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Home My WebLink About1025 CARLSBAD VILLAGE DR; ; CB961201; Permit-7 Permit No: CB961201 Project No A9601695 Development No. 8277 06/27/96 0001 0^ 02 C-TOT 97-00 06/27/95 12.52 ' BUILDING P E R' „ ! Page 1 of 1 Job Address: 1025 CARLSBAD VILLAGE DR Permit Type SIGN Parcel No: 203-320-30rOO Lot* • Valuation: 2 000 Occupancy Group- ' Reference* Construction Type- NEW Description- *8 SF ILLUMINATED WALL SIGN ^^^ ISSUED - ' NIKKO JAPANESE CUISINE a Applied. 06/27/96^ Apr/Issue- 06/27/96 Appl/Ownr . FULLER SIGNS 619 ?57 --- Entered ^y RMA 311 VIA EL CENTRO OCENASIDE CA 920,5^- "*"--. *** Fees Required *** -'' ^ " ^ Fees • Adjustments• Total Fees- Fee description Building Permit Plan Check Enter "Y" for Renewal >ee ; * SIGN TOTAL \ Tota-1 Credits: *"* Credits A A A .00 00 ,97,00 Ext fee Data 45.00 29.00 23 00 Y 97 00 CITY OF CARLSBAD 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 3075 Las Palaas Dr., Carlsbad, CA 92009 (619) 438-1161 1 PUUirnm From List I (see back) give code of Permit-Type For Residential Proiects Only From List 2 (see back) give Code of Structure-Type Net Loss/Gain of Dwelling Units PUVN CHECK NO. EST. VAL /A /5^}O PLAN CK DEPOSIT VALID. BY DATE tf 4~ t^.L W~ I I "! L. 2. PROJECT INFORMATION Address FOR OFFICE USE ONLY Building or Suite No Nearest Cross Street UXJAL DESCRIPTION Lot No Subdivision Name/Number Unit No Phase No CHUCK BULUW It1 yUBMl'ITELi Q 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report Q 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WO SQ FT lL STORIES # OF BEDROOMS # OF BATHROOMS NAME (last name first) CITY (,ir ainerenc from appucantj STATE ADDRESS ZIP CODE DAY TELEPHONE 4 APFLICAN1 Q CONTRA^ 1 OH NAME (last name first) CITY UAOhNI t-OR UJNIRACIOH LlOWNtH ADDRESS -3 ft tSf/} U AUfcNT h'UK UWNtK STATE ZIP CODE DAY TELEPHONE 7j" 7" / 5 PROPERTY OWNER NAME (last name first) STATE ZIP CODE DAY TELEPHONE 6 CONTRACTOR NAME (last name first) CITY & ADDRESS STATE STATE LJC ZIP CODE LICENSE CLASS DAY TELEPHONE CITY BUSINESS UC DESTGNEKNAME [last name firstj CITY STATE ZIP CODE DAY TELEPHONE STATE LIC # 7 WORKERS COMPENSATK3N Workers' Compensation Declaration I hereby affirm that I nave a certificate olconsent to self-Insure issued by the Director of Industrial 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) //^-fe 7 J~£ INSURANCE COMPANY ,/T^X^T j^CSAJp POLICY NO EXPIRATION DATE C ~~/ Certicate of Exemption I certify tnat in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as 10 become subject to the Workers' Compensation Laws of California SIGNATURE DATE 8, OWNER-BUILDER DECLARATION Owner-0 wider Declaration i hereby atrirm tnat l am exempt trom the Contractors License Law tor the following reason Q 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 ) D 1, 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) D 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 [SSOO]) SIGNATURE DATE THIS SECTION I'OR NoN-Rl^lDENT!AL UU1L1MNC PERMITS ONLV Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or nsk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?n YES a NO IF ANY OF THE ANSWERS ARE YES, A FIN AL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNl£SS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE ATfl POLLUTION CONTROL DISTRICT 9. CUffeTHUl'lTON LKNLUNtJ AUKN^V I"n"ereby affirm that therels a Construction lending agency lor the performance of the work tor which this permit is issued (.Sec 3097(U "Civil CodeJ LENDER'S NAME LENDER'S ADDRESS 10. APPLIUANT (JKK'ITJ-ICATION I certity that I have read the application and state that the above information is correct r 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 mspecuon purposes I ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CTTY OF CARLSBAD AGAINST ALL UABOJTIES, JUDGMENTS, COSTS AND EXPENSES 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 over 5'0" deep and demolition or construction of structures over 3 stones 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 abandoned at any time after the^orjcis commenced for a period of 180 days (Secaon 303(d) Uniform Building Code) APPLICANTS SIGNATU8£\ C""> \^ , __ - *• DATE WHITE. Fi& YELLOW- Applicant PINK: Finance City of Carlsbad Building Department WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self-insure for ™ A workers' compensation as provided by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. /7 N /I have and will maintain workers' compensation, as required by section 3700 [ — B/ of the Labor Code, for the performance of the work for which this permit is V / issued. My workers' compensation insurance carrier and policy number are: INSURANCE COMPANY POLICY NO.EXPIRATION DATE: (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the ™ C, workers compensation laws of California. Signature Date Warning: Failure to secure workers' compensation coverage is unlawful, and shall be subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, Interest and attorney's fees. March 3, 1995 2075 Las Palmas Dr • Carlsbad, CA 92OO9-1576 • (619) 438-1161 • FAX (619) 438-O894 SD COMPENSATION NSURANCE PO BOX 807, SAN FRANCISCO,CA 94101-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE 06-01-96 'POLICY'NUMBER-st 126956 - 96 CERTIFICATE EXPIRES 06-01-97 CITY OF CARLSBAD> - ATTN: BUILDING DEPARTMENT 2075 LAS PALMAS DRIVE CARLSBAD CA, 92009-^859 JOB ALL OPERATIONS This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated This policy is not subject to cancellation by the Fund except upon 30 days' advance written notice to the employer We will also give you 30 days' advance notice should this policy be cancelled prior to its normal expiration This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to alf the terms, ^exclusions and conditions of such ^policies EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS' $1,000,000 00 PER.'QCCURRENCE STANDARD EXCLUSION INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 06/01/96 IS ATTACHED TO AND FORMS A PART OF THIS POLICY , J EMPLOYER LEGAL NAME FULLER SIGNS 311 VIA EL CENTRO OCEANSIDE* CA 9205U SENA, JAMES JOSEPH AND SENA, PAULA THIS DOCUMENT-HAS A -BLUE, PATTER NED BACKGROUND, PRINTED. 05-23-96 PQ4( SClF-102S5(*EV:2-95);