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HomeMy WebLinkAbout2525 EL CAMINO REAL; 113; STE 113 PRE 2016; PermitCITY OF CARLSBAD WILDING DEPARTMENT Application 1BUltDiN6 Permit 729-1181 -Ext. 36 Building Permit Fee For Applicant to Fill In 5PAID DEC _EE_22Ot4******* Owners Name Universal Boot Shop .UO Mail Address Plaza Camino Real Building Dept. Use Only Contracor Millie & Severson Building Address Suite 113 Contr. Address pp Box 1269, LOu9 B&cI St. Near El Camino Real - Sat Back Bldg. Valuation NA Front P.L. Main Bldg. Side P.L. Garage Rear P.L. Other Group Zone Approved by To Const. 0 To Add 0 To Alter 0 Convert 0 To Move From Type of Const. Frame and Masonry Frame, Masonry, etc. To Be Used For De pt- .ci--r Kind of Foundation_______________ No. of Stories_______________ Floor Space (Sq. Ft. '128 Garage Floor Space (Sq. Ft.) Attached____________________ Detached________________________ Legal Description Contractor City Bus. Lic. No. Water Meter Sewage Disposal System Inspection Record Lot Block Subdivision________________________________________________ or Section Townsfiip Range No. of Existing Building Will this construction include any plumbing installation or alter- ation? Yes 0 No 0 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. 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 OR THAT I AM THE LEGAL OWNER If a check is tendered for payment for the above fee and the OF THE ABOVE DESCRIBED RE~SIUNTL,~L PROPERTY. check is not honored when presented for payment, your SIGNATURE building permit will be immediately revoked. City of Carlsbad Building Dept. OF PERMITTEE Permit void if work is not commenced within 60 days of issuance. -11 CITY OF CA SBAD BUILDING DEPARTMENT 729-1181 -Ext. 36 For Applicant to Fill In / PERMIT NO. TOTAL FEE $ - Application for ELECTRICAL Permit Buildinq DeDt. LjseAQlly PERMIT FEES: Each Fee U. BUILDING ADDRESS: Item Recpt. Sw. Lighting fixtures w/ballast for each 10 $ 1.00 St. Near Elec. Ranges, Clothes Dryers, Water Heaters .50 lec. Space Heaters Dishwashers, Garbage Disposers. Auto. Washers, Sta. Cooking Units .50 ADDRE L( I OTORS: Per each motor H. P. CITY L....._. 0 to 1 $ .25 'Ø L- 1 to 2 $ .50 TELEPHONE NO-11(0-')-- 2 to 5 $ 1.00 5 to 15 S 1.50 State City Business LicenseQ ) License 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 $ 200 Temp. Power Pole, 100 AMPS or LESS . S 3.00 For Each addI Meter, over one per service $ 3.00 IISC: 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 OF CARLSBAD ANDTHE STATE OF CALIFORNIA OR THAT AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESI- DENTIAL PROPERTY SIGNATURE OF PERMITTEE: S.D. G. & E. FINAL: zf~ CITY Of , CARlSBAD. BUILDING DEPARTMENT OWNER Universal Boot Shot MAIL ADDREssPlaza Camino Real Center CITY Carlsbad TEL. NO. PLUMBER Proffitt & Durenil Plbg,In ADDRESS 12630 So. Hawthorne Blvd. CITY Hawthorne 41.1o. 7722768 STATE CARLSBAD BUSINESS LICENSE NO. 165581 LICENSE NO. ITEM FEE 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 I TO 15 .30 LA. ADO. © 1.50 1 FLOOR DRAIN OR SINK © 1.25 1 25 LAWN SPRINKLER © 2.00 1 MISC. WATER PIPING @ 1.50 1 50 GARBAGE DISPOSAL © 1.00 VACUUM BREAKER OR BACK FLOW DEVICES 1 TO 5 © 2.00 6 75 GRADING PLAN YESD NOD PERMIT $ 2 00 TOTAL FEE $ 8 75 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 RçSIDENTIAL