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Home My WebLink About2525 EL CAMINO REAL; 9028; STE 9028 PRE 2016; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 05-24-2010 1' Commercial/Industrial Permit Permit No: CB100720 Building Inspection Request Line (760) 602-2725 Job Address: 2525 EL CAMINO REAL CBAD St: 9028 Permit Type: TI Sub Type: COMM - . Parcel No: 1563020900 ' .- Lot #: 0 Status: ISSUED Valuation: $0.00 Construction Type: VN- . Applied: 04/27/2010 Occupancy Group: Reference #: Entered By: RMA Project Title: CREATIVE COLLECTIONS- KIOSK AT Plan Approved: 05/24/2010 - ,. WESTFIELD MALL-NO PART OF STRUCTURE OVER 6 FT HIGH - Issued: 05/24/2010 - .. Inspect Area: V • V -. 'Plan Check#: V Applicant: V Owner:._ . S. • - JORGE RICO . ., '.'PLAZACAMlNOREAL : 7C!O WESTFIELD IROPERTY TAX DEPT (CARLSBADI CA-92 P0 BOX130940, DEPT WFLD 1621 GRAND AV 91977 .'\013 619 508-7039 (' Building Permit $0.00 Meter Size•• AddI Building Permit Fee / $0.00 AddI Red Water Con. Fee '('' . $0.00 Plan Check / $0.00 Meter Fee . '. . $0.00 AddI Plan Check Feet - f $0.00 SDCWA Fee __, . \ . $0 00 Plan Check Discount! / •$0.00 .-''--CFD Payoff Fee \•. V $000 Strong Motion Fee / - / $1:O0'PFF (3105540) $0.00 - Park Fee . $0.00'.....PfF_(4305540) \ $0.00 LFM Fee -, V $0.00 1icense Tax (3104193) 1 . $0.00. Bridge Fee $0.00 fLicense Tax(43O4193). ' I $0.00 BTD#2 Fee V $0.00 TrafficlmpactFee(3105541) I• V $0.00 V BTD #3 Fee V9.001, JTrffic'lmpact Fee (4305541) 1 I $0.00.1 V V Renewal Fee .. ' $0.00 PLUMBING.TOTAL\ J / 5 J $0.00 Add'l Renewal Fee $0.00 ELECTRICALTOTAL 4. • 5' J $0.00 V Other Building Fee V $65.00) ,MECHANlCALTOTAL - / $0.00 Pot. Water Con. Fee V • $0 %Mster Ee" ,' - $0.00 .00 Meter Size . \ Sewer Fee)".-J . . / $0.00 Add'l Pot. Water Con. Fee , - $0.00 ,Re1ev Parking Fee . / V $0.00 . • Red. Water Con. Fee \' .• .• $0.09ORFAdditioii6l Fees - V 7 $0.00 Green Bldg Stands (5B1473) Fee ,. $1.00 1 'HMP Fee V Fire Expedited Plan Review 41 $137.50 J V •/ S \ 4T0TALPERT FEES, $20450 17 Total Fees: $204.50 Total Balance Due: V $0.00 -. 5 V /f FINAL APPROVAL V •, V • V IF A /7 ,I V lnspector:..'! I' '- Date: ''I . ' / Clearance: NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively. referred to as "fees/exactions. You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and tile the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 332030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. - V V • You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY 10 any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired.- V ::- - • •• VV •• - 'V • V •-• • -, r. V .• -S.-. S S - - 5. V •• 4 V VV Vt. I - Plan Check No c,ó (C Z20 Building Permit Applica No :.. 1635 Faraday Ave., carIsbd,CA 92008 ':' Est. Value V Cl TV OF 760-602-2717-/-2718/-27191 Fax 76.0-602z8558 Plan Ck Deposit CARLSBAD wwwcarIsbadca.11 ov Date 4/7 /1(2 I JOB ADDRESS919 ., SUITE#/SPACE#/UN AIN v C10 CT/PROJECT A LOT # - 'V PHASE A A OF UNITS 'A BEDROOMS 'A BATHROOMS TENANT BUSINESS NAME .' - Ienvurnc '. CONSTRV TYPE 0CC. GROUP DESCRIPTION OF WORK include Square Feet of Affected Area(s) 0 ?