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Home My WebLink About2791 LOKER AVE W; MULTI-PERMIT FILE; CB993464; PermitCity of Carlsbad 10/07/1999 Electrical Permit Permit No:CB993464 Building Inspection Request Line (760) 438-3101 Job Address: Permit Type: Parcel No: Reference #: Project Title: 2791 LOKER AV WEST CBAD ELEC 2090811500 ASHWORTH Lot#: 0 Status: ISSUED Applied: 09/20/1999 Entered By: JM Plan Approved: 10/07/1999 ISSl,t~ i ,lQ,(Q7,&B~,,-,., ri• Inspect Arei:{ ., ... ,,. ,,. '' ' ' ::: ~,~;.,;:' ADD 480/277 100 AMP 3 PHSE FOR LIGHTS 400 AMP -... • l {\.,ii Applicant: VISTA ELECTRIC 2723 JACARANDA OCEANSIDE CA 92009 760-739-5948 Total Fees: $160.00 Electric Issue Fee Single Phase per AMP Three Phase per AMP Three Phase 480 Per AMP Remodel/ Alteration per AM Remodel Fee Temporary Service Fee Test Meter Fee Other Electrical Fees TOTAL PERMIT FEES FINAL APPROVAL Date: "1/4~ro 0.00 0.00 0.00 0.00 50.00 $0.00 $0.00 $0.00 $0.00 $160.00 $160.00 Clearance: _____ _ NOTICE: se take NOTICE that approval of your project includes the "Imposition' of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions.' You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which ou have reviousl been iven a NOTICE similar to this or as to which the statute of limitations has reviousl otherwise ex ired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 PERMIT APPLICATION Alv FOR OFFICE USE 0~, / r PLAN CHECK NO. ) '{ f'1 V CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. __________ _ Plan Ck. Deposit l"'+-,----+----r-- Validated By __ _,._.,_,~.....+:::---r+..,,.,.,.-- Date _________ +-="-'--+-....._~- Address (include Bldg/Suite #) ?.. t C, loKiiG'/2.. Busin ss Name (at this address) 1..,J..l......lo-12-,1.J- Legjl Description Lot No. Subdivision Name/Number ( Unit No. Phase No. Total# of units /~04/'>fP 3(/? J.a_,._,JUGe-h,:z.. L1Q-H'Tn:JC,,-.fJ A ~IX)J.11.i'i> ~ov ?4> P,+,c.JIUS-~bO ~/2:11 Assessor's Parcel# 2.0~-081-15" Description of Work -;::>. Existing Use ~ ' ) . ~ Proposed Use rl:WDLfC'l?c,u {..,f=M1.3'2'Ci>P-'i' SQ. FT. #of Storiesor # of Bedrooms # of Bathrooms Name Address City State/Zip Telephone# w.....anuctlil!l•~:~~-1;1 ; :·,,1~1:z;::r,::JZJ;~-::~J,:~,,.wil>.,,-'f.'?!!:\~,~'.4;~'.. · .• '.kc1!Ji1~~::;:"• : .. •·1~"'w~ -•l!!1~<•£:1A11iilL' /;;:,1~1111:~:EJ.'.lilllll (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 e~emytion. 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)). v~ ---~;z,v,C~ {tlJC, 3 -ll, NJ 14 us, 20S'C. z 7 _q;;,,~>< Name A dress City State/Zip Tel;pjJPne # State License# l/70?(:..3 License Class (!,JD City Business License# "'12.d,z '5..) Designer Name Address City State/Zip Telephone State License # _________ _ ii~!llilll!U'O.TfPN?J~uft'\isi;;,'.; ,,, ·· · .. , h~..aJ-; 11 //:, ::~£;:' ~.,,.; •• ff:: ;,5.i 1. Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: ~ ve 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 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: Insurance Company j_;;;t;;,.10N /r-JSUl%..""rN<;:..GCbwr.p Policy No.We! f-D!:>'9!3(,5'0 Expiration Date ~-/0-2.ooC (THJ"it'lfk>N NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) 8' ~E 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 secur~orkers' co pensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to_ one hundred thousand dollars <t 00), i1 _additi the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE~~~~~~li~~~i:-•iiiiliociiiiiiiiiiiiiiii DATE 1-Z0-91 Blll!if~ift#li.Jj·i'l;~qMll;1)!!al:~1i1:f\!l;t;it1~f, .,ii·i•.x0Tu1>,!iliff· ,,£;j1S,!i'f~'; 1 • ,t.llllll!t';;;/:llfai;e}\i;.;'.L ;i[lf1,: I hereby affirm that I am exempt from the Contracto 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). 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 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 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. D YES ONO 2. I (have / 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 / address / phone number / contractors license number): 4. l plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone number/ 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/ address / phone number / type of work): __________________________________________________________ _ PROPERTY OWNER SIGNATURE_______________________ DATE _________ _ fflfit.-Rttflil1~11-.Qaallll-llltt't$t9IIR,!,'/'.f;iil\!l®F"~:;il\Ji~;s;.fjpff1'.', •71//Jfcc'· .• ,iM.w\£4c;, .+!~l:i!t~>::i.1.,·I ; J,1 il!i\1 ;,;,;.;,-i; '.?:;.a 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 D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D 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. !flllllliiliDl:~a~o11tWl~N~tt~+1'1;\;1;:,;;':,::1:,::::1IBc.,;,.; ".;,.,::ix111251x:t;U<i,J/1ri:r:::r1iiBii:::;,x:+.· 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 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 Bui! ·ng 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 i not · ommen ed withi 65 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 t f a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE L.._f,..:._!.1~::1.....