PROPERTY. SIGNATURE OF PERMITTEE &UMBIN6 PERMIT - APPLICATION BUILDING NEAREST El Camino Real & Vista Way CROSS ST. GROUP I. ZONE Inspecfkn Record APPROVALS DATE INSPECTORS SIGNATURE UNDER _FLOOR _WORK ROUGH PLUMBING GAS PIPING GAS VENTS PLUMBING FIXTURES MISC. GAS TEST UTILITY CO. NOTIFIED FINAL Li5 I.Yl1r.1N 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 CAR D BUILDING DEPAR ENT 729-1181 -Ext. 36 TOTAL FEE $ PERMIT NO. —) . g. Application for MECHANICAL Permit For Applicant to Fill In fl TIN - flC3049?~CC~23W******16. NO. ITEM INSTALLATION AND/OR RELOCATION EACH ANT. 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 P&j STREET NAME For the installation or relocation of each boiler or compres- sor over three horsepower to and including 15 horsepower, or CONTRACTOR Southland Htq . & A, • C each absorption system, over 100,000 B.t.u.'s to and inclu- ding 500,000 B.t.u.'s $7.50 _...,,05j? L..— Plaza C am! no Real, A Limited Part: S. 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 2800 Temple Avenue 1,000,000 B.t.o. '5. $10.00 ADDRESS Long Beach, Cak. - 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 In and in- cluding 1,750,000 B.t.o.'S' $15.00 CITY For the installation or relocation of each boiler or refrigera- tion compressor over 50 horsepower, or each absorption 7 7 system over 1,750,000 B.t.u.'s. $25.00 CITY BUSINESS LICENSE NO. U For each air handling unit to and including 10,000 cubic lees per minute, including ducts attached thereto. $ 3.00 3 -' CITY BUSINESS LICENSE NO. For each air handling 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 ore- 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 3 .- ito 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 CODEOF 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 T AM THE LEGAL OWNER OF T OVE sCRImED PROPE GATE JOB FINALED SIGNED BY PERMITTEE:__________________________________________ 50 er. - ...: -USE BALL POINT- PEN'ONLY &.PRESS: HARD—,APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. - --i— ----. - - ---CARLSBAD BUILDING DEPARTMENT I APPLICATION & PERMIT .1 hereby affirm C1tt). that .1 I am '4 licensed u.nder. ..\o_2075 Las.PàImas.Dr.,.CarIsbad,.CA92OO9-1915(619).4381161 -, - - .--u._•- . - - ... - - -- .. 0 - U provisions of Chapter 9 (commencing with 1 JOB ADDRESS. AV.-ST. RD. THOMAS BROS NO. DATE OF APPLICATION BUSINESS LICENSE # V LUATION PERMIT NUM ER I,-, .14.~and Professions Code, and my license is In z ful I force and of Oct. e2 . LOT BLOCK SUBDIVISION ASSESSOR PARCEL NO. CO TR CT~DR CONTN RS PHONE N ZONE /- following reason (Sec.170 for's I-iiiense,Law for. the -.1.Business and Prolessions.Code; Any Oy Or county whit OWN t;4 OWNERS PHONE ij ffl)t4o4 cthce!ç • - ~--Tuires a permit to construct. issuance requhe ires LL LX 14c J , CONT ACTOR I Acc1RESS A ,f LJ STA E LICENSE NO. BUILDING SO. FOOTAGE repair any structure. prior to its plucanl for such permit Is life a signed statement bathe i ILI-' irj lje__ae._., .. _._. . . . _ _- ............a)' ., licensed pursuant 10 the provisions of the contractor' Licefl:eLaw (Chapter,9cormenongwdh Section 7Q000 OWNER'S MAtLIru?G ADDRESS / i2.12.- i. . 46 Div ion 301 the Business and Professions Code) or that is ea', " tAi DESIGNER DESIGNER'S PHONE vodIioflei.SecIWn7O3t.5byanappli l Iheret(om and the basis for the Jnt for a p exemtion 1'eroyI sub.1' . Div.. Lm", O7Q2_ . - - facts the applicant Is a.civil penally 01 not more than-live hun'--.