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HomeMy WebLinkAbout2525 EL CAMINO REAL; 234A; STE 234A PRE 2016; PermitUSE BALL- POINT. PEN. ONLY.& PRESS. HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. - ' r D I hereby affirm that I am licensed under - . <) 1') provisions of Chapter 9 (commencing with I Section 7000) of.Dlvialon 3 of the Business Iz and Professions Code, and my license is In L full force and effect. .. C) I hereby affirm that I am exempt-from the Contrac - for's License Law for the following reason (Sec. 7031.5 - Business and Professions Code: Any city or county which re quires a permit to Construct, alter, improve, demolish, or - repair any structure, prior to its issuance also requires he ap- plicant for such permit to file a signed statement that he is_ I. licensed pursuanr to the . provisions 01 the Conlracror's License law (Chapter 9 commencing with Section 7000 of 11 Division 301 the Business and Professions Code) or that is en- empt therefrom and the basis for the alleged exemption., Any violatiOn 01 Section-7031.5 by an applicant nra permit sub-,,7., I cts the applicant 10 a civil penalty 01001 more than live ' - ' 'died dollars ($500). ., -. 1.1.1, as ownerof the property, or my employees with wages - - as llroir sole compensation; will do the work, and the slruC- tUre is not intended or oftere for sale (Sec. 7044. Business - and Professions Code: The Contractor's License Law does not apply to an owner 01 property who builds or improves - - thereon and who does Such wOrh-himsell or through his own - employees. provided that such improvements are 001 intend' lul ed or Offered for sale. II, however,'the building or improve- Z ment is sold within one year 01 completion. the Owner-builder 39 will have the burden 01 proving that he did not build or im- - -0 — -prove for the purpose 01 sale), - - --- - - - _, - - I I I, as owner 01 the property,. am exclusively contracting with licensed contractors to construct the project (Sec. 7044. - Business and Professions Code:-" The Contractor's License Law does not apply loan owner of property who builds or im- , It proves tbetenn, and who Contracts for each projects with ,a - (JO - -. , - contractors) license pursuant to the Contractor's License - UI c Ii As a homeowner I am improving my home, and the 10110w' 4-i 7 ing Conditions exist: - ''e : . • CC-I - The work s being portormod pruol 10 sale 2. I have lined n .my.home .tor twelve months - prior to completion - Of this work. w - • 3. - I 'have - not - Claimed this exemption - during the a last three years. 0 I am'oempt Under Sec. ' - -. - , B & P.C. - t- for this reason - c. °o) 7ij. •c vf. - D thereby affirm that I have a certificate of consent to I self-insure. or a certificate of Workers' CompensationIn. r I - - surance, or a certified copy thereof (Sec. 3000. Labor Code) O 'IVa ." --r- r- ._ POLICY NO, , tO.J . ' pw7sV -r-r. Fu'JP - 01 -Copy is filed with the City - - - - -'- - DCertitieet copy is hereby furnished Ulf '- CERTIFICATE OF EXEMPTION FROM ..WORKERS' COMPENSATION INSURANCE - '-. -)This section need not be completed if the permit 'is for one hundred dollars l$tOOl9r less) LU I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any. 0 manner so as to become subject to the Workers' Compen- nation Laws of California. - - - )J NOTICE TO APPLICANT: If, after making this Certificate 01 Exemption, you shoUld become Subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Comply with Such provisions or this permit shall ' he deemed revoked. C 1:. •., - . - - TT- •- r' I -LI l hereby affirm that there is a construction lending for the performance of the work for which W; per- I mit is issued '(Sec. 3097, Civil Code) - .- --.