HomeMy WebLinkAbout2800 ROOSEVELT ST; ; 82-51; Permit"' z 0
!;:
"' ~ CJ .. 0
g[ ~ !. 0 CJ
a! .. z !
z 0 s z .. .. ,.
8
"' "' .. "' "' 0 ;l
![
D 1 her•-7 affirm that I am licensed under
provisions 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
L,c No_ Closs
I hereby affirm tha1 I am exempt from the Con-
~(n~ll,{17~~i;;: .;;: ~~,~~.~~~c:Je·~~,\~,
county wh,ch requires a permit to construc1
alter. ,mprove. demolish. or repair any struclure,
pnor to I1s issuance also requ1res the applicant for such perm,, to hie a s,gned statemenl that he ,s
licensed pursu.1nt 10 the pmv,s1ons of !he Con
tractor's license Law (Chapter 9 commencIng with Section 70CO ol D1v1s10fl J of the Business and Pro-
fessions Code) or that ,s exempt there/mm and the
bas•s for the alleged exemption Any v,olat,on of
Section 7031 5 by an applicant for a permit sub1ects
tne apphcan1 lo a c1v1I penalty ol no! more than live
hun,dollar;; ($500)
I. as owner o! the property, or my employees
, wages as the1r sole compensat•on, will do the
wo:\, and the structure 1s not intended or ollered for
sale (Sec 704-4, Busmess and f>fofess1ohs Code
The Con1ractor·s license Law does no! apply to an
owner of property who budds o, ,mproves thereon
and who cloes such work himself or through hrs own
employees. provided tha! such ,mproveme,1ts are
not m1ende1 or offered tor sale. If, however. the
bu1ldmg or improvement 1s sold within ooe year of
completion, the owner der will have the burden of provmg !hat he d n buold or ,mprove for the
purpose of sale)
D I. as owner o ro~rty, am exclusively
contractm9 with licensed contractors to construct
the pro1ect (Sec 704-4, Bus,ness and f>fofess1ons
Code The Contractor's License Law does not apply
to an owner of property who builds or improves
thereon. and who contracts for each pro1ects w,th a
con1ractoris1 license pursuant lo !he Contr..c:tor's
License Law)
0 I am exempt under Sec
for this reason
. B & P.C
D I hereby atf,rm that I ha•e a cert1t,cate of consent
to selt-msure. or a cen1t1cate ot Workers· Compensation Insurance. or a cert1f1ed copy thereof
{Sec 3800, Labor Code)
POLICY NO
COMPANY
0 Copy ,shied w•!h the crty
D Cert1f1ed copy 1s hereby furnished
CERTIFICATE. OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need no! be completed ,f the perm,t
1s lor one hundred OOtlars (1100) or less)
0 I certify that ,n the performance of the wort( !or
wh,ch this permit 1s ,ssued. I shall not employ any
person on any manner so as to become sub1ect 10
1he Wort(ers· Compensation Laws of Cailtom,a
NOTICE TO APPLICANT 11, atter makon;i !his Cert,
t1ca!e of E~emption. you should become subJect 1'J 1he Wort(ers· Compensation provisions of rhe Labor
Code. you must forthwith comply with such
provisions or this perm1t shall be deemed re~oked
D I hereby aH"m !hat triere 1s a construct,o"
1endmg agency for the performance ol lhe work for
which th,s permit ,s issued 1Sec 3097 C,v1I Code)
Lenders Name ___________ _
Lender's Add•ess __________ _
USE BALL POINT PEN ONLY & PRESS HARO APPLICANT TC' '-LIN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CARLSBAL ,UILDING DEPARTMENT API-LICATION & PERMIT 1200 Elm, Carlsbad, California 92008 (714) 438-5525
JOB ADDRESS .4 M~
AV.ST. OAT.&) QlT a,~•~-J;.~NSE, '!° ~;;;, PERMIT NUMBER
-Z-.7Cf J oJ RO.
.· .• : .• "i',,,•
O~'S NA.E /)}. . ½~:;;H;; PRIME !a>NTRACTOR .
1~~lt ZONE fv-S-/ ' --.. --~~ .A nl~JJ?"P I. " • . ... • .