( 5) 4 05 kk) r9aD h51J& Mk pJfr 77 EXISTING USE PROPOSED USE . GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS (, YES 0 # NOD YES 0 NOD YES 0 NO 0 rc V" V V V 0GNAeP,ME (if Different Fom Applicant)' APPLICANT NAME V..,, R'tEt ADDRESS 77 DDRESS1 CITY CI /V STATE -'ZIPg j crr e2.4fl OV E.CFAX 14 EMAIL V PROPERTY OWNER NAME. VV. ,. V '' , , V V V •, ', ', AL ADDRESS.....................................V ' ' V , ' ..' ADDRESS, 'V V V , , , .:•'''-:, ,' :. -.. . CITY STATE, ZIP CITY STATE ZIP Vt5k2; PHONE FAX PHONE Ito 0 CONTRACTORBUNAME V '•V V'•, , V ..........V FAX \ EMAIL EMAIL V ARCH/DESIGNER NAME& ADDRESS STATE LiCA' , STATELICV# ' ' ' . CLASS V , . (Sec 7031.5 Business and Professions Code Any City or County which requires a permit to construct, alter improve m deolish or repair any structure prior to its issu c 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'Secti n7 00 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the Any Section 031.5 for alleged exemption. violation of by any applicant a permit subjects the applicant to a' civil penalty of not more than five hundred dollars ($500)) j7 V ç/\• V , . ' ' V , V '", Wor rs Compensation Declaration thereby affii'm under penally of perjurj one of thy '110w i declarations have and will maintain a certificate of consent to self insure for workers compensabon as provided bySection 3700 of the Labor Code for Ihe performance of the work for which this permit is issued I have and will maIntain workers c m ensation as required by Section 3700 of the Labor Code for the performance t the rk for which this permit is issued My workers compensation ins rance mer and policy number a Insurance Co Ft I4I,4!, Policy No VV 4t3° I '• Exiration Date 4!s This section need not be completed it the permit is for one hundred dollars ($100) or, less 0 Certificate of Exemption I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California WARNING Failure to secure workers compensation coverage is unlawful and shalt subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100 000) in addition to the cost of compensattQn, da ages as 'provided for.in Section 3706 of the Labor code, interest'and attorney' s fees, CONTRACTOR SIGNATURE 'GENT DATF 5 (a t I b thereby affirm that lam exempt from 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 ordered for sate (Sec 7044 Business and Professions Code The Contractor's License Law does not apply loan owner of property who builds or improves thereon and who does such work himself or through his own employees provided that such improvements are not intended or offered for sale If however the building or improvement is sold within one year of completion the owner-buer 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 1 I personally plan to provide the major labor and mutenats for construction of the proposed property improvement 0 Yes 0 No 2 I (have! have not) signed an application for a building permit for the proposed work 3 I have contracted with the following person (firm) to provide the proposed construction (include name address! phone! contractors license number) 4 I plan to provide portions of the work but) have hired the following person to onoidinate supervise and provide the mator work (md ude name! address phone contractors license number) 51 will provide some of the work but I have contracted (hired) the following persons to provide thef work indicated (include name address! phone! type of work) ,.PROPERTY OWNER SIGNATURE U AGENT DATE FWD City of Carlsbad Bldg Inspection Request For: 12/21/2010 . . - Permit# CB100720 . Inspector Assignment: Title: CREATIVE COLLECTIONS- KIOSK AT . Description: WESTFIELD MALL-NO PART OF STRUCTURE OVER 6 FT HIGH - ELECT PROVIDED BY FLOOR PLUG Type TI Sub Type COMM Phone: Job Address: 2525 EL CAMINO REAL •. ,. S