--- — WI Lender's Name P• • r 9f. -ii - Lender's Address____________________________________ I . - CARLSBAD BUILDING DEPARTMENT . APPLICATION & PERMIT 2075 Las Palmas Dr., Carlsbad, CA 92009-1915 (619) 438-1161 . - - ,, - - •_. -' , UATION PERMIT NUMBER .108 ADDRESS . D, MAS BROS NO. DATEj/PLIç/TION BUSIN ENSE &R 255 J &eJ 60,4 __ J ZONE. - - LOT - BLOCK ' SUBDIVISION '' - - ASSESSOR PARCEL NO. - CONTRACTOR CONTRACTORS PHONE a (j/ OWNE' AME . ', I , ' OWNERS PHONE yr2LTOA '') R BUILDING SQ. FOOTAGE - , , • CONTRACT 5-1 RS AODRES 9 , ,+• - STATE LICENSE NO, 5/ -- OWNER' MAR!NGDORESS - DESIGNER DESIGNER'S PHONE DES C P ION OF WORK - -, •. 8561-.07/27/89 DESIGNER'S ADDRESS - STATE LICENSE NO. BldPmt 59.00 I-_- --- F/P F LR ELEV. NO 0CC GP EDU , - STORIES -- -, YO NO - - •, - - - - - - ING SPACE RES UNITS GRADING PERMIT ISSUED REDEVELOPMENT TYPE , - 0CC LOAD. FIRE SPR CENSUS TRACT —[PARK - . AREA - - CONST - -- — - , — Y O N 0 Y 0 NO YO NO Not Valid Unless Machine Certified - OTY PLUMBING PERMIT ISSUE - 50 OTY i - MECHANICAL PERMIT ISSUE - 1 00 SUMMARY/ACCOUNT NUMBER - if EACH FIXTURE TRAP • , INSTALL FURN. DUCTS UP TO t00,000 BTU BUILDING PERMIT 001-810-00-00-8220 ,f -/ / — EACH BUILDING SEWER - - - . — 'OVER 1009BTU' - . - --SIGN PERMIT' - ' 001810'00.00.8221' .:f EACH WATER HEATER ANLQ('VENT ' BOILER/COMPRESSOR UP TO)#1'P • PLAN CHECK 001-810-00-00-8891 EACH GASSYSTEM'1hl"OUTLETS . ' BOILER/COMPRESSOR 3k4P ' , TOTAL PLUMBING 0Oi-810-OO-OO'8222 - EACH GAS'SYST.MK'ORMORE • . --. - METAL FIREPLACE >.'- 4' -1' - '- '-. --ELECTRICAL -" 001:810-00-00-8223-- -r — - - EACH'INSTAJ/LTERREPAIR WATER PIPE . VENT FAN SJts)iE DUCT . . MECHANICAL 001-810-00-00'8224 EACH)UUM BREAKER_- - ' I MECHUST HOOD/DUCTS . MOBILEHOME 001-810-00-00-8225 - -- W)511..R-StIFTNER - - ,. -— . ,: - ' RELOCATION OF EA-FURNACE/HEATER -- - --- -.- SOLAR- -''-' 001-810-00-00-8226 — -- CH ROOF DRAIN (INSIDE) ' , DRYER VENT . . STRONG MOTION 880-519-92-33 MECHANtCAL --_- - . FIRE SPRINKLERS 001-810-00-00-8227 - TOTAL PLUMBING I ' - . - PUBLIC. FACILITIES FEE-_-320-810-00-00-8740 -- . • -- - - ' BRIDGE FEE 360-810-00-00-8740 QTY —ELECTRKAL PERMIT - ISSUE I, '5OO QTY. MOBILE HOME SETUP - - -- PARK.IN-LIEU (AREA I -- -' -'-.'-••-. - - NEW.CONS,J.EA AMPTSW1.I3KR. — - I CARPORT, - -- -. TIF -- •. 312-810-00-00-8835 . • — I PH 3 PH, , - — AWNING , - , LA COSTA TIF 311-810-00-00-8835 - EXIST BLDG EAAMP/SWTIBXR i' -- ' ' ' . ' FMF - - ---- - I PH 3 PH • ,' c ' , . - , - • - LICENSE,IAX_- 001'810;0000'8162 -- - REM0DEL'ALTIR PER CIRCUIT - ,.- — . - MFF 880-519-92-57 TEMP POLE' 200AMPS . -- '- - --- 4-' . -. --- -- -- - ----.- - - - -' - — OVER 200 AMPS - GARAGE ' -------- -- TEMP OCCUPANCY.(30 DAYS) ' • - - I - CREDIT DEPOSIT -. - - - -, -- __TOTAL ELECTRICAL -.l - I - i - TOTAL - TOTAL FEES P _—J - I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY - aplratlon, Every mltissuedbylfneBuildirvg Official under the provisions Otthis HAVE - '1l T IS REQUIRED FOR EXCAVATIONS OVER UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Cc e ut 'zed expire flmltalron and be mgric.e nuI and void It the building or work 1 .0 days from the date of such p, r r IS rro a --5' 0' AND DEMOLITION OR CONSTRUCTION OF DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERM)T IS per it, or If buif -such rk such permit is suspended or TTJRS OVER 3 STORIES IN HEIGHT ISSUED: TO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS GOVERNING BUILDING CON aba oned a an Irm a r I e wor IS commen d br a period of f80 dayo, STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. t ALSO AGREE TO SAVE INDEMNIFY AND . AP ICANT St NAT RE - - • WNERD CONTRACTO P ROVED BY KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND GRANTING OF THIS PERMIT.WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE 0 - TYPE DATE INSPECTOR BUILDING FOUNDATION INFORCED STEEL V MASONRY - V GUNITE OR GROUT SHEATHING El ROOF El SHEI$R. FRAME EXTERIOR LATH INSULATION V INTERIOR LATH & DRYWALL PLUMBING UNDERGROUND El WASTE El W,TER - TOP OUT El WASTE 0 WATER TUB AND SHOWER PAN GAS TEST 'V El WATER HEATER El SOLAR WATER. - - ELECTRICAL El ELECTRIC UNDERGROUND El UFFER •V ROUGH ELECTRIC V El ELECTRIC SERVICE 0 TEMPOR4RY El BONDING 0 POOL V - MECHANICAL El DUCT & PLEM., El REF. PIPING HEAT — AIR COND. SYSTEMS VENTILATING SYSTEMS -CALL FOR FINAL INSPECTI&J WHEN'ALL APPROPRIATE uj:JIc 1Ij -- V :LUãI!.]Lc - ---.