~:=~~t:::~~====----------DATE 9--z..6-(} 2 YELLOW: Applicant PINK: Finance Inspection List Permit#: CB993464 Type: ELEC ASHWORTH ADD 480/277 100 AMP 3 PHSE FOR LIGHT Date Inspection Item Inspector Act Comments 1/10/2000 33 Service Change/Upgrade TP AP 1/10/2000 33 Service Change/Upgrade TP NS 1/10/2000 34 Rough Electric TP AP SUB PNL, TRANS, WIRE TAP 1/10/2000 34 Rough Electric TP NS 10/14/1999 34 Rough Electric PD co Tuesday, June 06, 2000 Page 1 of 1 City of Carlsbad Inspection Request Permit# CB993464 Title: ASHWORTH For: 1/10/2000 Inspector Assignment: PD --- Description: ADD 480/277100 AMP 3 PHSE FOR LIGHTS 400 AMP Type:ELEC Sub Type: Job Address: 2791 LOKER AV WEST Suite: Lot 0 Location: APPLICANT VISTA ELECTRIC Owner: CHARTER GOLF INC Remarks: Total Time: CD Description 33 34 Service Change/Upgrade Rough Electric Associated PCRs Inspection History Date Description 10/14/1999 34 Rough Electric Act Comments Act lnsp Comments CO PD Phone: 7609296176 Inspector: __Q_ Requested By: KEITH Entered By: CHRISTINE Independent Testing & Engineering Services for Electrical Power Systems January 10, 2000 City of Carlsbad Building Inspection Department 2075 Las Palmas Drive Carlsbad, California 92009 Attention: Mr. Pat Kelly San Diego Area Office 9835 CARROLL CENTER ROAD, SUITE 103 SAN DIEGO, CA 92126 (619) 695-9551 FAX (619) 695-0861 Subject: Equipment Labeling Evaluation manufacturing equipment located at Sulzer Calcitek, 1900 Aston Avenue, Carlsbad, CA 92008. ETI Reference No.: 229-5059 Dear Mr. Kelly: This letter is to advise you that Electro-Test, Inc. (ETI) has completed its evaluation and testing of the equipment located at Sulzer Calcitek, Inc., and the equipment has been labeled. ETI will submit a final report by the end of the week. If you have any questions, or if we can be of further service, please give either Leif Hoagberg or myself a call at (619) 695-9551. Best regards, ELECTRO-TEST, INC. Y~w~ Don Weber Senior Compliance Engineer Copy: Mr. Kermit Stott, Sulzer Calcitek, Inc. r r JAN 10 '00 04=13PM ETI SAN DIEGO Please Deliver To: Name: Mr. Pat Kelly Company: Phone: Fax; City of Carlsbad 760-438-1161 760-438-0894 From: Don Weber The following letter will be mailed to you today. Number of Pages T (including this cove eti Reference Num Date 'I P.1/4 ell· ~lPctro • t~.1t inc.TTtl San Diego Area Office 9835 Carroll Center Road, #103 San Diego, CA 9:21.26 (619) 695-9551 Fax: (619) 695-0861 a-test.com 4 229-5283 Januaxy 10, 2000 If you should have any questions or need additional information, pl se do not hesitate to call Mr. Leif Hoegberg or myself at (619) 695-9551 Servi the United States with Offices Coast-oast JAN 10 '00 04:13PM ETI SAN DIEGO Independent Testing & Engineering Services for Electrical Power Systems January 10, 2000 City of Carlsbad Building Inspection Department 2075 Las,Palmas Drive, Carlsbad,: California 92009 Attention: Mr. Pat Kelly P.2/4. San Diego· Area Office · 9B35 CARROLL CENTi:cR ROAD, SUITE 103 SAN DIEGO, CA 92126 · (919) 695-9551 · FAX (619) 895-0861 Subject: . Equipment Labeling Evaluation of a bus tap whic modified a listed General Electric 480/277 volt, 800 amp switchboard locat d at Ashworth Inc., 2793 Loker A.ve West, Carlsbad, CA 92009. ETI Reference No.: 229-5283' Dear Mr, Kelly: This letter is to advise you that Electro-Test, Inc. (ETI) has co I leted an evaluation of a bus tap in the.right section of the UL listed, General Electric 1200 mp, 480/277 volt switchboard located at the above address and an ETI Field Evaluation Lab I, No. M222858, has been added adjacent to the GE nameplate on the section containing he modification. The tap consists of the addition of two termi~al lugs to each ph se of the bus using existing holes so the bus itself has not been modified. One of the termi als on each of the lugs contain 3/0 AWG THHN type conductors which feed an adjace t 200 amp, 600 volt fused disconnect switch. The other terminal on each lug contains a ngle #2 AWG, THHN type conductor which supplies an adjacent 100 amp, 600 volt fused isconnect switch. The length of both conductors is approximately 10 feet., Reference the att ched one-line diagram. We visited the jobsite on January 7, 2000 to visually examine t e equipment and found it to be generally.in conformance with applicable electrical standards ith the following exception: The conductors were not properly supported at the add lugs, in particular the B Phase ,lug. The conductors were installed in this lug so hat there was an excessive tension at the lug that would cause it to rotate to the rig and short against the C Phase bus bar if the single mounting bolt should come I ose. The electrical contractor for the job provided support for these conductors anct th A and C Phase conductors to relieve any tension that might cause the lugs to mo\'~ uld the bolt come loose. JAN 10 '00 04=14PM ETI SAN DIEGO P.3/4 If you have any questions, or if we can be of further service, pl se give either Leif Hoegberg or myself a call at (619) 695-9551. Best regards, ELECTRO· TEST, INC. Don W~ber Senior C~mpliance Engineer Attachment Copy Mr. Keith Almryde Ashworth Inc. 'I 'I ' ' ' ; .JAN 10 '00 04:14PM ETI SAN DIEGO X ' .... eTr R~F! z;z.cz _ s;-z.s .:J. --~~-------------P,4/4 ---(.~ t;,~--- I " '~·~·ii~-; ---~ \OOA.4~}{'-7'?, ... --~¢-4v.J, ··1-1E.'JJ ,N1., -~A" •• ". ........ --So•. · ttF.W ~-1"1<>/ic&V, "-7¢-4-w, .. ~----=-===:.-::.:.:.:.:.~::.:.t:.:.:.~~~:.