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HomeMy WebLinkAbout2559 EL CAMINO REAL; MULTI-PERMIT FILE; CB160471; PermitCity of Carlsbad 1635 FaradäyAv Carlsbad, CA 92008. Plumbing/Mechanical/Electrical (PME) Permit 03-08-2016 Permit No: CB160471 Building Inspection Request Line (760) 602-2725 Job Address: 2559 EL CAMINO REAL CBAD Permit Type: PME Status: ISSUED Parcel No: 1563022600 Lot #: 0 . Applied: 02/08/2016 Entered By: RMA Reference #: Plan Approved: 03/08/2016 PC #: 0 Issued: 03/08/2016 Inspect Area: 0; Project Title MACYS INSTALL NEW 60 AMP .3 POLE CIRCUIT FOR NE ENERGY MANAGEMENT SYSTEM-W/ DISCONNECT &DISTRIBUTION PANEL - Applicant: - Owner: HMT ELECTRIC INC CARTER HAWLEY HALE STORES INC - STE 105 V C/O TAX DEPT - 9550 WAPLES ST .. 7 W 7TH ST V SAN DIEGO CA 92121 CINCINNATI OH 45202 858-458-9771 Plumbing Fees . $0.00 Electrical Fees - . V $163.00: Mechanical Fees . * - 4 . $0.00 1 Other PME Fees . V $161.25 TOTAL PERMIT FEES $324.25 Total Fees: $324.25 Total Payments To Date: $324.25 Balance Due: $0.00 V . V V FINAL APROVhL : V. Inspector ) ') fYt1_- Date (3/7'?/ '))/(, Clearance V NOTICE Reese take ND11Cthat a4j of your project includes the lrri Cf tee4, dedications, or ct1e exactions bereeft cdl&]vy V referred to ¶ece ''cu beie 90 days from the date this permt ves issuecl to p-&est irriticzi of theee ffexaacxis. If you fattest them you rriEt fC1lCm the protest pxedies sorth in Gni-ent Code Section 6)20(a), and file the protest and any otw rrJ infcnTekri wth the Oty NbiW for processing in accordance wth Cailstai Mnat Code Section 3.32 XX30 Failure to Urry fdlcwthet p-cmkuewil any subsequent lejai action to attack eew, set aside, void, or arnil their irrrxsilion. V V V You are hathy RRTHER N3J11RED that ycur ngft to protest the IIfi1 fees/eaE DOES NOT APRY to 4fter and se er czicn fees and capacity 7pianr, zonng, gfair9 or other mlar applicationpixessing orsewe fees in correction wth thisproject. NCR DOES' lTPiA1Yto any fees'exicz- of hdi you have oreocusly been civen a NGflCE sirrilar to ths, or astoWich the statute of Iinitatioris has rxeiacv dheise adred V V - .'lTHE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: EPLANNING [--]ENGINEERING EBUILDING EIFIRE DHEALTH EHAZMAT/APCD Building Permit Application rty of Plan Check No. If 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value Ph: 760-602-2719 Fax: 760-602-8558 Carlsbad email: buildingcarlsbadca.g'ov Plan Ck. Deposit www.carlsbadca.gov f) Date Iswppp I - JDRESS SUITE#/SPACE#/UNITI CVPMJECT #1 LOT # PHASE # B OF UNITS B BEDROOMS B BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE 0CC. GROUP MMi,11t DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) tkttoJ o (O ? -Poi j,gj CjjT j1t. JE k i t c c -rEfr1 iUioi b/5WQPFLT /7.)7(àfr' PL- EXISTING USE - PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS F- YESD# NO[_ YES DNO EJ YESO NO[_] APPLICANT NAME PROPERTYOWNER Primary Contact ADDRESS ADDRESS (_It4/4/O iEAt_ CITY . STAT ZIP • CITY ST E: ZIP f¼' . ...............: .(sAO::A ( ..:.. p'/ ..1'...i .1: JFAX FAX P(ONE) PHONE .,:H. . . .. .... EMAIL - - EMAIL . . DESIGN PROFESSIONAL .: : .: . ,. : - CONTRACTOR BUS. NAME ADDRESS ADDRESS HE'r'E A CITY STATE ZIP CITY ST T ZIP ........................ - 1, .;: : S.., , ,,'.. , ..: PHONE FAX • PHONEy FAX . . EMAIL EMAIL (Vit STATE LIC. B STATE LIC.# • C CITY BUS. LIC.# (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 LawjChapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)). ®U(3U(DO° Q)1O®J Workers' Compensation Declaration: I hereby affirm under penalty of perjuiy 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 work e 'C ens ti n, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. 'Policy No. -cT.I . Expiration Date This section need not be completed if the permit is for one hundred dollars ($100) or less. . . . . . []Certirrcate 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 and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages,,ae ovid f Afi ion 3706 of the Labor interest and attorney's fees. CONTRACTOR SIGNATURE GENT DATE øOGLIoO(DO(OO D®(> 'I hereby affirm that lam exempt from 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'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 sate). D I, as owner of the properly, 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 improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). - [] I am exempt under Section-. -'-!-- Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. DYes ENo - 2. I (have I 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 I contractors' license number): I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone /contractors' license number): I will provide some of the %6k, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone type of work): ,PROPERTY OWNER SIGNATURE • . . AGENT DATE - - - 1 . c®c Ulm =0000Q00MMA0=1111w00 00 .,. 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? ,L,Yes Ci No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or aality management district? . Yes jNo - Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? L .Yes ir qu 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. . Jix3 - I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). - .....•., '•.+ .c...,_..._.. - .,-, -2--'- Lenders Name Lender's Address ' , '- .. :1 cerlifythatI have read theapplication and state that the above information isconsctand that the informationon the plans isaccurate. I agraetocomptywithàll Cityordinancesand State laws relabngto buitdingconstruction. I hereby authorize representative of the City of Cartsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANDEXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA An OSHA permit is required for excavations over 5 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 tithe 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 106.4.4 Uniform Building Code). ...APPLICANT S SIGNATURE '5 " DATE - -' STOP: THIS SECTION'NOT REQUIRED FOR BUILDING PERMIT ISSUANCE; S Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection ICERTIFICATEI .ZIIJANCY (Comm er c ia l1I.aProjects .? Fax (760) 602-8560, Email buildincitcarIsbadca.Qov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CO#: (Office Use Only) NAME . .,---.-, :'.- ADDRESS .'- ''."-" , "--':•'- .'-'.-".7,-'......................-'r-' BUILDING ADDRESSjI * '9" "' . S . •***;*.** . - 5..- - .. - CITY " xrr-.'sv-STATE ZIP ,. CITY STATE - zIP, Carlsbad CA PHONEr -..-.s.•.-.- FPJ(-- --.. . . . . EMAIL •,, ...........,. .... OCCUPANT'S BUS. LIC.No. . .' DELIVERY OPTiONS CONTACT NAME '4.'4 '.'+ ''' ....00CUPANT PICK UP: 'N CONTACT (Listed above) j OCCUPANT (Llstâd above) . ... . .. - ' CONTRACTOR (On Pg. 1) ASSOCIATED CB# MAIL TO: CONTACT (Listed above) 41R OCCUPANT (Listed above) - CONTRACTOR NO CHANGE IN USE / NO CONSTRUCTION FMAIL/ FAX TOOTHER: ' ",4' : Q CHANGE OF USE / NO CONSTRUCTION ,tA .4• ' 3*. . ,&*. .3.- ..APPLICANTSSIGNATURE- DATE ...................................................................................................... I' , ' • - . S. - . . . - . - . . . - :. .. ,. . .. . * S , .. -S • * - - I. Inspection List Permit#: C13160471 Type: PME MACYS-INSTALL NEW 60 AMP 3 POLE CIRCUIT FOR NE ENERGYMANA Date Inspection Item Inspector Act Comments 03/14/2016 39 Final Electrical - RI 03/14/2016 39 Final Electrical PY AP EsGil Corporation In Partners/iip wit/I government for cBuitiing Safety DATE: March 2, 2016 JURISDICTION: Carlsbad PLAN CHECK NO.: 16-0471 SET: II PROJECT ADDRESS: 2559 El Camino Real (Macys) PROJECT NAME: Stem Peak Power Equipment U APPLICANT 'J URIS. U PLAN REVIEWER U FILE The plans transmitted herewith have been corrected where necessary and substantially con ly with the jurisdiction's building codes. The plans transmitted herewith will substantially comply with the jurisdiction's codes when minor deficiencies identified below are resolved and checked by building department staff. LII The plans transmitted herewith have significant deficiencies identified on the enclosed chec 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. The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applica it contact person. The applicant's copy of the check list has been sent to: * EsGil Corporation staff did not advise the applicant that the plan check has been comple EsGil Corporation staff did advise the applicant that the plan check has been completed. Person contacted—Keith Kwasnr-- Telephone #: 619..995-9705 Date contacted'—'- (bl in erson ) Email: Keith.Kwasnystem.com Mail Telephone Fax j REMARKS: By: Eric Jensen . * Enclosures: EsGil Corporation . * LI GA fl EJ LI MB LI PC 02/25 9320 Chesapeake Drive, Suite 208 • San Diego, California 92123 • (858) 560-1468 • •Fax(858)560-1576 EsGil Corporation In (Partners flip with Government for(Building Safety DATE: February 17, 2016. 