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Home My WebLink About2774 LOKER AVE W; ; CB971324; PermitFIN~PPROVAL INSP."~ DATE /.1-/J:/f1 CLEARANCE ____ _ 2075 Las Paimas CITY OF CARLSBAD Dr., Carlsbad, CA 920()C) (619) 438-1161 J • FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. 9 7 L I1:Y EST. VAL. _gl,-CCf)_O _____ _ CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 Plan Ck. Deposit-----,,..,-.---- Validated By, {?A: Date ..2 /:Al (tf=7 1. PROjECT INFORMATION Subdivision Name/Number Total # of units Assessor's Parcel # Existing Use Proposed Use D9}J7;;~;~7;/ 011i/l ~H.,.-R.)J.JU SO. FT. #of Stories # of Bedrooms # of Bathrooms 2. CONTACT PERSON (If different from applicant) Name Address 3. APPLICANT O Contractor D Agent for Contractor D Owner Name Address Name Address 6. CONTRACTOR -COMPANY NAME City 0 Agent for Owner City City State/Zip Telephone# Fax# State/Zip Telephone# State/Zip Telephone # (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 ex::::n. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$5001). ~1t,1rr: SJ.fA:o.i-DJ /e~otA-HD! Sr. Vtsu ce: e,;,Df3 UY·SY):l1 Name Address City State/Z~ , Telep}~# ' State License # 4 s 6 8 s I License Class C -I, 1 City Business License # rr/.h{,' ~ - 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: 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. ~ 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: ! I Insurance Company r,1':m f:vNP Policy No. /l/ 7f'S'£ 1 Expiration Date ~ lJ..['i:Y (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 es to become subject to the Workers' Compensation Laws of California. WARNING: Failure to ae re workers' compensation coverage la unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred ), lf1dd on to tha cost of compensation, damages as provided for in Section 3706 of the La r co e, interest and attorney's fees. SIGNATURE --f DA TE _)-=-i..::..)....e/....._,.__"---- 7. OWNER-BUILDER DECLARATION 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). 0 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 ofworkl: __________________________________________________________ _ 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 1 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------------------------~ 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 B · ing 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 t need within 365 days from the date of such permit or if the building or work autho · ed by ch permit is suspended or abandoned at any time af need for a period of 180 days (Section 106.4.4 Uniform Building Code). /" j .2 1 DATE WHITE: File YELLOW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB971324 FOR 06/10/97 DESCRIPTION: AWNING OVER FRONT ENTRY-ACRYLI SYNTRON BIO-RESEARCH INC TYPE: MISC AV WEST STE: INSPECTOR AREA PLANCK# CB971324 ace GRP CONSTR. TYPE NEW LOT: JOB ADDRESS: 2774 LOKER APPLICANT: KNIGHT SHADE CONTRACTOR: PHONE: 760 724-5424 OWNER: REMARKS: R/JEFF/724-5424 SPECIAL INSTRUCT: TOTAL TIME: --RELATED PERMITS-- CD LVL DESCRIPTION PERMIT# SE900141 AS940009 FA940007 C0940051 FAD94006 AS950051 FAD95025 SE960075 TYPE swow ASC FALARM COFO FADD ASC FADD swow PHONE: J PHONE: INSPECTOR --hf!'-:-/_,------- STATUS ISSUED ISSUED ISSUED ISSUED ISSUED ISSUED ISSUED ISSUED ACT COMMENTS 14 ST Frame/Steel/Bolting/Welding ~/J ~~~~~~~~~~~~~~~ ..ii__ ~ ~~~~~~~~~~~~~~-":ii!.. ***** INSPECTION HISTORY***** DATE DESCRIPTION ACT INSP COMMENTS 2 77Y ~JL JJv< 44sr r ~ tf-t ffvcJJ-1 f3 t O Uf //#-£Ai--(C-,ew..t-:r f,,,;..tr,t4-a-.£ut_ ,,,,...,n,.,._ ·""'--- 4 • BUBBLE A'w NIN G . ---,·· - 0 · \..V ~ " :a:- (D -. " CD-·-1 (D-~--r-------1 I '-· :. --···:~.-::£::R.-:.'P.::J.../ _ 7:' -~ J/ I Ar: ... ~ -. ···-.... ~ - ~-· • /'-o·· G·E N ERAL f\lOT ES ' q)· f'E.R/M/TFR F/<.AN£ 1·· 1 GAL// rt/6£ . . . 0 -~--.. ~/g5·.· ·yj..-•. fl). 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