ç- DESCRIPTION F WORK . - ) I -- -- _._ . . -_ __. _._------- dred dollars ($500). . DESIGNERS ADDRESS 01 STATE LICENSE NO. E' 17as ower of the'roperIy. or my employees with wages ' a) ''as their sole compensation, will do the Work, and the 511CC' I - . .•-- - - - I- a - lure is not intended or offered for sale (Sec. 7044. Business _..9 &_i._,) i'rt.9 _j C•S•antJ Professions Code: elhe'Conlraclor'sLicensè Law does F/P FLR ELEV.I NO GP I EDU in., nsI apply In an owner 01 properly who builds orimproves .- ........ - . .5T)3R)5. ._ . . 6306,04/19/89-0001-01- ..,. Vu. .... .u' m r,010te011a0d, who does such work himself or through his own . I_-ui 2 - employees,'.provided that sock impronements are not intend-'-'t1'' YO NO Dior Elt, o edQrofteredforsalell:hewever:tkebu/dingorimprove. CENSUS TRACT PARKING SPACE ,RES UNITS . GRADING PERMIT ISSUED REDEVELOPMENTz ment is sold within one year.of compleliori,, the owner-builder - -' TYPEJ - 0CC LOAD FIRE SPR-'-''- will have the burden of proving that he did not build or. im-. -- . - - - - . ARE A prove for the purpose of sale). . , I • Y O N 0 nD NO ' Yk ND , Not Valid Unless Machine Certified - ,.. I It, as owner 01 the property: 'amexclusively contrácti6 -, - . . . tO WwflhhcenshdconlaaUorsioconsrrocttheproct)Sec 7044 , CITY. PLUMBING PERMIT - ISSUE 7 QTY. MECHANICAL PERMIT- ISSUEBusiness and Professions Code: -The Contractor's License ./5 , - . SUM MARY/ACCOUNT_NUMBER , - - ;:Law does not apply loan owner of property who builds Or im-, -, ' ' en -Proves c 0?c contracts -rise - EACH FIXTURE TRAP -- / nJ ense pursuant to the Contractor'i Lice INSTALL FURN. DUCTS UP TO 100,000 BTU - BUILDING PERMIT 001-810-00-00-8220 - Z Law). - I EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 001-810-00-00-8221 Il Asahorneowneram vnpronurug,rnyhonte. and Ilrefollow. Ji EC WATER HEATER ANDIOR VENT :.... - BOILER/COMPRESSOR UP TO 3 HP , . . . -. ._. PLAN CHECK u.001-810-00-00-8891 - being performed piorThe work is Pave lived in my home for. 1to1sale.. -; EACH GAS SYSTEM I TO 4 OUTLETS - BOILER/COMPRESSOR 315 HP TOTAL PLUMBING 001-810-00-00-8222 _.... __..pruor.to completion ol this work. . lot 3. I have 001 claimed this exemption during the !,, EACH GAS SYSTEM S DR MORE - - -. - METAL FIREPLACE - - . . ELECTRICAL 001-810-00-00-8223 I7 last three years, - jO-lameoernptuntfrSec - -• - -'' B&PC ' EACH INSTAL.. ALTER, REPAIR'WATER PIPE, . - VENT FAN SINGLE DUCT • . . MECHANICAL..... . 001-810-00-00-8224 - - - -.-u. -- lorthus reason ' -. - - -. EACH VACUUM BREAKER" - 1 - e, - MECH EXHAUST . HOOD/DUCTS ' - MOBILEHOME 001-810-00-00-8225 _________________ - - ' ________ ' (I( WATER SOFTNER--- - , .'" .' RELOCATION OF EA-FURNACE/HEATER'- ' SOLAR ' - 001.810.0000:8226 - - . ' - - - - -1 EACH ROOF DRAIN (INSIDE) - - DRYER VENT STRONG MOTION 880-519-92-33 --_. o 2 )CI '(hereby affirm that I have acertiticale 01 consent to up , - - ' TOTAL MECHANICAL - . FIRE SPRINKLERS 001-810-00-00-8227 ' svit.insure. or a certificate of Wo(kers' Compensationlo- '- , ' . - ' . 