HomeMy WebLinkAbout2525 EL CAMINO REAL; 158; STE 158 PRE 2016; PermitMODEL NO ..
BUILDG PERMIT APPLICTI
(8 /2 79 1723 O/J8. ,
City. of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only. Phone 729-1181 Permit
JOB Ds
PARCEL NUMBER
LEGAL 1DESCR .
LOT NO. -
-
BLA TRACT
c:JsE ATTACHED SHEET)
BOOK PAGE PAR.
OWNE - MAIL ADDRESS
2 £ m ZIP . PRONE
CO TRACTOR MAIL ADDRESS PHONE STATE LIC NO) CITY LIC'-IrO
TSt-i1I7)4_Cr 1(t' _R13.&tT,J1IS -/3aqs-rf ARCHITECT. OROESIGNER MAIL ADDRE -,,LIC ENSE NO.
ENGINEER MAIL ADDRESS PHONE LICENSE NO. -
5 . • -
COMPENSATION INS..CARRI ER MA L AOD.8E55 . BRANCH
6
USE O DING
- . NO. BDRMS NO. BATHS__________
8. Class ofwork: El NEW E ADDITION - ALTERATION - El REPAIR El MOVE El REMOVE
9 Describe work: ,. . "•-' . . .
10 Change of use from
Chahge of use to
11 Valuation of work: $ LAN CHECK FEE $/'5,0,/t" PERMIT $ .?9ll •5••
_FEE
SPECIAL CONDITIONS:
t,'~
bo
Const. _-
'pancy
Group
MICRO FILM FE
Size of Bldg.
(Total) SQ. Ft.
No. of
Stories
Max.
0cc. Load
Fire
Zone
Use
Zone
Fire Sprinklers
Required EYes ENo APPfIC40f1OrUACCEPTED BY PLANS CHECKED BY APPR OR ISSUANCE BY
OA_E &011 _ATE
No o
Dwelling Units
-
OFFSTREET PARKING SPACES:
_g,ered 1- Opn - _Ft.
NOTICE SpecialApprovals Required Received NotRequired
PLANNINGDEPT. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB.
ING, HEATING, VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- HEALTH DEPT.
FIRE-DEPT. TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS,OR IF
SOIL REPORT CONSTRUCTION OR WORK IS SUSPENDED-OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
OTHER(Specify) MENCED.
ENGINEERING 'DEPT. I HEREBY CERTIFY THAT I HAVE READ AND'EXAMINED THIS
APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.
WATER DEPT. ALL PROVISIONS OF LAWS AND ORDINANCES. GOVERNINGTHIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN. OR NOT, THE GRANTING 'OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
COT,Uçer\ON- RUT HE PERFORMANCE OF CONSTRUCTION.
Z -
OR AUTHORIZED AGENT IDATEl 0A~TURE-01
,
11CONI(RA-KOR
SIGNATURE_OF_OWNER_(IF_OWNER_BUILDER)(ATE)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. - M.O. CASH PERMIT VALIDATION CK. M. 0. - CASH
TOTAL FEES $
,,L, ,•, ''
'ELEçTJRIcAL ..PERMITJ APPLICATION
' City of CARLSBADç CALIFORNIA 2OO8 '.
AppIicantocompIete numbered 'saceson,'. 'Phone 729-1181 ' 'Permit No. " .• ,z '
JOB ADDRESS
r /' /J
• • LEGAL'
I DESCR.
LOT NO. •' - -•
-
J BILK. TRACT
(LJSEE ATTACHED .SHEET) • . - -. - ., •
-.• 1-
it
OWNER - MAIL ADDRESS ZIP PHONE
2
CONTRACTOR -.'', s MAIL ADDRESS - PHONE - STATE LIC. NO.
tLFC 31$o I S ,iiI Inj $4 ,Lr fjjj/ 3SSfbk" CITY LIC. NO.
ARCHITECT OR DESIGNER MAIL ADDRESS PHONE - LICENSE NO. -
ENGINEER MAIL ADDRESS / PHONE LICENSE NO.
5
' >' c - - - -i
COMPENSATION INS CAR IER MAIL ADDRESS - BRANCH
a.
.- USE OF
•z;: ..
8 Class of work: 0 NEW :.,El ADDITION '0 ALTERATION 0 REPAIR '• '
tv
9 Describe work
,
..• _____________________ ' • •
PERMIT, FEES
- - >--- --'- No Each
SPECIAL'CONDI-t*ONS: '
, 'SWIMMING POOL WIRING,
NO INCREASE IN SERVICE , •' .
NEW CONSTRUCTION, FOR EACH,
.PLANS CHECKED BY: 1A OR ISSUANCE BY FUSE
AMPERES OF MAIN SWITCH, OR BREAKER
NEW SERVICE ON - EXISTING BLDG
,,.FOR EA. AMPERE OF INCREASE • "VNOTICE .• 'IN MAIN' SERVICE-.. SWITCH, FUSE THIS PERMIT BECOMESNULL-AND VOID IF WORK ORCONSTRuC- OR BREAKER
TION..AUTHORIZE.DIS NOTLCOMMENCED WITHIN 120 OAYSOR.IF
CONSTRUCTION OR OR WORK"IS SUSPENDED ABANDONEO FOR A . '---•. •' '
e,.r'.W -S • - - - -
PERIOD OF 120 oAvsAT ANY TIME'AFTER WORK IS COM '
MENCED. . ' IN SERVICE, FOR EA. AMPERE OF
IHEREBY CERTIFY—THAT, I HAVE READ AND EXAMINED THIS' INCREASE - p APPLICATION AND' KNOWTHE SAME-TO BE TRUE AND CORRECT. 'ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL'BE COMPLIED WITH WHETHER SPECIFIED f, • L..
HEREIN OR NOT, THE-GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE 'AUTHORITY."TO VIOLATE OR CANCEL.THE TEMP. SERVICE UP TO AND INCLUD- '
PROVISIONS OF ANY OTHER S1TEOR LOCAL LAW REGULATING ING 200 AMP. P 4WORMANCE OFCONSTRUCTION.
TEMP 2CONCT-ION'ciOR-Tj4E
SERVICE OVER 200 AMP (- PER 100
SIGNATURE OF CO4 RACTOROR AUTHORIZED AGENT (DATE) -. - -ISSUANCE FEE . '
'041
• - ' ' - ' .TOTAL FEES
'' ''"'-''' " ' ' -' '' '-•-'
:' . -
' • SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
WHEN PROPERLY. VALIDATED (INTHIS SPACE)' THIS IS YOUR PERMIT'
PLAN CHECK VALIDATION c. •M.O. - CASH . PERMIT VALIDATION CK. - M.O. - CASH - -
, - ' -•'- •
. •
-. ' S ' • ' •
• ,•, -- , :, , • - '. •, •• , •,, ••. - •, •• * •.