----- QPECIAL CONDITIONS iI jjr-_i .• !VVV' - VVV'\ FIELD INSPECTION RECORD V V -REQUIRED SPECIAL INSPECTIONS V V INSPECTORS NOTES --.. - - INSPECTION 4 REQ. IF INSPECTORS DATE 'V •V CHECKED APPROVAL SOILS COMPLIANCE PRIOR-TO FOUNDATIONINSP . .STRUCTURALCONCRETE -V OVER 2000 PSI \ -• V V - V - - V - - -- - - V J PRESTRESSED I V V CONCRETE POST TENSIONED - CONCRETE e -FIELD WELDING V.V_VV__. I • HIGHSTRENGTI-eVVt; V '- - I -• VVV_ ------- BOLTS SPECIAL MASONRY PILES CAISSONS ------ V SV_ ?.VV 1 -: V V V • Vt.O V V V - ft . V - V .. ___• V : -- -- .. -- - - V V V V V V V-VVVV -- - - VVVV ._.Vt VV VVV..:_j.V... __• •. -- - V V - VVVVV_' VV VV - .........VV VVV4V If T':: I I ( çC C •—_\ \ tzVc -. V -. -. VV\% - : . - - - c(_ <-- 01/10/90 14:47 Page lof 1 Job Address: 2525 EL CAMINO REAL Permit Type: COMMERCIAL TENANT IMPROVEMENT Parcel No: 156-302-09-00 Valuation: 78,155 Construction Type: NEW Occupancy Group: B-2 Class Code: Description: 4060 SF RETAIL 11 Permit No: C8891765 Project No: A8903105 Development No: Str: Fl: Ste: 2t4 2530 01/10/90 0001 01 02 a tc- / c2L C-PRMT 3402-00 Status: ISSUED Applied : 11/13/89 Apr/Issue : 01/10/90 Validated By: DC BUILDING PERMIT *** Fees Required *** Fees Collected & Credits Adjustments: / Total Fees: 3,750.09 - description - ------------- Building Permit Plan Check Strong Motion Fee Enter 'Y' to Autoa1cLicenseTax * BUILDING TOTAL Enter "Y" for Plumbihg'Issue Fee Each Plumbing Fixture or Trap_, Each Water Heater \and/or Vent Gas Piping System * PLUMBING TOTAL Enter "Y" for Electric IsseFe'e Three Phase Per AMP\ * ELECTRICAL TOTAL ($t'Q Minirnum) Enter 'Y' for Mechanical Issue Fi 1/ Install Furn/Ducts b Each Install/Reloc AppliancèVent * MECHANICAL TOTAL / Tot ai Credits: .00 7 77 /7Tta1jaymerits: 348.00 Balance Due: 3,402.00 / Units, - ((Fee/Unit/ \ Ext fee Data \1 ( \ \K 1 \ 545.00 354.00 /2 12.00 > 2735.00 Y 3646:00 > , !l OP 2.50) 7. 50 >, H 1/Ô0H 2.50/ ' 2.50 I/f >, , /1.00 / 2.50 2.50 / 20.00 >)ccy / ( / 5.00 Y > / 100 /.50 /. 50 50.00 55.00 > / 15.00 Y > /i 0 0 9.0 9'.0,0 > 1.00 4.50 4.50 - 29.00 CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 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 n&ENANT IMPROVEMENT B - 0-INDUSTRIAL DNEW DTENANT IMPROVEMENT C - DRESIDENTIAL DAPARTMENT DCONDO DSINGLE FAMILY DWELLING DADDITION/ALTERATION El DUPLEX DDEKOLITION DRELOCATION DMOBILE HONE DELECTRICAL DPLUMBING DMECHANICAL DPODL DSPA DRETAINING WALL DSOLAR DOTHER_______________ PLAN EST. VAL 77,000 PLAN CE DEPOSIT 348 VALID. BY ,9 DATE 1311 11/13/89 0001 01 02 C-PRMT 348.00 Address but taing Or suite NO. 2525 EL CAMINO REAL STE # Nearest Cross Streets LEGAL DESCRIPTION Lot No. Subdivision Name/Number Unit No. Phase NO. CHECK BEL(HJ IF SUBMITTED: [J2 Energy Calcs 02 Structural Calcs 02 Soils Report Di Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK éLL. BLDG. SO. FIG. # OF STORIES CONTACT PERSON NAME /17/C (}JECAI&x7 ADDRESS CITY STATE C,4rZIP CODE DAY TELEPHON/t) 5O SIGNATURE f - /- r-4— APPLICANT DCONTRACTOR NAME - CITY ./'t-?"f' I PROPERTY OWNER NAME CITY CONTRACTOR - NAME CITY 07NT FOR CONTRACTOR DOWNER 1 "6AcEXlT FOR OWNER ADDRESS STATE ZIP CODE fe2-' DAY TELEPHONE 67 i) OWNER DLESSEE OTENANT ADDRESS STATE ZIP CODE DAY TELEPHONE ADDRESS STATE ZIP CODE DAY TELEPHONE STATE LIC. # LICENSE CLASS CITY BUSINESS LIC. # SIGNATURE TITLE DATE DESIGNER NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. H r7 —WORKERS'COMP EN SAT ION — "-.------ ---.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 8. 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 Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon,, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale.). 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). 