Suite: 9028 Lot: 0 Location: : • Inspecto OWNER PLAZA CAMINO REAL Owner PLAZA CAMINO REAL Remarks No response to Exp Letter. Can you final Total Time Requested By CHRISTINE Entered By CHRISTINE CD Description Act Comments 19 • Final Structural (N' 4i'. S S • Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History S 5 Date Description Act insp comments : , City of Carlsbad 06/29/2000 Commercial/Industrial Permit Permit No: 0B002361 Building Inspection Request Line (760) 602-2725 Job Address: 2525 EL CAMINO REAL CBAD St: 9028 Permit Type: TI Sub Type: COMM Parcel No: 1563020900 Lot #: 0 Status: ISSUED Valuation: $1,500.00 Construction Type: NEW Applied: 06/26/2000 Occupancy Group: Reference #: Entered By: MDP Project Title: MOBILE TELEISIS • Plan Approved: 06/29/2000 KIOSK . . . Issued: 06/29/2000 Inspect Area: Applicant: . - Owner: - NAKAMURA BEEMAN .' ILAZ,CINOREAL dO WESTFIEED CORP INC 12712 CARMENITA A,601 WILSHIRE 1630 06/29/00 0001 01 02 SANTA FE CA E5A 90025 C-PRMT 57-10 562-921-7067 Total Fees $57.10 Due $57.10 . , j5/ tMePe , ''.-% . Building Permit ( $34 00 Meter Size Add'l Building Permit Fee [ 1 $0.00.. dil Rei. Watei1on $0.00 Plan Check $22.) itte(Fee II I $0.00 Add'l Plan Check Fee - .') $0I0O I rIII R WA(I J J / - $0.00. Plan Check Discount $0.00 'IFjD PayoffFee' / J $0.00 Strong Motion Fee \ $Thc40 UF4F,_J..' / . • / $0.00 Park Fee '. \$0.00 e Fj F(CFD Fund') $0.00 LFM Fee . I\ $O'O'O INCORILCiéiië tax,/,* ax/ .' / $0.00 Bridge Fee . '' , (.CF Fur?d) / $0.00 BTD #2 Fee 990 ,. . $0.00 BTD #3 Fee '1 $0100/I ,Tfffic'lmat'(CFD F,und) • $0.00 L L) Renewal Fee; - •$0.00i. EM7ransportion Fee . $0.00 Add'l Renewal Fee . $0.00 PLIJMBING,..TOTAL . $0.00 Other Building Fee ' . $0.0—EEECTRAL TOTAL $0.00 Pot. Water Con. Fee ' $0.00 MECHANICAL TOTAL - , $0.00 Meter Size . . - Master Drainage Fee: $0.00 Add'l Pot.,Water Con. Fee $0.00 Sewer Fee: • . $0.00 Recl. Water Con Fee $000 Redev TOTA PERT pj ACCM1cFW!P4 I! C. FINAL APPUMMIOMA Inspector Date 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 toprotest 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, review, set aside, void, or annul their imposition. . Youare hereby FURTHER NOTIFIED that your right to protest the specified fees/exactionsDOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. CITY OF CARLSBAD - • • . • 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 FOR -OFFICE OFFICE USE ONLY PERMIT APPLICATION . PLAN CHECK NO._O CITY OF CARLSBAD BUILDING DEPARTMENT EST VAL 1635 Faraday Aye, CrIsad,CA 92008 Validated By".' _______________ - - Date________________________________________ LAI PROOTpRMATr0N p7-A C,4n#l1WO RIE/4L 1o[J1E TEL,S/s. j<Ia Address (include BldgISuite#) . ,' . . Business Name (at this address)- Legal Description Lot No Subdivision Name/Number, ,Unit No Phase No' Total # of units Assessor's Parcel # Existing Use Proposed Uses Description of Work SQ FT, #of Stones, # of Bathrooms 2 CONT&CTN(ffejropphcant) MI'-EPiAIV - - '- --1 ".,--•- - .