~::~:.:.::_ J , EsGil Corporation 'l.n Partnersfiip witfi (jovernment for 'Buitifing Safety DATE: 10/5/99 JURISDICTION: Carlsbad PLAN CHECK NO.: 99-3464 SET:I PROJECT ADDRESS: 2791 Loker Ave. West Bldg. 2 PROJECT NAME: Ashworth-Electrical ONLY D ~CAN::[ ~ D PLAN REVIEWER CJ FILE • The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. D The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff. D The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. D The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. D The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. D The applicant's copy of the check list has been sent to: • Esgil Corporation staff did not advise the applicant that the plan check has been completed. D Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Telephone#: Date contacted: (by: ) Fax#: Mail Telephone Fax In Person D REMARKS: By: Mike Puckett Enclosures: Esgil Corporation D GA D MB D EJ D PC 9/23/99 tmsmtl.dot 9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858) 560-1468 + Fax (858) 560-1576 I ., Carlsbad 99-3464 10/5/99 VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PLAN CHECK NO.: 99-3464 PREPARED BY: Mike Puckett DATE: 10/5/99 BUILDING ADDRESS: 2791 Loker Ave. West Bldg. 2 BUILDING OCCUPANCY: B/Fl/S1 TYPE OF CONSTRUCTION: VN BUILDING PORTION BUILDING AREA VALUATION VALUE (ft.2) MULTIPLIER ($) Electrical Only NA See Comments See Comments Air Conditioning Fire Sprinklers TOTAL VALUE See Comments D 199 UBC Building Permit Fee D 199 UBC Plan Check Fee D Bldg. Permit Fee by ordinance: $ D Plan Check Fee by ordinance: $ Type of Review: D Complete Review D Structural Only • Hourly D Repetitive Fee Applicable D Other: Esgil Plan Review Fee: $ 108.94 Comments: Esgil Fee = 1.25 hrs. at $87 .15/hr. = $108.94 Sheet 1 of 1 macvalue.doc 5196 PLANNING/ENGINEERING APPROVALS PERMIT NUMBER CB 99 3L.t. ?>Y ADDRESS ~ 7 9. ( -RESIDENTIAL RESIDENTIAL ADDITION MINOR ( < $10,000.00) PLANNER~ nn"1111cfnnmllllanninn ~nin•11rinn .an..,..,,1r.11r: DATE 9 / ;J.;i / 99 .··~RO~ PlAZA CAMINO REAL CARLSBAD COMPANY STORES VILLAGE FAIRE COMPLETE OFFICE BUILDING DATE_9 __ [J._J--..J:/9_<}'_ 04/24:/98 15: 00 Pai;re 1 of 1 B U I L D I N G P E R M I T Job Address: 2791 LOKER AV WEST Suite: Permit Type: ELECTRICAL Parcel No: 209-081-15-00 Lot#: Valuation: 0 Occupancy Group: Reference#: Description: ADD 2.0 AMP CIRCUIT W/ 28 LIGHT : FIXTURES Permit No: CB981202 Project No: A9801585 Development No: Construction Type: NEW Status: ISSUED Applied: 04/24/98 Apr/Issue: 04/24/98 Entered By: JM Appl/Ownr: VISTA ELECTRIC 760 650-3330 2723 JACARANDA COURT OCEANSIDE CA 92056 *** Fees Required Fees: Adjustments: Total Fees: Fee description Enter "Y" for Elect Remodel/Alter Per A Enter ~y" for Remod *** *** 02 25110() Data 10. ,)0 Y S.00 10.00 Y APPROVAL "~ ..... "---~TES: 1 S-· 1! CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION FOR OFFICE USE O~ 1. PLAN CHECK NO. 2{J V CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Pal mas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. ,,-Qt) Plan Ck. Deposit "2,JJ: Validated By ,~ ~tJ.. Date~r _ Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel# Existing Use Proposed Use ~~~~~~i!~' ~-,~~I t-00~N~~:-~=-~~~~J:~4-- Name Address City State/Zip Telephone# 1;6fil;~~~'cffiRk~,COMP'mme1, """" ;:>:; ,;:,:,,:.; ., .. ,,,,,,,;;·· :<,,, .. z,;,-~:t;;, • '.~?J:~-:~::,;:,,;¥;i,ji:~~·,~;;c~e1Jiik'.~;11f:['i!~l~~ .... ;:~+itai,;~,:J;j;;;a• (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 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500)) . .,, .s-q-45eru./, -Z.: 23 .:7l I\JoA CA-:. 'l.Dg 6r> -3~~?> Designer Name ~/tM f.. ,+-s A ,Jct7~ State License # _________ _ City State/Zip Telephone 'l;r::sM1A11BPca1E1rl'AmNs \p0:ftts: +:wdt*L .. ,,.,.,,,~_ •• :,;iltl111@i,11~~11~111ii:1nr),,1, illlft!'\·,, 1,(i · ,.,....,..~~,,.,..,,?'JJl&"'~;w.~-e.ir¥te·:t:~,~,,:;-... 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. 0 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_____________________ Policy No._____________ Expiration Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) '-2[: 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 addition to the cost of compensation, damages as provided for in Section 3706 of th• labor coda, intarHt and attornay'a fees. :f~~~~;~qu,~Rlffi~ ~---i =~,.'.';,_,s ... < .. ~· .: .,~.,-',,,,~,,,,~~:,l~~ .. ~1;•:C;:,:~;·:··i~ttt.111111 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). 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 / 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 / address / phone number / 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 / address / phone number/ 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 / address / phone number / type of work): __________________________________________________________ _ PROPERTY OWNER SIGNATURE_______________________ DATE _________ _ 11Umlililll.seo'flQt,fl-()J114"-fflllui(~lfi,1l!f'S!~l'i!\t'li1!::,\SS:iiilil~j!ii$''i~:,, .;;·.~ ~~,4:,\;;,fJ;;'.:l;(gi'1/dl?zi,SM+:!:i1;;1WF;<IB\p:1E1·k?.J)<F1'\f,?+Ui 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 J:8' NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? O YES W: NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES !,XL 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. lil!~_,..,Q.,..f:Djilllll!Rt'lll!l,.>:/lill;1;i:ii1J.li1ifls~i~/J~;,;~~-!!';t·111::~~-:k,.:;i,:1in~~:1;:,:.A:;;;;.1ill~[i~il!l·~ i;";:;W1ia:'::;,i'~'J~l~;,.1:;tefa;i1),~JIJ;11I~i!t --· ·. ~;,~;.1~ 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 ________________________ _ 1U'~i---l~'.M1 ···;¥t.¥B'R · ::,,,,<~1£!,'i?.~:11Y81:F~r~2-'1\;z~~'$il''';,''::lf;M1·•·;Y;ilili11i'l!.a''.':;~;'1'11Jllll:/}b:!:J,r;;i;,IIIIII 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 365 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 commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE J::"~ ').., l,...L--DATE t/-z-.+/=/.