INSPECTOR
I
4
/3O P
WVC11MOC /$/79 700 R. MHON1AL PERMIT APPLICAcFIONh'
City of CARLSBAD, CALIFORNIA 92008
' Aoø/icantto cómpIte numbered søaces only: Phone 729-1181 V
Permit Nn 771 /1~(i
JOB ADDR ESS . . "
LEGAL 1 DCSCR.
LOT 110 9LI U . - TRACT
. V
V
(]SEE ATTACHED SHEET)
V V
OWNER / V MAIL ADDRESS
2 7 I 77.'i?ia
V V V ZIP - - •. V PHONE
'CONTRACTOR ,A MAIL ADDRESS
M
PHONE V STATE LIC. NO. CITY LIC. NO.
ARCHITECT OR DESiGNER' V MAIL ADDRESS - VVVV PHONE LICENSE NO. V
VV,ENGINEER , V V ' MAIL ADDRESS ' V PHONE ' LICENSE NO. '
, - V 5;'
VLENDER , V MAIL ADDRESS
6 ,.L V V
V , , BRANCH ,
V V
US OF BUILDING VV V
V V
'V
Nt V V
of wo~k: D NEW 0 ADDITION 0 ALTERATION 0 REPAIR
:
Class
:81e: k
VL
V Type of Fuel: Oil 0 Nat. Gas 0 LPG. D
PERMIT FEES
V
V
SPECIAL CONDITIONS: • , V.. , No. Type of Equipment , -
VV .V,Fe V
Air Cond. Ujits_H.P. Ea. ,
7 Ref rigeratior Units—H.P. Ea. '
V ' .BoiIers—H.F Es. ' V
Gas Fired 4'VC. Units—Tonnage Ea. - V•
V V Forced AirjSystems—B.T.U. - M Ea.
APP LION.)SCCEPTEO BY: PLANS CHECKED BY: APPROVED FOR ISSUANCE BY: Gravity S$tems—BVT.U. M Ea. .
Floor Furaces—B.T.U. M -
V
V
V V
V
'Wall Heatr—B.T.U. M
NOTICE V '
V Unit He4rs—B.T.U. V
•M
THIS' PERMIT BECOMES NULL AND VOID IF'WORK OR CONSTRUC- Evapora4ve Coolers
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A A Clothes ç,ryerS
Veritilailon Fan .. PERIOD 'OF 120-DAYS AT ANY TIME AFTER WORK IS COM-
MENCED. V
HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS A Range ElO -
-
Air HandIin Unit— V C F M . . .
APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME TO, GIVE AUTHORITY TO VIOLATE OR CANCEL THE
V
Incinertor
-
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING .. V'-•#- ,..
CONSTRUCTION OR THE -PERFORMANCE OF CONSTRUCTION.
ell
SIGNAPUREOP CONTRACTOR OR AUTHOVRIEED AGENT (DATE)
ISSUANCE FEE $ 2.
TOTAL FEES - SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
V ' WHEN, PROPERLYVALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT V
PLAN CHECK VALIDATION cK. M.O. CASH. - PERMIT VALIDATION CK.' MO.. V CASH ,.
- - -V.
INSPECTOR
DATE: J[ThI 2 9 1979
-I,
- INTERDEPARTMENTAL INFORMATION SHEET RECEIVEAJ
BUILDING DEPARTMENT
BUILDING ADDRESS:
PLANNINGDEPARTMENT .
ZONE __LOT SIZE LOT WIDTH S
•
UNITS ALLOWED UNITS PROVIDED___________________________
PARKING SPACES REQUIRED PROVIDED________________________
7 COVERAGE ALLOWED PROVIDED
BUILDING HEIGHT ALLOWED . PROVIDED
FRONTSETBACK: SIDESETBACK: REARSETBACK:
ALLOWED
PROVIDED._______________
.INTRUSIONS S S
LA-NDSCAPE & IRRIGATION PLAN COMMENTS: •
.ENVIRONMENTAL PROTECTION REQ:
SCHOOL FEES: • DISTRICT: O!JNT:
A LD I T I ON ALCO MT
.0K TO ISSUE:1/1'C" 'DATE /4(4,oic TO, FINAL DATE
•
ENGINEERING DEPARTMENT flf ( '" '- ."J 1'
R.O.W.'' 'IMPROVIT______
SEWER CONNECTION jJ LOCATIONS_________________________
GRADING PERMIT EASEMENTS I(JP(••_ DRAINAGE _________
LEGAL. DESCRIPTION '•'
ADDITIONAL COMMENTS
OK TO ISSUE, DATE7é3/77 PWI OK TO FINAL DATE_________
FIRE DEPARTMENT
SPRINKLING SYSTEM • FIRE PROTECTION
FIRE ALARMS - II EXITS__________________________________
" FIRE' HYDRANTS LOCATION S
ADDITIONAL COMMENTS 7I7 ALrZ or / .
-S
S iS OK TO ISSUE: DATE JJ 29 779 ' OK TO. FINAL DATE
ATER DEPARTMENT
0EQUIREMENTS OF APPROPRIATE DISTRICTS MET
'_ USE BALLPOINT PEN ONLY & PRESS'HARD -, I 'APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CVr çi OM'
2r t I2 Ihreby affirm that am licensed under
U I - provisions of Chapter 9(commencing with
J1 ,S.ction 7000) ot Division 3 of the Business
Professions Coder and my license -is in
Zo
--
Lfuli fo'rce and effect.
I hereby attiän that I am• exempt from the Contrac-
or's Licedse' Law for,,the totlowing reason. (Sec. 7031.5.
.. Business and Professions Code: Any city or county whicc (C-
4quires a permit to construct, alter, improve, demolish, or
— .4.—re pair any structure, prior to its'issuance also requires he ap-'--'
plicant for such permit lb ,file a' signed Statement that he is
- ,_,I
-
icensed pursuant to lhe'provisions of the Contractor's
icense Law (Chapter 9 commencing with Section 7000 ot Division 301 the Business and-Professions Code) or that is ex-1
empl therefrom and the basis for the alleges exemption Any' ..,.,,violation 01 Section, 7031,5 by an applicant_tot a permit
(ects the applicant to civil penalty of not more than tine hun-
dred dollars ($500). -
k iPnl I as osner Ilhe property. or rn employees with wages
—. as their sole compensation, will do the work, and the struc-ture is not intended or'oftered to, sale (Sec: 7044, Business
' J and Professions Code:' The'Coniractsr's License Law does nor apply to an owner of property who builds or improves 1r
thereon and:who des o such work himself or through his own I I --'employees,' provided that such improvements are nor,inlend-4'- I
'.
ed or offered for sale.:),' however the building or improve-
,Z A,_ment is sold within one year 01 completion; the_ownerrbu4der,.5, eXIt_have the burden ot proving that he did not build or im- . prove for the purpose 01 sole).
