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Home My WebLink About2601 JEFFERSON ST; MULTI-PERMIT FILE; CB021996; PermitCity of Carlsbad 1635 Faraday Av Carlsbad,CA 92008 ... 07-03-2002 .. Plumbing Permit Permit No CB021996 CL Building Inspection Request Line (760) 6022725 S. F - •-'•. .5 -. .-,.. Job Address 2601 JEFFERSON ST CBAD I Permit Type PLUM Status ISSUE D6 Parcel No: . 1551704100 Lot #: 0 -.' Applied: . 07/03/2002 - -, Construction Type: NEW - Entered By: MDP -- Reference #: . . .' Plan Approved: 07/03I2002- - Issued:,07/03/2002 Project Title: -LAGUNA -TERRACESAPTS. Inspect Area:' SOLAR ON 100,200.500 & 600 BLDG - - Applicant: -MARK NAYLORSOLAR - HFLP/LAGUNATERRACE LLOjos (7/rZI'V) /W\' 1)1 ?) .; STE C HERMANSON MGMT N5, I I,.JI V JVV J. V 4539 ROXBURY RD.COP 240 Ou 7930 ARJONS DRIVE 92126 -. c - CORONA'DEL) MAR CA - Total Fees: $240.00 -' -Total Payments To Date: $0.004 Balance Due: •$240.00 Plumbing sue Fee Fixture or Trap ig A Building Sewer 1 0 $0.Q0 Roof Drain 0.00 Water Heater and/or Vent 00 Gas Piping System Vacuum Breaker- 0-'. Other Plumbing Fees, Master.Drainage Fee, Sewer Fee Additional Fees .7 !/ TOTAL PERMIT FEES INCORPORATED $240 00 1952 E P X, IRE.; .'PERMIT" ID S .. -- - - -- ,,- - ;/• - PERMIT HAS EXPIRED IN ACCORDANCE WITH U.B.C. -SECtION 1064 4_-<' DATE QSIGNATURE_oCu3 - •'-:--- - .:-t4 ., - S. .5 5S .5 - a .5 - --- -- ---------------------'-------- rr-r-- - - ---- - - -- '----<- -'i- -.,.--- -.,...----.-,. .-'-.--.- FOR, OFFICE USE ONLY PEF1IA1T APPLICATION PLAN CHECK NO 2.— 71 CITY' OF CARLSBAiD BUILDING DEPARtMENT I 1635 Faraday Ave., Carlsbad,,CA 92008 ,r Plan,Ck Deposit " Validated By_________________________ Date__________________________________ 1 'JECT INFORMATION Addr ss include ldg/Su e #) Business Name (at this address) Legal Description C. Lot No. . Subdivision ame/Number .. - Unit No. Phase No; Tota14-of units Ass es,r Parcel - (/o rqE tiin9L Proposed Use - Description-of Work . SO; #of Stories ' , #of Bedrooms 7#-6f Baipirtoorns 'Narne * '' Address -. City State Z p Telephone e Fax # ®r ZZOkjr jt56_r'.[ jv,, net fl AJor Owe r Addre%s '' City Stat- Zip Telephone S r475 j!QPRILOWNER Pr"1 1LC I,i't 447L Name - - Address - city state 'Zip Telephone S TrL Z iSec. 7031 .5Businessand ProfessionsCode: 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 Code] or that he is exempt therefrom and the basis for the alleged exemption. Any-.violatio i of Section 7031.5 by any applicant lQr 'perm4 su jeäts-the.a plicant,tO a civil penalty of not more thanfive hundeddol(arsl$5QQJ). * i 7 ø& 1 OJ5 c'n- c s 12 ?S1 qy- Name - - " Address -. City - , State/Zip Telep ne # State License # 1 7 License Class City Business License # cej c\ / CDesignert Name;;, 'C '' ' C-.' - Address -, iS --- City .. jo[State/Zi Telephone State License RMI&WIRK i — Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations 04 have and will maintain a certificate of consent to1 slf insure for workers compensation as provided by Section 3700 of the Labor-Code; abor Code for the performance.. lof the work for which this permit is issued.I I have and will maintain workers compensation as required by Section 3700 of the Labor Code for the prformance of the work for which this permit is issued My worker s compensation insurance carrier and policy, number are 1 1 Insurance Company ,:".f14'7'1Y2 tAlsO Policy No jg Expiration Date_________________ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$ 1001 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 subject to the Workers Compensation Laws of California WARNING Failure to secure workers ,compens ion overage is unlawful and shall subject an employer to criminal penalties and"civil fines up to one hundred thousand dollars ($100 O0O) in ,add to th os f compensation damages as provided for in Section 3706 of the Labor code interest and attorney s fees ..