0 I am exempt under Section Business and Professions Code for this reason: (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 NONRESIDENTIAL 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 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 tending 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, JLKONEHTS, COSTS AND EXPENSES WHICH MAT 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 commenced within 180 days froy'the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time aft the k is commenced for a period qYi80 days (Section 303(d) Uniform Building Code). OWN R'TRACTOR flBY PHONE APPROVED WHITE File YELLOW: Applicant PINK: Finance CITY OF' CARLSBAD INSPECTION REQUEST PERNIT# CB891765 FOR 03/16/90 INSPECTOR AREA PK DESCRIPTION: 4060 SF RETAIL STE #234 PLANCK# CB891765 0CC GRP TYPE: CTI CONSTR. TYPE NEW JOB ADDRESS: 2525 EL CANINO REAL STR: FL: STE: ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP COMMENTS 021390 Rough/Topout AP PK 020990 Frame/Steel/Bolting/Welding AP PK REMAINING WALLS 020890 Frame/Steel/Bolting/Welding AP PK PARTIAL WALLS 020890 Rough Electric AP PK PARTIAL WALLS . '.' . . . . . . B U I L D I N G- P E R M I T Permit Nd: CB930146 03/24/93 16:36 .. " . . P'roject No: A913 0021.1 Page. 'l of 1' -. . Development No: Job Address: 2525' EL CAMINO REAL Suite: 234A - Permit Type: COMMERCIAL' TENANT IMPROVEMENT 1640 03/24/93 000101 02 Parcel' No: t56-302-09-00' .. Lot#.: C-F'RMT 5?000 valuation: . : 11,800 Constrüdtidn Type: VN Occupancy'Group:.B2 . Reference#: . . Statu: ISSUED Description: ELEC. REMODEL / ADD COUNTER. .' . 'Applied: 02/11/93 ADD PHOTO AREA . . .. t, . Apr/Issue.: 03/24/93 - Entered By: MDP - App/Ownr : DAVE HOUSTON . 702 452-8168 5825 CHRISTCHURCH AVE. . . . .' LAS VEGAS, NEVADA 110 ' Fe&s Required **oflcted&Cedits -.3. Fees: ' 8;00 (( (\ -Adjustments: . OO To : .00 Total Fees 6 \® T Bala 'L 51 88.00 0.00 Fee description __4 Ext..fee, Data Building Permit 0 135.00 Plan Che6k Strong Motion Fee 2.00 Enter "Y" to Autoc lc Lice 215.00 Y (Lic T) C.F.1\. ' . ' 198.00 * BUILDING TOTAL \ . \ 0 . 638.00- Enter "Y" for Pluñtbin Is 'F ) 0 ' ' - 'N - ' INCORPORATED - . - - Enter "Y" for -Electric. I 'tiè re > 1952 10.00 1 -j Enter" Y " for Remodel \ V * 10.00 1 * ELECTRICAL TOTAL \ J/[/7 20.00 Enter '1' for Mechanical I suJ'e© \ . N -, i FINAL APPROVAL . - . .. '. INSi'D'ATEc3IV)— CLEAR NCE x, mrAk CITY OF CARLSBAD ,4 -r 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161)- LL) £/1VS6 ----- ' PE I7/ City of Carlsbad Building Department J' 2075 Las Patinas Dr., Carlsbad, CA 92009 (619) 438-1161 : 1. PERMIT TYPE A -Commercial Li New Building Pftnant Improvement B - 0 Industrial 0 New Building 0 Tenant Improvement C - C Residential C Apartment 0 Condo 0 Single Family Dwelling 0 Addition/Alteration Duplex C Demolition 0 Relocation 0 Mobile Home 0 Electrical 0 Plumbing Mechanical 0 Pool 0 Spa 0 Retaining Wall 0 Solar C Other__________ 2. PROJECT INFORMATION PLANCHECKNO. 3-.- L( Esr.VAL PLAN CK DEPOSIT M VALID. BY DATE a_t "\1 1155 02/11/93 0001 01 02 C-FRill 88.00 FOR OFFICE USE ONLY e 6)fl1,(fO 2e,11- A earest Cross Street LEGAL DESCRIPTION thE No. Subdivision Name/Number Unit No. Phase No. CHECK BELOW IF SUBMITtED: 02 Energy Calcs 02 Structural Calcs 02 Soils Report 0 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK (jc.c. e'-'— ( ADO C-0 us. 4&. . SQ. FT. 472 4 # OF STORIES - P1 ADDRESS .5926 CITY.' 2' V. ZIP CODE P911 0 DAY TEJ,.EPHONE 72-- 42-B/6 L. -.' 711S ADDRESS k G6 CITY STATE ZIP CODE DAY TELEPHONE PROPERIY OWNER NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE CDNTRM10R NAME 15 fytS ADDRESS "33-1V gLqecxf CITY A STATE C-67ZIP CODE OO' DAY TELEPHONE STATE LIC. 4(O24q LICENSE CLASS CITY BUSINESS UC. # 727'o 1,INEd1. IVI , LjIJ !WUttt /1;77- "-'i Ave CITY S L C - STATE(AA )-,. ZIP CODE F4103 DAY TELEPHONE 6/36 L7)8' STATE UC. # C-2 30'3 WORKERS' WM0ENSM1ON Workers' Compensation Declaration: I hereby affirm that I have a Certificate of consent to sell-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 or 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 DEC2ARA11ON Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 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.). 