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HomeMy WebLinkAbout2630 EL CAMINO REAL; MULTI-PERMIT FILE; CB090170; Permit\ : ( City of Carlsbad 1635 Faraday AV Carlsbad, CA 92008 02-02-2009 - Electrical Fermlt ,. Permit No CB090170 Building inspection Requet Line (760) 602-2725 ' '' .• ...-. .- 'iob Address 2630 EL CAMINO REAL CBAD Permit Type ELEC " 1" '- i '' Status ISSUED Parcel No 1670306100 Lot # 0 Applied 02/02/2009 1 Entered By LSM c Reference# ' Plan Approved 02/02/2009 PC #: Issued 02/02/2009 " ,Project Title: . FAMILY DENTAL- ELECT FOR Inspect Area: .' •; ., .'". • '.' ir MONUMENT SIGN UNDER6 . . . Applicant ------- 'SIGNS ON TIME SHINE ON PARK LANELLC: . . . .: 5670 EL CAMINO REAL . 4401MANCHESTER AVE #2061 .• • • . CARLSBAD CA 92008 1ASCA 92024 760 431 1050 ç)/7 ENCINIT j . . Electric Issue Fee / * S- (U ) ,- $10.00 • . Single Phase per AMP $0.00 Three Phase per AMP / / 0 $0.00 - - ,:Three Phase 480 Per AMP / 0 P v \JN ' \ $0.00 '. . i- Remodel/Alteration per AMP I 0 . $0.00 . 'V [•'-< Remodel Fee / \ si000 Temporary Service Fee Test Me-ter Fee Other Electrical Fees Additional Fees J ( c! ,TOTAL PERMIT FEES , 'J,1J/ $2000 Total Fees: $20.00 Total Payments To Date: 'c4 $20.00 Balance Due: / - $0.00 ... .. ,•/ . ,• : - Inspector: -( NOTICE: Please take NOTICE that approval of referred to as "fees/exactions. You have 90 da follow the protest procedures set forth in Goverr processing in accordance with Carlsbad Municil - review, set aside, void, or annul their imposition You are hereby FURTHER NOTIFIED that your changes, nor planning, zoning, grading or other fees/exactions of which you have previously be 1952 FINAL APPROVAL •:* • --: Date: 7_ __ Clearance: . ..'•• ii project includes the imposition" of fees; dedications, reservations, or other exactions hereafter collectively - om the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must . nt Code Section 66020(a) and file the protest and any other required nformation with the City Manager for , * ode Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack •'- • - __':',4................. • •44' • * _- . ,_4•., 4 it to protest the specified fees/exactions DOES NOT APPLY to water. - and sewer connection fees and capacity . ,- ilar application processing or service fees in'Oonnèction with this project. NOR DOES IT APPLY to any 4* iven a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. •' *r. 4 44•••*1 4 -.4 3,;_ 1 4 .. -, 4 , ••,.4 '55 - ,' - -., , . ' '• .,_;• .. _.• City of Carlsbad Plan Check No oêO)O 1635 Faraday Ave Carlsbad CA 92008 760602277/2718/2719 Est Value Fax 7'666,02-8558 8558 Plan Ck Deposit Building Permit Application ' Date JOB ADDRESS . . • . . SUITE#/SPACE#/UNIT# . APN .......... . '• _CT/PROJECT # • LOT # . PHASE # . # OF UNITS # BEDROOMS 0. BATHROOMS . TENANT BUSINESS ME. CONSTR:TYPE 0CC: GROUP DESCRIPTION OF WORK Include Square Feet ofAJected Area (J ig tI(,,.,,L{, pJl ?2LAk —VJ,0, UA,cM CL Y r( UU EXISTING USE 'h PROPOSED USE . .. GARAGE(SF) SPATIOS (SF) DEC (SF) .' FIREPLACE : - AIR CONDITIONING .FIRE SPRINKLERS YES 0 #_ NOD YES 0 NOD YES 0 NOD CONTACT NAME (if Different Fom Applicant) - APLICA, NAME .0 t-\ 4._- ADDRESS ADDRESS ,CITY - a.'. - .:.- STATE ZIP- . . CI •. . . STATE . .-ZIP - -. __________ CA PHONE FAX PHONE FAX EMAIL...............: . •EMAIL . -: . . •.. . . + € c PROPERTY OWNER NAME.. -- •- •• --• ..;. - CONTRACTOR BUS. NAME' i. .......... ADDRESS P ADDRESS CITY STATE ZIP CITY .,' ., STATE' ZIP PHONE FAX PHONE FAX EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS . - •. •, . - STATE C. # STATE UC.# ,; . . . CLASS . CITY BUS. UC.