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Home My WebLink About2736 LOKER AVE W; F; CB020241; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 ~· . 01-23-2002 Electrical Permit Permit No:CB020241 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2736 LOKER AV WEST CBAD St: F ELEC Parcel No: Lot#: 0 Reference #: Project Title: SPEC SUITE -MISC ELECTRICAL Applicant: DESIGN/BUILD TENANT IMP. SUITE B 9770 CARROLL CENTER RD. SAN DIEGO, CA 92126 619-954-9519 Total Fees: $45.00 Electric Issue Fee Single Phase per AMP Three Phase per AMP Three Phase 480 Per AMP Remodel/Alteration per AMP Remodel Fee Temporary Service Fee Test Meter Fee Other Electrical Fees Additional Fees TOTAL PERMIT FEES Owner: Total Payments To Date: 0 0 0 100 Status: Applied: Entered By: Plan Approved: ISSUED 01/23/2002 JM 01/23/2002 01 /23/2002 $0.00 Issued: Inspect Area: 9521 01/23/02 0002 01 02 Balance Due: $10.00 $0.00 $0.00 $0.00 $25.00 $10.00 $0.00 $0.00 $0.00 $0.00 $45.00 CGP 45-00 $45.00 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK No.((j:/Z '-·/A/ #-• CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST.VAL. __________ _ Plan Ck. Dep~ ----r-+----r-- ~:~:_at-ed_B_y-=_]-:_&:~_-_-_-1.:z_Z:i-_-~.,._~-...... i-. ~D-~--- 1. PROJECT INFORMATION Address (include Bldg/Suite #) 0 _ I Business Name (at this address) ?-7 ?de J-IJ/<-6---,Z /tve. ~T . F' .S ~ .st,,L1 ff Legal Description Lot No. Subd1v1s1on Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use Proposed Use Description of Work SO. FT. l>US{/. ~CAL--ff.{)-5 0 2. CONTACT PERSON (If different from applicant) # of Bathrooms Name Address City State/Zip Telephone# Fax# 3. APPLICANT D Contractor @Agent for Contractor O Owner O Agent for Owner t}_"f:32 ...J-~-=...:....· ....,.1\_..__---L-A4.....:..:;, ....... c..,..,rw-==-?&:>~-"--__..q~7~7~0 _V~4-01!~-1-L-C'~t-r_. ~&_6~'·-'~B~'-~_D....,,..._~CA~_q_2i~'-::2. ........ h __ 59'i..,..__,_.._...~ Name Address City State/Zip Telephone # C'A City Telephone# 6. CONTRACTOR -COMPANY NAME (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, commending 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. An ~i ation of Section 7031.5 by any applicant for a permits bjects the ap icar,t to a civil penalty f not.[Tl7f th~five hundred dollars [$5001). / ·A • I I s C . --'V, • , I / ' r License Class _p.,_,."'--------City Business License # -------- Designer Name Address City State/Zip Telephone State License # ---------- 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. 19 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 carrier and policy number are: Insurance Company ;;:>~ [:::q.,/ N D (THIS SECTION NEED NOT BE COMPLfuott= THE PERMIT IS FOR Policy No. /tJ(pq~{p -0-Z.... Expiration Date / -18 ~{) 3 ONE HUNDRED DOLLARS ($100) 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' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars $100,000), in additi~ to,,the ;ost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE 7 (~ ~~ DATE /,. 9--~ 0 ;;l,. 7. 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). 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). D 1. 2. 3. ------ 4. I plan to provide portions of the work, bu Business and Professions Code for this reason: number I contractors license numb;;:e_,r..,·:;_ ___________________________________ ~-==----------- 5. I will provide some.,¢ th'li work, but I have contracted (hired) the following persons to provide the work indicated (include name I addres of work): ,.-, PRO~RTY OWNER 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? 0 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? 0 YES ISi(_ NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES ~ 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 i a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME '/I LENDER'S ADDRESS ----------------------------- 9. APPLICANT CE FICATION 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 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 com ced for a perjQd of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE ._.t.:::....:=:.!~:!i:=::!::::8..~~":::../.~~C...:,:;;r::_...-7:.L::z.L _________ _ DATE WHITE: File YELLOW: Applicant PINK: Finance ~ ~ City of Carlsbad Bldg Inspection Request For: 02/07/2002 Permit# CB020241 Title: SPEC SUITE -MISC ELECTRICAL Description: Type:ELEC Sub Type: Job Address: 2736 LOKER AV WEST Suite: F Lot 0 Location: APPLICANT DESIGN/BUILD TENANT IMP. Owner: Remarks: CARRIED OVER FROM WED. Total Time: CD Description ~~ D Comments 34 Rough Electric Nr- Inspector Assignment: PS --- Phone: 6199545234 Inspector: '? 5 Requested By: ROBERT Entered By: CHRISTINE 39 Final Electrical + --f---- Associated PCRs Inspection History Date Description Act lnsp Comments 02/06/2002 34 Rough Electric CA PS ROLL TO THURS