' - - - L Lender's Address CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT /1 1200 Elm Carlsbad California 92008-1989 (619)438-5525 JOB ADDRESS yr. • AV, ST. RD. NEAREST CROSS ST. DATE OF APPLICATION - L . BUSINESS LICE SE A VALUATION PERMIT NUMBER 10 I i LOT I BLOCK SUBDIVISION ASSESSORPARCEL NO, ' . CONTRACTOR CONTRACTORS PHONW# . S ZONE : ' .. '- OWNER'S NAME VoLi- L2e-11-5,44-7 S--*AAijorAA 4111 .' ' . - • _____________ OWNER'SPHONE CONTRACTOR'S ADDRESS ____________ LICENSE NO. PLANI.D. BLDG USE CODE OWNER'S MAILING ADDRESS #-1 c, ts Oto cM. -ii 29' ut'S ,. , • STANDARD PLAN # BUILDING SQ. FOOTAGE, 1 . is L3u. ç, DESIGNER LICENSE m DESCRIPTION OF WORK DESIGNER'S ADDRESS DESIGNER'S PHONE .. .t '. - • ' -' ' ' FLR ELEV, NO STORIES OCCGP . -E ' vD NO , 000I71'134 . '1325 -8t CENSUS,TRACT .,GP.LAND USE PARKING SPACE RES UNITS GRADING PERMIT ISSUED REDEVELOPMENT - TYPE 0CC LOAD FIRE SPR AREA , --- CONST -. '. 5 5 - - - • ___________ Y N 0 vD ND ' vO NO Not Valid Unless Machin Certified CITY. PLUMBING PERMIT - ISSUE 7. QTY. MECHANICAL PERMIT. ISSU. E ,,, SUMMARY/ACCOUNT NUMBER EACH FIXTURE TRAP NSTALL'FURN. DUCTS UP TO 100,000 BTU __ BUILDING PERMIT , 01-00-00-8220 EACH BUILDING SEWER - , .• OVER 100,000 BTU - . . , SIGN PERMIT -- 01-00-00-8221 -- EACH WATER HEATER AND/DR T ' BOILER/COMPRESSOR UP 103 HP . PLAN CHECK • 01-00-00-8806 / '3 EACH GAS SYSTEM I TO 4 0 LETS , BOILER/COMPRESSOR 3-15 HP ,TOTAL PLUMBING ' 01-00-00-8222 — EACH GAS SYSTEM 5 0 ORE. - - METAL FIREPLACE , . - . - . ELECTRICAL - ' 01-00-00-8223 - - — EACH INSTAL.. ALT ,REPAIR WATER PIPE - . VENT FAN SINGLE DUCT - - MECHANICAL 01-00-008224 erJ" EACH VACUU REAKER , ' MECH EXHAUST - HOOD/DUCTS - ' MOBILEHOME 01-00-00-8225 WATER S TNER . . RELOCATION OF EA FURNACE/HEATER. _,• -- MOBILEHOME PARK INSP.•,'., - EAC_OFDRAIN(INSIDE) - ' SOLAR _01-00-00-8226 - - TOTAL MECHANICAL - • 'STRONG MOTION •-80-92-33-0519 .TOTAL PLUMBING -' - , - FIRE SPRINKLERS 01-00-00-8227 .•-• QTY. ELECTRICAL PERMIT - ISSUE - QTY. SOLAR -ISSUE - '. - PUBLIC FACILITIES FEE 32-00-00-893D - BRIDGE FEE - - IriEWCONSTEAAMPISWT/BKR - ' COLLECTORS - - - IPH -p, _3PH -- ' SCHOOLFEE - DISTRICT_ STORAGE TANKS • _______________ Carlsbad 80-92-21-0519 EXISTBLD,G.EAAMP/ An ' ." .R ,',• ROCK STORAGE , - Encinitas -,---80-92-22-0519 •-. _'-- - - 1'PH ' ' 3 PH - PUMP - - San D)eguito -80-92-23-0519 -- REP/OEL:ALT _ PER CIRCUIT - - PLAN CHECK FEE • ' • - San Marcos _:80-92-24-0519 - TE4P POLE Ojo AMPS - . .' -' ______•.'._----_n -- _ - •• - 0VE207stPS ,.",' -', - LICENSE TAX 01-00-00-8162 •- - TEMP OCCUPANCY (30 DAYS) -'• - • - I - - MIFF 80-92-57-0519 ' - - - - - • -• --_'- _, ,._• -_-_- - f - CREDIT DEPOSIT TOTALELELTRICAL _•' _ - _ - ___ - -:TOTALSOLAR - _ --- TOTAL FEESPAYABLE - - I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY Expiration. Every permit issued by Iflé Building Official under the provisions "olthis * AN OSHA PERM:T IS REQUIRED FOR EXCAVATIONS OVER Code 0 S expire by limitation and become null and void. If the building or work CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE rized h permit is not commen a wit in 180 days from the date of such 50" DEEP AND DEMOLITION OR CONSTRUCTION OF auth permit, DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS or it budino k aut$red by such permit is suspended or STRUCTURES OVER 3 STORIES IN HEIGHT ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON- abadondat any time af ter Iheorkcomencedbraperiod01180days. - STRUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND -_I_-..". AP ICAN S SI NATU E :ppo/ BY I,, A EXPENSES KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS A OWNER. CONTRACTOR - WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OFTE ' ' BY PHONE 0 - - GRANTING OF THIS PERMIT - TYPE DATE INSPECTOR BUILDING FOUNDATION REINFORCED STEEL MASONRY GUNITE OR GROUT FLOOR & CEILING SUB FRAME SHEATHING E ROOF E SHAR FRAME I EXTERIOR LATH INSULATION S INTERIOR LATH & DRYWALL 1. PLUMBING SEWER AND-BL/CO DIPLICO UNDERGROUND J WASTE 0 V/ATER TOP OUT 0 WASTE 0 WATER TUB AND SHOWER PAN Vi GAS TEST U WATER HEATER UJ SOLAR WAtER ....' ELECTRICAL U ELECTRIC UNDERGROUND 0 IlIFFER ROUGH ELECTRIC 0 ELECTRIC SERVICE U TEMPORARY 0 BONDING 0 POOL MECHANICAL U DUCT & PLEM., 0 REF. PIPING HEAT - AIR COND. SYSTEMS VENTILATING SYSTEMS I ¶ CALL FOR FINAL INSPECTION WHEN ALLAPPROPRIATE ITEMS ABOVE HA V5 BEEN APPROVED- ' - - FINAL PLUMBING . r. ELECTRICAL MECHANICAL GAS -- SrII3;;::: .5- ,•_ BUILDING SPECIAL CONDITIONS S - I FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS INSPECTORS NOTES INSPECTION REQ. IF CHECKED INSPECTORS APPROVAL DATE . . .5.. SOILS COMPLIANCE PRIOR TO FOUNDATION INSP - r \- . OVER 2000 PSI STRUCTURAL CONCRETE PRESTRESSED CONCRETE POST TENSIONED - CONCRETE FIELD WELDING HIGH STRENGTH BOLTS SPECIAL MASONRY PILES CAISSONS .. 5. '-: . - . I - • - • S • - . _________ 5-' I - - -.5 S' t• - .. ... . i--i I'-;:-I. . ''1 -\ - I' USE RAIL POINT PEN ONLY R. PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. CARLSBAD BUILDING 'DEPARTMENT ' - 2075 Las Palmas Dr., CarIsbad,-6 92009-1915 (619) 438-1161 JOB ADDRESS AV. ST. RD. TH AS BROS NO. S 1-) eniti 1' LOT BLOCK I SUBDIVISION I ASSESSOR PARCEL NO. - - . , CONTRACTOR I OWNER'S NAME OWNER'S PHONE CONTRACTOR'S ADDRESS OWNER'S MAILING ADDRESS o. '3d, - oJ, DESIGNER OESCRIPTION'OF WORK ' DESIGNER'S ADDRESS APPLICATION & PERMIT DATE OF APPLICATION BUSINESS LICENSE xk ' VALUATION PERMIT NUMBER 7, . __ CONTRACTORS PHONE ZONE....r- 00, r.(i4 1 t' iv f-z STATE LICENSE NO. BUILDING SO. FOOTAGE AA/a3 6&TQ . DESIGNER'S PHONE STATE LICENSE NO. - 8557-07/27/89-0001 01.—'02 BldPmt 214.00 \J ( I F/P F L R ELEV., - - YOND NO STORIES_ '0CC GP EDU - - - -' - - - - Not Valid Un/ens Machine Certified - I - CENSUS TRACT' 4 PARKING SPACE 0'- -' RES UNITS GRADING PERMIT ISSUED Y O N 0 REDEVELOPMENT AREA - . Y O ND -. TYPE CONST 0CC LOAD FIRE SPR YO NO OTY -,. PLUMBI NG PERMIT ISSUE - QTY MECHANICAL PERMIT ISSUE SUMMARY/ACCOUNT NUMBER /- - 'EACH FIXTURE TRAP , INSTALLFURN.DUCTS _JP1TO100.000 BTU ,- , BUILDING PERMIT 001-810'00'00-8220 - EACH BUILDING SEWER - - ' ' -0VER100,000,"'— ' ' -' SIGN PERMIT''--''001-810-00-00-8221- . EACH WATERHEATERAND/ORVENj-" BOILER/COMPRESSORUPTO ,!j-"_' , PLAN CHECK 001-810-00-00-8891 EACH GASSYSTEMl'TO'4'OjJ.'t'(TS , BOILER/COMPRESSOR 3j,-1l' _. ,, TOTAL PLUMBING 001'810'00'0O'8222 'EACH GAS SYSTEM ,D''bRE'"1 -- -,--- - METAL' FiREPLAC.,,..a""._.,(,.t'•,,_,_____ -.--- '-----ELECTRICAL--''' 001-810-00-00'8223 EACH INSTA),.'CfR. REPAIR WATERPIPE . - VENT FAfi.€1GLE DUCT - MECHANICAL 001-810-00-00-8224 EA,B(UUMBREAKER - . . 3&"XHAUSTH000!DUCTS . MOBILEHOME 001'810'00'0O'8225 ,('c'ccarrxrT,Icca ocInrATIesoJ OF CA CIIDPlArc,i.ICATCP -.- - EACH ROOF DRAIN I(NSIDEI ' . DRYER VENT ''' . STRONG MOTION 880'519-92-33 '7 TOTAL MECHANICAL . . - FIRE SPRINKLERS 001-810'0O-00-8227 -- - f _TDIALLUIeBING _PUBLIC FACILITIES FEE_- 320'810'00'00'8740 -- - - BRIDGE FEE 360-810-00-00-8740 CITY. ELECTRICAL PERMIT - ISSUE 00 QT.Y. I MOBILE HOME SETUP - ,, ,_ ., -- . , PARK-IN-LIEU (AREA ,.NEW CONST EA AMP,_'SWl. U,KR_, - CAR PORT .._. . - .TIE_. 