# C r' cAc t-t 7Z (sec. 1031 5 Business and Proleaxions Code Any City or County which 'requires a permit to conntriuct,'alIer improve demolish or repair any slrnceure pnar to its issuance also requires the applicant for such ponntil to file a signed statement that he is licensed _pursuant to the previsions of the Contractor's License Law (Chapter 9, commendingwish-Section 1000 of Division 3ef the Business and Professions Code) on (hal he is exempt therehom,.indelre.baaia for the alleged exemption;Any violation of Section 1031.5 by any applics I (or a permit subjects the app!icant to a civil penalty of not more than five hundred dollars ($500}). : Workers Compensation Declaration I hereby affirm under penalty of pequry 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 pernnrll is issued have and will maintain workers compensation as required by Section 3700 of Ihe Labor Code for the performance of the work for which Ihis pe it is issued My workers compensation insurance garner and policy number are Insurance Co SU_'oA4_&_ Policy No - — 3' Expiration Date This section need not be completed if the permit is for one hundred dollars ($100) or less (1 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 sublect 10 the Workers Compensation Laws of California WARNING Failure to secure workers co pensatlon coverage Is unlawful and shall subject an employer to criminal penalties and civil ftnes up toI'll one hundred thousand dollars (&100 000) In onto the cost of compensation, damages s' o e in 06 of the code interest and attorneys fees DATE - 1 I hereby affimr that! ant exempt from Contractors License Law for the following reason 0 I as owner of the property or my employees with wages as their soI'e ns compeation will do the work and the slruclure is not intended or offered for sale (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 men provided that such improvements are not intended or offered for sale If however the building or improvement is sold within one year ot completion the owner builder will have the burdeol proving that he did not build or improve for the purpose of sale) o I as owner of the property, am exclusively contracting with licensed contractors to construct the 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 Prolessions Code for this reason I personally plan to provide tire major labor and matenats for construction of the proposed property Improvement 0 Yes 0N6', 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 I contractors license number 4. 1 p Ian to provide portions of the work,~ but i have hiied th-e following person to coordinate, -supervise and provide them aj6r work (include name/ address phone i contractors; ice'rise, number): 5A will provide some of the work but I have contracted (hired) the following persons to provide the work indicated (include name address /phone! type of work) Y .PROPERTY OWNER SIGNATURE DATE (M 1tH3 JiCUf2 WfCJ,('L7- Is the applicarl or future- building occupant required to submit oüiiiesslariacully hazardous form b'risk mjement and ev'rrtion program under ctions 25505 25u33 or 25534 of the Presley Tanner Hazardous Substance Account Ad? 0 Yes 0 No 0 Is the applicanl or future building occupant required to obtain a permit from the air pollution control distnct or air quality management dislncl? Yes 0 -O ,N, Is the facility lobe consfrvcted 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 MAYNOT BE ISSUED UNLESS THE APPLICANT HAS MET OR lSTMEETlNGTHE REQUIREMENTS.OFTHE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT - - . •, - - - - - ti hereb1 ah rrr that there is a construction lending agency for the performance of the ork this permit in issued I Sec 3097 Civil Code) - • LendereNama - • - -. 