~ WHITE: File YELLOW: Applicant PINK: Finance PERMIT# CB981202 DESCRIPTION: ADD 20 AMP FIXTURES TYPE: ELEC CITY OF CARLSBAD INSPECTION REQUEST FOR 05/14/98 CIRCUIT W/ 28 LIGHT STE: INSPECTOR AREA PLANCK# CB981202 OCC GRP CONSTR. TYPE NEW LOT: JOB ADDRESS: 2791 LOKER AV WEST APPLICANT: VISTA ELECTRIC CONTRACTOR: PHONE: 760 650-3330 OWNER: REMARKS: C/RICK/ SPECIAL INSTRUCT: FINAL ELECTRIC@ LOADING TOTAL TIME: .;.-RELATED PERMITS--PERMIT# CB880425 88000066 CB920124 AS930059 AS930089 AS930093 FA940009 CB941197 RW970010 TYPE RETAIN COM ITI ASTI ASC ASC FALARM ITI ROW ::g::: 4L _..___ ,/J/ INSPECTORt9" __ __2~--------~~~-.....;;..-... __ =-:;;...' DOCK STATUS EXPIRED EXPIRED EXPIRED ISSUED ISSUED ISSUED ISSUED EXPIRED ISSUED CD LVL DESCRIPTION ACT COMMENTS ~11 EL __ F_i~n~a~l~E~l~e-c~t~r~i~·c_a_i _______ A-Jl ______________ _ .2..:+-JZnJ" ff €if v "7{._ ---------------------------------- ***** INSPECTION HISTORY***** DATE DESCRIPTION ACT INSP COMMENTS B U I L D U6/30/98 15::)2 Pa~re 1 of 1 Job Address: 2791 LOKER AV Permit Type: MECHANICAL Parcel No: 209-081-15-00 Valuation: o Occupancy Group: WEST ,. N G Suite: Lot#: Reference#: Permit Project Development No: No: No: Construction Type: Sta.tlts: CB982081 A9802749 Description: ADD A/C UNIT ALONG : UNITS WITH ELECTRIC EXISTING Appl :..ed: VN ISSUED (,6/30/98 Appl/Ownr : ASHWORTH INC 2791 LOKER AVE WEST CARLSBAD CA 52008 Fees Requi rec.i Fees: Adjustments: Total Fees: Fee descriotion Enter 'Y' for Mecha Install Furn/Ducts/ Other *** 760 Apr/Issue: 06/30/98 Enteret'l. By: MDP 438-6610 8580 06/30/98 00-01 01 02 C-PRHT 44-00 *** .00 ,GO 44.00 Ext fee Data 15.00 Y 9.00 20.CC ELECTRIC EXP~R~D PERMIT PERMIT HAS EXPIRED IN ACCORDANCE WITH U.B.C. ::m 1~:-8BfA1UIE /;p CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 .... FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. f 8 r 2.0)r( CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. _________ _ Plan Ck. Deposit ________ _ Validated By __________ _ Date _____________ _ Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units #of Stories # of Bathrooms Name Address City 117:'.'~Q.i\tifltttD1~-•i:iE:i-ilftd,~ilmivt~i:O::~li~~'ttir'~·,· ., State/Zip Telephone# Fax# Name Address City State/Zip Telephone# ,\i'~i~cJ'~z Name Address City State/Zip Telephone# 1i~:·•·:.1:!(:o"Nmw:o~;;qR'~•4;*~:,~·,·,½\'Bli'::;;;t1·';:' .. ; 'ilJ,'T:il&ls;t'"§''" ·, ·-,\'::,, · (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 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$5001). Name Address City State/Zip Telephone# State License # _________ _ License Class _________ _ City Business License # _______ _ Designer Name Address City State/Zip Telephone State License# _________ _ tti::;/,:,;~WOf(ttm~;OME~JAt10rl~ ,;·:~::,'.:<:->. <-:>·,·.".;., ;·.v 4,,, Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D I have and will maintairc 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. D 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____________________ Policy No.____________ Expiration Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) D 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 sul:>ject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage la unlawful, and shall aubjact an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the coat of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's faes. SIGNATURE______________________________ DATE _________ _ !j ,.::,:OWNER 8UIE!leiiDEcmATION''· ,0MJ:,*%'P:V"4iib@ik¥';,: ::, ...... :'.':;/>' ' ·•: '''t;(,./,:d:::;; •. ,::t. ; . . I her~by affirr:. that I arn exernpt from t~~, ~~~t~a~~,°!'~"~i~~nse l..aw 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). 'i 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 contractorls) licensed pursuant to the Contractor's License Law). D I am exempt under Section ______ Business and Professions Code for this reason: ,: !_personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO 2. I (have / have not) signed an application for a building permit for the proposed work. 3. I have contracted with the followi rson (firm) to provide the proposed construction (include narT,1e I address / phone number I contractors license number : •, 'S '-l 0-01 ..., •· c 1 -o 1 -LI:. <11{ it1,L.,.. i-vi ii.~1 ~1.l.3 ~" 11 ,. A-c1 L c 1 • -<.10 4. I plan to provid portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include"nam'~· / address / phone number I contractors license number): ________ __, ____________________________________ _ 5. l will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work): ___________ t-----------:;.-------7r,::----------,---;----,,=,...,:------------ W ·.PRO.P .. E····R···T···y .o·· w··. N.E. R.·.S .. IGN·····A·····TU······R·:'·.·. iiri~iiii~iiiiiftii~~~in~~i~Z0::;;--:,;;;;.~i'i;>,:,.;,JY;{)F -u-\COfJJ.f!{ifi£iTHIS'.S~'.11QJ\l':fOfl"l .... , ,,,,_,,,..,,,, , .. , 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? D 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? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site 7 0 YES D 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. 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 _____________ _ 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 c menced within 365 days fr m the date of such permit or if the building or work authori ed by s7 permit is suspended or abandoned at any time after the wor is com need r a riod o 1 80 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE ___,._...