l'i 'Cj' ner ot the property, aroetiiiv4 contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: .-The' Contractor's License C. Law does not apply roan owner 01 property who builds or im- '
proves thereon, and who contracts lot each projects with a" contractor(s) license pursuant to the Contractor's' License
1_lJ,Asa homeoe 'ner,l nsir rng my home, ardlhloIlow.... c_,.. in9 conditions exist:'—,- - "4.— -- --'--'--- —'b
I. The work is being performed prior to safe.
_ 2._!,Pave Iived io'nry trometor'twetve months -' prior 10 completion ot this work,
3. I- have not claimed this exemption during the
- last three years.- -s' - "-s.--
a 'E0' 'a.: 4,fr
- ' 0 lam exempt uñder'Sec,., B & P,C,r
'"!tor this reason'
. -
I f' .. 5.e. _. , IVJ 'thereby affirm that I have-a certilicute 01 consent to,
lf.insu,e, or a ce,titicdte 01 Workers' Compensation In "o ''' (') 4 s
s
a,ance, or a certitied copy thereot Icc, 3800, LabOr Code;' '\
POLICY NO. . . .
COMPANY .......&
D Copy is tiled with the ity: 'I?A.. 4 '-.-_ -. -_ ... - ''.-'-'-
"Cerritied copy is hereby lurnished
IL
- CERTIFICATE OF EXEMPTION FROM - -
O 'f$' "s.WORKERS' COMPENSATION INSURANCE
(I) .... (This section need not be completed it the permit -
LP is toe uoe.hundred dollars (0100) or less) LU .-.'Q I certify that in-the performance 01 the work forwhiCh
.'lhi5 permit is issued, I shall out employ any person in any
manner so as to beCOme.sub(eCt to the Workers' Com pen.
.'satiOn Laws of California. • .-j, -'
- NOTICE TO APPLICANT: It, alter making this.Ce,tilicate - ".401 Exem/tio'n. 'you should become subject to the Worker5'
Compensation' 'provisiuns,,ot the Labor Code, you 'rnust,_,,
forthwith comply with such provisions or this permit shall
' he deemed revoked,' "
- ,.- 0 :l'nereby atii'ih'at ther i i co'est,uctiov lending
k agency to the performarIceof the tqrk% (or which this uJ ol mit is issued (Sec. 3097. Civil Code) .,
C(
wI...t Lender's Name- -J I .'
Leoder's Address
i CARLSBAD BUILDING DEPARTMENT
"P— r APPLICATION & PERMIT :2075 Las Palmas Dr--Carlsbad, CA -920091915(619)A38-1161 '-'
JOB ADDRESS'. " - ' - . AV, ST, RD. THOMAS BROS NO. DATE OF APPLICATION '
- 5?S no
BUSINESS LICENSE # VALUATION PERMIT NUMBER -
' CONTRACTORS PHONE a g ZONE LOT,. I BLOCK , SUBOlVISION..,. ASSESSOR PARCEL NO.
'OWNER'SNAME :
CONTRACTOR
&rf1td' C+' rp. TID3/q.-3o7 4 All
1' J. 4 Q'455 -jri ot - Fr4. CO. - 31 - . --
OWNE R'S PHONE
) CONTRACT R'S AOOR ss STATE LICENSE NO. , •"' '" 'BUILDING SOFOOTAGE
&4".Ue. Sc- i5
- --- 1.L5oS — - • :. -UdPffit• -- - -638O
OWNER'S MAILINC ADR,S. - -- - - .- DESIGNER . . ,
-. DESIGNER'S PHONE
DESCRIPTION OF WORK
-3313 o
— SOW -11,7- Rex% o v6-4 -'o :2 DESIGNER'S ADDRESS STATE LICENSE NO.
EDU MAY - ..:
.
tZ- STORIES"
F/P
CENSUS TRACT J.PARKING SPACE RES UNITS GRADING PERMIT ISSUED e' REDEVELOPMENT FI
AREA
T
O
Y 0 C LOAD
— —:-----
C
RE
tY0 NO YO No-
Q'y PLUMBING PERMIT. ISSUE - 9 CITY. . MECHANICAL-PERMIT - ISSUE . - - ;- 5SUMMARY/ACCOUNT- NUMBER -
-. EACH FIXTURE TRAP-' INSTALL FURN. DUCTS )JP TO 100,00.0 BTU - BUILDING PERMIT - 001-810-00-00-8220
- EACH BUILDING SEWER' '-. . . ' OVER100,000 BTU. , - SIGN PERMIT ,' • 001-810-00-00-8221
EACH WATER.HEATER'AND/OR.VE-NT.. . - ' BOILER/COMPRESSOR UP-TO 3 HP - -s - - - - ' - —'PLAN CHECK:. :, - -001-810'00-00-8891- , .7.i/ _-- -. -_.. - -
EACH GAS SYSTEM I 104 OUTLETS ' ' ' BOILER/COMPRESSOR 3-I5 HP. TOTAL PLUMBING - 001-810-00-00-8222
EACH GAS SYSTEMS OR MORE . ' , ' - METAL FIREPLACE . . ' . ELECTRICAL 001-810-00-00-8223
-d EACH INSTAL, ALTER, REPAIR WATER PIPE' ' .-. .: VENT FAN SINGLE DUCT 4 . - - C .' • . ' - - MECHANICAL - - 001-810-00-00-8224' -
-
EACH _VACUUM BREAKER -_'I:M' "-'- - 'h' ' 'MECH EXHAUST - HOOD/DUCTS -.x '-,' MOBILEHOME 001'810'00008225
_•_
RELOCATIONOFEAFURNACE/HEATER ,i '. - - SOLAR -001-810-00-00-8226 - - VT 'ER S'OFTNERI _____4 ___-
- . DRYER VENT __4 :.,_.L-- ----, ._...STRDNGMOTION -_.•-.._-.._ '...880-51992-33 -EACH ROOF _DRAIN ONSIOEI..............''-
- ___-. _-i.-'---------.- -- ,•,. .-'.,
, -.
TOTAL MECHANICAL '- •
' "' Zi' _ -'
.
. - • _-
'' ''IVY I
-'FIRESPRINKLERS -001810-00-O0-8227 .
? TOTAL PLUMBING ., 1-' ' ' - .
' .PUBLIC' FACILITIES FEE __320-8100O-00-8740
,J I ' • S ' - -. ' • ' -
'CITY.
