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Home My WebLink About2647 GATEWAY RD; 101; CB100949; Permit05-27-2010 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Sign Permit Permit No: CB100949 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: PC#: Project Title: Applicant: ULTRAS IGNS 5458 COMPLEX SUITE 401 SD 92123 858-569-6716 2647 GATEWAY RD CBAD SIGN 2131912500 Lot#: $5,000.00 Construction Type:5A PERFECTLY AT HOME 2 ILLUMINATED WALL SIGNS AND 1 NON ILLUMUNATED Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: Owner: LNR CPI BRESSI RETAIL L L C C/O LNR PROPERTY CORP 4350 VON KARMAN AVE #200 NEWPORT BEACH CA 92660 ISSUED 05/27/2010 MDP 05/27/2010 05/27/2010 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Electrical Fee Renewal Fee Add'l Renewal Fee Other Building Fee Additional Fees $72.31 $0.00 $47.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $119.31 Total Fees:$119.31 Total Payments To Date:$119.31 Balance Due:$0.00 ^STORAGE ATTACHED FINAL APPROVAL Inspector NOTICE: Please take NOTICij/that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as lees/exactions." Yoi' 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 capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired, xif CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717/2718/2719 Fax 760-602-8558 www.carlsbadca.gov Plan Check No. Est.Value Plan Ck. Deposit DESCRIPTION OF WORK: Include Square Feet of AIR CONDITIONING YES | | NO FIRE SPRINKLERS YES| | N0 CONTACT NAME (If Different Fom Applicant) mtpg^tqH'3ADDRESS ^__ V (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 theapplicant 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 theBusiness 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 acivil penalty of not more than five hundred dollars {$500}). WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:i—i 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 workers^compensation|a^eguired bwSection 3700 of the Labor Code, for the performance of the work forwhjch this permit is issued. My workers' compensation insurance earner and policy number are: Insurance Co •S*yft^Q^. p"*l^P^-^- Policy No. \ l» V &*L*Q Expiration Date ^'-^ * I ( This section need not be completed if the permit is for one hundred dollars ($100) or less. I I Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100.000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. & CONTRACTOR SIGNATURE ^C^JLA^A \l\ i ^. V ^ tt. YjfAGEMT DATE ^ * '3^*3 "/O OWNER - B V IIO E 8 O E C L A I? A T I O N / hereby affirm that I am exempt frornGwka/xor'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 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 contractors) licensed pursuant to the Contractor's License Law). I am exempt under Section __Business and Professions Code for this reason: 1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement. I |Yes I |No 2.1 (have / have not) signed an application for a building permit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): 4.1 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): 5.1 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): ^PROPERTY OWNER SIGNATURE AGENT DATE City of Carlsbad Bldg Inspection Request For: 06/14/2010 Permit* CB100949 Title: PERFECTLY AT HOME Inspector Assignment: Description: 2 ILLUMINATED WALL SIGNS AND 1 NON ILLUMUNATED CANOPT SIGN Type: SIGN Sub Type: Job Address: 2647 GATEWAY RD Suite: Lot: 0 Location: APPLICANT ULTRASIGNS Owner: Remarks: Phone: 6199540171 Inspector: Total Time: CD Description 38 Signs Act Comments Requested By: NA Entered By: CHRISTINE Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments POLICYHOLDER COPY SD COMPENSATION FUND ISSUE DATE: 05-01-2010 P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE GROUP: POLICY NUMBER: 1711028-2010 CERTIFICATE ID: 787 CERTIFICATE EXPIRESf-Oji-01-201 1 05-01 -2O10/05^O t-201 1 SO % " U o -.„o /t.-:n This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 3Q days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. esentative V }bthorized Representative V J Interim President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #16OO - JOHN HADAYA, P.S - EXCLUDED. ENDORSEMENT #16OO - GUS HADAYA, T - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 05-01-2004 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER ULTRASIGNS, INC 9025 BALBOA AVE STE 150 SAN DIEGO CA 92123 SD (REV.1-2010)PRINTED : 04-16-2010 M0410 oKo /^£?*c^-V *%#V ,_ O ls» 00 ^ £ca X» cn 30 rn cooo 38 *>; m 30 -*•. i— ~J v> -n z3 co n co m 3 §55 m ? 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