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Home My WebLink About2525 EL CAMINO REAL; 165; STE 165 PRE 2016; PermitLICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provi- sions of Chapter 9 (commencing with Section 7000) of División'3 of the Business and Profes sions Code, and my license sin full force and ef- fect. . ' . OWNER-BUILDER DECLARATION ,Of hereby affirm that I am exempt from the Con- tractor's License Law for the following reason. (Sec. 7031.5 Business and Professions Code), Any city oi county which requires a permit to,con- struct, alter, improve,, demolish,' or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed state- c. - ment that he is licensed pursuant to the provi- sions of the Contractor's License Law (Chapter 9 - commencing with Section 7000 of Division 3 of the Business and Professions Code) or that is ex- empt therefrom and the basis for the alleged ex- emption. Any violation of Section 7031.5 by an ap- plicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars ($500). j. . Dl, 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 of-' - - fered for sale (Sec. 7044, Business and Profes- sions 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 of- fered for sale. If however, the building or improve- ment Is said 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). 01-as owner of the property, am exclusively con-' trading with licensed contractors to construct the project (Sec. 7044, Bus,jatss and Professions' Code: The Contractor's Lienfte Law does not ap- ply to an owner of prop dvI .ho builds or im- proves thereon, and ,o contracts for uch pro- jects with a contract 5) license urs nt to the contractors License , B. & P.C. forthIsrebn'V Date ç(.J' wner WORKERS' COMP SATION DECLARATION I hereby affirm that I have a certificate of con- sent to self-insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Labor Code). POLICY NO._________________________ COMPANY OCopy is filed with thef city. - -DCerttd copy is hereby furnished. - CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed Ifthe per- mit Is for one hundred dollars ($100) or less). I certify that In the performance of the work for which this permit is issued, I shal[no employ any person In any manner so as to become subject to the Workers Compensation Laws of California. NOTICE TO APPLICANT: If, after making this Cer- tificate of Exemption, you should become subject to the Workers' Compensation prokisions of the Labor Cd6e, you must forthwith comply with such - provislons,or thi's permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY - I hereby affirm that there Is a construction len- ding agen'cy for the performance of the work for -. . CITY OF CARLSBAD— BUILDING DEPARTMENT APPLICATION & PERMIT APPLICANT TO FILL IN INFOR- USE BALL POINT PEN ONLY 1200 ELM AVENUE (714) 438-5525 -. MATION WITHIN RED LINES NO: ' - ioa ADDRESS - ' - - - A'.'. ST. RD DATE AppLIcATIoN BUS. LIc NSE PERMIT NUMBER ' PRIME CONTRACTOR. -, C) L/''/ (_) • - ' - OWNER - OWNER'S PHONE - STATE LtfENSE Sm ,L. - OWNER'S MAILING ARD,RES? . ' •CQNTRACTOR'S.AODRESS, 67__4VI-iQ ,- CO.NTRACTOR'S - . - - .-• .'..-. 20O iC-4--' LOT BLOCK - SUBDIVISION - - ASSESSOR'S PARCEL NO. DESIGNER - - . . ., - •- : . • * - STATE LICENSE - DESCRIPTION OF.WORK -. - . ,-'' ,-., - - .-. .• . - - ( .. . , ., '. - . • . - - 7"7,&.44-j.JV" / Vjt12 /2t7J?(er%,rtJ - , DESIGNER'S ADDRESS - . •!/0I097B, DESIGNER'S PHONE - tc2O,sr-c ,,4D CENSUS TRACT -r GP LAND USE ZONING RES. UNITS PARKING SPACE sq f-ti NUMBER OF STORIES i, Not Valid Unless Machine Certified - LOAD - BLDG SQ FT BLDG USE DCC GP STANDARD PLAN B PLAN ID B TYPE CONST 0CC 1 - ,/)ç /,4'1,j,ij - 2.1. oô---,; . . - ]7JJJTION - - AMT, - CITY. - - - PLUMBING PERMIT --' - AMT. QTY. MECHANICAL PERMIT " ,3 EACH FIXTURE TRAP 2-.2- INSTALIFURN DUCTS UPTO 100000BTU -- / EACH BUILDING SEWER . (-- 'çY7" 7 OVER 100,000 BTU EACH WATER HEATER AND/OR VENT 2-- - 2 BOILER/COMPRESSOR UP 3 HP - - - ' . - EACH GAS SYSTEM TO 4 OUTLETS - . - . * BOILER/COMPRESSOR 3-15 HP — EACH GASSYSTEM 5 OR MORE - . .. - BOILER/COMPRESSOR 16-30 HP. - EACH INSTAL.,ALTER REPAIR WATER PIPE VENT FAN SINGLE DUCT EACH ff SPRINKLER SYSTEM 'iL' L MECH EXHAUST - HOOD/DUCTS • WATER SOFTNER . -' RELOCATION OF EA FURNACE/HEATER . -. BUILDING PERMIT Issue • - 3.00 Issu - - 3-pp SIGN PERMIT i I1IcFv - TOTAL PLUMBING • . i-- - TOTAL MECHANICAL. PLAN CHE2. Ye TRACTOR CON , — . . . . . . - . CONTRACTOR •.. . , . -. - - - . - • ALL INCLUIVt-PEHMIf 'UTY. ELECTRICAL PERMIT AMT. an', MOBILE HOME.PERMIT AMT.. TOTAL PLUMBING ELECTRICAL' ,t NEW CONSTEAAMP/SWT/BKR / t-4 -AWN - . -AWNING - .. PORCH - " . - - . - MECHANICAL " - 1. .