,,,.,
...MOB.ILEHOME SETUP -.--'
-'
.'-_-_ BRIDGE FEE 360-810-00'00-8740
-_PARK-IN-LIEU(AREA _1 QTY: '-'ELECTRIçAL"PERMITISSUE. .' -_____-________.I'. . .. ..t ' _--_.-'.-__'. , -
- NEW_CONSTEAAMP;SW1BKR' ____'. 'C.-- CARP-OAT"_'-: _______-- -' -- TIF _-- _-312'810-00-00-8835 . — -• -- - -
I _PH ___'T ____-'3 PH
-
AWNING _____-' — LA COSTA TIF -311_8100000_8835
E'XISTBLDGEAAMP/SWT'/BKR '
--'' ' GARAGE - _n _
'- * FMF
--s -I-PH _.------'--3-PH --LICENSETAX-.o$_001-810-00-00-8162 --(-' _'-
REMOOEL;ALTERPERCIRCUIT _'-r /-,),_ , - :_--' ___.ç ." _- _-' MFF 880-519-92-57 --
-
TEMPPOLE200' AM- PS ___._• __-' -•,, -_1 - . ' - - -
-'a:- - . -- OVER 2O0 AMPS '-...---,'. ,, ' - __-._.-...-
41 TEMP OCCUPANC-Y '(3O'DAYS(
"-'"1 _______' ___1 -- ,',. --•'--.-'..-. _. _-_- -_-_'-' CREDIT DEPOSIT 17 Tr -7 -
' " '1OTALELECTRICAi
'
'...TOTAE..i .., -., - - - :JOTAL FEES'.PAYABLE- s- wJ_-, u/ r -
, , .
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY - Expiration. Every permit issued bythi BuiIdigOfficiat undethe provisions OIthIs * AN OSHA PERM:T IS REQUIRED FOR EXCAVATIONS OVER Code shall expire by limitation and becorrie null and void If the building or work CERTIFY,UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCEUDING"THE authorized by such permit is not commenced within 180 days from 5'0" DEEP AND DEMOLFTION OR CONSTRUCTION Of the date of such, DECLARATIONS ARE TRUE-AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS permit, or it the buiIdin or work authorized by such peemil,is,suspended GOVERNING BUILDING CON- ISSUED: ,TO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS abandonedat any limeafter the workiscommencedforaperIodof
, -- - . - STRUCTURES OVER 3 STORIES IN HEIGHT.
-STRUCTION, WHETHER'SPECIFIEO'HEREIN -OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND - -
KEEP HARMLESS THE CITY OF CARLSBAD 'AGAINST ALL LIABILITIEs:JuD'GMENTs, COSTS AND -_P)lCA7..SIGNAflJRE . - -_ OWNER L'J
-EXPENSES WHICH MAY IN ANY
KEEP
WAY-ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE
.180 days._x)
-"' APPROVED'BY - -' - CONTRACTOR - , - ,•._, - DATE-
BY PHONE OF THIS PERMIT ,
TYPE DATE INSPECTOR
BUILDING
FOUNDATION
REINFORCED STEEL
MASONRY
GUN ITE OR GROUT
SUB FRAME Li FLOOR El CEILING
SHEATHING 0 ROOF 0 SHEAR
FRAME i I
EXTERIOR LATH
INSULATION
INTERIOR LATH & DRYWALL
PLUMBING
El SEWER AND BL/CO 0 PL/CO
UNDERGROUND 0 WASTE 0 WATER
TOP OUT 0 WASTE 0 WATER
TUB AND SHOWER PAN
GAS TEST
El WATER HEATER 0 SOLAR WATER
ELECTRICAL
0 ELECTRIC UNDERGROUND DUFFER
ROUGH ELECTRIC
O ELECTRIC SERVICE 0 TEMPORARY
O BONDING 0 POOL
7 MECHANICAL
Li DUCT & PLEM., 0 REF. PIPING
HEAT - AIR COND. SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED
FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
SPECIAL CONDITIONS
BUILDING
J%u_______ _________
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ. IF
CHECKED
INSPECTORS
APPROVAL DATE
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
OVER 2000 PSI
STRUCTURAL CONCRETE
-
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
8OL1S
SPECIAL MASONRY
PILES CAISSONS
.;B,U,IL D I N G' E R N I T. Permit No: CB9806,75'
O/07/98O7 50 Project No ."A98,00869 -
Page. 1 of 1 ... Development No
Job Address:,2525 EL CAMINO REAL Suite 158
Pdrmit lype COMMERCIAL TENANT IMPROVEMENT 576 04'07/98 0001 01 02
'Parcel No,:-,'156-302-09-00 Lot#: . .CPRMT 21900
Valuation 19,682 ConstructionType NEW
Occupancy Group Ref erence# Status tISSUED
Description: CTI' 758 SF IN'IERIOR.REMOD "• :App1ied:'03/0/98
SUNGLASS HU Apr/Issue 0/07/98
Entered By JM
;Appl/Ownr.:LAGENDORF DAN 414 857-3039
10505CORPORATE DRIVE #207
PLEASAN1 PRARIE CA 53158
*** Fees Required *** * Fe Collected & Credits -
------------Fee
Adjustments /oO,'t' 're4i 1t 00
.Total-,-Fees:; 3 .00 ) '-# 'Totar me' s: .176.00
Fee dsiptio 'Extfee''Dtt'a' -------------------
Plan. -Check
41.00
Enter '1' 'f Elect
Remodel/AlterI Per ,,A, P \J1 / f'J/ 25 25 00
Enter 'Y for Mecha cal fr'/ 15 00 Y,
InstallFurn/Ducts/H at Pmp />\ 9 00 9 00
t•. F INCORPORATED
*
-
1952
4 i" ' - •-4 - -' '
. j' .t - - ' • i•.
, * / -.
, * .2 - , , . 7. ' .
:
: f FINAL APPPn'/AL.
4.
CLEARANCE
I_.______.-•- — —•------• - - —
I. •- . .. . - - -. -- .• • - ..- . - -• 4 -, 4
-. * -•- • .. . c. I'
- •*.' - -- + - --
' V ' - ,,
.-, . ' - •. , CITY OF CARLSBAD
2075 Las Palmas Dr., Car1sbad,CA 92009 (619) 438-1161 - '
62Z
77777071:1
$at.IZ1p Tag1,di. 0
T.T°..........
øfnelVi or 'lie!' eny ...L flr 10 it; me pre*ii.. of me s ruiors U601,184Law I ehewp, "11414#0611%, and the usia t.r the 41I000 sf not reca. thin Ijys hundred d9IIs5 talpoji. C(1(&15Lo C(c.Ih (i'1 ,C13c.IlO
P.02 MAR-'02-98 NON 14:49 CITY OF CRLSBD CONN DE FAX NO. 4380894
FOR OFFICE USE PERMIT APPLICATION
17/7 7 J
Q
PLAN CHECK NO
CITY OF CARLSBAD BUILDING DEPARTMENT
•. ST. VAL. 2075 Las Paimas Dr., Carlsbad CA 92009 Plan Cit. Deposit (760) 438-1161 . . Validated By______
e15'9
-.----.-.- o'iiir.iiIo.uu...-...-
Local Dtliuon Lot We A ub..vwlcn Ntm&Nunlb.r (Jolt Pt!i We To& 0 of unit.
