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Home My WebLink About2736 LOKER AVE W; D; CB032501; PermitPERMIT APP.LICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1. PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO. Qs,,. z_~ EST. VAL.~---------- Address (include Bldg/Suite #) ~ -z.... .,_ l1.. 7"\I 21 ?:>(p t ,a,cc;--,s.. f's\) e . ~ .... , :i,-v Business Name (at this address) T72Aff11v tr'? • Unit No. Phase No. Total # of units M Af' /0?, 72- legal Description ~ lot No. Subdivision Name/Number f A/Z,4:;-v-:., Al\-t3 , Le TS -:::, -1/, ,rlAt.,r 7 4:: ?-1 Assessor's Parcel # Existing Use 2-Ct{-OBI-k B-CO {lfF, u; Description of Work H SQ. FT. #of Stories 2. ~AQ PER~l;;(H dJfft.f.~pplltdn!? f?_. -·---·--·~·---'-· Name Address City 3. APPLICANT O Contractor Ga' Agent for Contractor O Owner O Agent for Owner AU:;b/A (j..J s ~) A-t),) ~a) q no [> /tJ(!.g.OLJ_., (! n::; M Name ,; Address City Proposed Us~tG # of Bedrooms # of Bathrooms I State/Zip Telephone # Fax # -::;y f3S1, 9l4.0 J13, '8' 5 D. 1212t B9a ~ 84-s:,- state/Zip Telephone # 4;f PROPERTY OWNER t::t. lt:: f6Nm1'! c,,. 1s 8 6 N~Jt.l> fOL-1 TAN D!2 6A1v 21e-aq, cA ?J2; ()8 4,1f 9«>~a1.2-0 5. 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. Any violation of Section 7031.5 by an applicantjor a permit subjects the applicant to a civil penalty of not more than five ti ndred dollars)j5001). L:7,, ~ ~ P> (' , /lo '13 ' 6 , D r: A c, 2 .. ~:513 ~/- State license # _4:tt....__,,"'-'uW:...·.,.tb"'---L&----L __ Address p..._ City State/Zip Telephone # ~~S- license Class .t.,....L City Business License # / ~ ) ?D 4{o Designer Name a_,\ ......... - State License# --~-'---'-I.:...;;;/~-=---- Address City State/Zip Telephone 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 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. §l 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 '::::::5l7\TF, pu IJ !) Policy No. J lp{j, 1/k'J(o -;:l Q::>.:, Expiration Date O I· IP, -o~- (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100) OR LESS) 0 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, end shell subject en employer to criminal penalties and civil fines up to one hundred thousand dollars $100,000), in addition to the cost of compensation, d11m11ges as provided for in Section 3706 of the labor code, interest and attorney's fees. SIGNATURE J ,{_~ DATE _q.__-._.1(1'---'-0""--3..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 (Sec. 7044, Business and Professions Code: The Contractor's License law does not apply to an owner of property who builds or improves n, and contracts for such projects with contractor(s) licensed pursuant to the Conlte or's license law). D 1. 2. ONO 4. I plan to provide portion the work, but I have hired the following person to coordinate, supervise and provide the major work (include name I address I phone number)=---------------------------------------------- 5. me 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 PR OPE 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 }lJ 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 ~ NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site 1 0 YES ,'2f NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UN~SS 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 iJ a c~tion 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 _______________________ _ 9. APPLICANT CERTIFICATION 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 Cit\' 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 co n~; ~r ~ period o!),~O)J~(Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE ~ {./vt?C.p DATE '! rttJ /J,3 _____ ___;:=;, _______ _ WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request Permit# CB032501 Title: TRAPPINGS For: 01/15/2004 Description: ADD 2 HVAC UNITS@ ROOF W/ELEC Type: MECH Sub Type: Job Address: 2736 LOKER AV WEST Suite: D Lot 0 Location: APPLICANT ADDESSO LISA Owner: Remarks: MECHANICAL FINAL REQUESTED Inspector Assignment: PS --- Phone: 6199545234 Inspector:~ Total Time: CD Description Requested By: ROBERT Entered By: CHRISTINE ~ Comment ~ Pin~ 49 Final Mechanical Associated PCRs/CVs Inspection History Date Description Act lnsp Comments 11/19/2003 49 Final Mechanical CO PS CONDENSATES RUNNING OVER ROOF PLANNING/ENCINEERINC APPROVALS PERMIT NUMBER CB 03-{).~0 I ADDRESS {)13fo Loker Ave-wesJ -±!j) RESIDENTIAL RESIDENTIAL ADDITION MINOR ( < $10,000.00) . . PLANNER ~ (i()er:fCYL ENCi NEER DoCSIMISformsJPlanning engineering Approvals TENANT IMPROVEMENT PLAZA CAMINO REAL CARLSBAD COMPANY STORES VILLACE FAIRE COMPLETE OFFICE BUILDINC DATE9-//J~c)3 DATE -------