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HomeMy WebLinkAbout2700 CARLSBAD VILLAGE DR; ; CB981364; Permit7 4 Permit No CB981364 Pro}ect No A9801821 Development No: BUILDING PERMIT OV07/98 17 21 Page 1 of 1 Job Address. 2700 CARLSBAD VILLAGE DR Suite Permit Type SIGN Parcel No Lot# Valuation. 1,700 Construction Type NEW Occupancy Group Referenced: Status ISSUED Description- SIGN NONILUMNIATED Applied. 05/07/98 Apr/Issue 05/07/98 Appl/Ownr MOTIVATIONAL SIGNS 619 474-8246 C-PRMT *" 63-00 2200 CLEAVELAND AVENUE NATIONAL CITY CA 91950 A * A Fees Required * A* ^ff*' Fees-.Col lee ted & Credits *** Fees - Adjustments: Total Fees: Fee description Building Permit Plan Check * SIGN TOTAL 00 . 00 63 00 Ext fee Data Ba-ianeeJ EJi^ex: Urtfts '\ \C),^ \ 38 00 25.00 63 00 CITY OF CARLSBAD 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr, Carlsbad CA 92009 (760)438-U61 FOR OFFICE USE ONLY PLAN CHECK NO EST VAL / Plan Ck Deposit __ Validated By Date tzms Address (indude Bldg/Suite #)V X^T" Business Name (at tfcis address!^ Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor s Parcel Existing Use Proposed Use Description of Work CONTACT PERSON (it different from applicant) SO., FT ffof Stones of Bedrooms ff of Bathrooms Name 3 APPLICANT D Contractor Name [4 a> PROPERTY OWNER ' '' i fa\,<L M i L. C / *2 Address Q3 Agent for Contractor^ ^Q Owner_^ Address City (_] Agent for Owner f ^ t ~ City " '™"i" """" "* ' '"I" TV _,-, '''-' State/Zip State/Zip /V* ' i9 * ^.A-(A. 7/<?ra Telephone ff - Telephone ff Fax* ,. Name Address City * State/Zip Telephone * 5 CONTRACTOR-'COMPANY NAME " '•"" „ „ _ '„ ";, ~ . -*--,-•-, ~ -;-*- J'i " '»-''^*;?~^;r;T C^", " \ "*( "-, „ ~^ (Sec 7031 5 Business and Professions Code Any City or County which requires a permit to construct, altar, 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 ha is exempt therefrom and the basis for the alleged [exemption Any violation of Section 703^4 5 by any applicant ^o_r a permit subjects the applicant to a civil penally of not morqthan five hundred dollars 155001) Jame btate License # Address License Class City State/Zip 'Telephone City Business License # ^"2T oQ>G~& designer Name Address C:ty State/Zip Telephone State License # _ 6J WORKERS' COMPENSATION ( ; ' s" , ' " - ~JL > i '*'-*, ,1 ,!>/ * ' V"'CV \ R"i<l(, ^ *,""<',' Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations Sfl 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 felQD 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 earner and policy number are Insurance Company _ __ Policy No _ Expiration Date _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS IS1001 OR LESS) Q 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 10 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 ($JLOQ00) in addition toil he cost of compensation damages as provided for m Section 3706 of the Labor code, interest and attorney's fees JSIGNATUREns>DATE 7 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason LT] 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) Q 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 CD YES QNO 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) __ ____^^_ 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 COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY „_„_. , M. „ ,„„ ...!„*. <^M*t.< -AlLuL » X, >', ..-» '" !s 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? O YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES Q 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 . s „ „ „""„."„, 1TV" - J\-,V,,<.. '~,~ ~" _tV~_ ~~? "' f"L-"s '• - I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 30970) Civil Code) LENDER'S NAME LENDER'S ADDRESS 9 > APPLICANT CERTIFICATION ~ " _ " ""„ '~ V^-JllT,", TV "" '!„* "P_"L~ _u ll -^-f.-I'' "" ~' ™L7_ " „- ,~ »* „ ... 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 City 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 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 Officjatnnder the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is-^Totfcojnmenced wijnin 36J5 days from the drte of such permit or if the building or work authorized by si>ch pei/nit is suspended or abandoned at any time aftejxfhejftSj^Ts1 co*mfflinoed for,* period of 180 djfys (Sectional 06a4 4 Uniform Building Code) %fa)Lslty$£ JZ-JP^*'**^-' DATE WHITE File YELLOW Applicant PINK Finance APPLICANT S SIGNATURE PERMIT* CB981364 CITY OF CARLSBAD INSPECTION REQUEST FOR 05/28/98 DESCRIPTION: SIGN NONILUMNIATED TYPE: SIGN JOB ADDRESS APPLICANT: CONTRACTOR: OWNER: 2700 CARLSBAD VILLAGE MOTIVATIONAL SIGNS DR PHONE: PHONE: PHONE: INSPECTOR AREA PY PLANCK# CB981364 OCC GRP CONSTR. TYPE NEW STE: LOT: 619 474-8246 REMARKS: B/DAN/ SPECIAL INSTRUCT: INSPECTOR TOTAL TIME: CD LVL DESCRIPTION 38 EL Signs ACT COMMENTS ***** INSPECTION HISTORY ***** DATE DESCRIPTION 052298 Ftg/Foundation/Piers ACT INSP NR PY COMMENTS NO SUCH ADDRESS O6194740678 JOE JORDAN ©001/001 i The attached is forwarded to you as prepared by your Insurance Company Please read it thoroughlyWa will not be responsible for errors or omissions not leporteti to us. Please advise promptly if any change Is necessary ZENITH INSURANCE COMPANY Companv No 13145 21255 CALITA ST WOODLAND HILLS CA 91367 S COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE ITEM I INSURED NAME AND ADDRESS PRODUCER 090574A 050 Renewal of ZQ41Q8S7Q3 MOTIVATIONAL SYSTEMS, INC AND SEE ENDT WCOO-99-01 2200 CLEVELAND AVENUE NATIONAL CITY, CA 91950 Policy Number Z041088704 SD900510 OTHER WORKPLACES NOT SHOWN ABOVE See Endorsement WC-00-99-OS ADDITIONAL LOCATION ENDORSEMENT Policy Type WN Line- NON-PARTICIPATING Entity CORPORATION Billing Type STIPULATED Frequency. MONTHLY ITEM 2 .The Policy Period is from: 01/01/98 to: 01/01/99 12:01 A M. standard time at the msured's mailing address ITEM 3 A. Workers Compensation Insurance. Pan One of the policy applies to the Workers Compensation Law of the states listed here , CALIFORNIA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3 .A The limns of our liability under Pan Two are BodiU Injury By Accident $ 1,000,000 Each Accident Bodily Injury By Disease $ 1,000,000 Each Employee Bodily Injury Bv Disease $ 1,000.000 Policy Limit C. Other States Insurance-. Pan Thre« of tbe policy applies w the states if any listed hete AH states except states listed in item 3 A and NEVADA NORTH DAKOTA, OHIO WASHINGTON. WEST VIRGINIA. WYOMING D. See attached list for endorsements and schedules. ITEM 4 -l , • t •The premium for this'policy will be determined by our manuals of Rules, Classifications, Rates and Rating Plans. All information required1 belowlis subject to verification and change bv audit. ' 1 ' See endorsement WC-99-OO-Ol RATING SCHEDULE Total Estimated Annual Premium Minimum Premium : Deposit Premium 152.143 1.875 15.925 Countersigned At- San Diego, CA On 01/13/98 By WC-00-00-01 (Ed 04-84}INSURED COPY Authorized Representative