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 1 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? O YES OL NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? OYES Q NO Is the facility to be constructed within i'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 DIS'IiiICr. ereDy 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 10. APPLICANT CERTIFICATION I certify that 1 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 it) SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL UABIL1TIES JUDGMENTS COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF 11-115 PERMIT. 0511k 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 btilding or work authorized by such permit is not commenced within 365 days from the date of such permit or if the building or work authorized by P~c~~S h 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). SIGN(FUR DATE: /" 3 UNSCHEDULED INSPECTION DATE /z /Q INSPECTOR7 '~ ___________________ PERMIT #___ PLANC C46___ K JOB ADDRESS ,2-&-z- TIME ARRIVE: TIME LEAVE:___________ CD LVL DESCRIPTION ACT COMMENTS AS. A SA/9Y AWa DATE UNSCHEDULED INSPECTION INSPECTOR /L/1J7-7 PERMIT *Cd t-O/ V-r 6LANCK. JOB ADDRESS _2-6<1 r-/- TIME-ARRIVE: TIME LEAVE:____________ CD LVL DESCRIPTION • • ACT COMMENTS • • • • ______________________________ . ic - L1t5 - • T2 • £/6'&, ESGIL CORPORATION 9320 CHESAPEAKE DR.,.SUITE 208 SAN DIEGO, CA 92 123 (619) 560-1468 DATE: Mardi (•43' flAPPLICANT '-S JURISDICTION: L_-.r/5/.d jPLAN CHECKER OFILE COPY. PLAN CHECK NO: ___ SET: ours ODES IGNER PROJECT. ADDRESS: 5'f PROJECT NAME:___________________ 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 when minordeficien- 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.. 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. The applicant's copy of the"check list has been sent to: is Esgil staff I did not advise the applicant contact person that plan check has been completed. Esgil staff did advise applicant that the, plan check has been completed. Person contacted:_______________________ Date contacted: Telephone #_________________ REMARKS: . . . . By: Aurttz Enclosures: ESGIL CORPO TION DGA 0ci Date' 7-11Iq5 Jurisdiction CARLSBAD Pre are byi o Bldg. Dept. e,,- VALUATION AND PLAN CHECK FEE 0 Esgil PLAN CHECK NO. 3-/1 BUILDING ADDRESS -5 R 5 El APPLICANT/CONTACT L PHONE NO. (7o)1-/ BUILDING OCCUPANCY DESIGNER PHONE_____________ TYPE OF CONSTRUCTION -,L1 CONTRACTOR PHONE___________ BUILDING PORTION BUILDING. AREA VALUATION MULTIPLIER VALUE 7c9. Air Conditionirz Commercial - Residential . Res. or Comm., Fire _Sprinklers . Total Value . SHEET. OF J 12/87 91 B U I.,L Dr I N G P E R M I L Permit. No: CB980181 02/25/98 08:55 ' Project No: A9800243 Page 1 of 1 •. Development No: Job Address: 2525 EL CAMINO REAL Suite: 234A Permit Type': COMMERCIAL TENANT IMPROVEMENT .....- 4367 02/25/98 0001 01 02 . -00 Parcel No: 156-302-09-00 Lot#: C-PRMT 98 Valuation:' 28,,678 Construction Type: VN Occupancy Group:'. Reference#:. Status: ISSUED De&cription: 1103 SF TENANT: IMPROVEMENT •. Applied: 01722/98 'THE ICING' . Apr/Izsue:02/25/98 .. -' Entered By: MDP Appl/Own± : LEON, MARK . . 310 328-6300 1327 POST AVE #H .. TORRANCE,-CA. 90501 .*** Fees Required **'Eee.sConected & Credits Ad 57 4a red s 00 Total Fees: 79. Tot Tot!CPavn3nt: 181.00 cBa.ranoe Due: 398.00 Fee description /U it Ext.fee Data BuildingPermit Plan'Check , 181.00 278.00 Strong Motion Feel (7 ( . 6.00 Enter "Y" for P lumb sue Fe 20.00 Y Fixui\Tp\ Each Instali/Rear wateryMnej/4. > T'/ . 4 7.00 • 7.00 Enter 'Y' for Electric Is ue Fe . / 10.00 1 Remodel/Alter PerMP i e; 7 Install Furn/Duc.ts/ ~t` ?Z 4s 1952 oo 9.00 FINAJ,,APPROVAL --INSP.DATE42 CLEARANCE - 4 'S • - 4 . 4 4 -' 4- ,• CITY OF CARLSBAD 2075,Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 • - •.. • • .4, 11 ,O0. Jnrrs - V7cY7I . PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 IFORFICE USE ONLY - PLANCHECKNO.. EST. V1L. Plan Ck. Deposit, "S (' Vali'dated By_-' 5-.