31 S Ia ceo acetted copy fheeot(Sec 3800 LaborCode) 4 - / TOIALPLUMBIN(,. I I - i - -- -- - - -'- - PUBLIC FACILITIES FEE- -320 81000008740 - . - POLICY.NO. - ------------------- - > Z , COMP"'Y' '-k '• -, t..1 - - - . BRIDGE FEE 360-810-00-00-8740 2 QTY.. - ELECTRICAL. .PERM (T - ISSUE --- - - OTY. MOBILE HOME SETUP Copy is filed With the city 7 , . ' .,.5:_- - - PARK-IN-LIEU (AREA I ' - a) '--D-Certuieej copy is hereby furnished ' ''- - '- -- ' -NEW CONST EA A-MP'SWlBKR - -- .._.. - . -.. - CAR PORT - -' . u-u.. - - - ' TIF'- - - •'-.' 31281000008835- - '-u-'.IPH ....-4-.-u'- - 3 P - , AWNING -- • . LA COSTA TIF 311-810-00-00-8835 - r r ' ' i. " - ' I t., Li U '_.. WORKERS' COMPENSATION INSURANCE - - .u.. EX1ST.BLDG,EA AMP/SWT,'BKR -. •• a' .' I GARAGE - 1 - FMF __. U) (This section need not by completed if the permit is lot one hundred dollars ($1001 or less) ----P - t PH 3 PH '51 ', . a- - • - - . LICENSE TAXu I _j - 001-810-00-00-8162 - - Uu .Dcth1n't'pertormance or thework torwhiCrr " REMODEL 'ALTER' PER CIRCUIT ',' " - 4. f - MFF 88051992'57 CC this permit (s issued. l shall not employ any person inany I' - p---- - - ' -- -,- - - - ... - - ._ - ' . - - .manner so as to become subject to the Conrpen- - TEMP POLE 200 AMPS ion —sat Laws Of ColitOrnia,. --y . - e OVER 200 AMPS' 'i" - ' - r u',j , . - • . NOTICE TO APPLICANT: if. alter making this Certiticate! or Eoemption,you should become Subject lo the Workers''' - TEMP OCCUPANCY '(30 DAYS) -' ' • , ,. titl - Id',' ) . - Compensat on pro sons of the LaborCode you m SI forthwith comply with Chpo 50fl50 this pemtskall p - - -- - - - • , CREDIT DEPOSIT be deeTed revoked.,;,~ - - I - TOTAL ELECTRICAL I r r _tTOTA( I -CL TOTAL FEES PAYA__lp — - a ' li e ' ', - - I I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY I E puratlon, Every permit Issued byrheBuuldungOlfucual underlheprovusuonsolthus * AN OS y such permit is not commenced within 180 days from the date of Such HA REQUIRED FOR EXCAVATIONS OVER - , 1 hereby ulkrm Ihat there us a construcl,on lending..1 CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE his per. autl shall: ud become null and void II the building or work so-- DEEPb DEM0UTN O CONSTRUCTION OF LLI , agency lor the performance of the work for which t I DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT Is STRUCT S, OVER 3 STORIES IN HEIGHT 0 —mi is issued z (Sec - 3097. Civil Code), peri lit. th b Id Vo work authorize(' "-- ' • u;. I ISSUED: TO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS GOVERNING BUILDING CON- Ls Name— STRUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND .a don at a pended or II is the work is commen ur in ced such br a perio erm'ld 0118sus0 days. , ./ y1 N INSPECTORS NOTES / - S . FIELD INSPECTION RECORD ,REQUIRED SPECIAL INSPECTIONS INSPECTION REQ. IF INSPECTORS CHECKED APPROVAL DATE SOILS COMPLIANCE PRIOR TO FOUNDATION INSP STRUCTURAL-CONCRETE OVER 2000 PSI PRESTRESSED CONCRETE POST TENSIONED CONCRETE FIELD WELDING HIGH STRENGTH BOLTS SPECIAL MASONRY PILES CAISSONS H. I TYPE DATE INSPECTOR BUILDING FOUNDATION REINFORCED STEEL MASONRY GUNITE OR GROUT SUB FRAME 0 FLOOR 0 CEILING SHEATHING 0 ROOF 0 SI4EAR FRAME EXTERIOR LATH INSULATION INTERIOR LATH & DRYWALL PLUMBING 0 SEWER AND 131J94 0 PJCO UNDERGROUND 'E1 WASTE EJ!WATER TOP OUT 0 WASTE 0 WATER TUB AND SHOWER PAN GAS TEST O WATER HEATER 0 SOLAR WTER ELECTRICAL 0 ELECTRIC UNDERGROUND EJUFFER ROUGH ELECTRIC ELECTRIC SERVICE 0 TEMPORARY BONDING 0 POOL MECHANICAL DUCT & PLEM., 0 REF. PlPIG HEAT - AIR COND. SYSTEMS . .. ,-. VENTILATING SYSTEMS CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ITEMS ABOVE HAVE BEEN APPROVED FINAL r PLUMBING ELECTRICAL MECHANICAL LmZ BUILDING , SPECIAL CONDITIONS City of Carlsbad : f 1 1635 FaradayAv Carlsbad, CA 92008 . . 