-'.- . DATE - r!OwaER BUILDER'bECLA RAT IO... - 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 rroi 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'improve5 thereonC and who des' such work himself or through his own employees provided that such improve e mnts 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 contrctor(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 materials for construction of the proposed property improvement 0 YES;'DNO 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 number /,contractors license number( 4 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 number /,,contractors, license number):. __- _______- _____-_:_--_I ..............._____- _._______'. 5 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 E TT 01 * - Is the applicant or future building occupant required to submit a business plan scot lj hazardous materials registration form or risk man e t and pr v Ct 01 program under Sections 25505 25533 or 25534 of the Presley Tanner Hazardous Substance Account Act? 0 YES 0 NO Is the applicant or future rr building occupant required to obtain a perut 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 si-te?..: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.. •- - - - 0 18_CONSTRUCTION_LENDINGfAGENCY - — ... -' j ' Cl hereby affirm .that there is,a constructin P_d.t agenOy for,the rf urmarice ofthe wOrk for abich th CSrrnf 0 iosued (SCb. 3097(1)7;l5d0' - - C - -- - - .__ 'LENPER'S NAME - 'LENEP' S ADDRESS [9_ APPLICT_CERTIFICI(Q 7* - I certify that I have read the application and state that'the above information is collect and that the information on the1plans is accurate I agree to comply with all City 'ordinance's andtState laws relating'-to building constiuction. I' herebyauthorize 'rep resentitives of the Cit,- Of Carlsbad to enter upor 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 5'07 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 180 days from the e of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commence for a period of 1 y~io6.4.406ffoirrm Building Code) APPLICANTS SIGNATURE DATE,.. WHITE: File YELLOW: Applicant PINK: Finance -- _.. - :- - - - --------- - ._ '.-' - -; - - -- C-- . -- .- City of Carlsbad 1635 Faraday Av Carlsbad, CA' 92008 -' 07/24/2001 Electrical Permit Permit No CB012486 Building lnspection-Rqquest Line (760) 602-2725 ' ,- Job Address: 2601 JEFFERSON ST CBAD St:TP - Permit Type: - , ELK ',. - - Status: ISSUED Parcel No: ' 1551704100" , Lot #: 0 Applied: 07/24/2001 -Entered By: MDP - - Reference #:-. - - , Plan Approved:. 07/24/2001 Issued 07/24/2001 Project Title:-.' CITY STORM DRAIN PROJECT . inspect Area: TEMP POWER POLE ' Applicant ' TEMP POWER SYSTEMS 'HFLP/LAGUNA TERRACEL L C p-i. • ((__ 750 N. CITRACADO PKWY. /14001ARIMER ST-#300 'N . ESCONDIDO CA 92025 .' 7 OENVE9O8ó202' /7 .• ' 760439-1999 Total Fees: • $20.00 - TotalPaymenthTo'Date: \$'O.00 'BaIaháeDue: $20.00 .-- -- / - ___ \ V/ ' Electric Issue Fee, I ' $-10.00 ,- Single Phase per AMP 0 •,.,. -- r$0.'0p1 •. ' ThreePhaseperAMP. - 0 .r$OoO) Three Phase 480 Per AMP 0 "fro 0 1 Remodel/Alteration per AMP 0 $000 Remodel Fee Temporary Service Fee $1000 Test Meter Fee .00 Other Electrical Fes $0.00 , / Additional Fees ' - ' . $0.00 INCORP RATED TOTAL PERMIT FEES 1952 20.00, -- .. . ...