HomeMy WebLinkAbout2790 LOKER AVE W; 116; CB940470; PermitB U I L D I N G
04/27/94 08:28
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Job Address: 2790 LOKER AV WEST
Permit Type: ELECTRICAL
Parcel No: 209-081-14-00
Valuation: 0
Construction Type: NEW
P E R M I T
Suite:
Lot#:
Permit No: CB940470
Project No: A9400665
Development No:
Occupancy Group: Reference#: Status: ISSUED
04/27/94
04/27/94
DC
Description~ ADD OUTLETS/LIGHTS/PHILLIPS
Appl/Ownr : GOOD AND ROBERTS
1090 JOSHUA WAY
VISTA, CA 92083
*** Fees Required
Fees:
Adjustments:
Total Fees:
Fee description
Enter "Y" for Electr
Enter "Y" for Remode
* ELECTRICAL TOTAL
619
Applied:
Apr/Issue:
Entered By:
598-7614
.00
.00
20.00
***
Ext fee Data
10.00 Y
10.00 Y
20.00
FINAlAPPROVAL
INSP. ~ D~ '5"/~
CLEARANCE </'I I =
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
City o.f carlsbad Building Departllll!f'lt ~/··~
PERMIT APPLICATION •.. PLAN CHECK NO.
2075 Las Palmas Dr., carlsbad, CA 92009 (619) 438-1161 ~XIJ~~:.. ESf. VAL _____________ _ .. PLAN CK DEPOSIT ________ _
VAUD.BY -------------
1. PmtMI I l'YPE
-r,-,,, Phi I hes DATE ______________ _
A -U Commercial U New Buildmg U Tenant Improvement
B -D Industrial u New Building D Tenant Improvement
C -0 Residential O Apartment O Condo O Single Family Dwelling O Addition/ Alteration
0 Duplex O Demolition O Relocation O Mobile Home ~lectrical O Plumbing
0 Mechanical O Pool O Spa O Retaining Wall O Solar O Other ____ _
2. PRQJECT INFORMATION FOR OFFICE USE ONLY
Address Bmldmg or Suite No. Suites 116 & 117 2790 Loker Avenue
Nearest Cross Street
LEGAL DESCRIPTION Lot No. SubchV1s1on Name/Number Umt No. Phase No.
cfiECR BEWW IF SOBMII iEO:
D 2 Energy Cales C 2 Structural Cales C 2 Soils Report D 1 Addressed Envelope
NAME ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
4. Ai>PllCAN't UwNIRAC1dR DAGEN I FUR cdN1RAC1dR
ADDRESS
uowNt:H UAGENI FURUWNER
NAME Mark Langan 5355 Mira Sorrento Place, Suite 750
CITY San Diego STATE CA ZIP CODE 92121 DAY TELEPHONE {619) 452-3188
5. ~~mt~~ ¼§;;.a::;. ADDRESS tCf41
CITY~ STATE (A. c ZIP CODE ~ DAY TELEPHONE
ADDRESS 1090 Joshua Way
CITY Vista STATE CA ZIP CODl:92083 DAY TELEPHONE {619) 598-7614
STATE LlC. # 3 7 7 551 LlCENSE CIASS B CITY BUSINESS LlC. # 1195553
DESIGNER NAME Dennie Smith ADDRESS 5355 Mira Sorrento Place, Suite 750
CITY SAn Di~o STATE CA ZIP CODE 92121 DAYTELEPHONE
1. WdlUMtS' rnMPIDQ
452-3188 STATE LlC. # Cll, 701
Workers' Compensation beclarallon: I hereby affirm that I have a cert1hcate of consent to selt-msure issued by the Director of 1ndustnal
Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified
by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, I.ab. C).
INSURANCE COMPANY POLlCY NO. EXPIRATION DATE
Cemhcate of Exemption: I certify that m the performance of the work for which this permit 1s issued, I shall not employ any person m any manner
so as to become subject to the Workers' Compensation laws of California.
SIGNATURE DATE
s. dWNER-BUllDER DEUARA'fioN
bwner-Bmlder beclarauon: I hereby afhrm that I am exempt from the Contractor's Llcense Law for the followmg reason:
D 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 I.aw 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.).
D 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 I.aw 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 I.aw).
D I am exempt under Section ________ Business and Professions Code for this reason:
(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 I.aw (Chapter 9, commencing 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 any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars [$500]).
SIGNATURE DATE
COMPLETE fits sECnoN 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~55 5, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act?
0 YES NO
Is the applicant or future buildin~cu nt required to obtain a permit from the air pollution control district or air quality management district?
C YES NO
Is the facility to be constructed wit I 00 feet of the outer boundacy of a school site?
0 YES 0
IF ANY OF TIIE ANSWERS ARE A FINAL CERTIFICATE OF ocx:uPANCY MAY NOf BE ISmJED AFmR JULY 1, 1989 UNLF.SS TIIE APPUCANT
HAS MET OR IS MEETING TIIE REQUIREMENTS OF TIIE OFFICE OF EMERGENCY SERVICES AND TIIE AIR POLUfllON CONTROL DISfRICT.
9. rnNSIROCIION mNDING AGRNCV
I hereby afhrm that there 1s a construct10n lendmg agency for the performance of the work for which this permit 1s issued (Sec 3097(1) OVIJ Code).
LENDER'S NAME LENDER'S ADDRESS
to. Ai>PllCANT CER'l'MCATION
1 certify that 1 have read the apphcanon and state that the above mformallon 1s correct. I agree to comply with all City ordmances and State laws
relating to building construction. I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection
purposes. I AISO AGREE TO SAVE INDEMNIFY AND KEEP HARMLF.SS TI1E crIY OF CARISBAD AGAINST AIL IJABIUI1ES, JUDGMENTS, CDSTS
AND EXPENSES WIIlCH MAY IN ANY WAY AallUE AGAINST SAID CfIY IN CONSEQUENCE OF TIIE GRANTING OF TIIIS PERMIT.
OSHA: An OSHA permit is required for excavations over 5'0" deep molition or construction of structures over 3 stories in height.
APPLlCANTS SIGNATURE
PINK: Finance
,
•
SUITE 116 & 117
.._ _______ 11!!1"'' 111111
2790 LOKER AVENUE
CARLSBAD, CALIFORNIA
ELECTRICAi/PLUMBiNG
MODIFICATION
SMITH CONSULTING ARCHITECTS 535.5 MIRA SORRENTO PLACE SUITE 750 · SAN DIEGO, CALIFORNIA 92121
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