-' '--'''-- 3. .Name -/1/4 /(,4 j't,/Address f.7/t' fl1'IVIttt City 44,7/J FC.. tdre Z pC4 Telephbn# , Fax # ___4700_E'11T ractcr or tw Onar DAntforer Name L/VfF/..ELp , Addr,es .It City Set Zp Telephone 4 T'OPERTY 5INE - J 4 Name., '* '''"-' eddros '''' '- City, ' State/Zip Telephone # 4 NTRAC LS AME - 4 (Sec. 7031.5 Business and Professions Code: Any City. orCounty which requires a permit to construct, alter, improve',,demolish or repair any.strüçture,pri6r toits 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 'Liw [Chapter 9 commending with Section 7000 of Division 3 of the Business and Professions Code] ore that he is exempt therefrom and the basis for the alleged 'exemption-Any violation of Section 7031.5 by any appIicnt for a permit subjects theapplicant to a civil penilty of not more thin five hundred dollars I$500[)_ ."N4KA/flL'A- EE-flhiW jft ' sf/,.Si° ak 06.?o. 2-2a/''7o67. State/Zip Tale one, 9 qame License C 7 /4 , AddLicense r:ss Class CitYcity BusinessLicense #, ,Designer, Name" " •' - Address ''' '" 'City , State/Zip Telephone '. State License # $ - - Workers', Compensation Declaration: I hereby affirm under penalty 'of perjury, one of the following declarations: I have'and will maintain a'.certificate of as provided by Section' 3700 of the Labor Code, for the performance of the work for which this permit is issued I have and will maintain workers compensation, as requird bytSecibn 3700 of the Labor Code, for the performance of the work ,for which this perthit'is issued My wker s com ensatio insJrani'e carrier and policy number are Insurance Company, ,1://PL '' ' -"o" Policy Nor Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ISlOOl 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 penalties fines up to one hundred thosand dollais ($100 000) in addition to the)cost m of copensation damages as provided for in Section 3706 of the Labor code interest and attorney 's .fees. 1'SIGNATURE DATE OW DE&DAT1ö'J " - - herebi ffirm that I im'eemt from the Contractor's License Law for the following reason: I, as owner,of the property or, my employees with wages as their'sole compensation, will do* the work'and the structure' is'not intended or offered for sale'- (Sec. 7044 Business and Professions Code The Contractor a License Law does not apply to an owner of property who builds or improves thereon ,.and who does esuch -himself or,throughhis own employees; providedthat such improvements are not intended or offered'for sile. lf,'however, the building or improverrient 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) - D 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 ownerof property who builds or improves thereon and contracts for such projects ith contractor(s) licensed pursuant to the Cortractor'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 Ef'the proposdd pr'opertinirOv'emen. 0 YES DNO (have / have riot) signed an application for a buildif;perniit ,f or. the prop' sd work.' I have contracted with the following person (firm) to provide the proposed construction (include name I address / phone 'number I, contractors license number): '"- ',v , ,' - I plan to provide portions of the, work, but l,have hired the. following person-to coordinate, sUpervise, and,-4 provide,the' major work-(include name / address / phone 'number I contractors license number): - '- - - - ' - - ' - - ' " 45 5 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 I type of work) - 'PROPERTY OWNER SIGNATURE -' _.'-- _--' A DATE Ly * - C, ' ' ' i,''" , -' ,. Is the applicant or-future building occupant required to 'submit a-business plan, acutely"hazardous materials registration-form 'or' risk .managemenran'd preventioñ 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 requiredto obtain 'a4permit from theair pollution control district orair quality man'agemerit district? 