-. '- * PERMIT APPLICATION. '., .. . . . iTYOF CARLSBAb BUILDING DEPARTMENT 1635 'Faraday Ave.,. Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO.___________ EST. VAL. Plan Ck. Deposit Validated By___________________________ Date . Address (include Bldg/Suite #) . - - 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 Use DJ(oWork _ç SQ. Stones 4, # of Bedrooms # of Bathrooms 2 CONTACT PERSON (if different from applicant) Name . ' - Address City '. State/Zip Telephone # Fax # APPLICANT Contractor gant forContractor 0 Owner. 0 Agent for Owr..: fcQ.Y S 440U1L. 2' . -54AA'FM V4E AVW ) .C?gp84 07 to 0 . ,q'j IT Name . . Address . . City State/Zip Telephone # 4 PROPERTY.OWNER .'•' .: . ... . : : A. Name Address . City State/Zip' Telephone # 6.,. .CONTRACTOR COMPANY NAME . ' ..................................... .. .• :' ' , - . ................................. ISec. 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 Code) or that he is exempt therefrom, and the basis for the alleged axe ption Any lation 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)). 1tL.4j L c19Ls $j4Q ç. ,5'4p.(f FE. kV . Iisi L .. g OL( £/gq .1 'Name . . . Address . . . City * State/Zip Telephone # State Licenie# i83'i'33 . License Class C.. (0 . City Business License I/ 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: 0 I have and will maintaiR artificate of'consent'to 'self-insurefor workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work Ior which this permit 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 and policy number are: Insurance Company ' 'ZJ t) Policy No. b Expiration Date 10 01 0 1 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) 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 subje the Workers Compensation Laws of California, WARNING: Fa ure o ec re rke'rs' 'compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand doll ($1 , n dditlon ~hest of compensation, damages as provided for In Section 3706 of he .l. or àode, interest and attorney's fees.. SIGNATURE - . . 'DATE,I,J ( '7 OVNERBUILDE EC RATION I heieby affirm that I exempt from the Contractor's License Law for the following reason: 0 I, as owner of t roperty or my employees with wages as their sole compensation, will do the vork and the structure is not intended or offered for sale (Sec. 7044, Business a Professions Coda: The Contractor's License Law does not apply toan 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 haie 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 Law doel notapply to an'owne'r 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 Prof asslons Code for this reason 1 I personally plan to provide the major, labor"and materials for construction of the proposed property improvement 0 YES ONO 2 I (have / have not signed an application for a building permit for the proposed work 3 I have contractedwith the following person (firm) to provide the proposed construction (include name / address / phone number I contractors license number) ..tt .- . .. . 4. 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 number I contractors license number): 5 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 1COMLETETHISSECTION FOR NONRESIDENTIAL BUILDI(G -09 ItS O,NLY. L. 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 tobe 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. 