.aOr',Iirc.IE7 // / -. koliuee4.., Presumed __ 7,d10- 1Han?- a,jft,aJ7O#1 757. .' / _______ D.sDtlon of Work SO. Y. tef Stedos I • of b.eoma a of $uh,eo,na a. - coNTAqy PsSbi4 01 .i,in. .v'n. .i 7••T )tt(,3 I 'e 'C>5 toS (.o.'o..i . - P.wtt. (j)J.. c 44•c dl
S APPUCAJtD Covlpster 0 Agent for conssqtbv óumsti) L#Inos &°"3-c.- b.- S4- Name Addrssa
4. PROPERTh"DWNSR .- ....,,.... - .. ... LL 2-SC AI&a...L,rs.. £&vj.
ç CONYtUICTOR COMMNY NAi.s ...'•---"- ••-•--....T. --:-- b (sec. 7031.0 SIØIAIII an POfS35iOfl COdO. AnY ltY r County WItICR otufr. P!! 'o co'.. lstutnce. 1150 r*qu!rqIg. Ifo loiltoint for euh setmlt to the a aipted a,s,sMent øwl M s 9ot'eid it , elisOta, 9, oommening with 555110f1. 7000 of Division a of th Bu,lngaa and P,.fsotioss Ced.I W Any vloIlOn of 5q011o,i 70t.0 by nY sp0tical bra po,mft a dvi (I L\() . p yy( .
nr.,r
L 1?j4
, C.,-t. r 0. I State License l LY -' Uoee ClaSS '--i CO OifliAlpls . ...
----- - .5....
State Ucarn. 0 S. W6hXU*0 COMPENdATION . . .. -.-. ...... ......... . "T' ........ . .. . . woricarv, Compensation O.o$sretier.r I hereby affirm undo, penalty 01 owimy on. 01 Vii fcilOwmg sctsssIioni P floVa and will ITi5ifltbIA a certificate of consent 10 $plflfl3W5 for work.m' camps,don is o,ew(d.d by Ssctio,, 3700 of the (.100, Cod., for di• pamtwric. of !pnIwork for wrlich this permit Is Issued.
I have and will maintain workun cew.peftoetion, as required by Section 3700 Of lbS (.lbce Cod., fat the 05$0"nanc• of the woo b to, which this permit I. issued. My worker's cern node1i ir.su,anc. Carder and policy numb., era; - d - I A -' ifnsuranco Company '
Isr
7 Cx Policy woL. - a' (.9 '1 LI o Ebiltathe. jJ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT Is FOR OHS HUNDRED DOLLARS 1.1003 on LES$ CERTIFICATE OF EXEMPTION., I 0,tity the? a. the pet? on,i.nce of If's work for wInd, tiCs permit in is.ued. I shell ,un ainiloy any person I', any means, so as 10 0000rns subject 10 thO Work.,, Cempsn.stion Laws of C,r.tornis. . WARNING; FaIIv. to 5*CNO V Wilms'cempensisan 00 so (P IIRloWfWI. etil ~ 11"ll an 5IP9PV to 0 . and 0th StIll Up to o'IS iniidisd thousand dolls 100.00 1. .9dNlaii to iris nost Of ..an...admi. Ismegs. a. a.-.aesa tot in as~ 8700 tomat and RNnoy'e feesw SIGNATURE A-yi-)( (L.UL DATE 7- 7. OWNER.EUILOERD TION . .. ..-',........-........
I hereby affirm tp.a, I am. from it.. Contractova Uor.'sS Law to, Vie tOilowmg ,.ason; C3 1 as owner of the of= or my sfnpfoyess will, wags. as their sopa coa.prmw$on, wift GO the "al b G the stitictisti in not Intended or Offered for We (Soc. 7044. Business and Protessiono Cede: The Golitvabto,'s IJcsnsa Law doss not apoty to an orms, of p4ijia*p,' wits inda or inuimuss thiyson. oral 4,o doss SUCh work himself or through hi. Ount mp(oyecI. provided that 1.IEIt lipfovefAolitl S'S flit Intended or offered for 000. If. howquas. the Didishi, or smorovaffism in soPli within on. year of cempladon Pie ownsr-.Otd)dsr wm Isv. liii HoGan of proving that he did not build or Imroye for the anposs of isle). C3 i, as owner of The property, em exclusively cony acting with ft- ad contractors to construct the project (Iso. 7044. St*lnss. and P,otsi&en Cod.: The Contractors LICOASS law doss not apply to an owner of property who builds or (mpros-ss U..... and cOntract, for such prolect. with comrectoris) llcSn..d ourausnt to this Contractor's (Jeans. Law).
I am o,empt under Escilon Bualnaa* and Prates 1, w Cade for this reason,
I . I Personally Dion to Provide the mule' lobar and fnatsd&s to, cunsintIqn of the orogotod propuffy lmgtov.nanl. C3 YES QP4O I (have / have not) signed an sppllçsdon for a bldlding permit to, the Proposed wafli.
I hive contracted with the following person (firm) to provide the P"p°"d Confluuotion hinchid, n.m. '-111* Mi phou. rwn021 owitristots (ISsue flldober);
- I plan to provide portions of the work, but I have hired the following person to aichane, .vine and pitivi a the major ws,t Ondude name I sdtssso I phorie number I contractors licenies numbsr):
I will provide some of the work, but I Rave coftft.ctsd (hired) the following Persons to Provide Vie weVc ltdlos (indiols now.., address phone numbs, 1 typo Q! worki:
PROPIRTY OWNER SIGNATURS
- CoMpi.tims sstoH FOR NO't'.*'ttf7544 kuithdiso PmAP10 .p4LV Is the •ØlIe01lt s, tutu,e building occuosni rnoidrpij to um.fltl a Odurissi 041)1, acutely Msafndla MITS$5bi form or rho nvtegsm.ns end pitivainlon program under Sections 26805. 25030 or 25034 of the Preslsy.Tennàr HS3$fdos. Substance Account Act? Cl YES 0 NO Is the epólicam or future buIlding occupant r.qulred to obtain a ps,-dt from IIa air pollution cantEd 0bn$ct or sit Quality inan.9smlfiI district? 0 YES CI NO Is the facility to be constructed withIn 1.000 test or lbo outer boundary of a school she? 0 yes CI NO IF ANY OF THE ANSWERS ARE YES. A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROl. DlStCT. 8. cOIIiSTRUC1TON LCI'4D110 *CEMcv -------- - - I hereby affirm that there is a construction lending .qsncy for the perfomwncs 01 the work for which this pennt Is Issued (Sec. 3097(I) Civil Coda). LENDER'S NAME .