0 ,YES 0 NO - , ) lathe facility to be constructed within4 1 000 fe of the o6ter6'o'7 any of 'a school site? 0 YES 0 NO IF ANY OF THE ANSWERS'ARE YES, A FINAL CERTIFICATE OFOCCUPANCY' MAY NOT BE ISSUED UNLESS THE APPLICANT, HAS MET OR IS,MEETING THE, 'REQUIREMENTS OF.THE OFFICE ÔF,EMERGENCY SERVICES AND THE AIR POLLUTIONCONTROL DISTRICT - - ',',''.4- 18 - , 1 hiriby iffirm that there is a constructioh lending agincy for the perfurmdn-e of the e, rk for which th permit • SUed {Sec 3097(o Civil Code) -- ' - -'-'''m-" .'.'. ' - '',,', ', 4- ' '"'f -' - j C.',41 ' LENDERS NA _____... ___________- LENDER'S ADDRESS APPLIQjflçTIONk ' — ,, 1 certify that I, have read the application and state that the above information is correct and that the information onthe plans is accurate"'r I agree-to'comply with all 3City ordinances and State laws relating to building construct,cr I hereby outhorize representatives of the Cit, of Carlsbad to enter upon the above mentioned property for 'inspection j,rios's''I 'ALSO' AGREE TO" - SAVE, INDEMNIFY AND KEEP "HARMLESS THE CITY OFCARiSBADAGAINST ALL' LIABILITIES. S ,JUDGMENTS. COSTS AND EXPENSES WH!CHMAYJN ANY.WAY ACCRUE AGAINST SAID,CITY IN CONSEQUENCE OF THE GRANTING 0FTHIS 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' provlsiths'of this. Code"shall expire by'Iirhitation and become null and-ôid if the building or work authorized by such permit is not commenced within 180 days from the date of such prmit or if the building or work authorized by such permit is suspended or abandoned 14at any time after the work is commenced for a period of 1 0 s (Section 10644 Uniform Building Code) -' - - -1APPLICANT:S SIGNATURES_______-'_-___-____- __:' _' _'.''' ''.' "DATE '6' 6OO' '.: _WHITE File ,..YELLOW Applicant PINK Finance—_ November 10, 2000 Permit Number: CB00236 1 Issue Date: 6/29/2000 BEEMAN NAKAMURA 12712 CARMENITA SANTA FE SPRINGS CA 90670 RE: BUILDING PERMIT EXPIRATION ADDRESS: 2525 EL CAMINO REAL #9028 PERMIT TYPE: TI PLEASE CALL FOR-AN INSPECTION IF WORK IS COMPLETE Our records indicate that your building permit will expire by limitation of time on 12/26/2000... The provisions of UBC, Section,106.4.4 as amended by the Carlsbad Municipal Code state: "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 (unless issued prior to 7/1/99 which is one year from date of permit), 'or 'if, the building or work authorized by such permit is stopp&d at any time after the work is commenced for a period of 180 days or if the buildini or work authorized by such permit exceeds three calendar years from the issuance date of permit. Work 'shall be presumed to have commenced if the permittee 'has obtained a required inspection approval Of work authorized' by the permit by the Building Official within 180 days of the date of permit issuance. Work shall be presumed to be stopped if the permittee has not obtained a required inspection approval of vork by the Building Official within each 180 day period upon the initial commencement of work authorized by such permit. Before such work can be recommenced, a new permit shailbe obtained to do so, and the fee,' therefore, shall be one-half the amount required for a new 'permit for such work, and provided that no changes' have been made or will be made in the original plans "and specifications for such work, and provided further that' such, suspension or abandonment has not exceeded one year. In order to renew, action on a permit after expiration, the permittee shaWpay a new permit fee. . Any person holding an unexpired