___=--~----'--,"'"r'~~------------DATE __ f~__,)_,<..c:.::;J_., __ -'-lrd----- PINK: Finance '.'.._;-, / : .. -~---------··•-'''"" ___ ----- !1.1. 'i) i_l :~> t:::v~:. :1 t ::·: ! ~r () t.' a J. . ' . ~- I 11NS . =------- PPROVAL DATE ff ·ZZ·i CLEARANCE _____ , CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PEl™}T ,AFl>UCATION PIAN CHECK NO. City of carlsbad Building Department 2075 Las Pal11Bs Dr., tarlsbad, CA 92009 (619) 438-1161 EST. VAL-:_ _________ _ PLAN CK DEPOSIT VAUD.BY -------- 1. PmtMI I NPE DATE A -U Commercial D New Buildmg u Tenant Improvement B -D Industrial LI New Building D Tenant Improvement C -LI Residential D Apartment D Condo LI Single Family Dwelling )(Addition/Alteration 0 Duplex O Demolition O Relocation O Mobile Home O Electrical O Plumbing u Mechanical D Pool D Spa D Retaining Wall D Solar LI Other ___ _ 2. PRamcr INFORMATION FOR OFFICE USE ONLY Addressz1q,/ LL*,e/1!../IIJl iJFJT BmidmgorSmteNo. Nearest Cross Street J:1,_ rt,/~l!!!TE. LEGAL DESCRIPTION Lot No. sutxhV1s1on Name/Number Umt No. Phase No. CH£CR 8£IDW IF SUl3M11"1'£b: C 2 Energy Cales a 2 Structural Cales a 2 Soils Report C 1 Addressed Envelope ASSESSOR'S PARCEi. EXISTING USE DESCRIPTION OF WORK ,Aor:> Toi14'-1 e1-~r Fl'fvl/S PROPOSED USE SQ. FT. (,~ 000 ~ ,:"I # OF STORIES { 3. WN IACI P N (n merenf from applicant) NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE 4. :',J,~Q!e£r~t!ilf~ DAGEN[ FOR%1-:;R1ts~[Y}sgo~f "'~E~il,OROWNER CITY afJ}NJfl()f: STATE <!A-ZIPCODEqlo:5t DAY TELEPHONE C, JO ''-f It S. PROPERN OWNElt NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE 6 -~rw;r fill-t1£ClffWICfW-ADDRESS (S'Sl) ~(.. ~A(L ~Y.) CITY STATE ZIP CODE DAY TELEPHONE STATE LlC. # S'lUl8 LlCENSE CIASS c-zo CITY BUSINESS LlC. # DESIGNER NAME~'l '- CITY STATE ADDRESS ZIP CODE DAY TELEPHONE STATE LlC. # 1. WOltkEltS' WMPENSA:nON Workers' Compensat10n Deciarat10n: l hereby athrm that l have a certthcate of consent to self-msure issued by the Director of lndustnal 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, Lab. C). INSURANCE COMPANY POLICY NO. EXPIRATION DATE D D D owner-Builder Deciarauon: I hereby affirm that l am exempt from the Contractor's License Law for the followmg reason: 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.). 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). 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 Law (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 THIS sECiloN 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? DYES ONO 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 C NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES ONO IF ANY OF TIIE ANSWERS ARE YES, A FINAL CERTIFICATE OF CXDJPANCY MAY NCJf BE~ AFTER JULY 1, 1989 UNLF.SS TIIE APPUCANT HAS MET OR IS MEETING TIIE REQUIREMENTS OF nm OFFICE OF EMERGENCY SERVICES AND TIIE AIR POLUTTION CDN1ROL DISTRICT. 9. WNS'IRUCIION LENDING AGENCY 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) CIVIi Code). LENDER'S NAME LENDER'S ADDRESS to. APPlltANT cElt1ffidmoN I certify that [ have read the appilcatJon and state that the above mformauon IS correct. I agree to comply with au 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 10 SAVE INDEMNIFY AND KEEP HARMLESS TIIE CfIY OF CARLSBAD AGAINST AU. LIABIIJTIF.S, JUDGMENTS, CDSTS AND EXPENSES WIIlCH MAY IN ANY WAY ACDlUE AGAINST SAID CfIY IN CDNSF.QUENCE OF TIIE GRANTING OF TIIlS 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 365 days from the date of such permit or if the building or work authorized by ·~=ded oc abandoned" any time''"' m, ~,k ;, oommenced ro, a period of 180 days (Section 303(d) Unffonn BuUdiog Code). APPU~L nm _____ _ A-____.~~___;;..... ____ .......,_7WI-Il~;;;TE=-: 'F""ilre----:;YELL.=,.-;::O~W":--.Ap:--pl'°ic-an--:-t---;;P:.;INK:=·--;:;F;:-in-an-ce ____________ _ PERMIT# CB930332 DESCRIPTION: ADD 7 TYPE: MECH CITY OF CARLSBAD INSPECTION REQUEST FOR 11/17 /93 VENTILATORS/ELEC JOB ADDRESS: 2791 LOKER AV WEST STE: INSPECTOR AREA PD PLANCK# CB930332 OCC GRP CONSTR. TYPE NEW LOT: APPLICANT: WEST AIR MECHANICAL CONTRACTOR: PHONE: 619-630-6411 OWNER: REMARKS: BN/630-6411 SPECIAL INSTRUCT: TOTAL TIME: --RELATED PERMITS-- CD LVL DESCRIPTION PERMIT# CB880425 88000066 SE920012 CB920124 AS930059 TYPE RETAIN COM swow ITI ASTI PHONE: /J /l ___ PHONE: ~L£ INSPECT~%.~---' \11,,_Q=--6,,:::;....:::_,__ __ . STATUS EXPIRED EXPIRED ISSUED EXPIRED ISSUED ACT COMMENTS ~ ME _R...Lo....1u...:i.gL..h&..:./-=D;_u_c..::;t_s_J..;;.Da.,.:m;_p_e_r_s _____ M __ ..... f_....f_/0_,_/f._b __ · ______ _ ~ §',_~,U~f[w ± ------------------- ***** INSPECTION HISTORY***** DATE DESCRIPTION 071393 Rough/Topout ACT INSP AP PD COMMENTS I ~ :. ~: C : 9385 09/22/92 {)0(.1 01. 02 G--PfMT ,,:..,sc.r :.<..'r .. : ~ (\/· . ,,,,, '\ "l / I < ~ " ,..t_ J ~ • C J c"\ ,·, _._ ',.· ~ * ELECTRICAL :o~AL APPROVAL INSP. ~-DATE 1;/4Av CLEARANCE _____ , CITY OF CARLSBAD 2075 Las Palrnas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPUCATION ~ V PLAN CHECK NO. City of Carlsbad Building Department 2075 Las Palmas Dr., carlsbad, CA 92009 (619) 438-1161 FSf.VAL PLAN CK~D_EPOSIT ____________ _ VAIID. BY __________ _ I. PmtMI I i'YPR DATE A -~mmerc1al LI New Bmldmg U Tenant Improvement B -0 Industrial O New Building O Tenant Improvement C -U Residential O Apartment O Condo U Single Family Dwelling U Addition/ Alteration U Duplex U Demolition U Relocation U Mobile Home Hectrical O Plumbing LI Mechanical O Pool O Spa O Retaining Wall O Solar LI Other ___ _ 2. PRClJECf INFORMATION FOR OFFICE USE ONLY Building or Suite No. LEGAL bEscRIF'noN Lot No. Sulx!1V1s1on Name/Number Omt No. Phase No. CH£CR B£illW IF s0BMII"t'£b: ~ Energy Cales u 2 Structural Cales LI 2 Soils Report CJ I Addressed Envelope ASSESSOR'S PARCEL "1 ~~ ---l!RQPQS.f.ll USF. DESCRIPTION OF WORK ~V ,....;W'° f -,«!! 