•I Il. -l- I PH - .25 ...3 PH' / .. - . . . - MOBILE HOME — EXIST BLDG EA AMP/SWT/BKR SET-UP SOLAR I I I 1PH,25 3PH ' . RAMADA, CABANA — REMODEL/ALTER PER CIRCUIT - - . FENCE OVER 6' ••• . - - .. , . -. . - . . - I ' I I I 7I TEMP POLE .200 AMPS - . - .-.TOTAL MOBILE HOME. • . .• - ..'- - MICO-FILM - -.. ' - '• I I I OVER 200 AMPS '- - - - ____:_ -. , . . - - - '. ' '' . . •- I I - I TEMP OCCUPANCY (30 DAYS)-- - - . '_• ._-._-•_- I_-_'_I_I_I Tsczue 2--00 TOTALELECTRICAL - CONTRACTOR' - ' -. TOTAL FEES PAYABLE I_I_b1O_4U — IHAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, AND DO 'AN OSHA PERMIT IS REQUIREDFOR EXCAVATIONS OVER - OF - SGIOOL HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5-O" DEEP AND DEMOLITION 0 CONSTRUCTION FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY,—TRUCT ES OVER 3 TORIE N HEIGHT - - COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER - .. . ,' • . SPECIFIED HEREIN OR NOT. I,ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM. LESS THE CITY OF CA RI,SBAO AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND • -EXPENSES WHICH MA\' IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE -_- AP-P71—CANT'S —__..........,...) OWNERJ CONTRAC RD PP OVED BYñ .'/ DATE OF THE GRANTING OF THIS PERMIT --___________ __-•_._ _GENTDBYPHONE, SITE • ADDRESS: OWNER: PERMIT NO:- FIELD INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTORSNOTES WOOD FLOOR S S FOUNDATION • FORMS -SETBACK • TOILET - -_- UNDER FLOOR PLUMBIWG -. -UNDERFLOOR HEATING OKTOINSTALLSUBFLOOR SLAB FLOOR - - UNDER SLAB PLUMBING FOOTING • FORMS • SETBACK • TOILET - - OKTOPOURCONCRETE FRAME ROUGH ELECTRICAL S S ROUGH PLUMBING ROUGH HEATING/VENTILATING S •. - - FRAME OK.PLACE INSULATION - INSULATION OK • PLACE WALLBOARD • - WALLBOARD OK. PLACE TAPE EXTERIOR LATH OK. PLACE STUCCO FIREPLACE :: - - S • -, S DAMPER & STEEL -• - 5 5 ____________ - -. - - PLATE TI ES/HEIGHT OF CHIMNEY • - OTHER - - - - - -: - - TEMP POWER (POLE) - - - - - - - - SEWER • S - - GAS TEST - SWIM POOL • STEEL BONDING - - - - PRE DECK • - S • • - FENCE PREPLASTER SHOWN • FRAME PAN FINAL INSP BY BLDG DEPT S OTHER DEPT'SREQ COMPLETED - • - ELECMETER-PERM-TEMP - - GAS METER-PERM-TEMP CERT OF OCCUPANCY ISSUED r S S • -. - Lçe q (oC INTERDEPARTMENTAL INFORMATION SHRtCEVED INC DEPARTMENT S S DATE: ' 5 " JA! 3 1980 BUILDING A DDRESS S CITY OFCA'RLSBAD . c Building Department PLANNING DEPARTMENT, ZONE 'S LOT SIZE_'S _ , 'LOT 'WIDTH' UNITS ALLOWED UNITS PROVIDED__________________________ PARKING SPACES REQUIRED PROVIDED________________________ % COVERAGE ALLOWED S , S ' PROVIDED BUILDING 'HEIGHT ALLOWED PROVIDED FRONT 'SETBACK: ,' S :SID.E. SETBACK , REAR -SETBACK: . S ALLOWED PROVIDED________________ INTRUSIONS LANDSCAPE & IRRIGATLON PLAN COMMENTS:,' ENVIRONMENTAL' PROTECTION REQ: ' _' ' ' 1 ' •' S DIS RICT': ''"" '• . OUNT:,... ADD I TI ONAL 'COMMENTS:0 OK TO ISSUE: f7v DATEl -3-:-&K TO FINAL DATE. ' S ENGINEERING DEPARTMENT A.O.W. INDUSTRIAL WASTE IMPROVEMENTS________________ , SEWER CONNECTION S DRIVEWAY LOCATIONS_' GRADING PERMIT -,EASEMENTS DRAINAGE___________ LEGAL DESCRIPTION ADDITIONAL COMMENTS OK TO igSUE.htL DATE PWI . . ,' OK TO FINAL DATE FIRE DEPARTMENT SPRINKLING, SYSTEM ' . . FIRE PROTECTION -EQUIP. FIRE ALARMS' S EXITS' FIRE HYDRANTS' ' ' ' S - LOCATION ADDITIONAL COMMENTS, OK TO ISSUE-: - ' ' DATE ,,OK TO FINAL' DATE_______ WATER DEPART MENT REQUIREMENTS OF APPROPRIATE DISTRICTS-MET , ' DATE ''5 - 4 -- .B UIL D I N G P E R M I Permi.tV.No: CB910177,; 4 03/14/91 15 08 I Project No A9100222 Page 1 of Development No .. 16b -Address: 2525ELCAMINOREAL . Str: ** -Fl:.**** -Ste: 165 Permit Type 'COMMERCIAL TENANT' IMPROVEMENT 0 4/ 1 0001 01. Parcel No:-156 -302-09-60' -. . .. Valuation 40,672 .. + V.. .' - .5 5. -4 •• . Construction Type IlIN. — Occupancy Group B2 , Class Code Status ISSUED Description 1984 SF OPTOMETRY OFF REMODEL Applied 02/06/91 03/14/91 Validated By CD Appl/Ownr EIERCE, LEANNE '' 619-792-5733 ,. 1237 CAMINO DEL MAR #F - - 14 :E MAR- CA 0 ER MA Lic. OWNER . :.. .'V Fees 2 15 00 (i \ Adjustment.: ..fV (\.00 -• 6o:1 Total Fees ,1t5'00 T&tal Payips \ 231 00 I Balacue \ 1,884 00 Fee descriPtion] Ext fee Data Building Permit 4\ 356 00 Plan Check J 231 09 Strong Motion Fee J I I I 6 00.. ,Enter,.,'Yto AutocsaicLicense Tax >VEflhI.. I .1424.00Y * BUILDING TOTAL 2017 00 Enter Y" for Plumb\ing Issue Fee 3 / 7 50 Y • .• ••' . Each Piumbing Fixture or.i-rap ,$iIC>4)OøOCA,,Ol.O 2.50.. .. 2.5O.