18 " ONSTRUCTION LENDING 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 LENDERS 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 Citi of Carlsbad to enter upon the above mentioned property 'for.inspectiór'puiposes. 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 requird for excavations over 5'0 deep and demolition or construction of structures over 3 stories in height., EXPIRATION: Every permitC otco 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 enced thin 180 days from the date of such permit or if the building or work authorized b such permit is suspended or abandoned at any time after the work is f eriod 01,180 days (Section 106.4.4 Uniform Building Code) .-APPLICANT'S SIGNATURE '_. ____.' DATE -- WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For: 10/17/2001 Permit# CB012486 0 Inspector Assignment: PY Title: CITY STORM DRAIN PROJECT . . Description:TEMP POWER POLE S 0• .• Type:ELEC Sub Type:, 'Phone: 7607998703 Job Address: 2601, JEFFERSON ST . . . . Suite: TP Lot - .0 . . ••• . Location . . - . -. Inspector: OWNER. HFLP/LAGUNA TERRACE L L C Owner: HFLP/LAGUNA TERRACE L L C .. . - Remarks: . • 0 .0 ' Total Time: .. . . Requested By: GARY . Entered By: ROBIN CD Description • Act Comments - • • S 32 Const. Service/Agricultural p4? • (f7 ) S • Associated PCRs • • 0 • Inspection History - Date Description • . Act lnsp Comments 0 0 • 08/03/2001 39 Final Electrical. • CO PY • REPLACE BREAKER CANNOT READ AMPERAGE • • ;• 0 0 • I•.• • 0 • S S CtL471 B U I L D I N G P E R MI T.. Permit No: CB940!894 07/2.5`/94-0926 S Project No: A9401263 Page 1of 1 Development No: Job Address:. 2601 JEFFERSON ST Suite: Permit Type: PLUMBING V/'7895 02 07/25/94 0001 01 Parcel No 155-170-41-00 Lot# Ik -. C-PKMT 34-00 Valuation: 0 '.5.. - Corstruction. Type: NEW I3yi Occupancy Group: .Reference#:. ...' Status: -PE Description: 2 BACKFLOW;PREV. JEFF TOWNHSE Applied: 07/25494 Apr/Issue: Entered By: DC Appl/Ownr : PALOMAR WATER HEATER 619 7715080 .5 1800 WEST MISSION ROAD 'ESCONDIDO,. CA92025 T 1 . S *** Fees Required 4Fees G o 11,ected & Credits ----------------- Fees: 34 .00 0' .•• Adjustments 00 Tota'J,rthts \ 00 Total Fees: 34b.O . Tot? Pay \ :oo H •. .. - aianc'e \ 34.00 Fee description Und s e &U Ext fee Each Vacuum .Breakeri., PLUMBING TOTAL 34.00 INCORPORATED 1952 - FCLEARA 4ALJAPPROVAL LDATE7 'CE - ' CITY OF CARLSBAD . 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Patoms Dr., CarLsbad, CA 92009 (619) 438-1161 I. PERMIT 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: . PLAN CHECK NO. EST. VAL - PLAN CK DEPOSIT .3 VALID. BY DATE Net Loss/Gain of Dwelling Units 2. PRCIJECUINFOEMA11ON FOR OFFICE USE ONLY L!EJ—' Z 0/ fif ,q 50uu1g or Suite No. Nearest Cross Street LEGAL DESCRIPTION Lot No. Subdivision Name/Number Unit No. Phase No. CHECK BELOW IF SUBMIITED: - 02 Energy Calcs 02 Structural Calcs 02 Soils Report DI Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE rDESCRIPTION-OF WORK--) 84 e K FL (9 W Tio,"s (z) SQ. FT. # OF STORIES # OF BEDROOMS # OF BATHROOMS J. WN IAGI PEI{FON (II different from applicant) NAME (last, name first) ADDRESS CITY STATE ZIP CODE DAY TELEPHONE 4. APPUGANT U CONTRAcIUR Li AGENT FOR CONTRACIUR U OWNER U AGENT FOR OWNER NAME (last name first) ADDRESS CITY STATE ZIP CODE DAY TELEPHONE (IÔiERTY OWNER NAME (lstnamê first) -..T6M, I#. 1 /3 00 5Oi4 E#70 V9/(y /?041) CITY S4,41 j'Z6 O STATE 64 ZIP CODE DAY TELEPHONE 115 - 21 o UK name first)1Pñ10,4f,9I iTE/' TFXDRTt CITY ES COA'DZIOO STATE eR ZIP CODE ?. 