0 ri_ "~;;&.;:_ i i: L 3iftji#;,2.&t,f'.'.;:;wtt: NAME CI1Y ADDRESS STATE ZIP CODE DAY TELEPHONE 4. APl'llCAN I NAME LI CdN I RAC I OR u AGEN I FOR CdN I RACIOR ADDRESS u OWNER u AGEN I FOR OWNER CI1Y STATE ZIP CODE DAY TELEPHONE S. PitOPElt:i'Y oWNER NAME ADDRESS CI1Y STATE ZIP CODE DAY TELEPHONE ADDRESS 30-:,_z.. <,::,\.:~u.G 11e,._,Q._ s}; ZIP CODE C(.~ .. .C O 8 DAY TELEPHONE "J .)21 -8'-f i. ~ CI1Y BUSINESS LIC. # DESIGNER NAME LICENSE ClASS L -l 0 ADDRESS CI1Y STATE ZIP CODE DAY TELEPHONE STATE LIC. # 1. WoR1MtS' wMPRNSAliON Workers' Compensauon Declaration: I hereby affirm that I have a ceruhcate of consent to self-msure issued by the Director of Industnal 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, Lab. C). INSURANCE COMPANY POLICY NO. EXPIRATION DATE Cert1hcate of Exempuon: I certJty 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 8. oWN£1t-80ilD£1t OECLAltAnoN bwner-Butlder Declaration: I hereby afhrm that I am exempt from the Contractor's License Law for the foliowmg 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 Llcense 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 Llcense Law). 0 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 Llcense Law (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)). SIGNATIJRE DATE COMPLETE IBIS SEGllON FOR NON-RESIDENTIAL BUIIDING 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 25_:!0~25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? U YES l!YNO Is the applicant or future building occupa!)t required to obtain a permit from the air pollution control district or air quality management district? C YES a--NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES I:11--'R"O IF ANY OF 1llE ANSWERS ARE YES, A FINAL CERTIFICATE OF CXIlJPANCY MAY NOf BE~ AFTER JULY 1, 1989 ~ TIIE APPUCANT ~ MET OR IS MEETING 1llE REQUIREMENTS OF TIIE OFFICE OF EMERGENCY SERVICES AND 1llE AIR POIJ.UTION CDNTROL DISllUCT. 9. WNSIROCIION tmmmc AGENCY I hereby afhrm that there 1s a construction lendmg agency for the performance of the work for whtch this permit 1s issued (Sec 3097(1) CIVIi Code). LENDER'S NAME LENDER'S ADDRESS to. APPLICANT cElt'l'IFlc!AndN I certify that I have read the application and state that the above mformatlon 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 HARMI£SS TIIE ClTY OF CARLSBAD AGAINST AU. L1ABIUI1F..S. JUDGMENTS, CDSTS AND EXPENSF..<i WJilCH MAY IN ANY WAY ACX:RUE AGAINST SAID ClTY IN CDNSEQUENCE OF 1llE GRANTING OF TIIlS 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 o work authorized by such permit is not commenced within 365 days from the date of such permit or if the building or work authorized by such pe tis suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code). !>==l:l.!T_~fr1eJ DATE: 1 L$,i}9 ),r WHITE: File YELLOW: Applicant PINK: Finance .. ... DATE , ~t 1-/ q--z---- UNSCHEDULED INSPECTION INSPECTOR~-+.:---------- PERMIT # ________ _ PLANCK# _____ _ JOB ADORESS _____ '2-;;..-J~'1_1___,;;L-_o_!_L-_GVL__......; _____________ _ TIME ARRIVE: _____ TIME LEAVE: _____ _ CO LVL DESCRIPTION PERMITS 6/15/89 ACT COMMENTS .t1t.. cf2-q>,iJ'ry'?//tJr-<--1.-- Ill z 0 ~ :5 u Ill ,c e[ Q. = § IC ! ~ 5 I Ill z • .0 z 0 ~ z Ill A. 2 0 u Ill a: Ill ~ ac., i ll D I hereby affirm that I am licensed under provlelone of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. I ·hereby alfirm that I am exempt from the Contrac· to(s L,.cense Law for the following reason (Sec. 7031 5 Bu.siness and Professions Code· Any ~Ity or county which re- quires a perm,!, to construct, alter, improve, demohsh, or repair any structure, prior to its issuance also requires !heap- pilcant tor such permit to file a signed statement that he 1s hcensed pursuant to the provisions 01 the Gontractor·s License Law ( Chapter 9 tommencmg with Section 7000 of D1v1slon 3 of.the Bustness·.and Professions Code) or that 1s ex- empt therefrom and the basis for the allegea exemption. Any v1olatlon ot Section 7031.5 by an aJ)plicant tor a permit sub- Jects lhe apphcant to.a cwil penalty of not more than hve hun-dred dollars ($500) ! I I, as owner of tne property, or my employees with wages as ,their sole compensatmn, "will ~o !he work: and the struc-ture 1s not intended or ottered for sale (Sec. 7044, Business and Professions Code The Contractor's License .Law does not apply to an owner of property wHo b.uilds or improves 1hereon and who dbes suCh work himself or through his own employees, piovtded that such improvements are not intend-ed or altered for sale. If, however, the buikhlig or improve- ment 1s sold within. one year of completion-., the owner-builder will have the burden of provmg._ that· he did not build or im-prove for the purnose of sal.e) · r I I, as owner of the property, am exclusively contracting with license_d contractors to construct the project (Sec 7044, Business arn:I Pro1essions Code·. The Contractor's license law does not apply.to a" owner of property who builds or im-proves thereon, and who contracts for each projects with a contractor(s) license pursuant .to the Conlractor's License Law) r l_ As a homeowner I am improving my home, and the follow-mg conditions exist:. . . .