0 )PLICANT 4%JURIS. JURISDICTION: Carlsbad 0 PLAN REVIEWER 0 FILE PLAN CHECK NO.: 16-0471 SET: I PROJECT ADDRESS: 2559 El Camino Real (Macys) PROJECT NAME: Stem Peak Power Equipment The plans transmitted herewith have been corrected where necessary and substantially corn with the jurisdiction's codes. LI The plans transmitted herewith will substantially comply with the jurisdiction's codes when minor, deficiencies identified below 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. The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. LI The applicant's copy of the check list is enclosed for the jurisdiction to forward to the appli contact person. The applicant's copy of the check list has been sent to: EsGil Corporation staff did not advise the applicant that the plan check has been complE EsGil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Keith Kwasny Telephone #: 619 995-9705 ,ate c ;7elephone cted: 7(/9_(by:Yy Email: Keith.Kwasnystem.com P,MaiI. Fax In Person REMARKS: By: Eric Jensen Enclosures: EsGil Corporation El GA El EJ El MB LI PC 02/09 9320 Chesapeake' Drive, Suite 208 • San Diego, California 92123 • (858) 560-1468 • Fax(858)560-1576 Carlsbad 16-0471 IS February 17, 2016 GENERAL PLAN CORRECTION LIST JURISDICTION: Carlsbad PLAN CHECK NO.: 16-0471 PROJECT ADDRESS: 2559 El Camino Real (Macys) DATE PLAN RECEIVED BY DATE REVIEW COMPLETED: ESGIL CORPORATION: 02/09 February 17, 2016 REVIEWED BY: Eric 'Jensen FOREWORD (PLEASE READ): This plan review is limited to the technical requirements contained in the International Building Code, Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code andstate laws regulating energy conservation, noise attenuation and disabled access. This plan review is based on regulations enforced by the Building Department. You may have other correctons based on laws and ordinances enforced by the. Planning Department, Engineering Department or other departments. The following items listed need clarification, modification or change. All items must be satisied before the plans will be in conformance with the cited codes and regulations. The approval of the plans does not permit the violation of any state, county or city law. Please make all corrections and submit two new complete sets of prints to:. ESGIL CORPORATION. To facilitate rechecking, please identify, next to each item, the sheet of the plans U3Ofl which each correction on this sheet has been made and return this sheet with the revised plans. Please indicate here if any changes have been made to the plans that are not a r of corrections from this list. If there are other changes, please briefly describe them and re they are located on the plans. Have changes been made not resulting from this list? UYes Ll No 'Carlsbad 16-0471 February 17, 2016 ELECTRICAL and ENERGY COMMENTS PLAN REVIEWER: Eric Jensen ELECTRICAL (2013 CALIFORNIA ELECTRICAL CODE) Elaborate on the electrical service room layout and compliance with CEC 11 0.26(C)(2): If the existing service room used the twice the distance clearance to allow for One door access, this clearance shall be maintained. Include the following information: a Equipment description of all equipment in the room (and) a Distance between the equipment, both existing and STEM to existing as well as the dimensions of the room. . The jurisdiction has contracted with. Esgil Corporation located at 9320 Chesapeake Drive, Suite 208, San Diego, California 92123; telephone number of 858/560-1468, to perform the plan review for your project. If you have any questions regarding these plan review items, please contact Eric Jensen at Esgil Corporation Thank you Carlsbad 16-0471 February 17, 2016 (DO NOT PAY— THIS IS NOT AN INVOICE] VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PLAN CHECK NO.: 16-0471 PREPARED BY: Eric Jensen DATE: February 17, 2016 BUILDING ADDRESS: 2559 El Camino Real (Macys) BUILDING OCCUPANCY: BUILDING PORTION AREA (Sq. Ft.) Valuation Multiplier Reg. Mod. VALUE ($) Air Conditioning Fire Sprinklers TOTAL VALUE Jurisdiction Code Icb IBY Ordinance Bldg. Permit Fee by Ordinance •V Plan Check Fee by Ordinance I $161.25 Type of Review: 0 Complete Review 0 Structural Only * 0 Other .. . - El Repetitive Fee Repeats El Hourly 1.5 Hrs. @ * EsGil Fee $86.00 . I $1 29.001 * Based on hourly rate . Comments: 1.5 hours plan review. Sheet of 1 - macvalue.doc + To Date: $20.00 f$0.00 \. c$000 ) $0.00 I $0.00 $0.00 $0.00 fr"1 I, $20.00 / - / p - \ o" -'----') / fl \) / City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No: CB021452 Building Inspection Request Line (760) 602-2725 C' Status: ISSUED 0 Applied: 05/15/2002 Entered By: RMA Plan Approved:•• 05/15/2002 Issued: 05/15/2002 .;roject Title: MACVS WOMEN'S-ELECT ONLY FOR Inspect Area: INSTALL OF ROLL UP DOOR-PERMIT #CB021273 Applicant: .