- *-PLUMBING TO AL -00 111 Y f or. Elect' \ N '' / io oo, Three Phase Per AMP \ /.50'5000 - *ELECTRICAL TOTAL ($10 "1i..nmum)jJ? Q \j." ./ 55 00 'Enter 'Y for Mechanical Issue Fee> 2V_' 15 00Y k Instal1 Furn/Ducts - 00 9 00 , ,18 00 * MECHANICAL LTOTAL 33 00, 4 - •V "V 4 , - . - • • .. .5 . 5* - . - - •V.. V - V. - . -V. • - • . - .4 - - .5 - - V.- • V • • . - - . V. -. V -V.. V V. • V. 'V S - .3 - V.. V. V.5 4V.V V.5 1 V.- S • - • VV' - 'V...) V.5 S • V. ,'V, ., ..s... . •V.' V., V. V. V ,) - .• S - - . - - -•: V4 .5V • V., .. .5 -• ' - •AP-PROVAL' V IN ATt j~ ' 'T / ________________ •' ' .54 'CITY pf IC OF CARLSBAD 2075 Las Palmas Dr.,Carlsbad CA 92009 (619) 438-1161 -V - . V - V. - j • .5 V. • -. V V ' V. V. • • V - V. '• V VS-c 3.5 • V - V. V V • 'V .V. -. V'.5 -V 4. V. V . V • V A" - V PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 1., PERMIT TYPE I A -,,,COMMERCIAL pNEW ,1ENANT IMPROVEMENT B - 0 INDUSTRIAL UNEW ' IMPROVEMENT C - DRESIDENTIAL DAPARTMENT DCONDO OSINGIE FAMILY DWELLING DADDITION/ALTERATION [:3 DUPLEX DDEMOLITION [-]RELOCATION [-]'MOBILE HOME DELECTRICAL DPLUMBING EMECHANICAL EPOOI DSPA DRETAINING WAIL DSOIAR 0OTHE ,9 EST. VAL__________ PLAN CX DEPOSIT_____________________________ VALID. BY DATE c2 " 6E/Uô/Yi IXIVI W.02 C—F'RMT '231..00 Address -- Building or Suite no. .2.t2G At&$AO AhL PL- ctIo ei- csr - Nearest Cross Streets 1(015 LEGAL DESCRIPTION Lot No. Subdivision Name/Number Unit No. Phase No. Ir ,2 Energy Calcs 02 Structural Calcs 02 Soils Report Di Addressed Envelope 4SESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK LE 0 25MGL Eiti (c4 '.tkrmeaNsJE1 S-10 (j-oviSi. 1&h'EL) PLA2.A ctAM141 BLDG. SO. FIG. # OF STORIES o plOLAt-flLA...( (lc_cic.. CONTACT PERSON . NAME L.jiie. ".A. 1OE. ADDRESS 12-7 CA..kkito t7L MA 4LF CITY ci__. I'JiiY STATE CX ZIP CODE 'LO 14- DAY TELEPHONE A 4. SIGNATURE 1/7. 1 APPLItAM'I DCONTRACTOR 0 AGENT FOR CONTRACTOR DOWNER FOR OWNER NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE PROPERTY OWNER OWNER MA'-(1j'C. 'Z 52g ADDRESS DLESSEE ,TENANT j-ieo NAME f7. ..Jo_-. C L. aat c2 :zA-L. CITY _ (.Aa1...-'5' STATE <:4, ZIP CODE q2_oô DAY TELEPHONE 1)/lit... CONTRACTOR NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. A_____________ LICENSE CLASS CITY BUSINESS LIC. H SIGNATURE TITLE DATE DESIGNER NAME p... - i. ADDRESS \'2 ' -1 CAJ rb pz_ r"J.A4- - P CITY STAYEc4.. ZIP CODE 92-0 $4- DAY TELEPHoNE7q2...- G'7'> STATE LIC. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm that I have a certificate of consent to self-insure issued by the Director of Industrial Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. Q. INSURANCE COMPANY POLICY NO. - EXPIRATION DATE 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. SIGNATURE DATE OWNER-BUILDER DECLARATION- Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractors 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. 7046, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon,, and who does such work himself or through his own employees, provided that such improvements are not intended or-offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale.). - * 0 I, as owner of the p'roperty, am-exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Cede: The Contractor's License Law dces 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). - - o I am exempt under Section Business and Professions Code for this reason: (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requiresthe 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, commencing 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 hundred dollars ($5001). SIGNATURE - DATE 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 registr - ation form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? DYES DNO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? DYES ONO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? DYES , O IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OFTHE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. CONSTRUCTION LENDING,AGENçY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 30970) Civil Code). LENDER'S NAME LENDER'S ADDRESS APPLICANT'S SIGNATURE I certify that have read the application and state that the above information is correct. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives 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. JIJ)OMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. - - 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 days (Section 303(d) Uniform Building Code). VED APPCANT'S SIGNATURE DOWNER OCONTRACTOR [:]BY PHONE ARPROBY:: I DATE: WHITE: File YELLOW: Applicant PINK: Finance CITY OF CARLSBAD '-'INSPECTiON 'REQUEST PERMIT# CB910177 FOR 11/27/91 INSPECTOR AREA MC DESCRIPTION: 1984 SF OPTOMETRY OFF. REMODEL. PLANCK# CB910177 OCCGRP ,TYPE: CTI ' CONSTR. TYPE VN JOB ADDRESS: , 2525 EL CANINO REAL ,STR:** FL:****STE: 165' APPLICANT: PIERCE,'. LEANNE PHONE: 619-792-5733 'CONTRACTOR: PHONE: OWNER: ' MAY CENTERS INC. PHONE: ' REMARKS: MH/JOHN/967-5624 PAGE . IN, SPECIAL INSTRUCT TOTAL TIME: CD LVL DESCRIPTION ACT COMMENTS ' -19 ST Final Structural 29 PL Final Plumbing 39 EL Final Electrical 49.-'ME Final Mechanical A ***** INSPECTION HISTORY ***** DATE DESCRIPTION ' , ACT INSP COMMENTS, ,081591 Final Combo, NR. MPC - P081491 Final Combo ,CA MPC * 080991 Final Combo CO. MPC SEE INSP COMMENTS 071791 Interior Lath/Drywall AP MPC SEE INSP NOTES 7/17/91-& ATT 071591 Frame/Steel/Bolting/Welding PAMPC STRFRNT.NDS ARCH-AS-BLTS 071591 Rough Electric . ' PA MPC * STOREFRONT LIGHTS 071091 Frame/Steel/Bolting/Welding PA MPC STOREFRONT COLUMNS ONLY 071091 Interior Lath/Drywall PA MPC ' STOREFRONT COLUMNS ONLY 071091' Frame/Steel/Bolting/Welding CO,MPC SEE INSP NOTES DTD 7/10/91' 060491 Frame/Steel/Bolting/Welding PA, MPC' PHASE I/CEILING' GRID 060491 R'ough/Topout'. . AP MPC VENT TIE -UP 060491 Rough Electric -PA MPC PHASE. I/LIGHT *FIXTURES 060491 'Rough/Ducts/Dampers , CO MPC •NDS REG .SCREWED TO MAIN - 052291 Interior Lath/Drywall - PA MPC ' PHASE I DRYWALL 052091 'Interior Lath/Drywall ' NR MPC 051791. flisulation ' , PA MPC NDSRESTORED(PH 2) 051791 Rouh/?Topout -. - - PA MPC IN WALLS ONLY/NDS TO CHK CONN 051791 Rough Electric -• PA - MPC WALLS PHASE I 051791 Rough/Ducts/Dampers . NR .MPC 051791 Interior Lath/Drywall . PA MPC. EXTERIOR WEST WALL 051691 Ràuh Electfic ' CO MPC' IMPROPER SUPPORT OF CONDUITS 051691 Insulation • - . ' PA. MPC - INT. PARTITIONS - 0.1691 Rough/Topout PA MPC WALLS ONLY/NDS VENT CONN INSP 051691 Rough/Ducts/Dampers NR - MPC 043091 Underground/Under Floor AP PK - 041691 Underground/Under Floor CA PK - • BY STEVE 4/5/91 .' . MALL oF i' DLI MTh. . j'71 9-46AU&E. z'1- rliL i . . ILJDIL0°e' i-: EUb ;.• .- .. -.- \ ( - H NO. C-11723 Cb * 1/4f 22sf ii U It ADDED BRACEING DETAIL @ SOFFIT ABOVE GLASS WALL 4 COVERING WORK PERFORMED DREINFORCED CONCRETE DSTRUCT. STEELASSEMBLY WHICH REQUIRED APPROVAL BY OPRE-STRESSED CONCRETE DREINFORCED GYPSUM DGLUE-LAM.FABRICATION THE SPECIAL INSPECTOR OF DREINFORCED MASONRY OPILE DRIVING DOTHER JOB ADDRESS 252.5 Plaza Camino Real Carlsbad 'NO. 91-106 FOR WEEK ENDING 6-21 9: OWNER OR PROJECT NAME Optometry - Space 165 BLDG. PERMIT NO. . .91-177 PLAN FILE NO. CONSTR. MAT'L (TYPE.GRADE,ETC.(, Demising Wall of Display Area @'Front ARCHITECT Yeakel & Associates DESIGN STRENGTH SOURCE OR MFGR. ENGINEER Author KaelSerata DESCRIBE MAT-L. (MIX DESIGN, RE-BAR GRADE & MFGR.) ASTM A24 12 Gauge Simpson Clip GENERAL CONTRACTOR Bachman Associates .ASTM A36 FCAW. NR 211 CONTR. DOING REPORTED WORK .Osborne Welding - - LAB RECEIVING & TESTING CONSTR. MAT'L SAMPLES Wyman Testing Laboratory WELDING INSPECTION 6-19 S S Visually inspected the fillet welding of simpson clips to existing beam connections in the fo'llowing locations: newheader for, demising wall. Certified, welders were observed for proper welding procedures and techniques. , . Completed welds were inspected for size, length, location, and unless otherwise- noted •are free of visible defects and in aöcordance with the AWS D1.1, .UBC and detail 5X on sheet A-!.a of approved drawings. 0 This report concludes the welding inspection for this project. 0' - 0• 6,192021 AN /; Co Aj Wyman Testing Laboratories 13230 EVENING CREEK DRIVE SOUTH, SUITE 218 SAN DIEGO, CALIFORNIA 92128 S (619) 486-0354 CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED ALL OF THE ABOVE ' .. . REPORTED WORK, UNLESS OTHERWISE NOTED I HAVE FOUND THIS • IGN TUR OF REGISTERED IN PECTOR'- S - WORK TO COMPLY WITH THE APPROVED PLANS SPECIFICATIONS,& - f. g4co APPLICABLE SECTIONS OF THE CITY OF SAN DIEGO BUILDING LAWS. DATE OF REPORT - - REGISTER NUMBER ck Wyman Testing Laboratories 13230 EVENING CREEK DRIVE, SOUTH' SUITE 218 SAN DIEGO, CALIFORNIA 92128 (619) 486-0354 COVERING WORK PERFORMED DREINFORCED CONCRETE DSTRUCT. STEEL ASSEMBLY WHICH REQUIRED APPROVAL BY OPRE-STRESSED CONCRETE 0 REINFORCED GYPSUM DGLUELAM.FABRICATION' - THE SPECIAL INSPECTOR OF - DREINFORCED MASONRY DPILE DRIVING DOTHER JOB ADDRESS 2525 El Camino Real - Space 165 No. 91-106 FOR WEEK ENDING 5-10 19 9: OWNER OR PROJECT NAME Optometry . BLDG. PERMIT NO. - 91-177 PLAN FILE NO. CONSTR. MAT'L (TYPE GRADE,ETC.) Misc. Structural Steel ARCHITECT - Yeakel & Associates DESIGN STRENGTH