-, 1. The work. IS being pertormed pnor to sale 2 I have ltved fFl my hon\e for twetve mo_l)ths pnor to completion .of this work 3. I have not claimed this exempllOfl during the last three years. • g /h~~r":a:t under Sec _______ . B&P.C. ~------'------ D I hereby.BffirrnJhBfl have a certificate of consent to self-insure. or a certificate of Workers· ColTipensation In- surance. or a c~rtified copy there6f {Sec. 3800. Labor Code) POLICY NO COMPANY Copy \S flied with the cit~· D Certified copy·fs·herebY fufnished CERTIFICATE OF EXEMPTION FROM WORKERS· COMPENSATION IN-SURANCE (This section need not be completed if the permit -is for one hundred dollars ($100\ or less) D 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· Compen- sation Laws of California. NOTICE TO APPLICANT: If, after making this Certificate of Exemption. you should become subject to the Workers· Compensation provisions of the Labor Code. you must forthwith comply with such p'ro-v:tSions or this permit shall be deemed revoked. D I hereby affirm that there is a construction lending agency for the performance of the work tor which this per- tnit is issu8d (Sec. 3097. Civil Code) Lender's Name----Cc~----------- L:ender's Address ______ ~----- USE BALL POINT PEN ONLY & PRESS HARD QTY. QTY. CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad, CA 92009-1915 (619) 438-1161 PLUMBING PERMIT· ISSUE QTY. EACH FIXTURE TRAP EACH BUILDING SEWER EACH WATER HEATER AND10R VENT E.ACH GAS SYSTEM 1 TO 4 OUTLETS EACH GAS SYSTEM 5 OR MORE EACH INSTAL. ALTER, REPAIR WATER PIPE EACH VACUUM BREAKER WATER SOFTNER EACH ROOF DRAIN (INSIDE) TOTAL PLUMBING ELECTRICAL PERMIT -ISSUE 5-QTY. YO ND vO NO REDEVELOPMENT AREA YO NO MECHANICAL PERMIT· ISSUE INSTALL FURN. DUCTS UP TD 100.000 BTU OVER 100.000 BTU BOILER/COMPRESSOR UP TO 3 HP BOILER/COMPRESSOR 3 15 HP METAL FIREPLACE VENT FAN SINGLE DUCT MECH EXHAUST HOOD/DUCTS RELOCATION OF EA FURNACE/HEATER DRYER VENT TOHiL MECHANICA( MOBILE HOME SETUP APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. TYPE CONST /Y-- OCC LOAD I FIRE SPA vO NO VALUATION PERMIT NUMBER ZONE r" ·Mo~ BUILDING SQ. FOOTAGE 9068 08/1.6/89 0001 Ol l::J.t!Pmt 02 30-0 Not Valid Unless Machine Certified SUMMARY/ACCOUNT NUMBER SIGN PERMIT oo 1-810-00°00-8221 PLAN CHECK 001-810·00-00-8891 TOTAL PLUMBING 001-810-00-00-8222 ELECTRICAL 001°810·00-00-8223 ------MECHANICAL 001-810·00-00-8224 MOBILEHOME 001-810·00-00-8225 SOLAR 001-810-00-00-8226 STRONG MOTION 880-519-92·33 FIRE SPRINKLERS 001-810·00-00-8227 PUBLIC FACILITIES FEE 320-81O·OQ-00-8740 BRIDGE FEE 360-810-00-00-87 40 PARK-IN-LIEU (AREA " ' "" '°'" EA AM, SW'8'" I I """"T I II -" I[ I 1 PH }PH AWNING I ~" vvv,~ '" 1 EXISTBLDGEAAMPISWT'BKR GARAGE TIC 312-810-00-00-8835 I A rnc::TA TIC 311-810-00-00-8835 FMF 1 PH 3 PH LICENSE TAX 001·810·00·00·8162 REMODEL ALHR PER CIRCUIT MFF 880-519-92-57 TE MP POLE 200 AMPS OVER 200 AMPS CREDIT DEPOSIT ~ u::: >-~ 0 C. E Q) I- -0 0 ('.) c ro () C. C. <I'. I -"' C a: 0 (/) (/) Q) (/) (/) <I'. I s: .2 ai >- Q) () C ro C u::: ;=- C Q) ~ (.!) 0 u Q) C. (/) C 2 .r:::. s: r- t ~i ~ ~ ~,. ~ \,: TYPE I DATE INSPECTOR BUILDING ' I FOUNDATION I . REINFORCED STEEL f MASONRY I GUNITE OR GROUT I . SUB FRAME D FLOOR D CEILING SHEATHING D ROOF D SHEA~ FRAME I . EXTERIOR LATH I INSULATION ' I INTERIOR LATH & DRYWALL ' I PLUMBING I I D SEWER AND BL/CO D PL/CO UNDERGROUND D WASTE D WATER TOP OUT D WASTE D WA"fiER TUB AND SHOWER PAN I GAS TEST I D WATER HEATER D SOLAR WATE;R I ELECTRICAL I D ELECTRIC UNDERGROUND D UF;FER ROUGH ELECTRIC I D ELECTRIC SERVICE D TEMPORARY D BONDING D POOL I I I MECHANICAL I D DUCT & PLEM., 0 REF. PIPING: HEAT -AIR COND. SYSTEMS " VENTILATING SYSTEMS -~ -. '• ·., _·· -I .. . , .. I . CALL FOR FINAL INSPECTION WHEN_ ALL APPR_ OPRIAT~ ITEMS ABOVE HAVE IBEEN.Af_PROfJEO: ,: -\·· ·, ·. ' FINAL PLUMBING ELECTRICAL MECHANICAL GAS BUILDING SPECIAL CONDITIONS ' I I '" :,~ f I I I l I I I-- I \\ : <, \ A'--..: .. :' ' 2h..2/M -r I I -. ' ·, I ·{i88t::JIUJfa ··1 -.-·-...:~ .;.-.>~', .. . '·<.-. . •·. l ' FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES INSPECTION REQ. IF INSPECTOR'S DATE -~ CHECKED APPROVAL . SOILS COMPLIANCE PRIOR TO FOUNDATION INSP STRUCTURAL CONCRETE OVER 2000 PSI PRESTRESSED CONCRETE POST TENSIONED CONCRETE FIELD WELDING HIGH STRENGTH BOLTS I SPECIAL MASONRY PILES CAISSONS •. ' . '-1: --------· ·-· -~-. ' -. ·-' -.. ' .. ---· !. ' .•. -. ' ' -\ -'C'_-•,., .. ·.· \ . ~ ·'' -· .... . ',' .. ·. ·\ \ ... . -..... ,-.. ., ... --. -. ---. ·' \ . ' .. ! •... .. \ -~-. ' ---,··-'·, , . .', :-:,,1 ,, ·. "-... ·, , ... -·. \ \ ·, \ .. -... \ .. .; --•· . \ ..... II) z 0 s ~ c., ~ C I[ 8 C Ill 0 ~ 5 I Ill ! z 0 j:: ~ z Ill 0. :I 0 c., II) ic Ill :..: a: 0 31: ![ O I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profenlons Code, and my license is in lull force and effect. I hereby affirm that I am exempt from the Contrac- tor's license Law for the following .reason (Sec. 7031.5 Bu~iness and Professions Code: Any city or county w~icli re-qu1r~s a permit to constru~t. alter, improve, demolish, or repair any structure, P.nor to Its issuance also requires !he a~- plicant for such permit to Ille a signed statement that he 1s hcensed pursuant to the provisions of the Contractor's License Law (Chapter 9 commencing with Section 7000 of D1vis1on 3 of the Business and Professions Code} or that 1s ex- empt therefrom and the basis tor the aUegea exernp.tion. Any violation of Section 7031.5 by an applicant !or a permit