0 • -. ••• - .Lender's Address . • \- . - _ nO : - - - - I ceetsfythat I hau road the applIcation and state above information is coneaiid thatthe information on the plans is accurate I agree to ccmplywfth all Cftyprdlnahces and State laws imtatingw buildingconstnjctlon. I hereby authonze represerltatwe of the City of Carlsbad to enter upon the above mentioned property for rispectron purpciès I 'AL LSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS ThE CITY OF CARLSBAD AGAINST ALL LIABILII1ES JUDGMENTS COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CflY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT 'OSHA. An OSHA pertnf s for required excavations over 50 cop and demolitr or ocnuoton nst of stiuctures over3stories ax ht he EXPIRATION Every permit issued by the Buildoig Offlc erthe tins Code shall expxm by Irmitaten and beosme nut and void if the building or work authortzed by sudt permits not wnmenced within,., 180daysfr0mthedateof5uchpertrnt6rdtheb or sudipe ts Suspended or abandoned at any time after the work scommenoedf raperof180days(SectIan 10644UnifotmBuitdangCode) ,.APPLICANT S SIG DATE2 4 . F -F 4 - .BUI LD IN G-PFE R M.I T , PrmitNà: CB921011 09/124/9a. 15:30 , •-;.• Project No: A9200277 Pge 1 of 1. . - Deveiopmeht No: - F •F.. F - Job Address: 2630 EL CAMINO REAL "Suite: - . Permit Type ELECTRICAL 14 444 09/24/92 0001 01 02 Parcel No - Lot# , CFRMT 35 30 .Valuation': - .. .0 I - Construction ;Type: NEW .. .,. . Occupancy Group: •. - Reference#: -. Status:. ISSUED-' Description TEST METER PER CAMERO Applied F F CB91-395 F F •F Apr/Issue: 09,24/92. Validated By DC Appl/Ownr NINTEMAN CONSTRUCTION 619-'490-6800 F 4375JUTLAND- DRIVE - SAN DIEGO CA 921 Fes Required 4 1ctd: &C editsF *** - --------Fete -- ------------ -- Adjustments: • / 0.0• . - .00 Total--Fees: 'F ., . Tl*:\. .00 F. Ba1an ..,.'f.:: e: • . .35'.0O ion 't Ext -fee A,'Data - 25 .'00 Y * ELECTRICAL TOTAL 10.00 Y. 35. 00 - . -fh\ INCORPORATED, •F .• F(••_ F .- F._ F - - 1952 $ oI©c F1 APPROVAL IN 4 CL CE ;•F•. CITY OF CARLSBAD 2075 Las Palmas Dr Carlsbad CA 92009 (619) 438-1161 - • ..• •• F F• F . - • F 4 ' 'F • . ,5 F - SF F • F - - - . -- F F ', -- • F -. • - _• • PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 1. PERMIT TYPE A - U Commercial U New Building U Tenant Improvement B - 0 Industrial (]New Building 0 Tenant Improvement C - 0 Residential 0 Apartment 0 Condo 0 Single Family Dwelling 0 Addition/Alteration Duplex 0 Demolition 0 Relocation 0 Mobile Home 0 Electrical 0 Plumbing O Mechanical 0 Pool 0 Spa 0 Retaining Wall 0 Solar 0 Other__________ 2. ng or PLAN CHECK NO. VAL F CE DEPOSff_______________ D. BY FOR OFFICE USE ONLY Cross Street CHECK BELOW IF SUBMIITED: 02 Energy Calcs 02 Structural Calcs 02 Soils Report 0 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DE9IPTION OF WoRK77— 111j yr. 4 Ot)O # OF STORIES (JJN IAUI PEIV,UN (it dillerent from applicant) NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE APPLICANT U CON !RACIUR LI A(ENT FOR CONTRACTOR U OWNER U AGENI FOR OWNER NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE NAME//M4) ,4cs$7T ADDRESS t'rrSAit) L)/fd?' STATE NVIIAZIP CODE DAY TELEPHONE 5'/16-26OC) S. CON1'IAcrOR NAME /Jjji4t) ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE UC. # LICENSE CLASS CITY BUSINESS UC. # DESIGNER NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE UC. # WORKERS' WMPENSA11ON Workers' Compensation Declaration: I hereby atlirm that I have a certificate 01 consent to sell-insure issued by the Director of Industrial Relations, ora certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. Q. INSURANCE COMPANY POLICY NO. EXPIRATION DATE Certificate 01 Exemption: I certiFy that in the performance oF the work For which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. SIGNATURE DATE OWNER-BUILDER DECLARA11ON Owner-Builder Declaration: I hereby aFFirm that I am exempt From the Contractor's License Law For the following reason: 0 I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. 