permit may apply for an extension of 'the time within which work. may commence under that permit when. the permittee is unable to commence work within the 'time period required by this section for good and satisfactory reasons The Building Official may extend the time for action by the permittee for a period not exceeding 180 days on .written request by the permittee showing that circumstances beyond the control of the permittee have prevented action from being taken'. No permit shall be extended more than once. ' Please check below, indicating your intentions and return this letter to us Project abandoned. A new permit will be obtained prior to, commencing work. No fee' extension requested for '180 days. (attach a letter of explanation) Renewal permit requested. If the project has been completed and only a final inspection is needed, please call the inspection request line at '(760) 602-2725. If you have any questions, please contact the Building Inspection Department at (760) 602-2700 PAT KELLEY Principal Building Inspector 1635 Faraday Avenue • Carlsbad, CA 92008-7314• (760) 60272700 • FAX (760)602-8560' ® -- 4 • 1 4 - 4' ' .•c-_ • ,-- -. 4 . • 4 . .-- - ;_' • - --. I BUILDING PERMIT PgimitNoCB%1293 07/15/96 12 43 Project No A9601844 Page 1 of 1 Development No ;Job Address: 2525 EL CAMINO REAL-- Suite: 9028 -: Permit Type SIGN 4 Parcel No 156-302-09-00 Lot# 29 07/15i96 0001 01 02 Va1uation 2,400 Construction NEW 11600 Occupancy Group Ref erence# -. Status ISSUED Description WALL SIGN-ILLUMINATED-BANK OF Applied 07/15796 AMERICA TELLER MACHINE , Apr/Issue 07/15/96 -, EnteredBy ;RMA Appl/Ownr MINA-TREE SIGNS 209-941-2921 4 P0 BOX 8406 4 :STOCKTON CA 95208 .•t . - } 4- :.. FeesRequired - . ***. Fee Sql1ected - &C±ethts --------------Fee------------I --------- Adjustments 0 To'ttVr t\ 00 • Total Fees: 0 To S. 116. .00 00 Fee description fi 7 ffl'\pUnits \rJh t Ext fe Data ------------------------ ---------------- Building Permit —..-- 54 00 Plan Check' Enter "Y" for-Ren waQe • 4 INCORPORATED - 1952 çL J 4 - - ,• . -. 4 -. 4. .—;• .r. • 4 - • I.e - - •• '- •1 - • r - - • PERMiT AFPUCTION i PLAN CHECK NO City of Carlsbad Building Department - . •, ..;--, 2075 Las taLDr., CarLsbad,CA 92009 (619) 438-1161 -' ESF.VAL PLAN CK 24OO 1.PERIT1YPE , . POSIT_______ VALID. U DATE /0 c Ip' From List 1.(see back) give code of Permit-Type: _1 •-'• For Residential Proiects Only From List 2(see back) give .. .. I Code of Stnicture Net Loss/Gain of Dwelling Units 2. PROJECT' INFORMATION FOR OFFICE USE ONLY 1-Address.._....BudingorSut . . r Nearest Cross Street -Z 4-2 r LEGAL DESCRIPTION Lot No. Subdivision Nam/Nurnber.; ..- . Unit No.; .-,. Phase CTh-IECK BELOW IF.SUBMIYIED: •- . -.... 02 Energy Caics 02 Structural Calcs (32 Soils Report . I] I Mdrêsséd Envelope ASSESSOR'S PARCEL EXISTING USE -. 'PROPOSED. USE DESCRIPTION OF WORK - ('&yt ccQ.L( (d/L) I Loc SQ. FT. I •3 • # OF STORIES . # OF BEDROOMS # OF BAThROOMS . U)NFALii'EKJN (it thilerent from ap licant) ,. .,.. . -. . , -•. 0 NAME (last name first) * ADDRESS P.-c: • • 0 • CITY 7jc(C.fTh SfATECk, ZIP CODE. Z.O DAYTELEPHONE 2_o ?/frZQZ( APPLICAKI UCONTHACIOR IL NT FOR cUNIRACiUI( UOWNER [JAGENT FOR OWNER NAME (last name first) B ( L - ADDRESS - C Ccp COY vc. i& STATE ZIP CODE t 2( ( 'DAY TELEPHONE j ç —, ç- . 3 ( -i PROPERTY OWNER. NAME (last name first) LCA-4A.t. (4.... 