- LENDEWE AOORESS__. - - - *poLicAiar tERTIFLCATI*11 ........... •• -. ....._
-: ....- P certify that I hive road tAo application sno slat, that the above information I. sotroct and diet ma In? W,ttatign on ift p117* in eqçipe. I agree to comply with all City ovdlnencea and Slot. PewS relating to building conspuedan. I hereby authorize rsvreaottallvll 61 the Cli? ai Cothibad to antw upon She above m*Ittlonsd property for Inspection purpose,. I ALSO AGREE TO SAVE, INDIMNIPY AND kW HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIAIIIJT(U. JUDGMENTS, 005'TS AND SXPENSES WHICH MAY AeWAconug 40*053? 5*10 cITY os coNsROuelcV Op THE GRANTING P Thus psnlerr. 0511*; An 0611* permIt is reauiredAol elccavationsforar lid
dydiSaction
construttlon of EUUCSIIVSb cvat 3 etudes in height. EXPIRATIOPd: Every permit ised Mv the 0t4fldinO/OIIId hi* Cod, sitsfl espirs by lImItatIon and becom, null a void If Via building 0' work autltorlsed by such permit Is 4t comr,hcedfvIithln fr ouch permit or If th, building or work .Utbe$lad by permit Is suspended or obandorn.d at any time after Vi 1'u.1iPs 1finmofi,%d fo f I 108.4.4 Uniform Building code). / APPLICANT'S SIGNATURE 6tY DATE WHIT - PIle vst.*.cv: Applicant PINK: Finance
CITY OF CARLSBAD
INSPECTION REQUEST .•
PERNIT# CB980675 FOR 06/10/98 '. INSPECTOR AREA TP
DESCRIPTION: CTI 758 SF INTERIOR REMOD ' 'PLANCK# CB980675
SUNGLASS HUT ... 0CC .GRP
TYPE: CTI 'CONSTR. TYPE NEW
JOB ADDRESS: 2525 EL CANINO REAL STE: 158 LOT:
APPLICANT: LAGENDORF DAN' PHONE: 414 857-3039
CONTRACTOR: PHONE:
OWNER: PHONE:
REMARKS: C/STEVE/800/591-6071 INSPECTOR
SPECIAL INSTRUCT:
,
. t . •'
- TOTAL TIME:
CD '. LVLDESCRIPTION. ACT COMMENTS
19 ST Final Structural ' ic cr4,
29 PL Final' Plumbing
39 EL Final Electrical'
49 ME Final Mechanical '
HISTORY.***** ' *.****,INSPECTION
DATE DESCRIPTION ACT INSP COMMENTS
06089.8 Final Combo •' - NR TP , NO ACCESS
060498 Interior Lath/Drywall .' AP TP PATCH @ 1 HR WALL
060198 Frame/Steel/Bolting/Welding AP. TP T-BAR ADDED @ STOCK RN.
060198 Frame/Steel/Bolting/Welding CO TP ' ' NEED TO PATCH 1 HR DMZ WALLS
052798 Underground/Conduit-Wiring AP TP . . .
052798. Frame/Steel/Bolting/Welding AP TP' PER REV WALLDTL
052798' Rough Electric , ' 'AP TP . .
052798 Interior Lath/Drywall '. AP TP
0522,98 Frame/Steel/Bolting/Welding NR .TP ND PLN REV.
052198 Frame/Steel/Bolting/Welding . CO TP 'SEE JOB CARD .
052198 Underground/Under Floor CO. TP'
052098 Frame/Steel/Bolting/Welding NS TP MISSED'
052098 Underground/Under Floor . NS TP MISSED
051598 Frame/Steel/Bolting/Welding CO TP SEE JOB CARD
051598 Rough Electric CO TP
Mfl'? 26 '98 08 22flM DCC SAN DIEGO P 1/3
FAX Transmittal
DICKINSON CAMERON CONSTRUCTION Co, INC.
Main Office -, East Coast . Hawaii
140 Lomas Snta Fe Dr., Suite 200 119 West 23rd Street, Suite 1002 1643 Kahai Street Solana Beach, CA 92075 New York, NY 10011 Honolulu, HI 96819
Tel: 619-793-9104 Tel: 212-929-7364 Tel: 808-845-4677
Fax: 619-793-9112 Fax.,. 212-929-8372 Fax: 808-845-4936
DATE
ro
VTTN;
FAX #:
FROM I'-) 601'DiAiE
SUBJECT: 17-
P,&J.D 771- ,E /w/ ,'J Z,' p
1ZC?J 777f t g I £CJ/ (( // yE f4
J? O P
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(6 (2) (793 q (
- 7Th'-
05 22/ty 6 "s' 2i'RN bGO THE TRICARICO GROtP PC P.
NG1
I M51 OM C.LEM AV IOMOOT14
OIN& NSTALLA110N I1$14 LNLCD
Pill
. F LOORTANSITQN
SC-A cc
-
- XI11N EGK
IkM AL 61M DFRAGINS
AS REWREM 0, 52N.O.C.
r ClUN6..
____
V X 4' AT t2' *2 Ai.T
STOCK - - SALEE
AREA AFqEA.
Drn. IelE RATtV &'tP eo
5/8 F91C RATM Gr? 13' 1-41
fArITk7N
ITITN rTPES
LM
CAM
S"ALE: NTIS
I
771,
. 4 . -.
EsGil Corporation
In Partnership with government for Bui0ingSafity -
.. .-.. -
DATE:. 3/31/98 . . . . . . . 0 APPLICANT
JURISDICTION: Carlsbad . . . . . . . PLAN REVIEWER
0 FILE
?.PLAN CHECK NO.:98-675. . SET: 11 . . . 4 .
PROJECT ADDRESS: .2525 El Camino RealSte. 158 . •. .
. PROJECT NAME: Siinglass Hut TI
Li
.
The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes See Remarks $
The-plans transmitted heréwitftwill substantially comply with the jurisdiction's building-codes
4 whn'minor deficiencies. identified below are.resolved and checked by building department staff.
.'
. The plans transmitted herewith have significant deficiencies identified on the enclosed äheck list
and should be corrected and resubmitted for a complete recheck
LII The check list transmitted herewith is for yoUr information: The plans are being'held at Esgil
Corporation until corrected plans are submitted f6r recheck
. .--' . • :
The applicant's copy of the check list is encibsed for the jurisdiction to forward to the applicant
contact-person.l
-
The applicant's copy of the check list has been bent to
Esgil.Corporation staff did not advise the applicant that the plan check has been completed.
, •
,• . • .• .4 • .- . -.•
Esgil Corporation staff did advise the applicant that the plan check has been completed
Person contacted Telephone #
Date contacted: (by: ) •. • Fax #:
Mail TeIephone Fax In Person - • . . .
- - •-
REMARKS The city will please verify and 'rove the Disabled Hardship document from
the Tenant for the disabled access upgrdes aridmake part of the plans per Mike.
Peterson. . . . . . • . -
By Mike Puckett ' Enclosures
•
- Esgil Corporation .. . • .• 1 • . . .