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.). 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). 1 am exempt under Section Business and Professions Code for this reason: (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]). SIGNATURE DATE COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY: Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? DYES 0 N 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 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 CDWI1LOL DIS11UC117. ereby allirm that there is a construction lending agency For the performance of the work For which this permit is issued (Sec 3097(1) Civil Code). LENDER'S NAME LENDER'S ADDRESS 10. APPLICANT CERTIFICATION I certify that I have read the application and state that the above inFormation is correct. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CI17Y OF CARlSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF ThIS PERMIT. OSHA. An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Expiration. Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 365 days from the date of such permit or if the building or work authorized by sucyPermit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code). 9 17Z DATE:_______ • - • - * : -. . . '-, - -1 • *:• .. - - ..-- - - - -- a ---. ,-- g. -B U. I L D I NG'P E RN 'I T 4 Perini t-No CB920511 .,05/22/92 14:27 - . Project •N: -A9201327: Page 1 of 1 * Development No Job Addres: -263p. EL. CAMINO REAL- Str: . Ste: Permit Type ELECTRICAL 4 7773 05/22/92 0001 01 t Parcel No:. : . -C--PRMT 2000 - Valkiation: - - 0 .4 - r Construction Type: NEW .. . - 0ccupancy.Groüp: Reference#: . .4 Status: ISSUED. - Dscription:, 100 AMP TEMP. POWER POLE . - • Applied: 05/22Y92 - . - : • • •. Apr/Issue: 05/22/92 Validated _.By: MDP Ap1/Ownr : TEMP*., UTILITY SERVICES -. 619 ..471-5494 -* * Y. • 11167 LAWSTREET. 4SAN MARCOS. CA' 9206 -- 'Fees Required. e~ do ~ed Cr ------ 0.0 \Adjustménts:i •-: % -;~, - Pia '00 Balan e' 20 00 E ECTR I ICAL -UY I ". . L TOTAL 20_00' - i INCORPORATED 1952* / • -. • . 14 : 8-• 'F'' F - • - "• - '4 - F V • *4 4• 'I -. . - , 4 .- F -'F *' F, 'F 'F ----F .•* - .•, .. _'.;' -F - .: :. -• • - - '-, - CITY OF CARLSBAD 2075 Las Palmas Dr Carlsbad, CA 92009 (619) 4-38-1161 • - ' • ., - * ' EST. VAL . G-)- PLAN CE DEPOSIT_____________________________ VALID. BY /tt DATE FOR OFFICE USE ONLY PERMIT APPLICATION S City of Carlsbad Butlding.Department 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 4 1. PERMIT TYPE A - []COMMERCIAL pHEW -]TENANT IMPROVEMENT B - 0 INDUSTRIAL DNEW DTEWANT IMPROVEMENT - 0 RESIDENTIAL DAPARTMENT DCONDO DSINGLE FAMILY DWELLING D ADD ITION/ALTERATION - El DUPLEX DDEMOLIT.ION,' DRELOCATION DMOBILE HOME XLECTRICAL OPLUMBING' DMECHANICAL OpOOL DSPA DRETAINING WALL DSOLAR DOTHER - 2. PROJECT INFORMATION -' PLAN'CHECK No. Address 7-'é3 0 / Building or Suite - Nearest Cross Streets LEGAL DESCRIPTION Lot No. ' 5ubdlvisiorf Name/Number . Unit No. Phase No. CHECK BELII4 IF SIJBNITTED: . - 02 Energy Calcs .02 Structural Calcs 02 Soils Report l Addressed'Envelope * ASSESSORS PARCEL EXISTING USE PROPOSED-USE DESCRIPTION OF WORK 0 /-e RIOG SO, FTC, H OF STORIES 3. CONTACT PERSON' NAME J,// .Se.o tt /V7 . S ADDRESS /44_'C STATE 'ZIP CODE '91"Z 0 DAY TELEPHONE CITY 5a.iy..._ SIGNATURE -4-. APPLICANT 'A A C NTRACTOR NAME jC4tLiLY4 DAGENT FOR CONTRACTOR UOWNER 'DAGENT. FOR OWNER ADDRESS 17 Lc 3+-.• CITY,". 010(5 y'! aS STATE (2Ot ZIP CODE '7 ' '- DAY TELEPHONE 5.., PROPT.RTY. OWNER NAME OWNER SEE ADDRESS 1/ 375•1 j.D,ES54 b7AWT3 CITY 7::, i ._(43/O STATE . ZIP CODE '1 -2_//-:7 - DAY TELEPHONE 6 COURACTOR NAME Dora-V'14 // ti ty-"s AAA s (p 7 I - CITY / _5 STATE ZIP CODE '7,... 