--~R'S MAILIN'2:AESS ~ , • CTOR'S AiJORESS -_, _f.lCENIIE op; "t[,;;: S-I BLOG USE CODE . •· _ _., ~~oz, ;;4. . .... : . . -,$..--.. : M BLOCK l SUBOIVISION I :,~Q d J;;~~
. ST ATE ue£NSt: # STANDARD PLAN# BUILDING SQ. FOOTAGE I.•-·. . I< J ,;. 1!_·;,_ -e, /,.l'c:_ . lPTION OF WOJ'IK
DESIGNER'S~ . ~ .... ~ ... ON~-
171J-,c,~ ~~-~ ;J-i'b.i". nuo..-e£r--\· s#.~'i__· .J._; _ ... --
/'~ I .-~ 'I
. . .f/; .. ,1, FLA ELEV. NO OCC GP EDU
' . . STORIES 3 /Ut. /~;;57;;~ . •.· . ,, : y vO NO
.
CENSUS TRACT I GP LAND USE I PARKING SPACE RES UNITS DijL I :37d~ !,/,:,;/• .
GRADING ~EAMIT ISSUED REDEVELOPMENT TYPE ace LOAO FIRE SPA AREA CONST
YO '□ vO NO vO NO Nor Valid UnMS Machine Certifi«J
QTY. PLUMBING PERMIT· ISSUE QTY. MECHANICAL PERMIT -ISSUE SUMMARY/ACCOUNT NUMBER ' -I -
EACH FIXTURE TRAP INSTALL FURN. DUCTS iJP TO 100,000 BTU BU!!-OING PERMIT 01-000-4220 ~,.?,-.l/?
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01 ·000-4221 --r/!b .t;J
1-
~ ------------
EACH WATER HEATER BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01-000-4806 --II-----~ TOTAL Pl IJUBING
-~
EACH GAS SYSTEM 1 T BOILER/COMPRESSOR 3-15 HP 01 000-4222 ~---------..?!"rn,cAL -
EACH GAS SYSTEM 5 0 · MFTAI FIREPLACE 01-000-4223
EACH INST Al.--. ALT-ER·:-----------
VENT FAN SINGLE DUCT . ,,,,. MECHANICAL 01-000-4224 --
EACH VACUUM B~KER MECH EXHAUST -HOOOlOUCTS ./. MOBILEHOME 01-000-4225
-
WATER SOFT~ER I RELOCATtON OF EA FURNACE/HE TER I/ MOBILEHOME PARK lNSP
EACH ROOF DRAIN (INSIDEi ! '() ..... SOLAR 01-000-4226
-----------~---# TOT.G.L MECHANICAL5 i I" I/ STRONG MOTION 65-640-0519 " --I -__ __, ' TOTAL PLUMBING ' , I .,, I FIRE SPRINKLERS 01-000-4227
QTY. SOLAR-I~
PUBLIC FACILITIES FEE 25-000-4933 QTY. ELECTRICAL PERMIT -ISSUE BRIDGE FEE
---·-·-----~ .. ----·-
NEW CONST EA AMP/SWT.-BKR C ECTORS / SCHOOL FEE -DISTRICT
-
ST RAGE T~S 7 -
I PH 3 PH _./ . , . Carlsbad 65-623-0519 -----
EXIST BLDG EA AMP/SWT/BKJV" / RJ clv?foRAGE ,/ Encinitas 65-624-0519
----./ , 1-1 -r----.-
I PH / 3 PH , r . "'1M P San Oieguito 65-625-0519
REMODE_L-'ALTER ERCIRClJ1i-__ ------------· /~ V-PLANCHErAFt~ SanMarcos -----65-626-0519
~~~:~li;t~C;~~S:AYS~ ---_ ·--v ',µ_ ---_:-I_~ ~=~-----. ----------· ---= =-----
TOTAL ELECTRICA_L__ y -----. -~ TOTAL SOLAR --TOTAL FEES PAYABLE // ~ , OS-~
,~w~•~'••••••~""'"''"....,"'"'""'""'"''""""' -----~•'"--~• ~~-CERTIFY UNDER PENALTY OF PERJURY THAT AU INFORMA'flOH "HEREON INCLUDING THE Coda shall Hpi;ra by lim/~tion and become null and void fftfiil, or ~,, '-7;.,.,· .:,1 -· OF . ..-author1zedbysuchpermit1Snotcommenced11rithinl80i:ta,,.trom:tha4ateqf '"·'' .'.';':, -• ' ~ClARATKJNS ARE TRUE ANO CORRECT ANO I FURTHER CEflT1FY ANO AGREE IF A PERMIT IS permit, or if the buikfl~ wo,ti; authorized by sucti ""lf _fS · «~ -.,; · ., ~ .. , T ISSUED: TO COMPlY WITH ALL CITY, COUNTY ANO STAlE-LAWS GOVERNING BUILDING CON· abandoned at aft .. time a the work is commenced for · .'-, -._ • ,/'.'< ·, -, --~ . .._
SlRUCTION, WHETHER SPECIFIED HEREIN OR NO,, t Al.SO AGREE TO SAVE INDEMNIFY AND · -APPR VED BY ~
KEEP HARMLESS THE CITY OF CARLSBAD AGAINST All LIABILmES. JUDGMENTS, COSTS AND ~rs SI~ IATl!RE .. ow•s:7' .. CONmAcTORO /I ~ 'I-. 't
EXPENSES WHtcH MAY ,N ANY WAY ACCROE AGAIHST SA'{D CITY IN CONSEQUENCE oF THE..i ~. L ~ .. .... -, .. ev-PHOHe~ u 1,...----L,., GRANTINGOFTHISPERMIT. ._ ' ... __ _._ . --.-· ... -• ... I
>, .;
0 a. E
"'
" 0
CJ
c "' ~ a. a. <(,
~ .Q w >-
"' u, .,
u e Q.
