HomeMy WebLinkAbout2540 EL CAMINO REAL; B; CO160002; Certificate of OccupancyCity of Carlsbad
01-05-2016
1635 Faraday Av Carlsbad, CA 92008
Certificate of Occupancy Cert of Occ#:C0160002
Permit Type: COFO Related Bldg Permit#: CB152392
Bldg Address: 2540 EL CAMINO REAL CBAD St: B
Parcel No: lte,70S06QOO Issue Date: 01/05/2016
Occupant Name: DAVID W. STEMLEY, O.D.
Contact Name: DAVID W. STEMLEY, 0.D.
Building Owner:
AZALEA INC<LF> ME PACIFIC PARK ASSCS LLC
C/0 HUGES INVESTMENTS MANAGER
PO BOX8700
NEWPORT BEACH CA 92658
Description of Use: OPTOMETRIST
Phone#:
Phone#: 760-729-9353
Phone#:
I certify that this building or portion complies with the California Building Code for the group and division of
occupancy and the use for which the proposed occupancy is classified. The above information is true and
correct, and I make this statement under penalty of perjury.
Signature of Building Offi i Dare J/tdJr!_
FOR DEPARTMENTAL USE ONLY
Date Routed ___ _
Use Zone ____ _ Occupancy Group: B Construction Type: 58
Dare~ Approved __ Disapproved __
Date -----Approved __ Disapproved __
Inspected By ______ _ Date ____ _ Approved __ Disapproved __
Commen~:----------------------------------~
cor.1PLETE 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 Acfl Yes No
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air Quality management districfl Yes No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Yes No
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF
EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
I certify that I have read the application and slate that the above Information Is conectand that the Information on the plans Is accurate. I agree tD comply with all City ordinances and Slate la\\S relatingtD building construction.
I hereby authorize representative of the City of Carisbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBA.D
AGAINST ALL UABILrTIES, 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 SCJ deep and demolifun or oonstruction 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 berome null and voi:J if the building or v.ork authorized by such permit is not rommenced v.ffllin
180 days !iom the date of such permit or if the building or v.ork authorized by such permit is suspended or abandoned at any time after the v.ork is rommenced for a period of 180 days (Section 106.4.4 Uniform Building Code).
,R5 APPLICANT'S SIGNATURE Dav DATE
• STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE.
Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection.
Fax (760) 602-8560, Email building@carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008.
CONTACT NAME David W. Stemley, 0.D.
ADDRESS 2540 El Camino Real, Suite B
CITY STATE Carlsbad Ca
PHONE FAX
ZIP
92008
760-729-9353 760-729-0583
EMAIL
drdaves@sbcglobal.net
DELIVERY OPTIONS
PICK UP: CONTACT (Listed above)
CONTRACTOR (On Pg. i)
MAIL TO: CONTACT (Listed above)
CONTRACTOR (On Pg. i)
OCCUPANT (Listed above)
OCCUPANT (Listed above)
MAIL/ FAX TO OTHER: _______________ _
A5 APPLICANT'S SIGNATURE David W. Stemley, O.D.
CO#: (Office Use Onty)
{!,O/IR 0002..
OCCUPANT NAME David W. Stemley, 0.0., Inc
BUILDING ADDRESS
2540 El Camino Real, Suite B
CITY STATE
Carlsbad CA
OCCUPANT'S BUS. LIC. No. 1206319
ASSOCIATED CB# __ e~B ...... J.'--'~~2"""'3""-q-+--2..=--
NO CHANGE IN USE/ NO CONSTRUCTION
CHANGE OF USE/ NO CONSTRUCTION
DATE 01/04/2016
ZIP
92008