E] .GA CM EJ - fl PC. 3/23/98
• .
' - trnsmti.ot
9320 Chesapeake Drive, Suite 208 • SanDiego, Califor'ni'a 92121.• (619) 560-1468. • Fax (619) 560-1576
-
• • - - 4 .. -. - - - '•
4
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008 .5 .fl.- •
. 5. .09-04-2012 Commercial/Industrial Permit Permit No: .CB120616
Building Inspection Request Line (760) 602-2725
- , . .-
'_ •. : ',, . -
-s -
Job Address 2525 EL CAMINO REAL CBADSt 158
Permity Type: - TI . . . Sub Type: COMM - .' . Status: ISSUED' -. . •.
Parcel No: •- 1563020900 -., . Lot #: 0 i'., . Applièd: 04105/2012
on:$.28,100.00'- Construction Type NEW Entered By JMA
Occupancy Group:. ' . Reference #' , .. Plan Approved: 09/04/2012 .
- Issued 09/04/2012
Inspect Area *
Plan Check #
- Project Title SUNGLASS HUT REMODEL 757 SF
so
Applicant Owner
STARR DE L CRUZ - PLAZACAMINO REAL
-
~QCARLSE!Ab,-CA~
,-'C/O,WESTFlELD PROPERTY TAX DEPT ç .
2413 PACIFIC COAST HWY,#202. PO1BOX 130940"DEPT WELD ,•, - '- ..
LOMITA CA 90717 92013 N310-606-2078 JJ'\I
';er Size ~Q Buildin
Permit
5 Me r Size
AddiB?iding Permit Fe/"\ O I Red. Water N so 00
Plan Check ' . /' $211.50 Meter Fee .., ' $0.00.. ..
AddI Building Permit Fee / $0.00 SDCWA Fee \ $0.00 . ... .:
Plan Check Discount' . / $0.00 . CFD Payoff Fee \ . . $0.00 ' . .. Strong Motion Fee / - / -- $5.90 PFF (3105540) . . \ . ' . $0.00
Park'Fee .5$0.00 ..-- PFF(4305540).-,.',. - \ '. '$0.00 .
" LFM Fee . - ' / — / .. ' $OPP -,c Licensejax (3104193) \ $0.00 . .
, 'Bridge Fee ' . I - $0.00 Lic'ense-rax (4304193) '- \ - -. $0.00 BTD#2 Fee I $000 Tráffic Impact Fee (3105541) $000
BTD#3 Fee $000 Traffic Impact Fee (4305541) $000 14 j
-, Renewal Fee $0.00 PLUMBING-TOTAL } . . I . $0:00- Add'l Renewal Fee ' . $000 \ ELECTRICAL TpJAL $67.00
Other Building.Fee , $0.00 * MECHANlCTOTAL J ,J ' .-j .$0.00.
Pot Water Con 0 Fee $ 00 I MasterDrainagFe\% I Ti / 1 $0 00 - t .?-iIDk I f . .. .
, Meter Size : ' . ' SewerFee ' ' / ? $0.00 " .....,.t.,.
'Add 'I Pot Water Con Fee \ $0 00 - Redev Parking Fee / / $0.00 '
Red Water Con Fee $0 00Additional Fees / / $0.00
Green Bldg Stands (5B1473) Fee tsi.00 HMPFee / / 7?
Fire Expedidted Plan Review \ $317 50C0RGreen Bldg Standards Plan Chk / 7' fiTOTAL PERMIT FEES1 /4 $905.05'
\V./
Total Fees: . $905.05 Total:ayrnents ToDate: $905.05ç\ aace Due: . . $000
4
EINALAPPR
Inspector
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, . •0 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 t6water 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
5,.t' V.5'AtI¼.IIVfl!O fiji vviuit,ui Ti/U POTts ijItsVPyUQPT UccIl '.4IVCIPO I
•
limitations has previously otherwise expired.
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C I T Y O F 7606022717 / 2718 / 2719'Plan Ck. Deposit / A fl I CflA r - . Fax 760-602-8558 . - LfrIL)D/%L) - .
wwwcarlsbadca.gov Date qfr7,'z. I
JOB ADDRESS T-. - - SUITEC/SPACE#/UNITC . APN 9 Ca'.i'n
- I Ii6)gs
CT/PROJECY# LOT# PMASE# #OFUNITS #8EDROOMS #BAIHROOMS TENANT • CONSTR. TYPE OCC.G OUP
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) 1.
TôJC 767S2nS1aS :'';i\L) xi(itj
fl!-Pecd Ct1
'Flee-4f (
-
I_______________ p4íI )c1 t . (fl thJ' -. : •.. ..
IFIREPLACE EXISTING • ( P DUSE • • GARAGE (SF) PATIOS (SF) DECKS(SF) AIR NDITI NING FIRE SPRINE
SD#.: •N YESIOJ YESNOE
APPUA AME ?PrI Con3 iec (2(42 , APPLICANT NAME (Secondary Contact)
ADDRES~ADDRESSS
__- _'---•-—:
.. - ___ PHONE , . . F . - . . . PHONE FAX
.
EMAIL__
• -..._________-_____:-_____.
PROPERTY OWNER NAME fj_4fi /d_L L_. CONTRACT?R.BUSAME . '----.
cny . . . . - •. STATE ZI...............CITY . ... . . - STATE. . . . -ZIP
f2a. _:rtj _j76C;) •///cOLd1.._/1 (h&rt.7 ________.
ADDRESS . - ADDRESS •. - . - ., .•
cnv ,, . - . . STATE J . .. ZIP . .. CITY ... .. - .. .. STA ........... ZIP . - :'7 ___.c-/f-•-___• 11,V___ .: ___'-/27/'11 -
HONE
I FAx 77. P79
q_. __F 27 - 7/, _C9f' EMAIL
•Js iWcø
, ___:.EMAIL
:.
AR 0 SIGN NAME DDRESS . STA C. a STATE LiC. . . CLASS CITY LJC.# .43gi2L(.._ BUS.
'Ouu , ousiriess ariu rruiessuuris i..oue; Mny t.ity or iounty wnicn requires a permit to construct, alter, improve, oemoiisn 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 applicanffor a permit subjects the applicant to a civil oenaltv of not more than fIve hundred dollars 50011 - -
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
FA -
I have and wIll maintain a certificate of consent to setf4nsure 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' cam nsallon,as required by Section 3700 of the Labor Code, for the perform p; of the work for which this permit is issued. My workers' compensation nsuranje ca er and policy
number are Insurance Co__ POIiC No.' o Pocri g IYIXIt ii u/6016 C Expiration Date /Jt//
section need not be completed lithe permit is for one hundred dollars ($100) or less. - .• " I •
Certificate of Exemption: I certify that in the performance of the work for width this permit Is Issued, I shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of
Califomia. WARNING: Failure to secure worker's' 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, dam as as provided for In Section 3706 of the Labor code, Interest and attorney's fees. • ' -.
