HomeMy WebLinkAbout2639 STATE ST; ; CB921269; Permit• ' PERMIT AP~.ATION PLAN CHECK NO.
City of carlsbad Building Department
2075 Las PallllllS Dr., Carlsbad, CA 92009 (619) 438-1161 ESf. VAL. __________ _
PIAN CK DEPOSIT _______ _
VAIID. BY __________ _
I. PFJlMI I liPE DATE
A. UCOmmerc1al □New Bu1ldmg LI lenant Improvement
B -D Industrial □ New Building D Tenant Improvement
C -□ Residential D Apartment D Condo D Single Family Dwelling □ Addition/ A1teration
□ Duplex LI Demolition LI Relocation □ Mobile Home □ Electrical □ Plumbing
U Mechanical U Pool D Spa D Retaining Wall □ Solar □ Other
2. PRQJECI' INFORMATION FOR OFFICE USE ONLY
Address .;2~3'j ;5 ~;;le_ .5-/. BuUdmg or Suile No.
Nearest C~Street
mt o. ase o.
CHECK BEWW IF SOBMll 1£0:
□ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope
ASSESSOR'S PARCEi, EXISTING tJSE PROP9SED USE
DESCRIPTION OF WORK CO.NJ,
SQ.Ff. od
NAME ADDRESS
CITY ~~e .4-SSTATE..3 ZIP CODE DAY TELEPHONE
NAME
Yrt--~ ~f~':fi .-3 ADDRESS
CITY ZIP CODE DAY TELEPHONE
NAME ADDRESS
CITY ._54-r>?G STATE ZIP CODE DAY TELEPHONE
STATE !JC.# LICENSE CLASS CITY BUSINESS !JC. #
CITY STATE ZIP CODE DAY TELEPHONE STATE !JC.#
7. WORk£k:, .. tfiMPF.NSAIION
Workers' Compensat10n Oeciaratmn: I hereby af!Jrm that I have a certificate 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
Certihcate of £xempuon: I certtfy that m the performance of the work for which this pemut 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
8. OWNEK-B0DDm OfilARA.11UN
0Wner-Bu1lder Declarauon: I hereby afhrm that I am exempt from the COntracto?s License Law for the following 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 Llcense 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.).
fii-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).
□ 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 plicant to a ci~nalty of not more than five hundred dollars [$500]).
SIGNATURE C~<Z4('.4..., DATE /2,... _
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?
CYES CNO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
□ YES □ NO
IF ANY OF TIIEANSWERS ARI! YES, A FINAL CERTIFICATE OFOOCUPANCY MJ\YNITT BE IS.5UED AFIBRJULYI, 1989UNIBSS TIIEAPPIJCANT
HAS MET OR IS MEETING TIIE REQUlREMENTS OF nm OFFICE OF EMERGENCY SERVICES AND TIIE AIR POlLUTION WNTI\OL D1511UCT.
9. WNSIROCIION LENDING AGENCY
I hereby afttrm that there 1s a constructmn lend mg agency lor the performance of the work for which this permit 1s issued (Sec 3097(1) Civil Code).
LENDER'S NAME LENDER'S ADDRESS
lo. APPUCXN I C!EkliFICAllUN
I certify that I have read the application and state that the above mformat1on 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 AISO AGREE ID SAVE INDEMNIFY AND KEEP HARMIJ'.SS TIIE CITY OF CARISBAD AGAINST AU. LIAIIIUl'IES, JUDGMENTS, CDSTS
AND EXPENSES WIIICH MAY IN ANY WAY MDUIE AGAINST SAID CITY IN WNSEQUENCE OF TIIE GRANTING OF TIUS 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 Ccxle 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 Building Code).
DATE: ______ _
WHITE: File YEIJ.OW: Applicant PINK: Finance
I • , ..
PERMIT# CB921269
DESCRIPTION: 100 AMP OVERHEAD
CONVERSION
TYPE: ELEC
JOB ADDRESS: 2639 STATE ST
APPLICANT: CANTABRANA, RUBEN
CONTRACTOR:
OWNER:
REMARKS: MH/PK
SPECIAL INSTRUCT:
TOTAL TIME:
LVL DESCRIPTION
CITY OF CARLSBAD
INSPECTION REQUEST
FOR 05/26/93
TO UNDERGROUN
STE:
INSPECTOR AREA PD
PLANCK# CB921269
OCC GRP B-2
CONSTR. TYPE NEW
LOT:
PHONE: 619 434-1965 ~:g::: /] /J~ I\ . ;J ,,f
INSPECToi.../;f;JJ ~ ·
ACT COMMENTS CD
39 EL _F_i_n_a_1_E_1_e_c_t_r_i_c_a_1 _______ ~ ______________ _
***** INSPECTION HISTORY*****
DATE DESCRIPTION ACT INSP COMMENTS