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Home My WebLink About2702 LOKER AVE W; ; CB982229; PermitU7/14/98 12:07 PaJe 1 of 1 B U I L D I N G P E R M I T Permit N<: B<3t' 2.;c, Project No: A~d02949 Development No: Job Address: 2702 LOKER Permit Type: ELECTRIC'AL P1rcel No: Valuat1 on: O AV WEST Occupancy Group: Description: TEMP POWER POLE Suite: Lot#: Reference#: Construction TypE>: NEW Status: ISSUED "--;(' -~,/1ll 18 9010 07/14/98 0001 01 02 /qa Appl/Ownr : LUSARDI CONSTRUCTION 1570 LINDA VISTA 760 744-,-'0l C-PRNT 20.00 SAN MARCOS CA 92069 Fees Required *** ----------------------------Fees: Adiustments: Total Fees: Fee aescr1ption --------------------Enter "Y" for Elect Enter "Y' for T mpo CLEARANCE * "* * ------------------------- .oo .00 20.00 Ext fee Data 10.00 Y 10 .00 'i ------..-.- F ~· OVAL DI = 8-(/~ re? CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-ll6I FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. £8 mr CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST.VAL.~--------~ Plan Ck. Deposit ZuDU Validated By T:1? 6; Date 7(-L't/~ Business Name (at this address} Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel II Existing Use Proposed Use Description of Work ~ SO. FT. llof Stories # of Bedrooms # of Bathrooms 2. tfo1'Jt£~~!7tm eppficentl Name Address City State/Zip Telephone# Fax# 3. APPLICANT 0 Contractor 0 Agent for Contractor 0 Owner 0 Agent for Owner Name Address City State/Zip Telephone# 4. PROPERTY OWNER Name Address City State/Zip Telephone# 6. CONTRACTOR • COMPANY NAME _bd,~~~~:.LJ._~~~Ll!..L.L~~~~~~~~~~f,,L.:-/-~~I ::a:: License 11 _A __ t?_1-'--~--'o ... 0;.._7...__ License Class _ _,_A __ g""'-------City Business License # -------- Designer Name Address City State/Zip Telephone State License II---------- 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: O 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. '1n I have and will maintain work~rs' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is f.,~ued. My worker's com ensat1on insurance earner and policy nu ber are: ,,,. ~ :3 3 / Insurance Company 0. Policy No. W<....o 1:::7 03 D f Expiration Date /-o /~/'7 / 1 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($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' compenaetlon coverage la unlawful, end shell subject an employer to criminal penalties end civil fines up to one hundred thousand dol ($1 ,00 i to th cost of compensation, damages es provided for in Section 3706 of the Labo?~·?3arest end attorney's fees. SIGNATU E DA TE _4,7_~...__q.::_..__•--'7'-"'(L..._ __ _ 7. OWN R-BUILDER DECLARATI I hereby affirm that i am exempt from the Contractor's License Law for the following reason: O 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). 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}. O 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 ONO 2. I (have I 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 I address I phone number I 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 I address I 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 I address I phone number I type of work): __________________________________________________________ _ PROPERTY OWNER SIGNATURE----------------------- COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY DATE ________ ~ 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 O 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 O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O 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 ________________________ _ 19. APPLICANT CERTIACATION 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 Citt 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 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 wor menced for a period of 180 days (Section 106.4.4 Uniform Building Code). DATE V CI I r\\At, 1'1. ...... 1; .... .,,.... Dltl.lV, c; ... .,, .........