"' ;;
0
~ ., u
C "' C
U::
,:.
C .,
a,
i5
0
1, .,
a. u,
C
~ .c ,:
PERMITS
ISSUED FOR
2791 MADISON ST
HAVE BEEN SCANNED
UNDER
2800 ROOSEVELT ST
etitp of etarlgbab
REQUEST FOR INSPECTION RECORD
INSPECTOR -~---------PERMIT NO.
TIME:....,.---,~+---
__________ DATE:-=l~J..../.c.£.=-
OWNER __ _;j....Q.~U~UU.d.,4..L _________________ .J__~---
ADDRESS _!.£_ _ _.::;,~___.'"---~J.L___:'-"'<...f,ILJ..-P!,..Z,kt..,L',~-----c-----,,t--------
BUILDING
D FOUNDATION
D REINFORCING STEEL
D MASONRY
0 GROUT -Gi:nJ.!TE
0 FLOOR AND CEILING SUE!"FRAME
0 SHEATHING D ROOF D SHEAR
D FRAME
D EXTERIOR LATH
D INSULATION
D INTERIOR LATH OR DRYWALL
D FINAL
PLUMBING
D UNDERGROUND PLUMBING
D S~NDPUCO
~p OUT PLUMBING
D TUB OR SHOWER PAN
D GAS TEST
D WATER HEATER
D SOLAR WATER
D FINAL
..
ELECTRICAL
0 TEMPORARY SERVICE
CJ UFFER GROUND
:,□ ELECTRIC UNDERGROUND
D ROUGH ELECTRIC
D POOL BONDING
D ELECTRIC SERVICE
o FINAL
MISCELLANEOUS
0 CONDITIONED AIR SYSTEMS
0 SOLAR HEAT
D PATIO
[] POOL D SPA
U SIGN
D GRADING"
D DRIVEWAK
D .F.!NAL
SPECIAL INSTRUCTIONS _________ ~-------------------
Monday D Tuesday D Wednesday D Friday
W o{l. ~ J;-t;u~
°'j ~ R(rl--/}¥A-I ] d ~
\. /J/-./U~,x_y Afe\ ~ ~ ~ ' '
() ((_ 7 6 ~ ~ ~
27q l -A f. R G' L £ Z,-R L c._
'
G-1t-s f4 £ n R-) 0 JVP 1
" f o RTi o./4 o ;= fa /Te121f17oN
4/#~
.:/.e,3 -///j
Tenant Improvement
City of Carlsbad
APPLICATION FOR CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438-5525
Address where Business 2791A Madison will be conducted
Name of Occupant The Jazzercise Boutinue
Address of Home Office of 2Sos Roosevelt Occupant if different from above St.
----·-·-----------------VALIDATION
Buildint Permit o. 82-51
Business Phone I,"· _cc '.1
Home Office 434-2101 Phone
Owner of Building Robert Wilson Address 2747 Roosevelt St. Phone ..,,,a_~ri17
Type of Business Retail Clothing Sales
Describe exact use of alt portions of each building and lot
Previous use of Building
_ Type of flammable or explosive liquids to be used, if any None
I certify that I have read the statements contained in this application; that they are true and correct, and that I make this statement under penalty of perjury.