0 I '"- ADDRESS 2- - - c i.i cn (j- (s (, q . STATE ZIP CODE DAY TELEPHONE CONTRACTOR . NAME (last name first) . ADDRESS -y--- ••• CITY f,.... STATE •c ZIP CODE' DAY TELEPHONE 2- cD < — ''4 I .-.. . ( STATE DC. # 7 LiCENSE CLASS C-13 CITY BUSINESS LIC. # DESIGNER NAME (last name first) - .. ADDRESS - ........•. . . CITY STATE ZIP CODE ' DAY TELEPHONE -•- . STATE LIC. # 7. WORKERS' COMPENSATION_. . - Workers' Compensation Declaration: I hereby atlirm 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 ' I by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab.-C). INSURANCE COMPANY (L tk#tLfrt < POLICY NO.0-O003&,!b EXPIRATION DATE 7—) - Certificate 01 Exemption: I certify that in the performance 01 the work [or 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.. ..•--i - - . SIGNATURE - DATE - 8. OWNER-BUILDER DECLARATION ..0wner-kSuiIder_ Declaration: _I_ hereby _alum, that_I_am_exempt_from_the_Gontractor's_License_Law_for_the following_reason---.__. _• 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 "c" -----------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 in -' • - - 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 pur ose of sale),' I,as owner of the property, am exclusively contracting with licensed ontracrors 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 (3 rI 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 toa civil penaicyof not more than five hundred dollars [$500]) - I tilvi ' ill SIGNATURE - - : ---- -. - • - DATE ':-- . COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY: - - -. '. .' -. . •. . - . p Is the applicant or future buildingccupant required to sibmiti business plan icuteIy hazrdou'mate,als'reistuon forubr risk nanaenezt P revention prograth under Sections 25505, 25533 or 25534 of the Presley Tanner Hazardous Substance Account Act? -&I , • 01 Is the applicant or future building occup4nt required to obtain a permit from the air pollution control district or air quality management district? CLYES _NO -' Is the facIlity to be constructed wIthin 1,000 feet of the outer boundary of a school site?. _ ' lf Itd 54_ ,JiV. ).l. dv 1• MIt .th-. •de$,J I?..t.. •. . I4i'.,[), ,j fVI -Iit .)'t!!rF. i •,ii s'-; fi0ij'j - - I . r , I ;.. IF .• - ------- ----------, ANY OF 111K ANSWERS ARE YES, A FINAL CER11FICA1'E OF OCCUPANCY MAY NOT BE ISSUED AFI JULY it 1989 UNLESS 111K APPLICANT: HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISI1UCF. - • 19.- WNSi1tUCI1ON.LEND[NG AGENCY__..__. -_________________••. __..,__________ 0 ____- • __.___.__-. ••__________________________•0•• i1hereby aIirm}ha, thereisacI struction_lending agency, tor_the _performance oçtle_work_for1 whi5h this_pes3nitp_issued_(Sec_1p97(i)_Uvul - •.IJ .4. - ' - fI.I!)/ • 'rY-jr-4 -' ' • -- " • ---------------• jc' j-.'! • - ric- •Jc. 1-in' 1,-.iIpf..-,L-,i r'vi' -r- ri-i! •t • LENDER'S NAME - - LENDER'S ADDRESS • "" • -------------• • • / 10.. APPLiCANT CEI[I1FICPa1IUN - . . • . - u 1_ 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 it) SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS - AND EXPENSES WIUCH MAY IN ANY WAY MX3tUE AGAINST SAID CITY IN CONSEQUENCE 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 stones 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 gon4atn it is not commenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or e after the work is commenced for a period of 180 days (Section 303(d) Uniform Building APPLiCANT'S SIGNATURE 0 - . - .• I DATE:1f- - WFIITE: File YELLOW: Applicant PINK: Finance :0 - I - - •.-. - - -: - • 0