sub- 1ects the applicant to a civil penalty of not more than hve hun-dred dollars ($500) I J I, as owner of the Property, or my employees w1th wages as their sole compensation. will do the work , and the struc- ture 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 improv,ements are not intend-ed or offered for sale. If, however, the building or improve- ment is sold within one year 01 completion, the owner-builder will have the burden of proving that he did not build or im- prove for the purpose of sale). ! l l, 3s 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 im- proves thereon, and who contracts tor each projects with a contractor(s) license pursuant to the Contractor's License Law). Jl As a h?'"eowner I am improving my home, and the follow mg conditions exist: 1. The work is being performed prior to sale 2. I have lived in my home for twelve months prior to completion of this work I have not claimed this exemption during the last three years. D I am exempt under Sec. _______ . B & P.C. for this reason D I hereby affirm that I have a certif1cate of consent to self-insure. or a certificate of Workers· Compensation In- surance. or a certified copy thereof (Sec. 3800. Labor Code) POLICY NO. COMPANY ·7 Copy is filed with the city D Certified copy 1s hereby furnished CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE {This section need not be completed if the permit is for one hundred dollars ($100) or less) 0 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' Compen- sation Laws of California. NOTICE TO APPLICANT: If. after making this Certificate of Exemption. you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. D I hereby affirm that there is a construction tending agency for the performance 01 the won<. fof which this per- mit is issued (Sec. 3097, Civil CQde) Lender's Name ____________ _ Lender's Address. ____________ _ USE BALL POINT PEN ONLY & PRESS HARD. QTY. QTY. CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad, CA 9200~1915 (619) 438-1161 PLUMBING PERMIT· ISSUE EACH FIXTURE TRAP EACH BUILDING SEWER EACH WATER HEATER ANO/OR VENT EACH GAS SYSTEM 1 TO 4 OUTLETS EACH GAS SYSTEM 5 OR MORE EACH iNSTAL.. ALTER, REPAIR WATER PIPE EACH VACUUM BREAKER WATER SOFTNER EACH ROOF DRAIN (iNSIDEi TOT AL PLUMBING ELECTRICAL PERMIT · ISSUE NEW CONST EA AMPSWT BKR 1 PH 3 PH EXIST BLOG EA AMP/SWT/BKR 1 PH 3 PH REMODEL AL HR PER CIRCUIT TEMPPOLE 200AMPS OVER 200 AMPS TEMP OCCUPANCY 130 DAYSI TOTAL ELECTRICAL vO N 0 vO NO REDEVELOPMENT AREA vO NO MECHANICAL PERMIT -ISSUE INSTALL FURN. DUCTS UP TO 100,000 BTU OVER 100,000 BTU BOILER/COMPRESSOR UP TO 3 HP BOILER/COMPRESSOR 3 15 HP METAL FIREPLACE VENT FAN SINGLE DUCT MECH EXHAUST HOOD!OUCTS RELOCATION OF EA FURNACE/HEATER DRYER VENT TOiAI..MECHANltAf APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. I TYPE CONST ace LOAD I FIRE SPA vO NO TOTAL PLUMBING ELECTRICAL MECHANICAL MOBILEHOME SOLAR STRONG MOTION FIRE SPRINi<LERS PUBLIC FACILITIES FEE BRIDGE FEE PARK·IN·LIEU (AREA TIF LA COSTA TIF FMF LICENSE TAX MFF CREDIT DEPOSIT VALUATION PERMIT NUMBER ZONE j1/~ BUILDING SQ. FOOTAGE 2376 10/07 /88 0001 01 BldPll'tt 02 14. Not Valid Unless Machine Certified 001 ·810·00·00-8891 001·810·00·00·8222 001·810·00·00·8223 001·810·00·00·8224 001 ·810·00·00·8225 001·810·00·00·8226 880·519·92·33 001·810·00·00·8227 320·810·00·00·87 40 360·810·00·00·87 40 312-810-00-00-8835 311-810·00·00·8835 001·810·00·00·8162 880·519·92·57 ~ u::: >, ~ 0 a. E Q) t- i -0 0 (!) C <1l -~ a. a. <( I ¾. C a: 0 Cl) Cl) Q) Cl) Cl) <( I s: .2 Qi >- Q) (.) C <1l C u.. ::::. C Q) Q) C, 0 t5 8-C/) C ~ .c ~ -;:. ~~- 1.: \-~~: le -:,· i ,;;; r . ' i ~:; I< I,·_ I ; ,ii' r ~ ii; ,,i·-: 7, I (. 1:. I- i [·. TYPE DATE INSPECTOR BUILDING FOUNDATION REINFORCED STEEL ' MASONRY GUNITE OR GROUT SUB FRAMED FLOOR D CEILING SHEATHING D ROOF D SHEAR FRAME EXTERIOR LATH INSULATION INTERIOR LATH & DRYWALL PLUMBING D SEWER AND BUCO D PL/CO UNDERGROUND D WASTE D WATER TOP OUT D WASTE D ~ATER TUB AND SHOWER PAN GAS TEST D WATER HEATER D SOLAR WATER ELECTRICAL D ELECTRIC UNDERGROUND DUFFER ROUGH ELECTRIC D ELECTRIC SERVICE D TEMPdRARY D BONDING D POOL MECHANICAL D DUCT & PLEM., D REF. PIPING HEAT -AIR COND. SYSTEMS ' ' .. _ -... -t VENTILATING SYSTEMS CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE .. ···-··--.. -···· ... ---. --... -- FINAL /) PLUMBING / ~/;;.,/ J/'J """I ELECTRICAL ,, I I .. ... ' MECHANICAL . '· ' t ~ GAS ·, -, BUILDING SPECIAL CONDITIONS 01> 8 fl I 3~C, FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES ' INSPECTION REQ. IF INSPECTOR'S DATE CHECKED APPROVAL . SOILS COMPLIANCE PRIOR TO FOUNDATION INSP STRUCTURAL CONCRETE OVER 2000 PSI PRESTRESSED CONCRETE POST TENSIONED CONCRETE FIELD WELDING HIGH STRENGTH BOLTS ' .., . SPECIAL MASONRY PILES CAISSONS ' .. ,-.. , ....... ... ..... : __ ' --. \ . .. , ... , .. " .,,,. ,,. ,. --,_, s11,? ·;o\c~ \86 :;ocir ~:~r ""';' -., .. --' . ; . ' I ' ~,,_ ·, . -· ---• A-;.. -~ • '--. A -,--·· ! i . ' ••• XNERGy 8 '~ 2237 Faraday Ave., Suitel0O Carlsbad, California 92008 www.xnergy.net License # 516015 ( _r ~ ~d-...g__s --11---,? /-. k} c¼.,.-/1.eiv~ bA Jeff Gosselin President Innovative Engineering & Construction Management ph: 760.438,7676 fx: 760.438. 7679 800.4XNERGY jeff@xnergy.net PACIFIC I ENVIRONMENTAL --~ • TECHNOLOGIES,,INC. ~00 Jon Gow President a CA 92882-7123 135 Enterprise ~~~~6 c~~n (951)-582-9946 Tel: (951).f82ngow@peticleanair.com E-ma, . JO t ctor's License # 599654 CA General Con ra