Dated this 15t!PY of Anril '19 82 in the City of Carlsbad, State of Callfornla . -
Signature of -m tf ,/, / .4 Iii A/ L Signature of I kl J.., .. &~ ./ Applicant '1 , r v:-;7' /I. _.,., Building Official
u "
FOR DEPARTMENTAL USE ONLY
Use Zone fl-.'.J Occupancy Group /.7-,e. Type of Construction -v-"
Planning
Oated/k ?/ 1)-~ Approved / Department ' " Disapproved By
Engineering
Date ~ • n, ~oved , ICZ_.✓-Department Disapproved By
Fire
Date C J -f" 2,,--Approved ,11 C--Prevention Disapproved By
Health
Date S-fl.~ 82-.. .~~.,i• ',\el R-~ Department Disapproved By
Building
Date .L.. /. .. 'Ii" ,e. '1' -/I Department Approved,-:--,_ Disapproved By
,I I -·; I
I I
,
White -Building Dept. Yellow -Appllcant Pink -Finance Gold -Fire Dept.
SEE
2800 ROOSEVELT ST
FOR
INFO ON
2791 MADISON ST
S~EET;J a 711 Ir. fl AP (5cJ DATE,_'l_E_C_E_IV_ED BUILDING DEPARTMENT
BUILDING ADDRESS:
P~ANNING DEPARTMENT
;/j;~o~~
CITY OF CAR SBAD
Bulldlng Department
ZONE __________ LOT SIZE _________ LOT WIDTH _________ _
UNITS ALLOWED ____________ UNITS PROVIDED ____________ _
PARKING SPACES REQUIRED PROVIDED ___________ _
% COVERAGE ALLOWED _____________ PROVIDED
BUILDING HEIGHT ALLOWED PROVIDED
FRONT SETBACK: SIDE SETBACK: REAR SETBACK:
ALLOWED
PROVIDED ______ _
INTRUSIONS
LANDSCAPE & IRRIGATION PLAN COMMENTS:
ENVIRONMENTAL PROTECTION REQ:
ADDITIONAL COMME
OK TO ISSUE:
ENGINEERING DEPARTMENT
R.O.W. INDUSTRIAL WASTE ------_______ IMPROVEMENTS _______ _
SEWER CONNECTION ________ DRIVEWAY LOCATIONS ____________ _
GRADING PERMIT __ _,, ____ ~EASEMENTS • DRAINAGE ____ _
LEGAL DESCRIPTION Pou 33,, JV;3C: ,d,a4eh $,L >
ADDITIONAL COMMENTS_7 ____________________________ _
FIRE DEPARTMENT
SPRiliKLING SYSTEM ____________ FIRE PROTECTION EQUIP. _______ _
FIRE ALARMS EXITS ________________ _
FIRE HYDRANTS LOCATION __________________ _
ADDITIONAL COMMENTS
OK TO ISSUE: _____ DATE _______ OK TO FINAL ______ DATE. ____ _
WATER DEPARTMENT
REQUIREMENTS OF APPROPRIATE DISTRICTS MET _____ ---,.
~-CARLSBAD FIRE DEPART~ENT ~
. --z_
PAGE·t OF_. __ 1275 ELM AVENUE, CA~LSBAD, CA 92008
(714) 438-552 l
APPROVED 401 SAPPROVED
(? i If;:;._. Z. ~
PLAN CHECK REPORT
PLAN CHECK # 'i/z-s I
OTHER REF H -----
PROJECT_ ✓J:;}<' ,,.,:/4A/4-,(1,,.,,,?,!'"~-ADDRESS lll1Pi5o/./
ARCHITECT ____________ ADDRESS ________ PHONE _____ _
OWNEF;J _______________ ADDRESS ________ PHONE _____ _
OCCUPANCY _____ CONST. L TOTAL SQ. FT. c "7 1 Z-STORIES
□ SPRINKLERED~ENANT IMP.
1.
2.
3-
4.
_Ks.
APPROVAL OF PLANS IS PREDICATED ON CONFORMING TO THE
FOLLO\'/JNG CONDITIONS AND/OR MAKING THE FOLLOWING
CORRECTIONS:
++++++++++++++++++++++++++++++++++++++++++++++++++++
Provide one copy of the floor plan(s), site plan, and sheets _______ _
Storage, dispensing or use of any flammable or combustible liquids, flammable
1 iquids, flammable gases and hazardous chemicals shall comply with Uniform
Fire Code and -----------------------------8 u i l ding ( s) not approved for high piled combustible stock. Storage in closely
packed piles shall not exceed 15 feet in height, 12 feet on pallets or in racks
and 6 feet for tires, plastics and some flammable liquids. If high stock piling
is to be done, comply with Uniform Fire Code, Article 81.