f'y 36. ksi SOURCE OR MFGR. , ENGINEER - Arthur Karl Serata DESCRIBE MAT'L. (MIX DESIGN, RE-BAR GRADE &MFGR.) 16 Gauge Joist (2-60SJ16 456 CO-NER #211.) GENERAL CONTRACTOR 'Barkmin 12 Gauge Simpson Strong Tie A-24 FCAW CONTR. DOING REPORTED WORK Osborn Welding NR 211 .035 ASTMA36 LAB RECEIVING & TESTING CONSTR. MAT'L SAMPLES Wyman Testing Laboratory WELDING INSPECTION - 5-7 - - Visually inspected the fillet welding of Simpson strong tie clip connections in the following locations first floor ceiling of phase I - joist span perpendicular -beams. Clips welded all around then joist screwed to clip. Certified welders were observed for proper welding procedures and techniques. Completed welds were inspected for size, length, location, and unless 'otherwise noted are 'free of visible defects and in accordance with the approved specifications as per engineer sheet S-7. - Approval from city is still required. 'Plans 'are still, in plan-check. CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE INSPECTED ALL OF THE ABOVE REPORTED WORK, UNLESS OTHERWISE NOTED I HAVE FOUND THIS ' , ./SIGNATU/E OF REGISTERED INSPECTOR WORK TO COMPLY WITH THE APPROVED PLANS SPECIFICATIONS,& - ' is--/ ' APPLICABLE SECTIONS OF THE CITY OF SAN DIEGO BUILDING LAWS. - DATE OF REPORT REGISTER NUMBER • ESGIL CORPORATION 9320 CHESAPEAKE DR., SUITE 208 • SAN DIEGO, CA 92123 (619) 560 1468 -. DATE: ________________________________________ APPLICANT eflISDICTh JURISDICTION: /LS5Ai2 EPLAN CHECKER - - . TFILECOPY PLAN CHECK NO: SET: IL- rus flDESIGNER PROJECT ADDRESS: Z25 17 #/( PROJECT NAME rr7Y -f---r The plans transmitted herewith have been corrected where L- necessary and substantially comply with. the jurisdiction's building codes 4 i - j The' plans transmitted herewith, will substantially comply . with.the jurisdiction's building codes when minor deficien- cies identified . " are resolved'and'. checked by building department staff... The plans transmitted, herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted -for a.complete recheck. . Li The check list transmitted herewith is 'for your information. The plans are being held at Esgil Corp. until, corrected plans are submitted for recheck. E The applicant's copy of the' check lis€'is enclosed-for the jurisdiction.to return to the applicant côntact'person. Li The applicant's' cQpyof the check list has been sent to: j Esgil staff did not advise the applicant cohtact' per.on that plan ,check hasbeen completed. Li Es,gil staff did advise applica'h't that the plan check has been completed. Person contacted:_______________________ Date contcted: ' Telephone # ' [1 REMARKS: There shall be a minimum 10 ftrclear width to .a height of feet between any projection from a tenant Léring the mall and the nearest kiosk', vending machine, or other obstructi/on 'to egress. By: 5YEJ /'L11V)' Enclosures: ESGIL CORPORATION LIGA 0AA URN 0DM' . ' Date //h/ Jurisdiction _CARLSBAD Preparedbyi . b Bldg. Dept. 5yQ7 171 VALUATION AND PLAN CHECK FEE ij Esgil PLAN CHECK NO. _i/ 77 BUILDING ADDRESS'- APPLICANT/CONTACT L&4-'"J PHONE.HO.________________ . BUILDING OCCUPANCY DESIGNER'.PHONE_____________ TYPE OF CONSTRUCTION II. -/'J- CONTRACTOR PHONE__________ BUILDING PORTION BUILDING AREA VALUATION VALUE MULTIPLIER - -,. ,:-:--. • Air Condi-t1onin - Commercial."- .- -,-- _•@ * - Residential . Res. or-Comm.,-- - . Fire Sprinklers ________________ - -• Total Value . . • BUILDING PLANCHECK ENGINEERING CHECKLIST Cf) DATE (5 PER: ) I ITEM CPLETE CL PLANCHECK NO.H (Dfl ITEM INCOMPLETE a NEEDS YOUR ACTION 1 2 3 2.S2 EL CMirJ VE. 169 ' ITEM SELECTED • S N R / T D D C C C PROJECT ID PLAZA H H E E E LEGAL REQUIREMENTS - K, K K Site Plan EFT . E E 1. 'dimensiàned Provide a fully' site plan drawn to scale. Show: north arrow, property lines, easements, existing and proposed structures, streets, existing street improvements', right-of-way width and dimension setbacks 2. Show on site plan: Finish floor elevations, pad elevations, elevations' of finish grade 'adjacent, 'to building, existing topographical. lines, existing and proposed slopes,, driveway with percent (%) grade and, drainage patterns Ri' E3. Provide legal description and Assessors Parcel Number Discretionary Approval Compliance 4 No Discretionary approvals were required Project complies with all Engineering Conditions of Approval for Project No. I1 E Project' does not comply with the following Engineering Conditions of Approval for Project No. Conditions complied with by:Date Field Review El ED El Field review completed. No issues raised.. ' 8. Field review completed. ' The