-, --. '-.--- -. '-' -'---. •••_•4 . .,— 1.' Description of Work .- ... - .'-'- SQ. FT. . 'S -- #of Stories ' -# of Bedrooms # of Bathrooms 0 II&Lfflijot't -p - rnc I -i k-t H- vt- ()EL (___.31 1Q306 Name - , -. Address - - ' C t Star, Zip To5 phone P FaX # 3°AjC T Q"Cir °5for 1J Ant Contotr fl pTi 0 nr A gtnt for 0 n -r via C 6'33- tQ Name - -. - 'Address - City tat Zip To ephono -- Name Addre,,s City State Zip . Telephone P , J . '(SeC. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any struCtire, prior to its -. ç' 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 - J\)'[Chapter 9, coending with Section .000 of D' ision 3 of the.Business and ,P ofessions Code] or that he.is exempt therefrom, and the lasis for the alleged O oof Section 7O315 pph'cant a rnit sp avflpef n thaq ame 'Address i; ' ,' 4i.- City '.' -State/Zip Teleh'o #, State License # LicensClass.______________________ City'Biisin'ess License# _' Designer Name , •, Address --. , - City State/Zip Telephone / O" ,State: License 1 Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the.following declar.uuns: :0 I have and will maintain acertificate oconsent'to self-insure tor.workers compensation as provided by Section 3700 of the, Labor Code, for the performance -- of the work for which this permit is issued. • -. - . - S 0- - 1-have and will maintain workers' compensation, as required by Section 3700 of the Labor CodeZfor theperformance of the work forwhich this permit is issued. My worker's compensation insurance carrier and policy number are: lnsüran'ceCorpany - - -- - ' . Policy No. ,Expiration Date__________________ (THIS'SECTION NEED NOT BE COMPLETED IF THE PERMIT-IS-FOR ONE HUNDRED DOLLARS [$1001 OR LESS) - rO CERTIFICATE OF EXEMPTION: certify that in the performance of the work for which this permit is issued1 shIInot'employtany RpTsRn in any, manner sb as to become subject to the Workers Compensation Laws of California WARNING: Failure to secure workers', compensation -coverage isunlawl and-shall-subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100 000) in addition to the cost of compensation damages as provided for in Section 3106 of the Labor code interest and attorney's fees ,SIGNATURE - . . DATE WNERi RAñb 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 Code: The, Contra ctor's License iaw.does not apply to n'one of pr6perty who builds or improves thereon, and,Wh6-doeSr. 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).' - o I, as owner of the property, am exclusively contracting with licensed contractors to construct ,the p'roject (Sec.-7044 -Business and Professions Code; The Contractor's LiceñseUw doe-s not apply to an owner of property who builds o 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. D,YES.. ONO "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 number / contractors license number): I plan tO piovide portions of the woFk but ave hired the following bdinate,pervise 'supervise end provide the major work (include name I*address I phone number / contractors license number):_______ h__ person to c I will provide some of the work, but I have contracted )hired) the following persons to provide the work indicated (include name I address./ phone number /,type of work).................' - -- - - - PROPERTY OWNER.S)GNATURE . __-____.. - - DATE'- 0 ____. _- ______,.,. S , •, , -. - 'ttr- -----'----- t- - __- .,- Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and preyention 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 of5the 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. T-16 CENff1-N_G_V .'.- - 1" !J - Ihereby affirm that there is a construction lending agency for the performance of the work for which thispermit is issued (Sec. 3097(i) Civil Code). - LENOER'S NAME - _-_-''--_-' LENDER'S A6DRESS -. - - I-certify that -I-have read the-application and state-that the above information is corect and that the infdrmation'on the plans isaccurate.