— RITE ELECTRIC CARTER HAWLEY HALl C/O TAX DEPT ,71W 7TH ST \ ;i 300 GARDENA AV 91204 CINCINNATI OH 45202 818 242 9891 1 r-j / T'i • Total Fees: $20.00 . / / Electric Issue Fee - .. F '. Single Phase per AMP , Three Phase per AMP -.-.."--.. - -Three Phase 480 Per AMP Remodel/Alteration per AMP.3 ! Remodel Fee I •, . f ......- Temporary Service Fee ) ) -, Test Meter Fee ! - ... - Other Electrical Fees : Additional Fees - • TOTAL PERMIT FEES . • \ Job Address: 2559 EL CAMINO REAL CBAD .:Permit Type: ELEC - - Parcel No: 1563022600 Lot #: 4 STOF\J5t,O2 0002 01 COP 02 .2000 FINAL APPROVAL Inspector: Date: 6 , 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 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. . You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and cpacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fps/pyactinns of which you have nreviouslv been aiven a NOTICE similar to this, ores to thich the statute of limitations has previously otherwise expired FOR OFFICE USE ONLY PLAN CHECK NO.()2.../(,f52.., EST. VAL. Plan Ck. Deposit Validated By 4.. Date PERMIT.APPLICATION 0 CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 L55 1 PROJECT INFOR ATION —27&1r15 .E Address (include Bldg/Suite #) Business (am Legal Description Lot No. Subdivision Name/Number a essor's Parcel # Existin Use (i•\ _\J-1-1.4J .2 Description of Work SQ. FT. 2. CONTACT PERSON (if different from applicant) (at this address) Unit No. Phase No Use Total # of units # of Bathrooms LI1) Stories # of Name Address City State/Zip Telephone # Fax # fl ntfbrOwn. Name Address City State/Zip Telephone if I' 4. PROPERTY OWNER ' . - 'Name Address City State/Zip Telephone if 5 CONTRACTOR COMPANY NAME (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, 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 exe pti n. Any vi lati of. Section W31.S by any applicant for a permits bjects the applicant to a civil p alty of not more than five hundred dollars ($5001). W1 ___ __I 'O tc1-uJe..,. _uii.L_____&-frzoif_ç'z Vg4/ Name Address City ' State/Zip T lephon if State License if 2 36 6o_I_ License Class (2-10 City Business License if ,z Designer Name Address City State/Zip/' // Telephone State License # 6 WORKERS COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: E] 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. I 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 a1d policy number are: / Insurance Company 5734.7 Policy No. / Expiration Date________________ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) o 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 sObect to the Workers' Compensation Laws of California. WARNING: Fa)he to secure workers' co sation coverage Is unlawful, and shell subject an employer to criminal penalties' and civil fines up to one hundred thousand dollar (1O0,000), in 4ditIon to h cost of compensation, damages as provided for in Section 3706 of the Laor codp, interest and attorney's fees. SIGNATURE I_)_- DATE 1-5 / p 7Q.,OWNER BUILDER DECLARATION I heieby affirm that I am exempt from the Contractor's License Law for the following reason: C] 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. 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: I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO ((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 I address / phone number / contractors license number): I plan to provide portions,of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name I address / 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 / address / phone number / type of work): PROPERTY OWNER 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? 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. 8 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. 