10-17-2003 - Commercial/Industrial Permit Permit No: CB032457 Building Inspection Request.Line (760) 602-2725 Job Address: 2525 EL CAMINO REAL CBAD St: 113 Permit Type: TI Sub Type: COMM Parcel No: 1563020900 Lot #: 0 Status: ISSUED Valuation: $105,000.00 Construction Type: NEW Applied: 09/05/2003 Occupancy Group: Reference #: Entered By: MDP . Project Title: NEW MODE FASHION .. . Plan Approved: 10/17/2003 3,500 SF IMPROVEMENT . Issued: 10/17/2003 - .- Inspect Area: - Plan Check#: Applicant: .-Owner:----.-.... . YOUN KEN . . PLAZA CAMINO REAL . STE 960 C/O WESTFIELD CORP INC 6856 10/17/03 000. 01 0. 3435 WILSHIRE BLVD . 11601'WILSHIRE BLVD N COP 60401 LOS ANGLES 90010 LOS ANGELES CA'90025 Y .BuiIding Permit- / \..$561.96, Meter Size ' . . - AddI Building Permit Fee $0.00 -. AddI Red. Water Con. Fee $0.00 PIai Check /$365.27'i..,. Meter Fee.' \ 0 $0.00 AddI Plan Check Fee 7 $0.00 1frSDCWAFee . $0.00 Plan Check Discount / $0.00 CFD Payoff Fee $0.00 Strong Motion Fee / -$22.05----.....--PFF-----.--.. \ ç, $0.00 Park Fee ' / $0.00 LFM Fee $0.00 License Tax $0.00 Bridge Fee $0.00 License Tax (CFD Fund) j)\ $0.00 BTD#2 Fee $0.00 -'Traffic Impact Fee /J $0.00 -y BTD #3 Fee $0.00 s ,Traffic Impact (CED Fund) 1 $0.00 Renewal Fee $0.00: '( PLUMBING TOTALS . J $0.00 Add'I Renewal Fee -..$0.00i ELECTRICAL1TOTAL I j$20.00 Other Building Fee \'.N $0.00L.. MECHANICALTOTAL / / $0.00 Pot. Water Con. Fee \ \. $0.00'',' Mister Drainage Fè / / $0.00 Meter Size \ '7\ Sewr Fee) J. / $0.00 AddI Pot. Water Con. Fee \ $0.00 'Rdv Parking Fee / / $0.00 - Red. Water Con. Fee \ $0.00 Additional Fees / I - $0.00 - - \ tNC0F FEES ('-.... / $969.28 U 1952 s- \ - Total Fees: $969.28 - \TotaIPaymè/Ints To Date: $365.27 Balaiice Due: $604.01 N U /Ij.'\Q)\\) / - • 4 1 It •_ - •- - .•-. .- .•'• -• . .•. ..-.- -. . .-.-•. ,• . - PERMIt APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 I. FOR OFFICE USE ONLY PLAN CHECK NO.!_ic ,1~7 EST. VAL. Plan Ck. Deposit Validated 131 Date I J? -Cz 1Wo O4/2 Bldg/Suite #) & Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use 3Ø49/0/03 0002 01 02 Descriptioh of Work 50. Ft. #of Stories # of Bedrooms '-'(.iW'bf Bathroom6527 q3cjc4- 2.J ONTA PERSON (if di erent from applicant) L/i( Jt J4.6 L'fSt1W.Q L g 0 ts eLS cA ooi7&j Name 3. APPLICANT 0 Contractor Address City 0 Agent for Contractor 0 Owner "'ent for Owner ct State/Zip Telepho e # F x # Name Address City State/Zip Telephone # PROPERTY OWNER ,\,Name - Address City State/Zip Telephone # 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 - exemTton. A violation6f Sec on 31.5 by any a plicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$5001). O4 (f t A . 4 r d 900 Natne Address City State/Zip )'e p ne -' State License # '),' "7 License Class City Business License # / Designer Name Address City State/Zip Telephone State License # WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: C3 I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 0 I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compens -ion insurance carrier and policy number ar . 