312-810-00-00-8835 - ' 1 PH - - 3 PHJ • - - . - AWNING , LA COSTA TIF 311-810-00-00-8835 EXIST BLDG EA AMP/SWT BKR GARAGE - I ' FMF ' — - -' - - tPH 3 P' ' .- . I , - -. ' LICENSE TAX - ,001:810'00:00:8162 - - - REMDDEi'ALTR PER CIRCUIT , ' /i9' ! ' . MFF 880-519-92-57 'TEMPPOLE'?OOAMPS - OVER 200 AMPS-- - . • - - TEMP OCCUPANCY (30 DAYS).— ,, - - . . .'---'-.' - ' I , ' . --.' —'CREDIT-DEPOSIT'-'—-- --'- -'-- -7 -/-->--'-- - -' IOIA'L ELECTRICAL ''- - ' s,nf..! .. - PAYABIL .'1' I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY - Expiration. Every permit issued by the Building Official under the provisions of this * DJIOSHA P • IS REQUIRED FOR EXCAVATIONS OVER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall authorized by h permit not commenced within 180 days from the da ire by limitation and become null and void It the te of such or work 5' 0" DEEP D DEMOLITION OR CONSTRUCTION OF DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A-PERMIT IS permit, or if the buifdino or work authorized by such permit is suspended or STAtiC S OVER 3 STORIES IN HEIGHT -'ISSUED:- TO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS GOVERNING BUILDING CON , abandoned at any lime alier t,eork is Commenced for a period of 180 days. STRUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEIVINIF, -0 -- EP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LiABiUTT)ES, JUDGMENTS, COSTS APPLICANT TUy/ OWNERD, CONTRACTOR APPROV75 BY - L5j, i--EXPENSES IN ANY I - WAY ACCRUE WHICH MAY AGAINST SAID CITY IN CONSEOUENCE OF THE // 4( ' BY PHONE 0 GRANTING OFTHISPERMfT. / i 2r 0 I herebytfIrm that I am licensed under 5 P!Ovlelofle of Chapter 9 (commencing with I- SectIon .7000) of.Dlvlslon 3 ot.the Business cc -, and Professions Code, and my license is In - L full force and effect. , - I hereby affirm that I am exempt trom. the Contrac , toe's License Law Or the following reason (Sec. 7031.5 -Business and Professions Code: Any city or county which Ce' quires- a permit to construct. aIter. improve, demolish,' or repair any structure, prior to its issuance also requires tIre ap- plicant for Such permit to tile a signed statement that he. is, licensed pursuant to. the 'provisions 01 the Contractors License Law (Chapter 9 commencing with Section 7000 01 Division 301 the Business and Professions Code) or that is en ,. empt therefrom and the basis for the alleged exemption.' Any violation of Section 7031.5 by an applicant for a permit sob' - jects the applicant to a civil penally 01 not more than live hun- dred dollars (9500). -- - - - -. I I, as owner 01 the property, or my employees with wages I I as their sole compensation., will do the work, and the struc' lure is not intended or offered Or sale (Sec. y044, Business _j and Professions Code: The Contractor's License Law dues not apply to an owner 01 property who builds or improves -0 thereon and who does such work himself or through his own - 2 It employees, provided that such improvements are not intend' SM edor uttered for salo. It, however, the building or imprsve'_ -. Z moot is sold within one year 01 completion, the owner-builder will have the burden 01 proving that he did not build or im' -0 - prove for the purpose 01 sate),-'''--- II. I, as owner 01 the property,. am exclusively contracting r'r with licensed contractors to Construct the