0 DAY TELEPHONE 9 r - co ffO STATE UC. # 3/30 LICENSE CLASS C- 3 6 CITY BUSINESS LIC. # DESIGNER NAME (last name first) ADDRESS STATE ZIP CODE DAY TELEPHONE STATE LIC. # workers' compensation Declaration: i nereoy affirm mat i nave a certiricate or consent to sell-insure issued ny me Director or Industrial Relations, or a certificate-6f 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, Lob. C). / /'I 7E ,%v7 POUCY NO. Z,93/16MIRATION DATE so as to become subject to the Workers' Compensation Laws of California. SIGNATURE DATE 8. OWNER-BUILDER DECLARATION Owner-k3uilder Declaration: I hereby affirm that I am exempt from the Contractors License Law for the following reason: 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 I am exempt under Section Business and Professions Code for this reason: (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$5001). SIGNATURE DATE COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY: Isihé 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 0 N Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? DYES 0 N IF ANY OF ThE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCXUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVIC S AND THE AIR POLLUTION CONTROL DIS11UCf. 9. WNSTI{UCI1ON 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 ID. APPLK..AN CEI[IIFICATION I certily 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 CI1Y OF CA1USBAD AGAINST All ]LIABILITIES, JUDGMENTS COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF TIllS 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 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 ç any ti after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code). PPUCANTSSIGNATURE f/ ../ P DATE: PINK: Finance 4' "I, - CITY OF CARLSBAD—BUILDING DEPARTMENT S - 5 APPLICATION & PERMIT USE,BALL POINT PEN ONLY. 1200 ELM AVENUE ,(714) 438-5525 NO. ',. ' -- - - JOB ADDRESS " AV. ST. IIOII 13c1n14R1S101t-J1 1Srr, -I I -. DATE OF APPLICATION BUS. LICENSE PERMIT NUMBER - - OWNER . -. OWNER'S PHONE f-. IME CONT,IAcTÔR • STATE LICENSE OWN R 5 MAILING ADDRESS NTRAcTOR S ADDRESS LOT BLOCK SUBDIVISION -. ASSESSOR'S PARCEL NO. bES16NER I DESCRIPTION OF WORK e. ro..o. .s s r-€.. S r1 <e..r SyS1€A'v DESIGNER'S ADDRESS (f - CONTRACTOR'S - Not Valid UnleEs Machine CertifIed STTE LICENSE DESIGNER'S PHONE CENSUS TRACT GP LAND USE ' ZONING - - RES. UNITS . PARKINjSPACE NUMBER OF STORIES BLDG SQ. FT. BLDG USE DCC. GP STANDARD PLAN # PLAN I DE I TYPE CONST 0CC. LOAD MECHANICAL PERMIT AMT. INSTALLFURN.DUCTSUP TO100,000BTU OVER 100_000BTU BOILER/COMPRESSORUPT03HP. BOILER/COMPRESSOR 315HIP BOILER/COMPRESSOR 16-30-HP VENTFANSIPiGLEDUCT MECHEXHAUST- —HOOD/DUCTS aTY, PLUMBING PERMIT AMT, QTY, EACHFIXTURETRAP . - EACHBUILDINGSEWER - - EACH WATER HEATER AND/OR VENT - - — EACH GAS SYSTEM 1 TO 4 OUTLETS EACH GA SYSTEM5 ORMORE . EACHINSTAL., ALTER, REPAIR WATERPIPE - - EACHLAWNSPRINKLERSYSTEM WATER SOFTNER .. RELOCATION OFEAFURNACE/HEATER _' ' BUILDING PERMIT -_'./G - SIGN PERMIT TOTAL PLUMBING I CONTRACTOR . . '' TOTAL MECHANICAL CONTRACTOR ' . , _- PLAN CHECK ALL INCLUSIVE PERMIT . UTY ELECTRICAL PERMIT AMT QTY MOBILE HOME PERMIT AMT TOTAL PLUMBING ELECTRICAL - NEW CONST EA AMP/SWT /BKR . - AWNING - MECHANICAL -' ' 1PH15 _3PH . - PORCH .'MOBILE HOME EXIST BLDG EAAMP/SWT/BKR__. SET-UP .... ' SOLAR 1PH _25 _3PH . RAMADA, CABANA S__ I - REMODEL/ALTER PER CIRCUIT . - FENCE OVER 6' _ - TEMPPOLE200AMPS --- . - TOTAL MOBILE HOME ... .1 MICO-F I'IM - OVER 200 AMPS - TEMP OCCUPANCY (30DAYS) irX.'OO