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Home My WebLink About2804 STATE ST; ; CB911686; PermitPERMIT APPLICATION City of carlsbad Building Departaent 2075 Las Pal,..s Dr •• carlsbad, CA 92009 (619) 438-1161 i. PFllMI I I YPR A -D COmmerc1al LI New Buddmg B -□ Industrial □ New Building U tenant Improvement □ Tenant Improvement PLAN CHECK NO. I EST. VAL PLAN CK Dl!POSIT ________ _ VAIID. BY __________ _ DATE C -□ Residential □ Apartment D Condo D Single Family Dwelling D Addition/ Alteration □ Duplex D Demolition □ Relocation □ Mobile Home~Electrical D Plumbing □Mechanical □Pool □ Spa □Retaining Wall □Solar ther M£1'f)!.., f'c~4L- 2. PROJF.Cf INFORMATION FOR OFFICE USE ONLY Address 2./30/( S~ BuUdmg or Smte No. (, Nearest Cross Street ~ □ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope ASSESSOR'S PARCEi. EXlSTING USE PHOPOSED USE DESCRIPTION OF WORK ~;CAL 'f@E57?/L /-r.J i'l. -,XA Frie... Sic; ,;v 4£-f I~ CJ .AM/ $"QI/IC~ SQ. FT. # OF STORIES 3. WN IACI PFJ<SUN (IC dnierent from apphcanf) NAME .:::TONN t...€/(oj ADDRESS CI1Y STATE ZIP CODE DAY TELEPHONE 4. XPMCANI UCONIKACIOR DAGENI FOkWNIRACIOR uuwNtK UAGENI FOR OWNER ADDRESS l}'f/1 ,'f"v£R..7i:: DillV~ NAME~oJ-£/._.B:7;¥;<. CI1Y STATE ZIP CODE DAY TELEPHONE ~7-7~£/ NAME CI1Y CA,iLf8Al> STATE ADDRESS ZIP CODE DAY TELEPHONE ADDRESS CI1Y STATE ZIP CODE DAY TELEPHONE STATE uc. #$8'.%WuCENSE CLASS CI1Y BUSINESS UC. # CI1Y STATE ZIP CODE DAY TELEPHONE STATE UC.# 7. WOltkERS' WMPENSAI ION Workers' Compensation Declaration: I hereby afhrm that I have a ceruhcate of consent to self-msure JSSued by the Director of lndustnai 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 POUCYNO. EXPIRATION DATE Cert1hcate of Exempuon: 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 C-alifomia. SIGNATURE DATE A. OWNEk-D0UDkk DHtDJtAliUN bwner-Bmlder Declarat1on: I hereby affirm that I am exempt from the Contracto?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 Ccxle: 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 Ccxle: 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 Llcense 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 Llcense Law (Chapter 9, commencing with Section 7000 of Division 3 of the Business and Professions Ccxle) 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 COMPffilE 'IRIS SEGIION FOR NON-RESIDEN IIAL BUILDING PERMl'l's 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? □YES ONO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □YES □NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □YES □NO IF ANY OF TIIEJ\NSWEIIS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE 15SUEDAFTERJIJLY 1, 1989 UNIJ!SS TIIEAPPIJCANT HAS MET OR IS MElnlNG TIIE REQIJIREMENTS OF nm OFFICE OP EMERGENCY SERVICES AND TIIE AIR POillJTION CDNTROL DJSTIUcr. 9. WNS'IROCIION mNDING AGENCY I hereby afhnn that there 1s a constructmn lendmg agency for the performance of the work for which this penmt 1s issued (Sec 3097(J) Civil Code). LENDER'S NAME LENDER'S ADDRESS IO. APPDCXN I CltilliFICXIIUN I certify that I have read the apphcatton and state that the above mformauon 1s correct. I agree to comply with all City ordinances and Stale laws relating to building construction. I hereby authorize representatives of the City of c.arlsbad to enter upon the above mentioned property for inspection purpooes. I AI.50 AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS TIIE CfIY OP CARlSBAD AGAINST ALL UABIUI1ES, JUDGMENTS, CDSTS AND EXPENSES WIRCH MAY IN ANY WAY ACCRUE AGAINST SAID CfIY IN CDNSF.QUENCE OP nm 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 such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 303(d} Uniform B ildin Code). APPLICANTS SIGNATUR~ DATE: / 2. / 1... 9- 0 . -------' --·· -----·--·- .. PERMIT# CB911686 DESCRIPTION: NO FEE TRAFFIC TYPE: ELEC CITY OF CARLSBAD INSPECTION REQUEST FOR 12/19/91 SIGNAL 100 AMPS INSPECTOR AREA MP PLANCK# CB911686 OCC GRP CONSTR. TYPE NEW JOB ADDRESS: 2804 STATE ST APPLICANT: LEKOS ELECTRIC CONTRACTOR: LEKOS ELECTRIC STR: FL: STE: !~g~~; ~i~-::~=~fil / OWNER: CITY OF CARLSBAD PHONE: 438 ,lxl ~ REMARKS: MH/LEE/447-7661 SPECIAL INSTRUCT: METER PEDESTAL FOR INSPECTOR ~Jl\,........,~.c~-~--------TRAFFIC SIGNAL TOTAL TIME: CD 39 DATE LVL DESCRIPTION EL Final Electrical DESCRIPTION ~-C-OMM--E-N_T_S __________ _ ***** INSPECTION HISTORY***** ACT INSP COMMENTS ·------·--··--·-------