project (Sec. yOdd, 'Business and Professions Crdr: 'The contractor's License Law does not apply loan Owner oi prvperly who builds or im' proves thereon, and who contracts Inc each projects with a contractor(s) license pursuant to the Contractor's License Z Law) - IT) As a homeowner lam improving my home, and the 10110w' - r ...ingcunditioosexist: z4.',.,e?r1)4i') . I f. - - r: The work is being pertormed prior to sale, "T 2. I have lived, in r my home for,. twelve months prior to completion 01 this work.' 3. .1' have 'not 'claimed 'this exemption during 'the 0 last three years. fit '0 lam exempt under Sec. , B& P.C., • br this reason'' .'. , j,__ " , . . . 'A.r r by' 0 I hereby affirm that I have a certificate of consent to sell-insure. or a certificate or Workers Compensation In.' - - ied copy thereof (Sec. 3800. Labor Code) s~ran~e. or a certil POLICY NO.0 COMPANY - 'O'Copy is tiled with the city-' 0 Certified Cop'1'is frehebyturnistreO' O CERTIFICATE OF. EXEMPTION FROM C.) • WORKERS' COMPENSATION INSURANCE fl I) .r,IThis section need not be completed if the permit ''is to, one hundred dollars 101001 or less) 3C !'..$.EJ I certify that in the performance 01 the work for which CC Ibis permit is issued. I Shall not employ any person in any_,., 0 '..'manner so as to become subject to the Workers Compen. sation Laws of California. ' NOTICE TO APPLICANT: If. alter making this Certificate o Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Comply with such provisions or this permit shall be deemed revoked. - - -, D'f herb.ftirm that there is construction lending1 agency fur the performance of theworfi br which this per' -'alt ?'i 'mil "is issued (Sec. 3097, Civil Code( ----------------- WI Lender's Name L 'iAd 5s '_'" TYPE I DATE INSPECTOR BUILDING FOUNDATION REINFORCED STEEL MASONRY GUNITE OR GROUT SHEATHING 0 ROOF 0 SHEAR - - FRAME EXTERIOR LATH INSULATION INTERIOR LATH& DRYWALL PLUMBING - - - — - UNDERGROUND DWASTE DWATER TOP OUT DWASTE E3 WATER TUB AND SHOWER PAN GAS TEST WATER HEATER 0 SOLAR WATR - - - ELECTRICAL o ELECTRIC UNDERGROUND 0 U1FER .- ROUGH ELECTRIC I 0 ELECTRIC SERVICE 0 TEMPORARY O BONDING 0 POOL MECHANICAL 0 DUCT & PLEM., 0 REF. PIPIN HEAT - AIRCOND.SYSTEMS VENTILATING SYSTEMS --• - - " " CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE io FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS . INSPECTORS NOTES- .-.-- - INSPECTION REQ. IF INSPECTORS DATE -. CHECKED APPROVAL- SOILS COMPLIANCE PRIORTO FOUNDATION INSP.- STRUCTURAL CONCRETE -• - - - -- -. — —i-- - — — -."-- -- . — - - . OVER 2000 PSI PRESTRESSED -. - CONCRETE -- -POST TENSIONED . - . - - - --- - - --- .-.----- - — -. - . - - 4.— -- - - CONCRETE - .FIELD WELDING. HIGH STRENGTH'- 's. - BOL12S-..--- 1 .A. - .•- . -- - .. -- . -- SPECIAL MASONRY . .----------- - -4 . -. - ..-4..- •..4 -PILES CAISSONS .•• .-..- --.---.. ... . •-----.- -- -•.- - - -- L----- - . : -. - -.- --- - - . — - 4 -- / t —_—--' --S S - .. -. - -..'•I44 .'.- - S - .- -.-------------.--. - S .