HomeMy WebLinkAbout2727 STATE ST; 100; CO160026; Certificate of OccupancyCity of Carlsbad RECORD COPY
1635 Faraday Av Carlsbad, CA 92008
08-18-2016 Certificate of Occupancy Cert of Occ#:C0160026
Permit Type:COFO Related Bldg Permit#:CB160215
Bldg Address:2727 STATE ST CBAD St: 100
Parcel No:2030540300 Issue Date:08/18/2016
Occupant Name: BABA COFFEE Phone#:
Contact Name:ROBERT PASTOR Phone#:760-710-7360
Building Owner:
MARTIN DORIN&BILLIE REVOCABLE TRUST 01-10-94 Phone#:
P 0 BOX 546
FALLBROOK CA 92088
Description of Use: RESTAURANT
I certify that this building or portion complies with the California Building Code for the group and division of
occupancy and the use for which the proposed occupancy is classified.The above information is true and
correct, and I make this statem t under penalty of perjury.
Signature of Building Offie I Date0/M
FOR DEPARTMENTAL USE ONLY
Date Routed
Use Zone Occupancy Group:B Construction Type: 5B
Inspected By Date 29/15/Approved Disapproved
Inspected By Date Approved Disapproved
Inspected By Date Approved Disapproved
Comments:
•
ON MN
'C OMPLETE THIS SECTION FOR NON -RESIDENTIAL BUILDING PERMITS ONLY
Is the applicant*'re building occupant required to submit a business plan, mutely hazardous materials registration form or risk managementaid prevention program under Sections 25505, 25533 or 25534of the
Presley-Tanner Hazardous Substance Account Act?Yes /No
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?Yes 1 No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?Yes f 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.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code).
Lenders Name Lender's Address
APPLICANT CERTIFICATION
Icedirythatt have reed the application and state diatthe above information IsconectandMatte Intimation on the plans Is accurate. I agree to complyvirth ad Cityordhlances and State laws relatingto IxdIdegconsbuction.
hereby authorize representative of the City of Carlsbad to enter upon the above mentioned propertyforinspection purposes. I ALSO AGREE TO SAVE,INDEMIFY AND KEEP HARMLESS THE CITY OF CARLSBAD
AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHApentis required for excavations over 5'0' deepaiddemolition or construction of sbuctures over 3 stories in height
EXPIRATION: Every permit issued by the Btniding Official under the provisionsofthis Code shall admire by imitationaidbecome nut aidvoid if the bulking await authorized by such permit is not commenced within
180 days from the dateof sudi pantor ff the bulding or work is suspendedaabandoned at anytine after thewric is axanenced for a period of 180 days (Section 106.4A Ui Hi &Acting Code).
A5APPLICAM'S SIGNATURE 1(Z)-
--1 DATE
•r '
STOP
STOP:THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE.
Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection.
Fax (760) 602-8560, Email buildingecadsbadcagov or Mali the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008.
CO#:(Office Use Orly)
002—LP
CONTACT NAME ,
4/
.OCCUPANT NAMEKobeC-1)Px.A04 Co
ADDRESS BUILDING ADDRESS
z 12 /#200 272 7Set;ItZ00
STATE ZIP CITY STATE ZIPCITY
avri.51.et el_e4fic Carlsbad CA
PHONE FAX
•
EMAIL OCCUPANTS BUS. UC. No.
DELIVERY OPTIONS
PICK UP:CONTACT (Listed above)OCCUPANT (Listed above)
CONTRACTOR (On P.1)
ASSOCIATED CB#4°62-1S--
MAIL TO:CONTACT (Listed above)OCCUPANT (Listed above)
CONTRACTOR (On Pg. 1)NO CHANGE IN USE/NO CONSTRUCTION
MAIL/FAX TO OTHER:be
CHANGE OF USE/NO CONSTRUCTION
,ESAPPUCANT'S SIGNATURE /DATE