1 / Insurance Company .i ' Policy No. L9 Expiration Date 4-1,//, (THIS SECTION NEED NOT E COMPL ED IF E PERMIT IS FO ONE HUNDRED DOLLARS ($1001 OR LESS) ,, C] 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: F - re to sec e workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand do[ rs ($1 0 1, Ition to t 4 of compensation, damages as provided for in Section 3706 of the L7or cod e/ ere and attorney's fees SIGNATURE DATE ECL TI I hereby affirm that I am exempt from the Contractor's License Law for the following reason: o 1, 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). El 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 / 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 I 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 I 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 I phone number / type of work): PROPERTY OWNER SIGNATURE ______________________________________ DATE _____________________ 1. 1. COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505. 25533 or 25534 of the Presley-Tanner Hazardous Substance 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME LENDER'S ADDRESS__________________________________________________________ APPLICANT CERTIFICA11ON 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. ( 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 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 de1Stlon 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance '1 City of Carlsbad Bldg Inspection Request For 12/15/2003 Permit# C13032457 Inspector Assignment: TP Title: NEW MODE FASHION Description: 3,500 SF IMPROVEMENT Type: TI Sub Type: COMM Phone: 0000000000 Job Address: 2525 EL CAM INO REAL Suite: 113 Lot 0 Location: Inspector: , APPLICANT. YOUN KEN Owner: CHASM ENTERTAINMENT INC <LF> PLAZA CAMINO REAL Remarks: Total Time: Requested By: KIM Entered By: KAREN CD Description Act Comment 19 Final Structural 29 Final Plumbing 39 Final Electrical 49 Final Mechanical Associated PCRs/CVs Inspection History Date Description Act lnsp comments 12/08/2003 14 Frame/Steel/Bolting/Welding AP TP 1 HR CORR. CElL 12/08/2003 24 Rough/Topout wc TP 12/08/2003 34 Rough Electric . wc TP 12/08/2003 44 Rough/Ducts/Dampers wc TP 11/19/2003 14 Frame/Steel/Bolting/Welding AP TP SOFFITS 11/19/2003 24 Rough/Topout WC TP 11/19/2003 34 Rough Electric AP TP SOFFITS 11/19/2003 44 Rough/Ducts/Dampers WC TP 11/18/2003 14 Frame/Steel/Bolting/Welding PA TP SOFFIT © EWALL ONLY 11/17/2003 14 Frame/Steel/Bolting/Welding NS TP 11/13/2003 14 Frame/Steel/Bolting/Welding co TP SOFFITS N.P.P. 11/04/2003 14 Frame/Steel/Bolting/Welding CO TP .11/04/2003 18 Exterior Lath/Drywall wc TP 11/04/2003 18 Exterior Lath/Drywall NS TP co , City of Carlsbad 1635 FaradayAv Carlsbad, CA 92008 09-2-2003 Miscellaneous Permit Permit No: CB032635 Building Inspection Request Line (760) 602-2725 Job Address: 2525 EL CAMINO REAL CBAD St: 113 Permit Type: MISC Subtype: OTHER Status: ISSUED Parcel No: 1563020900 Lot #: 0 Applied: 09/23/2003 Valuation: $0.00 Entered By: SB Reference #: Plan Approved: 09/23/2003 Issued: 09/23/2003 Project Title: NEW MODE FASHION DEMO Inspect Area: TILE AND WALL PANELS NO NEW CONSTRUCTION Applicant: - Owner: WESTIN CO -- PLAZA CAMINO REAL. C/O WESTFIELD CORP INC 11601 WILSHIRE BLVD 2319 10 TH STREET 92006 7 - LOS ANGELES C90025 N 213-675-4867 / / .fJ Miscelaneous Fee #1 PERMIT FEE -- ' $60.60 Additional Fees so oo TOTAL PERMIT FEES •' '- / $60.00 \ Total Fees $60.00 Total PaymentsTo Date: $0.00/ / Balance Due: $60.00 -- : I - 4873 09/23/63 0002 01 02 7 192 / C6P 60-00 7 DATE_CL ,NE__________ SIGNATURE FOR OFFICE USE ONLY PERMIT APPLICATION CA PLAN CHECK 1\10.)