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Home My WebLink About2554 STATE ST; ; CB921235; PermitIt C. y r ur : r1t n: 10 Apr,, w11r : MILLF-~R, Ii/. DE.A ox 7- F • : \ l u.., tn ll t .., : < ta.L FI?' PvWA , C'A Fee lPScr 1pt 1011 ~nter v for E.le 11.:.,lL Phc1St-' Per ; ELt RICA~ T TA l Lt <.: #: ) ' I >E. CITY OF CARLSBAD l t--1 0254 11/30/92 0001 01 02 6,.. 4ts- C-PRMT :0-0◊ . . [-'. & llf' It E.xt 1 P to. ) . 2075 Las Palrnas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION PLAN CHECK NO. .,City o/carlsbad Building Departinent 2075 Las Pal111as Dr., Carlsbad, CA 92009 (619) 438-1161 EST.VAL:...._ __________ _ PLAN CK DEPOSIT _______ _ VAIJD.BY ___________ _ 1. P£ltM1 I IYPE DATE. _____________ _ A -LI Commercial D New Building LI Tenant Improvement B -□ Industrial □ New Building □ Tenant Improvement C -□ Residential □ Apartment □ Condo □ Single Family Dwelling □Addition/Alteration □ Duplex □ Demolition □ Relocation □ Mobile Home H Electrical □ Plumbing □ Mechanical □ Pool □ Spa □ Retaining Wall □ Solar □ Other ____ _ 2. PROJECT INFORMATION Address 2S,h State Street Nea~ Cross S'treet Building or Su11e No. A,B,C & D. um r DOC97201REC68 20 Seaside Lands Map 001722 CHECK 8£WW IF SUBMI 11 £0: D 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report o. ia o un SQ. IT. 3. WN IACI PERSON (Ii dillerenl from applicant) NAME CITY STATE STATE CA NAME -SAME CITY STATE NAME Owner to designate •• CITY ADDRESS ZIP CODE ZIP CODE 92074 ADDRESS ZIP CODE ADDRESS DAY TELEPHONE DAY TELEPHONE DAY TELEPHONE DAY TELEPHONE FOR OFFICE USE ONLY STATE STATE UC.# ZIP CODE LICENSE CLASS ADDRESS CITY BUSINESS I.JC. # DESIGNER NAME CITY STATE ZIP CODE DAY TELEPHONE STATE UC. # 1. WOilKERS' WMP£NSA'i10N Workers' Compensauon Oeclaral 10n: I hereby affirm that I have a certificate ol consent to sell-insure 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 0 by the Director,.pf th~ insur,i;r thereof filed ~ith the Building Inspection Department (Section 3800, Lab. C1 • l . ~~a~e vompensa~ion 1175240-92 continuous po icy INSURANCE COMPANY POLICY NO. EXPIRATION DATE _ _ SIGNATURE DATE 8. 0WNER-80IIDER bEciARATION bwner-Bu1Jder Oeclarauon: I hereby affirm that I am exempt from the Contractor's License Law tor the tollowing 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.). XX: 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)). SIGNATIJRE DATE COMPLETE 1'His SECI ION 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? □ 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 D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES □ NO IF ANY OF 11IE. ANSWERS ARE YE.5, A FINAL CfillTIFICATE OF CXDJPANCY MAY Ncrr BE 15.5UED AFTER JULY 1, 1989 UNLF.55 1llE APPUCANT HAS MET OR JS MEETING TI-IE REQUIREMENTS OP nm omCE OF EMERGENCY SERVICES AND 11-IE AIR POILU11ON OONlllOL DISllUCT. 9. WNSI R0Cl1ON umornc AG£NCV I hereby affirm that there 1s a construcuon lending agency for the performance of the work for which this permit 1s issued (Sec 3097(1) C1V1J Code). LENDER'S NAME LENDER'S ADDRESS lo. APPUCAN"I CEltmlCATION I ceruly that I have read lhe apphcauon and state that the above inlormauon 1s correct. I agree to comply w1lh 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 m SAVE INDEMNifY AND KEEP )WlMLF.SS nm Cl1Y OF CARLSBAD AGAINST ALL UABIIJTIES, JUDGMENTS, CX>STS AND EXPENSES WIDCII MAY IN ANY WAY Aa:RUE AGAINST SAID Cl1Y IN OONSEQUENCE OF TIIE GRANTING OF TI-OS 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 uspended or abandoned at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code). DATE: ______ _ File YELLOW: Applicant PINK: Finance PERMIT# CB921235 DESCRIPTION: 160 AMPS OVERHEAD PER PETERSON TYPE: ELEC JOB ADDRESS: 2554 STATE ST APPLICANT: MILLER, W. DEAN CONTRACTOR: OWNER: REMARKS: MH/753-9473 SPECIAL INSTRUCT: TOTAL TIME: CD 39 LVL DESCRIPTION EL Final Electrical CITY OF CARLSBAD INSPECTION REQUEST FOR 12/22/92 TO UNDERGRND INSPECTOR AREA PD PLANCK# CB921235 OCC GRP CONSTR. TYPE NEW STR:** FL:**** STE: A/B/C/D PHONE, 6"~ PHONE: ) L PHONE: INSPECTOR • ACT C9>rENTS C/l_ // M~ V ------------------ -------------------- ***** INSPECTION HISTORY***** DATE DESCRIPTION ACT INSP COMMENTS -··-··-----··---