HomeMy WebLinkAbout2633 STATE ST; ; CB921270; PermitPERMIT APPLICATION ~ ~
PLAN CHECK NO.
City ot Carlsbad Building Department
•2075 Las Pal-s Dr., Carlsbad, CA 92009 (619) 438-1161 EST.VAL~-----------PLAN CK DEPOSIT _______ _
VAUD.BY ___________ _
1. P£ltM1 I IYPE DATE:..._ ___________ _
A -LI Commercial □ New Bu1ldmg LI Tenant Improvement
B -□ Industrial □ New Building □ Tenant Improvement
C -D Residential □ Apartment □ Condo D Single Family Dwelling □ Addition/ Alteration
D Duplex LI Demolition D Relocation □ Mobile Home □ Electrical □ Plumbing
□ Mechanical □ Pool □ Spa □ Retaining Wall □ Solar D Other ____ _
2. PROJF.Cf INFORMATION
Address .26 ::313 ~ &,T. Build mg or Su11e No.
FOR OFFICE USE ONLY
mt o.
CHECK BEWW IF SOSMI 11 ED:
□ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope
ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRJPTION OF WORK t!.t:!> A) (/.
# OF STORIES
1~sm-~1ca9
~VT~,&,"2A-d.JJDRESS
NAME
CITY
ADDRESS
ZIP CODE DAY TELEPHONE s. PllOPl!lll'Y OWNrut
NAME .:5#-me.. -4-S ~RESS
ZIP CODE CITY STATE DAY TELEPHONE
6. CbN'l1tAc'IOJt
NAME ADDRESS ,..,.
CITY s~e STATE ~IP CODE
LICENSE ClASS
ADDRESS
DAY TELEPHONE
STATE UC.# CITY BUSINESS UC. #
DESIGNER NAME
CITY STATE ZIP CODE DAY TELEPHONE STATE UC. #
1. WOilRERS' wMPENSA 11ON
Workers' Compensation Dedarauon: I hereby alllrm that I have a cenillcate of consent to sell-msure issued by the Director of lndustnal
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
Ceruhcate of Exemption: I cerufy that m the perlormance ol 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 California.
SIGNATURE DATE
8. OWN£it-B0IlDER OECl.AltA'IIDN
D
□
Owner-Builder Declaratton: I hereby alftrm that I am exempt lrom the Contractor'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 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 e basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the licant to a civil pe of not re than five hundred dollars ($500]).
SI~~~~TE THIS SECTION FOR NON-RESIDENTIAL BUILD~tffirrs ONLY: DATE ~-P,-,9sJ
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
lF ANY 01' THE ANSWERS ARE YF.S, A FINAL CERTIFlCATE 01' oa::tJPANCY MAY Nor BE ISSUED AfTER JULY I, 1989 UNLESS THE APPLICANT
HAS MET OR IS MEimNG THE RF.QtJmEMENTS 01' TIIE OFFICE OF EMERGENCY SERVICES AND TIIE AIR POlllJTION CDNlROL DISllUCT.
9. wNSIR0CIION tl!NDINC AGENCY
I hereby afhrm that there 1s a construcnon lending agency lor the perlormance of the work for which this permll 1s issued (Sec 3097(1) CIVIi Code).
LENDER'S NAME LENDER'S ADDRESS
to. APPDCAN'i' CER'm'ltA'MoN
I cernfy that I have read the appltcatton and state that the above mformauon 1s correct. I agree to comply w1tn 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 THE CfIY OF CARISBAD AGAINST AU. UABIIIllF.S, JUDGMENTS, CX>STS
AND EXPENSES WIDOI MAY IN ANY WAY ACX:RUE AGAINST SAID CflY IN CDNSF.QUENCE OF THE GRANTING OF nos PERMIT.
OSI·IA: 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 aba ed at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code).
DATE: ______ _
Applicant PINK: Fmance
-F'ERMIT# CB921270
CITY OF CARLSBAD
INSPECTION REQUEST
FOR 05/26/93
DESCRIPTION: 100 A OVERHEAD
CONVERSION
TO UNDERGROUND
INSPECTOR AREA PD
PLANCK# CB921270
OCC GRP B-2
CONSTR. TYPE NEW TYPE: ELEC
STE: LOT:
PHONE: 619 434-1965
JOB ADDRESS: 2633 STATE ST
APPLICANT: CANTABRANA, RUBEN
CONTRACTOR:
OWNER:
REMARKS: MH/PK
SPECIAL INSTRUCT:
PHONE: . PHONE: t/L
INSPECTOR~-'::~ '
TOTAL TIME:
CD LVL DESCRIPTION ACT COMMENTS
39 EL Final Electrical /hl
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***** INSPECTION HISTORY*****
DATE DESCRIPTION ACT INSP COMMENTS