I. TOTALELECTRICAL . - .,\ TOTAL FEES PAYABLE CONTRACTOR -. I HAVE CAREFULLY EXAMINED THE COMPLETED 'APPLICATION AND PERMIT, AND DO HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I,ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM- LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE ',- 'AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OV 5-0" DEEP AND DEMOLITION OR CONSTRUCTION OF STRUCTURES OVER 3 STORIES IN HEIGHT - - . - - . - -A ANTATURE _________0 00NTRACTO:J _'ø7I LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provi- sions of Chapter 9 (Commencing with Section 7000) of Divisiàn 3 of the Business and Profes- sions Code, and my license is in full force and ef- fect. . OWNER-BUILDER DECLARATION Dl hereby affirm that I am exempt from the Con- tractor's License Law for the following reason (Sec. 7031 .5Business and Professions Code), Any city or county which requiresa permit to con- struct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to fife a signed state- ment that he is licensed pursuant to the provi- sions of the Contractor's License Law (Chapter 9 commencing with Section 7000 of Division 3 of the Business and Professions Code) or that is ex- empt therefrom and the basis for the alleged ex- emption. Any violation of Section 7031.5 by an ap- plicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Dl, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or of- fered for sale (Sec. 7044, Business and Profes- sions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or of- fered for sale. If however, the building or improve- ment Is 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). Dl, as owner of the property, am exclusively con- tracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not ap- ply to an owner of property .ho builds or im- proves thereon, and who contracts for such pro- jects with a contractor(s) license pursuant to the Contractor's License Law). I am exempt under Sec._, B. & P.C. for this reason_________________________________ Dale _____________ Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of con- sent 10 self-insure, or a certificate of Workers' Compensation Insuran , or a certified copy thereof (Sec. 3800, Lab Qode). POLICY NO._________________________ COMPANY []Copy is tiled with the 4ty. OCertified copy is herebt furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the per- mit is for one hundred dollars ($100) or less). I certify that in the performance of the work for which lhi. permit is issued, I shall not employ any nt person iny manner so as to become subject to the Workers' Compensation Laws of California. NOTICE TO APPLICANT: If, after making this Cer- tificate ojxemption, you should become subject to the Wkers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION. LENDING AGENCY I hereby affirm that there is a Construction len- ding agency for the performance of the work for which this permit is issued (Sec. 3097, Civil Code). APPLICANT TO FILL IN INFOR- MATION WITHIN RED-LINES. fo I t r - -7o EcEWED EN INE. OCT 2 31980 Fire Protection Company pV SUITE 1 • SAN DIEGO, CALIFORNIA 92126 • (714) 578-0880 - (714),484-0522 n CAtLD •- - 1111 Building Depa rtmet LIC.#351498 CT'( OF CARLSbAU - APPOV TO CAR iZb \•Jolt ATTENTION -. DATE R f--UJ Vcl D CONTRACT OCT22 8O of 0 CITY OF cARLSBAD -. /a, L. A CA FIRE DEPAR TMENT MAILED _____ .- • • • •• BY HAND •. • - CONTRACT NO. ENCLOSURES ARE FOR ACTION INDICATED BY - - - -- NO - - z OF 0 • DESCRIPTION 9 _z COPIES •- 0 - .0 > > 0 000