following issues or discrepancies with the site plan were found E El 0 A Site lacks adequate public improvements El E 0 B Existing drainage improvements not shown or, in conflict with site plan C Site is served by overhead power lines FRN001O DH REV 11/27/90 21 Industrial Waste Permit is required Applicant must complete Industrial Waste Permit Application Form and submit for City approval prior,to issuance of .a Building Permits. Permits must be issued prior to occupancy. Industrial Waster Permit accepted - Date:By Fees Required EJ t'..1/..1 27 Park-in-Lieu Fee Quadrant: Fee per Unit: Total Fees:_____ DtJ$ 23. .Trffic Impact Fee Fee Per Unit: Total Fee:__________ E]. tJ/A 24 Bridge and Thorough fare Fee Fee Per Unit Total Fee E] tJJf4 25 Public Facilities Fee required EJ iJ/P 26 Facilities Management Fee Zone:—Fee:- O NJ 27. 27 Sewer Fees Permit No.EDU's_______ Fee 0 28. Sewer Lateral Required: 0 Fee: 0 • 29. REMARKS: ENGINEERING AUTHORIZATION TO ISSUE PERMIT BY SHEDELL DATE 15 FRN0010 DH REV..11/27/90 - -1'- ---. - I - -- - ohmãflnConstrUcon . #574580- 2k may 1991- -- _- •- - - -- . 1 4 - City of Carlsbad IC - - - 2075 Las Palmas Dr.,',- - —Carlsbad, Cr92008 --: kttn BuildingDirecror -_ - Visionworks . - - - - --: : - -• -Subject: - 2525 El Camino-Real #165 .- Carlsbad Plaza Camino Real Carlsbad,1Ca 92008 Re ApprovalofPhaseI 41 Dear Sirs -. - _16-0!-der to start phase II we request an approval'of the phase I We would like to remove the barricade of phase I and build the new barricade of phase 11 We have approval from - : Tte Fire Denf for the barricades and a o phase conuction The' do& in phase I will now become the temporary entry f6r the'store awl the exihñg entry door will be blocked of in ttle ,iewharncade of phase II We -'understand,"that we will not receive a final-until pie II 'as-been completed r-Please cntact us and theinspector-.of bir deciion - _ — •- .- -iA' \ \ - Sincerely, - *- - Bac aim Constructiop \\ -' Ken Emmons-' - - - a - - - - -,--- I•. - *, - -. .- -* - - - - - . - --,- - .. - . -. - . . -- . . .- .. . . •• a . •-.- - - -t_ * . . . -. -S '• -- -- - 9-- * . .•-*•. .. . - - - . — - . 5963 La Place Court Suite 302 • Carlsbad California 92008 • (619) 431-0777 FAX (619) 431-1722 - F F B U I L D I N G PE R MI T PCR No CR91029 05/09/91 12 43 - PrOjectNo A9100907v Page 1 of 1 Devlopment No'.:- 'Job., Addreiss 2525 EL CAMINO REAL Str ** Fl **** Ste 165 Permit Type PLAN CHECK REVISION P 1 N 156-302-09-00 2312 0/09/9i 0001 01 02 arce 0. .. . -. •c-PRMT Valuation 0 - Construction Type VN . Occupancy Group 4B-2 Class Code • Status ISSUED Description NEW DETAIL FOR CONNECTION OF 'Applied 0509/91 NON-BEARING WALL Apr/Issue 05/69/91 - •: • Validated-'Bi: KZH F Appl/Ownr BACHMANN CONSTRUCTION 619-431-0777 5963 LA PLACE CT -' CARLSBAD,CA .'92008,• ::-. ? , C , 4 ic.- C'NO',1. 1 4 Fees 1000 . Fee description Ext fee Data --------------------- t.- -, . - -- ,. .-• • .- .- . __4 -- •- • 4 . - 3 .• '- .. - ,'LEpANcE - r __._J . -• - - : : / - - . . - n 4 4 - - - - - .• - - . 4' - _,.-.. , 4- ,' . - . . CITY OF CARLSBAD - 2075 Las Palmas Dr, Carlsbad CA 92009 (619) 438-116 Ax - -' •- .4 - 4 — -F- . - . - • - -. '• S 0 ESGIL CORPORATION 9320 CHESAPEAKE DR., SUITE 208 SAN DIEGO, CA 92123 (619)5601468 DATE: JURISDICTION: Of (AA-t~S--f-S A-0 PLAN CHECK NO: SET: I.. PROJECT ADDRESS : L fl APPLICANT ICTO flPLAN CHECKER P]FILE COPY UPS DESIGNER PROJECT NAME The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. Li The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficien- cies identified are resolved and checked by building department staff. . The plans transmitted herewith have significant deficienbies Li identjfied on the .enclbsed check list and should be corrected and resubmitted for a complete recheck.. . 0 5 . Li The .cheOk list transmitted herewith is for your information; . 0 The plans are being held at Esgil Corp. until corrected plans are submitted for recheck fl The applicant's copy of thecheck, list is enclosed for the jurisdiction to return to the applicantcontact person. The applicant's copy of the check list has been sent to: Esgil 'staff did not advise the applicant contact person that plan check has been completed... [j Esgil staff did advise applicant that the plan check has been completed. Person contacted: Date contacted: 0 Telephone. .# S c p- tv-i..-' jJ s pi rp Ui &r r-& fi g . • 0 . S By 5'Y&i) ,1-&fl' Enclosures ESGIL CORPORATION ct/ ...... . S S • E GA AA El RN DM ¶4 . •-.