-,--. , _________ ______ 4.,, _5 '.S—. FINAL PLUMBING ELECTRICAL - r MECHANICAL GAS BUILDING- SPECIAL CONDITIONS S\ .5-I . . - - .5 - 1" -: .... . -1 • f' u • '-i- - , . City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 05-11-2015 Commercial/Industrial Permit Permit No: CB131512 Building Inspection Request Line (760) 602-2725 Job Address: 2525 EL CAMINO REAL CBADSt: 111 Permit Type: TI Sub Type: COMM ' Status: EXPIRED Parcel No: 1563020900 Lot #: 0 Applied: 06/20/2013 Valuation: $117,782.00 Construction Type: 5B Entered By: LSM Occupancy Group: Reference # Plan Approved: 09/23/2013 Issued: Inspect Area Plan Check #: Project Title;' PAYLESS SHOES- REMOVE AND REINSTALL RACKING REMODEL LIGHTING AND CASHWRAP AREA PER ESGIL 3,173 SF TI Applicant: , Owner: GERI FOX . ' ' PLAZACAMINO REAL C/O WESTFIELD PROPERTY TAX DEPT 5030 VICEROY AV P0 BOX 130940, DEPT WFLD NORCO CA 92860 , . . CARLSBAD, CA 92013 951-279-0604 Building Permit , ' '$766.18 Meter Size Add'l Building Permit Fee $0.00 , Add'l Red. Watei Con. Fee $0.00 Plan Check ' ' ' $536.33 Meter Fee $0.00 Add'I Building Permit Fee $0.00 ' SDCWA Fee' ' $0.00 Plan Check Discount ' $0.00 CFD Payoff Fee $0.00 Strong Motion Fee ' $24.73 PFF (3105540) $0.00 Park Fee $0.00 PFF (4305540) ' ' $0.00 LFM Fee $0.00 ' License Tax'(3104193) ' $0.00 Bridge Fee $0.00 License Tax (4304193) ' $0.00 BTD #2 Fee ' $0.00 ' 'Traffic Impact Fee (3105541) $0.00 BTD #3 Fee ' $0.00 Traffic Impact Fee (4305541) $0.00 Renewal Fee ' $0.00 PLUMBING TOTAL ' $0.00 Add'I Renewal Fee , ' $0.00 ELECTRICAL TOTAL ' . $41.00 Other Building Fee . $0.00 MECHANICAL TOTAL $0.00 Pot. Water Con. Fee . $0.00 Master Drainage Fee , $0.00 Meter Size Sewer Fee. $0.00 Add'l Pot. Water Con. Fee $0.00 Redev Parking Fee , $0.00 Red. Water Con. Fee . $0.00 Additional Fees $0.00 Green Bldg Stands (5B1473) Fee $4.00 HMP Fee ?? Fire Expedidted Plan Review , $227.50 Green Bldg Standards Plan Chk ?? TOTAL PERMIT FEES $1,599.74 Total Fees: '$1,599.74 Total Payments To Date: $1,599.74 Balance Due: '$0.00 FINALAPPROVAL 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 Govemrtent 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 capacity 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 given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. P41 THE FOLLOV41NG APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: ILANNING QENGINEERING MBUILDING DHEALTh DHAZMAT!APCD Building Permit Application Plan Check No. f3j51 Est. Value jil, 7Z 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit 40,-7q email: buildingcarlsbadca.gov Date (4f/2of).3 Iswppp I - www.cartsbadcagov JOBADDRE IS , I SUI1E#/SPACE#/NIT# #BATHROO1I I AP I N I5B 'VZ. - - .T/PR0iECT# 110T# 1PHASE# #OFUNITS #B5DROOMS TENANT BUSINESS NAME 1CONSTR. TYPE I 0CC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) t.i 14 rmic p.E,.tvDEL- ,JUID€- iirø46 P4 Lacr Soail.Ci. £ dTI i C s j ,RZi# $ IELV 7CT F. 111, TL'P- SZ c 4EtJ F1-VDIIIJ G jiLc T4tL-4 T?per t4L 3, 4i -i:I EXISTING USE IPROPOSJMUSE IGARAGE (SF) PA110S(SF) IDECKS(SF) I IFIREPLACE I5B'DI lAIR CONDITIONING IFIRE SPRI,LERS _.1 — YESN0DI YESN0D APPLICANT NAMEPr rCon . A7((NT7 ADDRESS ADDRESSQ V cpg k) CITY TATE ZIP tVO?CD k- 1Z1oD STATE PHONE. 1161 4q PH WE FA Ell QUO 7 EMAIL EMAIL PROPERTY OWNER NAMEft4 ceii p ONTRAC.R BUS. NM . ADDRESS j5 acr aepj ADDRESS i - 4STATE CITY STATE ZIP PHONE FAX PHONE /k EMAIL EMAIL,7-'- ER NAME & ADDRESS QC• LIC. # STATE liCe I CLASS I CITY BUS. LIC.# (Sec. 7031,S 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 a 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 1$500)). - Workers' Compensation Declaration:! hereby afflnn under penally of perjury one of the following declarations: 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 perfor1nance,pjfrvork for which this permit is intued. My workers' compensation insurance carrier and policy number am: Insurance Co. _JT '9 Policy No. _'' 9 Z'/_? Expiration Date section need not be completed if the permit is for one hundred dollars ($100) or less. 