_b'3~ CI-11Y OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. Plan Ck. Deposit Validated By 'I Addre(includ Bldg/Suite #1 ' Business Name (at this ad ress) çQ,ç1J Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Ass 9s,or's Parcel # Existing Use/do, ?,& s ((. ., Proposed Use Descriotion of Work SQ. FT. #of Stories # of Bedrooms # of Bathrooms Name Address City State/Zip Telephone # Fax # 1LINTOContractorD AforContr tore DOwner fwner,.._ I ('6'- "-'i m77/m c:7(7j Na e Address / City State/Zip Telephone # -.-- Name Address City State/Zip Telephone # rsooNTJAcToR:coMPANYNAME (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 e7m A 42 plion nY violation of Section 7031.5 applicant fora permit subjects the applicant to a civil penalty of Na r&e Address CiTY State/ i elep ne # a License # License Class City Business License ii EcJ 1' AddJ" __Cffty tate/ZipY one / State License # Workers' Compensation Declaration: I hereby affirm under penalty 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. 0 I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is isued. My worker's comp9psation i urance arrier arupolicy number are: Policy No. 7' 2 Expiration Date) Insurance Company (THIS SECTION NEED NOT BE COMPLETED F THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100104 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 nFaiture he Workers' Compensation Laws of California. WARNING:secure workers' compensation overage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand d 0,000),Jn addition the cost ofcgapensat1on, damages as provided for In Section 3706 of thp.abor code, interest ed attorney's fees. SIGNATURE\ iS. CIA..—Z.c.--.5 DATE -...-- I heieby 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 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). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). 0 I am exempt under Section Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO 2. I (have / have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (include name I 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 I 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 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 feat 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. I hereby affirm that there is a construction landing agency for the performance of the work for which this permit is issued (Sec. 30970) Civil Code). LENDER'S NAME LENDER'S ADDRESS__________________________________________________________ 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. X 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 c menced within 180 days from the date of such permit or if the building or work authorized by such ppmit is suspended or abandoned Vat any time after the work is m ed for a nod of 18 ays (Section 106.4.4 Uniform Building Code). APPLICAN' S SIGNATURE DATE 7 WHITE: File YELLOW: Applicant PINK: Finance MARK KIM 6t99221827 Miscelaneous