CONTRACTOR SIGNATURE -'. DAGENT DATE Q'-
- ----- . - ..--• -•---- -• -
I hereby affirm that I em exempt from Contrscto?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 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 sate. 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, in exclusively contracting with licensed contractors to constrict 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). *
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 Dyes No ' . • .
- 2.1 grave / have not) signed an application for a building permit for the proposed work. * . - . •
-
- 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address I phone! contractors' license number):
4.1 plan to provide portions of the wont, but I have hired the following person to coordinate, supervise and provide the major work (include name/address I phone contractors' license number):
-
-: 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name! address! phone! type of work): - • -
'PROPERTY OWNER SIGNATURE , • ' - []AGENT • DATE - -
pa gociag 1qn
'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 Ad? L.Yes - L No _V
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? L.JYOS No -
Is the fadlity to be constructed within 1,000 feet of the outer boundary of a school site? I 1Yes f'J 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. "
130MMMOV= rknMoome ..., ...... .
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's Address
:.::VV .. - • .
I certifythati have readthe'appllcatiori and state thatthe above Information ls correct and thatthe Information on the plans Isaccurate. I agree tocomplywlthall City ordinances and State laws relating tbulldlngconsbuon.
I hereby authorize representative of the City 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 Cli? INCONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA An OSHA permit Is required for excavations over 5V deep and demolition or construction of structures over 3 stories In height.
EXPIRATION: Every permit issued by the Building Official under the provisions ofthis Cede thaT expire by Imitation and become null and void tithe building or work authorized by such permit is not ccthrnenced within
dayi or woek is for dl days (Section lo6.4.4 Uniform Building Code).
APPUCANVS -' DATE'
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-
:
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•,
,. ; •,S.f%. • . 4 .'* V.
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STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE.'.
Complete the following ONLY if a Certificate of Occupancy will be requested at final, inspection. V V
IFf CATE 0 F OC CUPA NCY I C o m..N--...
Fax (760) 6028560, Email www.buildinpcadsbadca.qov or Malithe completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008.
(Office Use Only).
ViV
[CO#:
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V
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CONTACT NAME OCCUPANT NAME - • V,SV . , - ' -
V -
- . •
ADDRESS V
BUILDING ADDRESS '-
CITY - - STATE - ZIP . -. CITY STATE V -ZIP V
V - Carlsbad CA V V
PHONE FAX .. .
EMAIL
V
- .V OCCUPANT'S BUS. UC. No.
DEUVERYOPTIONS
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CONTRACTOR (On Pg. 1)
ASSOCIATED CB#_' V
MAIL TO: CONTACT (Listed above) V OCCUPANT (Listed above) '
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CONTRACTOR (On Pg.i) NO CHANGE IN USE / NO CONSTRUCTION
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APPUCANVS SIGNATURE
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>CB120616 2525 EL CAMINO REAL 15
SUNGLASS HUT: REMODEL 757 SF
CITY OF
CARLSBAD INSPECTION RECORD Building DI.Aslon
II INSPECTION RECORD CARD WITH APPROVED
PLANS MUST BE KEPT ON THE JOB
21 CALL BEFORE 3:30 om FOR NEXT WORK DAY INSPECTION
21 FOR BUILDING INSPECTION CAW 760-602-2725
OR GO TO: www.Carisbadca.gov/Bulidlng AND CLICK ON
"Request Inspection"
DATE: C1 Iii Ii 2
TI COMM
Lot#: STARR DE L CRUZ
RECORD COPY
OWNERS' NAME
Required for Final If Checked Notes
U Planning/ Landscape 760-944-8463 Allow 48 hours
U CM&I (Engineering inspections) 760-438-3891 Call before 2 pm
Fire Prevention 760-602-4660 Allow 48 hours Z_- 9411
Type of Inspection
:IIJlu,]I[
FOUNDATION
Date Inspector Type of Ins pctIon Date
WAECTRIC UNDERGROUND 0 UFER - (0
1pspector
REINFORCED STEEL ROUGH ELECTRIC WALLS
MASONRY ROUGH ELECTRIC CEILING 'I If [ f'it
0 GROUT 0 WALL DRAINS 0 ELECTRIC SERVICE 0 TEMPORARY
T1LTPANELS 0 BONDING 0 POOL
POUR STRIPS PHOTO VOLTAIC
COLUMN FOOTINGS ANAL
SUBFRAME0_ FLOOR 0_CEILING
ROOFSHEATHING UNDERGROUND DUCTS PIPING
EXT. SHEAR PANELS __________ /2 0 DUCT & PLENUM 0 REF. PIPING
FRAME 7 '/ '/y fE 1" HEAT-AIR COND. SYSTEMS
INSULATION VENTILATION SYSTEMS
EXTERIOR LATH
_____
___________
FINAL
INTERIOR LATH &DRYWALL
1
-27,/1-il.- ___ (c 'tt
SEWER & BL/CO 0 PL/CO
Date Inspector
FINAL OCCUPANCY
ll
A/S UNDERGROUND VISUAL
Date Inspector
UNDERGROUND DWASTE OWATER /2 A/S UNDERGROUND HYDRO
TOPOUT OWASTE DWATER ? j '.1t f C 7 'c, A/S UNDERGROUND FLUSH
TUB & SHOWER PAN A/S OVERHEAD VISUAL
GAS TEST 0 GAS PIPING A/S OVERHEAD HYDROSTATIC
WATER HEATER 0 SOLAR WATER A/S ANAL
ANAL F/A ROUGH-IN
____________ ______________ F/AF1NAL
600- PRE-CONSTRUCTION MEETING FIXED EXTINGUISHING SYSTEM ROUGH-IN
603-FOLLOW UP FIXED EXT1NG SYSTEM HYDROSTATIC TEST
605- NOTICE TO CLEAN FIXED EXTINGUISHING SYSTEM ANAL
607- WRITTEN WARNING MEDICAL GAS PRESSURETEST
609 - NOTICE OF VIOLATION MEDICAL GAS ANAL
610- VERBAL WARNING
ANAL ANAL
REV 6/2012 SEE BACK FOR SPECIAL NOTES
o
Section 5416. Health and Safety Code, State of California
There shall be not less than one water closet for each 20 employees or fractional part thereof working at a
construction job site. The water closet shall consist of a patented chemical type toilet.
For the purpose of this section the term construction site shall mean the location on which actual construction of a
building is in progress.
A violation of this section shall constitute a misdemeanor.
"All-construction or work for which a permit is required shall be subject to inspection and all such construction or work
shall remain accesill6'n1 thposed for inspection purposes until approved by the inspector. Work shall not be done
beyond the point indicatéd in ech suc6essive inspection without first obtaining the approval of the inspector.
DATk ADDITIONAL NOTES
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