- .4 ' . . .. - 4 - 4 Dates Jurisdiction - Prepared byz . Bldg. Dept. . -cYe1.7 M-Le\ VALUATION AND PLAN CHECK FEE . Esgil PLAN CHECK NO. 1-7 7( gZ\I) BUILDING ADDRESS Z Z E CA,--,, ,J APPLICANT/CONTACT 77iJ A/g4,JJ PHONE NO : BUILDING OCCUPANCY_ - 4 DESIGNER PHONE _-• TYPE OF CONSTRUCTION "" CONTRACTOR-PHONE__________ &. + ' .777 E3 ,IJ I D I N G P E R, ii I T; 06/14/91 1O 33 Froict.No - i.-' ••.•• • - - •' --,-•- ,.• 1 Piqe 1 or 1 • Deuc1opnier, L No 2'2' FL CflMJNU RERI. btr * F1 9 714Sej6+ F'rruiL type PLIN CHECK HLUISI(JN -. - Pace, 1o.:..i'56-3O.2-O9-OO . PFitT U1uL ic r, - tdri'tr'ictiori lype ••l, - .. Orcuparic y Group 2 £1a Lode , Stdtu ISSUED cr i pt ion "REDUCE SPACE OMIT 1'fNI( HDWR - 'A rift 1 id O/13/°1 UF 061 i 4/9 I .. Ui1 dted'.11 by KZH 1ip1/0whr F'IFI'CF, 'LrflNNC 6l9-/9?-7H - - •. - -s -. 3 s4 •1. * I. '. 1237 CAMINO.DEL'MAR 1 -: DLL MflR, CI 9?O l r. '8 Fees TtPrr A ba1a\ \ 11OOO :\1\L_ _E> 'tc'Data 8. Col. ;1ii S wl 71 Ar £PPROV111L ' ._DATE '...._. 4. CLEARAWCE : CII'! OF CARLSBAD I -, .-.- .-• '- - . . - . - 2075 Las Palmas Dr. Carlsbad CA 920O9(619) 438-1161. - - -. - - • • - '. - - - S.; - - • •. . - . . , - - .. . • • •-' . - . - - - . _5, I - - - 4 -. ,. • .4 _•: • - EST. VAL , PLAN CE DEPOSIT_____________________________ VALID. BY DATE PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 1. PERMIT TYPE I A - 0 COMMERCIAL ONEW •TENANT IMPROVEMENT 8 - 0 INDUSTRIAL ONEW DTENANT IMPROVEMENT C - []RESIDENTIAL [3 APARTMENT E] CONDO DSINGIE FAMILY DWELLING DADDITIOW/ALTERATION DDUPLEX [-]DEMOLITION [-]RELOCATION DMOBILE HOME [-]ELECTRICAL []PLUMBING []MECHANICAL DPOOL [J SPA []RETAINING WALL C] SOLAR DOTHER PROJECT INFoRMATI no / Building or Suite No. ( Nearest Cross Stree LEGAL DESCRIPTION Lot NO. Subdivision Nan,e/NLHrOer Unit NO. ,'nase NO. CHECK BEL(M IF SUBMITTED: [12 Energy Calcs l:J2 Structural Calcs 02 Soils Report pi Addressed Envelope ASSESSORS PARCEL EXISTING USE PROPOSED USE PM&S 0cc ofq#i I lae,td 0f n 17 004ni C. #,OWX E eTw BLDG. SO. FTG. H OF STORIES CONTACT PERSON NAME I4 Co ADDRESS53 CtfLC ci- 4Ci CITY STATE (). ZIP CODE DAY TELEPHONE *3/—o-7,7 T7 SIGNATURE APPL DCONTRACTOR 0 AGENT FOR CONTRACTOR DOWNER DAGENT FOR OWNER NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE PROPERTY OWNER ,J OuNERroc4O( f<o?cev COU .. NAMEIYLA (en ADDRESS /,44/ SEE []TENANT CITY STATE/1.O ZIP CODE DAY TELEPHONE CONTRACTOR NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. H LICENSE CLASS CITY BUSINESS LIC. H SIGNATURE TITLE DATE DESIGNER NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. H WORKERS' COMPENSATION Workers Compensation Declaration: I hereby affirm that I have a certificate of consent to self-insure issued by the Director of Industrial Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C). INSURANCE COMPANY POLICY NO. EXPIRATION DATE 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. SIGNATURE DATE OWNER-BUILDER DECLARATION - Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 I as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Cede: The Contractor's License Law does not apply to an owner of property who builds or improves thereon,, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale.). 0 I, as owner of the property, am exclusively contracting with licensed contractors to Construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). 0 I am exempt under Section Business and Professions Cede for this reason: (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, commencing 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 hundred dollars ($5001). SIGNATURE DATE 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? DYEs FIND Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? DYES ONO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? DYES ONO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. - 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 30970) Civil Code). LENDER'S NAME LENDER'S ADDRESS APPLICANT'S SIGNATURE I certify that I have read the application and State that the above information is correct. I agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives 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 CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. Expiration. Every permit issued by the Building official under the provisions of this Code shall expire by (imitation and become nut[ and void if the building or work author/ ed 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 aba oned a y time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code). APPL DOWNER []COHTRAC1OR -]BY PHONE WHITE: File YELLOW: Applicant PINK: Finance NT DCONTRACTOR 0 AGENT FOR CONTRACTOR ,fr,&i Oc&f Iic- - - .A ADDRESS STATE ('frj