Fee #1 -' Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES.,- Total Fees: I $65001.1 Total &ToPate: 1 $65.01 06-02-2010 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No: 0B100994 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: PC#: 2525 EL CAM INO REAL CBAD St: 113 MISC Subtype: OTHER 1563020900 Lot #: 0 $0.00 Status: ISSUED Applied: 06/02/2010 Entered By: JMA Plan Approved: 06/02/2010 Issued: 06/02/2010 Inspect Area: Project Title: FLAVA: INSPECTION FOR C OF 0 Owner: -, PLAZA CAMINOJ (c/d WESiFIELD PO O)1 3O94O ..,dARLSBAD, ERTY\ TAX DEPT W FLD.. Ty ' *' '4' . $6"5.00 I I " 1•i . $0.00 INCORPORATED Inspector( FINA APPROVAL ____________ Date: Clearance: NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of lees, 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 1oth 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 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 <<0 CITY OF Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718/2719 Plan Check No. Cot oo'1 c/ Est. Value ni.... #i Fax:bO-O -bb CARLSBAD www.carlsbadca.gov "" '-"• Deposit - Date JOB ADDRESS f I (3 SUrTE#/SPACE#/UNIT# APN - - ,T/PROJEö'r'vi LOT # PHASE # # OF UNITS # BEDROOMS # BATHRO MS TENANT BUSINESS NAME CONSTR. TYPE 0CC GROUP DESCRIPTION OF WORK: Include S uare Feet of ffected Area(s) EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) IDECKS(SF) FIREPLACE YES 0 #_ NO 0 J AIR CONDITIONING IFIRESPRINKLERS YES 0 NOD YES 0 NO 0 CONTACT NAME (if Different Fom Applicant) flrJc -/Cr'rr'1 APPLICANT NAME ADDRESS - 0-525- ADDRESS CT STATE ZIP H Cr 3bc CA CITY STATE ZIP PHON)7 F(X 7 7 PHONE FAX EMAIL EMAIL PROPERTY OWNER NAME CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS STATE UC. # STATE UC.# CLASS CITY BUS. UC,# (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 Matter 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 civil penalty of not more than five that dollars ($500)). fk Workers' Compensation Declaration: I hereby affirm 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 performance of the work for Which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. Policy No. Expiration Date This section need not be completed if the permit is for one hundred dollars ($100) or less. 0 Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'. Compensaton Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (11,100,000), In addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees, CONTRACTOR SIGNATURE []AGENT DATE - I hereby affirm that lam exempt from Contractor's License Law for the f0110wingreason: 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 ProfessionsCode: 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). 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 DYes Cl No - - 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 name 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 name/address! phone / 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 I phone! type of work): .JKPROPERTY OWNER SIGNATURE 2 _______ DAGENT DATE INA CITY OF CARLSBAD Unscheduled Building Inspection. Building Department 1635 'Faraday Avenue Carlsbad CA 92008 760-602-2700 DATE: 62 INSPECTOR: ' PERMIT#: CONTACT:t& PHONE#: JOB -ADDRESS: &S ' • •• DESCRIPTION: ' • • •• ' • • • •. • Bldg Inspection Form ' • • • Page 1 of I • ' • ' Rev. 06/09