0 7 DAY TELEPHONE ,7' / - 4" 4'. • H_,5".35 LICENSE CLASS -._. CITY BUSINESS LIC. 'ST)TJ LIC. - - - " i 1 .- .4' , x} - SIGNATURE: 74t%L4Z'(' 3 . TITLEt1//. DATE 57 DESIGNER NAME . , ADDR SS f. -- CITY STATE ZIP CODE DAY TELEPHONE - STATE LIC. H 7: WORKERS' COMPENSATION . . 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 Bui (ding Inspection Department (Section 3800,,Lab. C). ' •. S. INSURANCE COMPANY :F POLICY 110.3QT2_5T EXPIRATION DATE Certificate of Exemption:.. I certify that in the performance of the work-for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California. S • S SIGNATURE •. - DATE, - 8. OWNER-BUILDER DECLARATION . .. . . Owner-.Builder Declaration: I hereby affirm that I am exempt from the Contractor's, License Law for the following reason: o I as wner of the property or my empl'yeeswith wages as their sole compensation, wilt do the work and the strukture is not intended or offered for sale (Sec. 7044, Business and Professions Cede: 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 hisTown 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-bui(der will have the burden of proving that he did not build or improve for the purpose of sale.). . 0 I, as owner of thi property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Cede: The Contractor's License law does not apply to an owner of property who builds or in,roves thereon, and contracts for such projects with contractor(s) liensed pursuant to the Contractor's License Law). -, . . . •5 .5 0 I am exempt under Section, - ', Business and Professions Code for this reason: , S - •. (Sec.7031.5,Business and Professions Code: Any City br County which requires a permit to construct, alter,, improve, demolish, or repair any structure, prior to its issuance, a(sorequires the applicant for such permit to file a signed statethent ,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 S ' S - - DATE COMPLETE THIS SECTION FOR 'NDN-RESIOEWTIAL BUILDING PERMITS ONLY: , . S -, - • - . 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? S ' 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 Dwo - . S , - .. , - '• Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?. DYES UNO - - 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.* 9.. 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 ''-'•. , - '' - . - . * - 10.- APPLICANT'S SIGNATURE-` - ' I certify that I have read the application and state that the above information is correct. I agree-to comply with all -City ordinances and State laws relating - to building construction. I hereby authorize representatives of the Ciy of Carlsbad to enter uponthe above mentioned property.for.inspection purposes. I'ALSO AGREE TO SAVE INDEMNIFY AND KEEPjHARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAT IN'ANY WAY ACCRUE AGAINST SAID ,CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. Expiration Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit- i"not coménced 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 303(d) Uniform Building Code) 00 APPLICANT'S [:)BY PHONE DATE': - - - ' - - -- .W HITE: File.YELLOW:'Applicant PINK: Finance '' CITY OF.CARLSBAD S . 5 INSPECTION REQUEST PERNiT# CB920511 . FOR 05/28/92 INSPECTOR AREA MP DESCRIPTION; 100 AMP ,TEMP. POWER POLE PLNCK# CB9.20511 0CC GRP' TYPE,: ELEC . ..• . CONSTR. TYPE NEW, JOB ADDRESS: 2630 EL CAMINO REAL STR: ',FL: STE:. APPLICANT: TEMP. UTILITY SERVICES. S. PHONE: 619'471-5494 CONTRACTOR: S • • S PHONE: S OWNER: : - I - PHONE: (4 S REMARKS: NH/CONNI,E/471-5494 INSPECTOR S SPECIAL INSTRUCT TOTAL TIME:' _____ , S S •, 5 S - S S CD LVL DESCRIPTION S •SS j ACT COMMENTS 32 EL Const Service/Agricultural S ... 5 S INSPECTION HISTORY DATE DESCRIPTION ACT INSP COMMENTS