- -I agree to comply, with all Cityprdinances' and State la'ws relating -to building. construction. hereby authorize' rèpresentativès of the -Citsof 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'O" deep and demolition or construction of Ctructures'over 3 stories in'height. - - _,, ''-ç-'--- - --r. - - ,,-. EXPIRATION: Every permit issued by the Building Official un e pro in 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 3 - d s ro t - e - such permit'or if the building or work authorized by such 'permit is suspended or a do ed a ime after the-w r - commence -for p r o - a I tion 106.4.4 Uniform Building Code). PPI,A IN __Y DATE WHITE: Filé' YELLOW: Applicant P1 :Fihnâe CITY OF CARLSBAD INSPECTION REQUEST PERNIT# CB980181 FOR 9-3/23/ INSPECTOR AREA TP DESCRIPTION: .1103 SF TENANT IMPROVEMENT PL1ANCK# CB980181 "THE ICING" 0CC GRP TYPE: CTI CONSTR. TYPE: VN JOB ADDRESS: 2525 EL CAMINO REAL STE: 234A LOT: APPLICANT: LEON, MARK PHONE: 310 328-6300 CONTRACTOR: / PHONE: OWNER: - PHONE:, REMARKS: C/ PM PLEASE INSPECTOR SPECIAL INSTRUCT: TOTAL TIME: --RELATED PERMITS-- PERMIT# TYPE STATUS AS980020 ASTI ISSUED CB980506 MISC ISSUED CD LVL DESCRIPTION ACT COMMENTS 19 ST Final Structural 49 ME Final Mechanical ***** TNSPPCTT(ThT WTSTC)PV ***** 29 PL. Final Plumbing 39 . EL Final Electrical DATE DESCRIPTION ACT INSP 031998 Frame/Steel/Bolting/Welding AP TP 031998 Rough Electric AP TP 031998 Rough/Ducts/Dampers AP .TP 031698 Frame/Steel/Bolting/Welding AP TP 031698 Rough Electric AP TP 031698 Rough/Ducts/Dampers . AP TP 031198 Rough Combo CO TP 031098 Rough Combo . NS .TP 030998 Interior Lath/Drywall PA TP 030998 Frame/Steel/Bolting/Welding AP TP 030998 Rough/Topout AP TP 030998 Rough Electric NR TP 030998 Underground/Under Floor AP TP COMMENTS T-BAR CElL CElL LITES DUCTS STOR. FRNT FRN CElL LITES @ STR FRNT DUCTS NOT COMPLETE ONE SIDE TO TAPE BACK SIDE OF STR FRNT UNDER FLDOR EsGil Corporation £Prbjessiona[P&znQeViezt) Engineers DATE: 2/12/98 JURISDICTION: Carlsbad PLAN CHECK NO.: 98-181 PROJECT ADDRESS: 2525 El Camino Real PROJECT NAME: The Iàing TI SET: I]j/ NT 1:03 :JURI•.' REVIEWER 0 FILE a The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. El The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff. El The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for. recheck. Tj The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. The applicant's copy of the check list has-been sent to: N Esgil Corporation staff did not advise the applicant that the plan check has been completed. LI Esgil Corporation staff did advise the applicant that the, plan check has been completed. Person contacted: . . Telephone #: Date contacted: (by: ) Fax #: Mail Telephone Fax In Person REMARKS: By: Mike Puckett ' Enclosures: Esgil Corporation LI GA 11 CM El EJ E PC . log . ' trnsmti.iot 9320 Chesapeake Drive, Suite 208• San Diego, California 92123 • (619) 560-1468 '• Fax (619) 560-1576 Carlsbad 98-181 2/3/98 VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PLAN CHECK NO.: 98-181 PREPARED BY: Mike Puckett DATE: 2/3/98 BUILDING ADDRESS: 2525 El Camino Real BUILDING OCCUPANCY: M TYPE OF CONSTRUCTION: BUILDING PORTION BUILDING AREA VALUATION MULTIPLIER VALUE .. ($) Tenant Improvement 1103 26.00 28678.00 Air Conditioning Fire Sprinklers TOTAL VALUE. . 28,678.00 1991 UBC Building Permit Fee 0 Bldg.-Permit Fee by ordinance: $ 278.00 U 1991 UBC Plan Check Fee .0 Plan Check Fee by ordinance: $ 180.70 Type of Review: 0 Complete Review 0 Structural Only 0 Hourly LI Repetitive Fee Applicable 0 Other Esgil Plan Review Fee: $ 144.56 . • Comments: '. • • • • Sheet 1 of 1 macvalue.doc 5196 vq-3ç3 B U I L D I N G P E R II I T Permit No: CB980506 02/172'98 15:19 Project No: A9800653 Page 1 of 1 Development No: Job Address: 2525 EL CAMINO REAL Suite: 234A Permit Type: MISCELLANEOUS Parcel No: 156-302-09-00 Lot#: Valuation: 0 Constructioi. Type: VN Occupancy Group: Ref erence#: 4133 O'/17/9 IUED Description: REMOVE NON-BEARING PARTIONS - ApTg: 0D/1/ AND CEILING NO NEW FRAMING Apr/ rssue: 02/1 /8 Entered By: MDP Appl/Ownr : S7S ENTERPRISES 408.727-3833 78-365 HWY. 111 #325 LA QUENTA, CA. *** Fees Required *** Fëeollected & Credits Fees: 30X0 (2 (r/\ /\ N. Adjustments:. /.00 ''o'taa',M red ts: .00 Total Fees: 130.doO To s](S'ayIp 's: .00 / B&1aiide ue" 30.00 Fee _!!!