ZIP CODE OWNER OWNER ADDRESS DOWNER DAGENT FOR OWNER 7 DAY TELEPHONE 0 DLESSEE OTENANT SIGI A NAME CITY Lk-kj r- PROPERTY NAME PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 1. PERMIT TYPE I A - DCOMI4ERCIAL Li NEW TENANT IMPROVEMENT B - INDUSTRIAL DNEW DTENANT IMPROVEMENT C - FIRESIDENTIAL DAPARTMENT DCONDO DSINGIE FAMILY DWELLING DADDITION/ALTERAT DDUPLEX DDEMOLIYION DRELOCATION DMOBILE HOME DELECTRICAL DPLUMBING - DMECHANICAI DPoOL DSPA DRETAINING WALL DSOLAR DOYHER EST. VAI. PLAN CE DEPOSIT_____________________________ VALID. BY - DATE - L C4,nfno Kq/ Building or Suite Nearest Cross Streets LEGAL DESCRIPTION Lot No. Subdivision Name/NLmer Unit No. Phase No. CHECK BELOW IF SUBMITTED: []2 Energy Calcs '2 Structural Calcs £12 Soils Report Dl Addressed Envelope ASSESSORS PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK NiuJ OeMc / hbf- (of? BLDG. SQ. FIG. # OF STORIES 3. CONTACT PER ON NAME -kv't (b y) I ADDRESS 5q(,3 Lq P/aee CITY D// f STATEUrT . ZIP CODE q c.x:D;' DAY TELEPHONE 4,I. —07 J7 CITY STATE ZIP CODE DAY TELEPHONE CONTRACTOR NAME iQy y - i &/115#. ADDRESS 67& 3 plAet e..-T430 2- CITY Cu. STATE c.4q ZIP CODE DAY TELEPHONE /fZ,f__0777' - STATE LIC. # LICENSE CLASS CITY BUSINESS LIC. H SIGNATUJ (/7'//'/"VtVV 7(,J TITLE DATE xnnarçc CITY 5tb'7t.4' . STATE ZIP CODE DAY TELEPHONE STATE LIC. H WORKERS' COMPENSATION Workers' Compensation Declaration: I- hereby affirm that I have a certificate of consent to self-insure issued by the Director of Industrial Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C). INSURANCE COMPANY POLICY NO. EXPIRATION DATE 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. SIGNATURE DATE - OWNER-BUILDER DECLARATION Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractor's License Law for the following reason: o 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. 7064, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves threon,, 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 tale.). 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professins 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: (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, commencing 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 hundred dollars [$5001). SIGNATURE DATE 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? DYES DNO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? DYES DNo Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? DYES NO , IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. - 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 30970) Civil Code). LENDER'S NAME LENDER'S ADDRESS APPLICANT'S SIGNATURE I certify that I have read the application and state that the above information is correct. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives 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 CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. Expirati n. 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 ai3Elrized 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 be fiedJat any time aft r the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code). I ANTI Sl OWNER kCO.TRACTOR [:]BY PHONE APPROVED WHITE: File YELLOW: Applicant. PINK: Finance .. • ESGIL CORPORATION 9320 CHESAPEAKE DR., SUITE 208 SAN DIEGO CA 92123 (619)560-1468 DATE: JURISDICTION: . - JURISDICTIO JTFILE COPY PLAN CHECKNO: SET: "UPS - - DESIGNER PROJECT ADDRESS:'.''2' PROJECT NAME: . . fl The plans transmitted herewith have been corrected where necessary and substantially comply, with the jurisdiction's building codes. ' The plans transmitted herewith will substantially comply .with the -jurisdiction's building codes whenminor deficien- . cies 'identified are resolved and checked.by building department staff. .' fl The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected ' ' and resubmitted for a complete recheck. D The check list transmitted herewith is for your information. .The plans are being held at Esgil Corp. until corrected plans are submitted for recheck. The applicant's copy of the check list is enclosed for the jurisdiction to return to the applicant contact person. LI The applicant's copy of the check list hasbeen sent to: Esgil staff did not advise the applicant contact person that ' • :•.' plancheck has been completed'. • ' [T Esgil staff did advise applicant that •the plan check has been' 'completed. Person contacted: Date contacted: Telephone • REMARK S : ()' Z/ C6s-J A-iH-, rFjC7 S ,Ci/i S-E - / () 5&E VkLti 1-'r7 aoi s Cj1'( Er (AmeDi By: Y77 ,4z(111 Enclosures: ESGIL CORPORATION Li GA AA . LI RN , 0DM • . —