HomeMy WebLinkAbout2646 STATE ST | 2656 STATE ST; ; CB921254; Permit97" 1,.:;J-/~?7+1~ ~
PERMIT APPLICATION ~ ~
PI.AN CHECK NO.
City of Carlsbad Building DepartMent
2075 Las Pal-s Dr., Carlsbad, CA 92009 (619) 438-1161 FSf.VAL'-------------PLAN CK DEPOSIT ________ _
VAIID. BY ___________ _
DATE'---------------
A -0 Commercial LI New Building D Tenant Improvement
B -□ Industrial O New Building □ Tenant Improvement
C -□ Residential □ Apanment □ Condo □ Single Family Dwelling □Addition/Alteration
□ Duplex D Demolition D Relocation D Mobile Home &U;lectrical □ Plumbing
D Mechanical □ Pool D Spa □ Retaining Wall □ Solar D Other ____ _
2. PROJECT CNFORMATION
ress s rze ~A-I V\S ~~g or
Nearest Cross Street Vl veJ"510 (\ 'r.:e
CHECK 8£U5W IF s08MI 11 ED:
D 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report D I Addressed Envelope
ASSESSOR'S PARCEL
DESCRIPTION OF WORK l) V\ ;,\..R..r ~ rl.?v ;:_J EXJSJ]~G u~ PROPOSED USE
SQ. IT. # OF STORIES
3. WN IACI PERSON (1f dulerenf from applicant)
NAME ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
DOWNER □AGENI FOR OWNER 4. APPDCAN'I
NAME
~wNIRACIOR □ AGEN I I-Oil WN I RACIOR
ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
&. ~p~~~\Oflb--6,y..,¼--,~"VJ)DRESS C90 3 \ S-\-5t if~tl~ d'SICQ
CITY STATE (/t-ZIP CODE ~ 0"5°f DAY TELEPHONE 9"6.? ..)-0 '°3>0
STATE I.JC. ~'6it)7 I.JCENSE Cl.ASS c.,...:10 CITY BUSINESS I.JC.#
CITY STATE ZIP CODE DAY TELEPHONE STATE I.JC.#
1. WOIUMtS' cDMPENSA:t10N
Workers' compensation Oeciarauon: I hereby allirm that I have a ceruhcace of consent to self-insure issued by the Director of industnal
Relations, or a cenificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof cenified
by the Director of the insurer thereof filed with the Building Inspection Oepanment (Section 3800, Lab. C).
INSURANCE COMPANY POI.JCT NO. EXPIRATION DATE
□
□
□
Ceruhcate of Exempuon: I ceruty that in the performance of the work lor which this permit 1s issued, I shall not employ any person in any manner
so as co ome su · t Lo the Workers' Compe t' n Laws of California.
ere ya 1rm at am exempt rom e w or L e o owing 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.S by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500]).
SIGNATIJRE DATE
COMPLETE TI-11S SECI ION FOR NON-RESIDENTIAL BUILDING PERMITS oNLV:
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 □ NO
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 THE ANSWERS ARE YES, A FINALCER1TFICATE OFOCX:UPANCY MAY NOf BE ISSUED AFTER JULY 1, 1989 UNLESS THEAPPUCANT
Ii/IS MET OR IS MEETING nm RF.QumEMENTS OF nm OFFICE OF EMERGENCY SERVICES AND nm AIR POLLUTION CDNlllOL DISilUCT.
9. <DNSI ltOCI ION LENOCNC ACENcV
I hereby alhrm that there 1s a construction lending agency for the performance of the work tor which this permit 1s issued (Sec 3097(1) CIVIi Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPUcAN'I C£Jt'l'MCA'l1ON
I cerufy that I have read the applicauon and state that the above inlormauon 1s correct. I agree to comply with all City ordinances 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 AlSO AGREE 10 SAVE INDEMNIFY AND KEEP HARMLF.SS nm CTIY OF CARLSBAD AGAINST ALL UABIU11ES, JUDGMENTS, CDSTS
AND EXPENSF.S WI-DOI MAY IN ANY WAY ACXJUJE AGAINST SAID CTIY IN OONSF.QUENCE OF nm GRANTING OF nus PERMIT.
OSHA: An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height.
YEI.J..OW: Applicant PINK: Fmance
. .
I
PERMIT# CB921254
DESCRIPTION: OH TO UND
TYPE: ELEC
CITY OF CARLSBAD
INSPECTION REQUEST
FOR 02/25/93
2656/2658/2676 STATE
STE:
INSPECTOR AREA PD
PLANCK# CB921254
OCC GRP
CONSTR. TYPE NEW
LOT: JOB ADDRESS: 2646
APPLICANT: BESTRONG
CONTRACTOR:
STATE ST
ELECTRICAL PHONE: 619 967-5030
OWNER:
REMARKS: MH/BRIAN/967-5030
SPECIAL INSTRUCT: CALL AND CONFIRM TIME****************888
PHONE: a
p:::::CTO~})L
TOTAL TIME:
CD LVL DESCRIPTION ACT COMMENTS
_3.B_9_/ __ E_L _M_F_·_n_a_~_E_l_e_c_t_r_i_c_a_l _______ ~---------------
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***** INSPECTION HISTORY*****
DATE DESCRIPTION ACT INSP COMMENTS