_L_ -- Miscellaneous Fee it,- #i . 30.00 PERMIT * MISCELLANEOUS TOTA . 30.00 \ \( I.EIRED PERMIT \ 1952 4 PERMIT-HAS-EX 1, CQRDANCE WITH UK N '—....DA11E_ —'SIGNATURE FFINIAL APPr_ CLEARANCE CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmàs Dr., Carlsbad CA 92009 (760) 438-1161 1. PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO.___________ EST. VAL. Plan Ck. Deposit Validated By__________________________ Date dr.*s linclup1igt4te b' Legal Description Assessor's Parcel I Lot No. Subdivision Name/Number existing Use let this address) Unit No. Phase No. Total I of unit Proposed Use Description of Work SQ. FT. lot. Stones I of Bedroom I of Bathrooms .......................................__ &4- Lcer4 .CONTACT.PERSON(ftdlffsrentfvàmappllcant) .................. .r' T; .::: :.' . / Name . Address City StetelZip Telephone I Fax I APPLICANT Contractor 0 Agent for Contreo 0 Ownè? 0'Aäitfr Owner .:'r............. Name Address City State/Zip Telephone I PROPERTYOWNER Name Address City State/Zip Telephone I S CONTRACTOR COMPANY NAME —77 ' (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 lChapter 9, commending with Section 7000 of Division 3 of the Business and Professions Codel or that he is exempt therefrom, and the basis for the alleged for subjects, the applicant oeclvpe5o reth a hMndred clQllars50O ~v I ut —1 0~ nkt~ALkAto Name V Address . City state/bp Telepho e# State License P License Class .f City Business License I (:3Q)':_\ Designer Name Address City . State/Zip Telephone State License P 6 WORKERS COMPENSATION - - Workers' Compensation Declaration: I hereby affirm under penalty of penury 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, 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 compensation insurance carrier and policy number are: Insurance Company 029.7Zr PINWAO Policy No. Expiration Date _P/ 9P' (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*1001 OR LESS) CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California, - WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to crIminal p.naltlU and civIl f 10 ines up to one hundred thousand dollars .000), In eddlt to of compensation. damages as provld.d for In SectIon 3706 of the Labor code,Int.r,st and attorney's fees. SIGNATURE Ia,) . DATE 7 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 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. ,how.ver, 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 Lew 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 em 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 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 I phone number / contractors license number): I plen.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 I address / phone number / type of work): PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOR NON.RE51D1N724L BUILDING PERMITS ONL - Is the applicant or future building occupant required to submit a business plin, acutely hazardous materials regiatraton 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. CONSTRUCTION LENDING AGEI - 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 CERTIFICATiON I certify that I have read the application and state that the above Information is correct and that the Information on the plans Is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the CIfl' 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 with' 385 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 k is commence r erio o 80 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE Z/' DATE -P7 —?.P WHITE: File YELLOW: Applicant PINK: Finance