3097(i) Civil Code(. LENDER'S NAME LENDER'S ADDRESS_____________________________________________________________ 9 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 Cit%' 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 equired for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit iued 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 Qimenced with 180 180 days jAii 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 comi1e?tçed for a peô1d of 180 rays (Section 106.4.4 Uniform Building Code). i , S DATE // 2_ WHITE: File YELLOW: Applicant PINK': Finance VJ B U L IN G PER MI T Permit No CB960361 03/05/96 17:11 . • ProjectNo: A9600531 Page 1 of i DevelopmentNo Job "Address: 2559 EL CAMINO REAL Suite ' Permit Type ELECTRICAL 6347 03/051% 0001 01 Parcel No: 156-302--26.-OO Lot#: . .' C-PRwr. 20;oo Valuation 01 Construction Type NEW Occupancy Group: Reference#: . , Status: ISSUED, Description: EXTENDEXIST SECURITY CIRCUIT''' Applied: 03/05/96; TO NEW 120 V SEC POWR SUPPLY-MACYS-BRDWY Apt/Issue: 03/05/96 14 Entered By.:',RMA .. Appl/Ownr : 'SELECT, ELECTRIC ' 310-4-6382 , '.118164 W 135Tg ST .' "1 HAWTHORNE CA 90250 Fees-Required—- Fees,Collected&. Credits ---------Fee------------20 ----------------------- Adjustments /oo Tota 1\ 00 -.- Total Fees 2)5 0. Total Ppt'içs \ 00 ' 20.. 00, Feedescription / Vts Wtht\ Ext fee Data ELECtRIC.AL TOTAL, 20.!00 IN INCORPORATED 1952, 10 14 CLEARA . . . ,. HM DAT 'CITY OF CARLSBAD - 4 4 , - 2075, Las Pahnai Dr., Carlsbad, CA 92009 (619) 438-1161 . •. ..••,.. ,. I I f - - * 4, . - .•' 1 - •, - . -•. PERMIT APPUCATION City of 'CarLsbad BuiLding Departient 2075 Las PaLs Dr., CarLsbad, CA 92009 (619) 438-1161 PERMrf TYPE From List I (see back) give code of Permit-Type: --------------------------------------------------------- For Residential Projects Only: From List 2 (see back) give Code of Structure-Type: Net Loss/Gain of Dwelling Units PROJECT INFORMATION PLAN CHECK CHECK NO. 3 VAL I cit DEPOSIT FOR OFFICE USE ONLY Leas ouiiaing or suite No. Nearest Cross Street ( 44k (OA WAY CHECK BELOW IF SUBMITTED: 02 Energy Calcs 02 Structural Calcs 02 Soils Report Dl Addressed Envelope ASSESSOR'S PARCEL . EXISTING USE PROPOSED USE DESCRIPTION OF WORK SQ. yr. # ofsiom # OF BEDROOMS # OF BATHROOMS (.464'4 3. LION TACT }'EKSJN or different from applicant) NAME (last, name first) ADDRESS CITY STATE ZIP CODE DAY TELEPHONE NAME (last name first) ( 94N'P,(EPDRESS ff51 44, CITY f,0,11M STATE ff,4 ZIP CODE 7" DAY TELEPHONE (70) 4'e' 7.. /777 5. PROPERTY OWNER ' NAME (last name first) ADDRESS 2,!'r I',r ( CITY STATE ZIP CODE 9219 0 DAY TELEPHONE (C(97 - NAME (last name first) CITY ADDRESS STATE dA ZIP CODE 7,Lf o STATE UC. # V6i' 17 LICENSE CLASS name ) (ycrAy/ DAY TELEPHONE (j,c') 6?- 0. CITY BUSINESS UC. # CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. # 7. WORKERS' (X)MPENSATION 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 Owner-Builder DFclaration: I hereby affirm that I am exempt from the Contractors 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). 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 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 PERMITh 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 ONO 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. ereby 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 I certity 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 10 SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABilItIES, JUDGMEN1'S, 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 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 within 365 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). APPLICANTS SIGNATURE ->_ 2 DATE: - - -V p. CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB960361 FOR 05/28/96 INSPECTOR AREA TP DESCRIPTION: EXTEND EXIST-SECURITY CIRCUIT PLANCK# CB960361 TO NEW 120 V SEC POWR SUPPLY-MACYS-BRDWY S oCC GRP TYPE: ELEC CONSTR.. TYPE NEW JOB ADDRESS: 2559 EL CANINO REAL STE: LOT: APPLICANT: '.SELECT ELECTRIC PHONE: 310-644-6382 CONTRACTOR: PHONE: OWNER PHONE REMARKS: MW INSPECTOR / SPECIAL INSTRUCT TOTAI. TIME: --RELATED PERMITS-- PERMIT# TYPE STATUS S CB960043 CTI ISSUED AS960011- ASTI ISSUED - CB960134 MISC ISSUED CD LVL DESCRIPTION ACT COMMENTS S. - 39 EL Final Electrical' 'S - ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP COMMENTS 043096 Final Electrical NR TP ND CONT ON SITE OR ARRNGM TS 04299.6 Final Electrical NR TP UTL CONTRACTOR 030796 Rough Electric CO PD NO ACCESS 4 "V \. - S -