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 coverag 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 PmvlCed for In S 06 of Labor code, Interest and attorney's fees, CONTRACTOR SIGNATURE /g" DAGENT DATE ... _j — o[goawww)D U6OØO , I hereby affirm that lam exempt from Contractor's License Law for the following reason: [J 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 loan 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). [J 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 loan owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). [J I am exempt under Section Business and Professions Code for this mason: - - I personally plan to provide the major labor and materials for construction of the proposed property improvement DYes [}'lo I (have! 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 same address/phone! 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 same! address phone! contractors' license number): I will provide some of the work, bull have contracted (hired) the following persons to provide the work indicated (include name! address/phone! type of work): ..'PROPERTY OWNER SIGNATURE ' []AGENT DATE Is the applicant or future building occupant required to submit a business plan sly hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? tYes o - Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air anagement district? 1j.Yes r No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? ,Yes No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLE THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. a coDIzi eoLJc3c? - . - + - I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name - - - Lender'sAddress I certifythatl have read the application and state thatthe above Information toconsct and thatthe information ontheplansisacoirata I agree to comply with all City ordinances and State laws felattngto building construction. I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspedion purpoves. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST AU. LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CITY INCONSEQUENCE OF THE GRANTING OF THIS PERMIT. - OSHA An OSHA permit is required for excavations over 50' deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Building Official dam the provisions of this Code shall expire by imitation and become null and void tithe building or work authorized by such permit is not commenced within 180 days from the date of such permit or tithe bullring or authorized by such pa suspended orabandoned nyUrns after (he work is consnencedfor a ad of 1 days (Section 1064.4 Uniform Building Code). .APPLICANT'S SIGNATURE - . - DATE j.() 7/3 - - -- STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. gCERTIFICATE_.z1ETa Fax (760) 602-8560, Email bUiIdina()CarIsbadCa.pov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. (Office Use Only) CONTACT NAME - - - - OCCUPANT NAME . . -- ADDRESS - - - -. : BUILDING ADDRESS - - - CITY -. - -. STATE . -- - ZIP -. - CITY STATE ZIP - Carlsbad CA - - - -• -- .-,,.. PHONE FAX - - EMAIL .- . - - - OCCUPANTS BUS. UC. No. - - -. - DWVERYOFNONS PICK UP: CONTACT (Listed above) ' OCCUPANT (Listed above) - .CONTRACTOR (On Pg. 1) --- - ASSOCIATED CB# - MAIL TO: CONTACT (Listed above) .-',OCCUPANT (Listed above) - - CONTRACTOR (On Pg. 1) NO CHANGE IN USE / NO CONSTRUCTION YMAIL/ FAX TOOTHER: - '- - CHANGE OF USE I NO CONSTRUCTION LAPPLICANT'S SIGNATURE . - - DATE - ,