Medical gas system(s) shall comply with N.F.P.A. Standard 56F.
Fire extinguishers shall be provided based upon the following criteria:
_Aa) l-2A rated ABC extinguisher for each30,u, sq. ft. or portion thereof
;ob) maximum travel distance to an extinguisher of 7.S-feet c) other: _____________________________ _
6. Fire sprinkler system(s) per N.F.P.A. Standard shall be -----------provided to protect __________________________ _
7, Dry chemical extinguishing system(s) shall be installed per N.F.P.A. Standard
96 to protect cooking equipment and exhaust system.
8. Plans of -------------------------------
system(s) shall be approved by the Fire Department prior to installation of
system(s).
9-Show on site plan locations of all nearby proposed or existing hydrants within
200 feet.
10. Hydrant(s) shall be provided and located ________________ _
Show location(s) on site plan. Fire FIO\,: -gpm for-hours from ------· ---hydrants.
11. Access for fire apparatus is not adequate. Provide ------------
12. shall be of hour construction --,--,---------,-------------with openings protected with ___ hour assemblies.
Comply with regulations on attached sheet(s).
~1t]:~
Report mailed to architect Met with -----------
-····---· -------
2/"lc/J>._ J), D~te
{Attach to Plans
,. .
PAGE 2 OF 2__
CARLSBAD FIRE DEPARTMENT
PLAN CHECK RcPORT
PLAN CHECK¥. ,Y-2-S/
14. Drapes and other decorative materials shall be flame retardant. Certification
thereof shall be provided. Exits, exit lights, fire alarm stations, hose
cabinets and extinguisher locations shall not be concealed by decorative
material.
15. Interior finish shall conform with Title
regulations.
California Administrative Code
l 6.
__ 17.
18.
__ 19.
20.
.){21.
22.
__ 23.
24.
25.
){.__26.
Fireplaces and other appliances employing open fla~es shall have metallic guards.
Loose chairs exceeding 299 shall be bonded together in groups of 3 or more.
Storage and janitor closets shall be of one-hour construction with all openings
protected with 3/4 hour self closing and latching assemblies.
An approved fire alarm or two-way communication system shall be provided per.
Title 24, California Administrative Code.
An occupant capacity sign, with minimum one inch letters and numbers, shall be
posted near main exit (, ______ _;square feet per person) •
Exit doors shall be openable from the inside without the use of a key or any
special knowledge or effort.
A "TH IS DOOR MUST REMAIN UNLOCKED WHENEVER THE PUBLIC IS PRESENT" sign, with
minimum one inch letters, shall be provided adjacent to main exit door ___ _
"EXIT" signs shall be in block letters minimum 6 inches high. Luminance on
face of sign shall be 50 lux.
"EXIT" si;;ns shall be electrically illuminated and energized from separate
circuits. Show on electrical plan(s).
One of the above circuits shall be part of the emergency lighting system.
An "EXIT" sign shall be posted over exit door5 ~ F/!tJ:<-'T ,:JC /<E/1,e
(J
and directional signs located ------------------------Show locations on floor plan(s).
__ 27. Approved ~anic hardware shall be provided on exit doors __________ _
_){_2a.
Show on door schedule.
Corric!o,(iv..,,.,.t,/ swzi) shall be of one-hour construction with door open-
irigs :Jr::::2c::-d <•Pith 20 minuta self c1osir:g and latching assemblies.
__ 23 .. ¾l actdi:,onal exic door shall be provided in _______________ _
,k._30.
___________________ ----J?er Uniform Building Code, Chapter 33.
feser / ,REvER-S"? .><W/;Vef aF EX/ r po" ,e /-EelJ ✓:,e,r,; '
.za <-:Y ,e iC' I Pt7A:. {: ff I"'. Se c 33 o 3(A) u fJ c)
IC-. 2? r
'7 7 '
20-,., ro /e,J . .4 ~ /_/' C /4 /7 cCv _. .,. I CA.I/ ;,e -z/4 1 :;r V > .,,
J ;i:F,/ AA..4~ /1.d -/-?-7 I" ,-fA:"C>'""'f · c;-;t
7 7 Date