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Home My WebLink About1915 CALLE BARCELONA; # 135; CBC2021-0493; Permit                                                              (Cityof Carlsbad Ad Art Inc. 150 Executive Park Blvd. Suite 2100 San Francisco CA 94134 559-284-1287 joy.aller@adart.com 826051 ref. # 22819 ( City of Carlsbad COMMERCIAL BUILDING PERMIT APPLICATION 8-2 Plan Check _C_B_C_20_2_1_-0_4_9_3 __ Est. Value PC Deposit --------- Date _1_/_3_/2_2 ____ _ Job Address 1915 Calle Barcelona Suite: 135 APN: 255-012-04 ---- CT/Project#: __________________ Lot#: ___ _ Fire Sprinklers: 0 YES O NO Air Conditioning: 0 YES O NO Electrical Panel Upgrade: 0 YES O NO BRIEF DESCRIPTION OF WORK: Install Exterior Signage 0 Addition/New: _____ Living SF, ___ Deck SF, ___ Patio SF, ___ Garage SF Is this to create an Accessory Dwelling Unit? 0 YON New Fireplace? 0 Y ON, if yes how many? __ □Remodel: ____ SF of affected area Is the area a conversion or change of use ? 0 Y ON 0 Pool/Spa: ____ SF Additional Gas or Electrical Features? ------------- □Solar: ___ l<W, __ Modules, Mounted:ORoof O Ground, Tilt:O YO N, RMA: 0 YON, Battery:OY ON, Panel Upgrade: Ov O N D Reroof: __________________________________ _ D Plumbing/Mechanical/Electrical Only: --------------------------□ Other: _________________________________ _ APPLICANT (PRIMARY CONTACT) Name: Ad Art -Joy Aller Address: 150 Executive Park Blvd. Suite 2100 City: San Francisco State: CA Zip: 94134 Phone: 559-284-1287 Email: joy.aller@adart.com DESIGN PROFESSIONAL Name: ________________ _ Address: ________________ _ City: _______ State:. ___ Zip: ___ _ Phone: ______________ _ Email: ______________ _ Architect State License: __________ _ PROPERTY OWNER Name: TREA NW FORUM AT CARLSBAD OWNER LLC Address: 1905 Calle Barcelona Suite #200 City: Carlsbad State: CA Zip: 92009 Phone: 760-635-9168 Email: ___________________ _ CONTRACTOR BUSINESS Name: ___________________ _ Address: __________________ _ City: _______ State: ___ Zip: ______ _ Phone: ___________________ _ Email: ___________________ _ State License: ______ Bus. License: ______ _ (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/she is licensed pursuant to the provisions of the Contractor's License Law {Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code} or that he/she 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}). 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carl5badca.gov B-1 Page 1 of 2 Rev. 06/18 ( OPTION A): WORKERS'COMPENSATION DECLARATION: I hearby affirm under penalty of perjury one of the following declarations: D1 have and will maintain a certificate of consent to self-insure for workers' compensation provided by Section 3700 of the Labor Code, for the performance of the work which this permit is issued. ~e and will maintain worker's compensation, as required by Section 3700 of the Labor Code, for the performance of t he work fo~~hich ,..er~ A .. My workers' compe sation insurance carrier and policy number are: Insurance an',! ame: ~kl\, ~ \N' ~ ~~ Policy No. ---l'-41-+v-l~~l,,l{H-t.----Expiration Date: --4~4 -..~~,..,_,.. __ D Certificate of Exemption: I certify that in the performance of the work for which this per it is issued, I shall not employ any person in any manner so as to be come subject to the workers' compensation Laws of California. WARNING: Failure to secure workers compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to $100 ddition the to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. • _ / ... ~ ( ._ I CONTRACTOR SIG NATUR _,:._t~-;\:-r-"(::~:::::========---7 AGENT DATE:~ ( OPTION B ): OWNER-BUILDER DEC ARATION: I hereby affirm that I am exempt from Contractor's license Law for the following reason: DI, 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). DI, 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). D1 am exempt under Section ________ Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. QYES Q NO 2. I (have/ have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (include name address/ phone/ contractors' license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name/ address/ phone/ contractors' license number): 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name/ address/ phone/ type of work): OWNER SIGNATURE: □AGENT -------------------------DATE: _____ _ CONSTRUCTION LENDING AGENCY, IF ANY: I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name: ____________________ _ Lender's Address: ____________________ _ ONLY COMPLETE THE FOLLOWING SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY: Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registrat~fm or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Yes /~ Is the applicant or future building occupant required to obtain a permit from the air pollutio~con I district or air quality management district? Yes / a;: Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Y 7 N IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSU UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. APPLICANT CERTIFICATION: I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representative of the City of Carlsbad to enter upon the above mentbned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND 'XPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.OSHA: An OSHA permit is required for excavations ove • 5'0' deep and demolition or construction of structures over 3 stories in height. 1635 Faraday Ave Carlsbad, CA 92008 B-1 Ph: 760-602-2719 Fax: 760-602-8558 Page 2 of 2 Email: Building@carlsbadca.gov Rev. 06/18                                  {city of Carlsbad